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Macrophages and osteocytes are important regulators of inflammation, osteogenesis and osteoclastogenesis. However, their interactions under adverse conditions, such as biomaterial-associated infection (BAI) are not fully understood. We aimed to elucidate how factors released from macrophages modulate osteocyte responses in an in vitro indirect 3D co-culture model. Human monocyte-derived macrophages were cultured on etched titanium disks and activated with either IL-4 cytokine (anti-inflammatory M2 phenotype) or Staphylococcus aureus secreted virulence factors to simulate BAI (pro-inflammatory M1 phenotype). Primary osteocytes in collagen gels were then stimulated with conditioned media (CM) from these macrophages. The osteocyte response was analyzed by gene expression, protein secretion, and immunostaining. M1 phenotype macrophages were confirmed by IL-1β and TNF-α secretion, and M2 macrophages by ARG-1 and MRC-1. Osteocytes receiving M1 CM revealed bone inhibitory effects, denoted by reduced secretion of bone formation osteocalcin (BGLAP) and increased secretion of the bone inhibitory sclerostin (SOST). These osteocytes also downregulated the pro-mineralization gene PHEX and upregulated the anti-mineralization gene MEPE. Additionally, exhibited pro-osteoclastic potential by upregulating pro-osteoclastic gene RANKL expression. Nonetheless, M1-stimulated osteocytes expressed a higher level of the potent pro-osteogenic factor BMP-2 in parallel with the downregulation of the bone inhibitor genes DKK1 and SOST , suggesting a compensatory feedback mechanisms. Conversely, M2-stimulated osteocytes mainly upregulated anti-osteoclastic gene OPG expression, suggesting an anti-catabolic effect. Altogether, our findings demonstrate a strong communication between M1 macrophages and osteocytes under M1 (BAI)-simulated conditions, suggesting that the BAI adverse effects on osteoblastic and osteoclastic processes in vitro are partly mediated via this communication. Biomaterial-associated infections are major challenges and the underlying mechanisms in the cellular interactions are missing, especially among the major cells from the inflammatory side (macrophages as the key cell in bacterial clearance) and the regenerative side (osteocyte as main regulator of bone). We evaluated the effect of macrophage polarization driven by the stimulation with bacterial virulence factors on the osteocyte function using an indirect co-culture model, hence mimicking the scenario of a biomaterial-associated infection. The results suggest that at least part of the adverse effects of biomaterial associated infection on osteoblastic and osteoclastic processes in vitro are mediated via macrophage-to-osteocyte communication. [Display omitted] [ABSTRACT FROM AUTHOR]

To determine if there are differences in condylar volume, glenoid cavity and joint space between patients diagnosed with facial asymmetry (FA), between affected and contralateral sides and with respect to subjects without FA. Cross-sectional, retrospective study comparing CT/CBCT images from patients with FA diagnosis referred to a private clinic, versus a control group, age and sex matched, of patients requiring orthodontic treatment without FA. The 3D Slicer software was used for the analysis. Bivariate analysis was performed to compare qualitative variables using Chi-square or Fisher tests, and for normal distribution quantitative variables, the t-student test was used. The level of significance was p < 0.05. The FA group (n = 138) included: Hemimandibular Elongation (HE) (n = 64), Hemimandibular Hyperplasia (HH) (n = 12), Hybrid Form (HF) (n = 20), Asymmetric Mandibular Prognathism (AMP) (n = 25), Glenoid Cavity Asymmetry (GCA) (n = 9) and Functional Laterognathism (FL) (n = 8). The control group (n = 20) had no FA and no signs or symptoms of temporomandibular dysfunction. The right condylar and glenoid cavity volumes were significantly larger in FA cases. The volumes of the right and left joint space had significant differences only in HE patients. Condylar volumes are higher in almost all FA subgroups compared to matched controls. The glenoid cavity volume is larger in FA patients, except for the GCA right and FL left sides. Regarding articular spaces, HE was the only entity with less volume on the contralateral side. The evaluation of structural volume by 3D-CT images helps to diagnose and differentiate FA subgroups. [ABSTRACT FROM AUTHOR]

• Cooling on AZ31 alloy allows the deposition of HVOF HAp/S53P4 composite coatings. • Cracking and delamination occur during HVOF deposition if cooling is not controlled. • Hydrogen evolution on the AZ31 surface in SBF can be modulated depending on the HAp/S53P4 coating thickness. • Constituent phases on the coating do not have influence on hydrogen evolution behaviour. Bioactive thermal spray coatings produced via high-velocity oxygen fuel spray (HVOF) from hydroxyapatite (HAp) and bioactive glasses (BG) have the potential to be employed on temporary implants due to the ability of both HAp and BG to dissolve and promote osseointegration, considering that both phases have different reaction and dissolution rates under in-vitro conditions. In the present work, 75% wt. HAp - 25% wt. S53P4 bioactive glass powders were HVOF-sprayed to obtain HAp/S53P4 BG composite coatings on a bioresorbable AZ31 alloy. The study is focused on exploring the effect of the stand-off distance and fuel/oxygen ratio variation as HVOF parameters to obtain stable structural coatings and to establish their effect on the phases and microstructure produced in those coatings. Different characterization techniques, such as scanning electron microscopy, X-ray diffraction, and Fourier transform infrared spectroscopy, were employed to characterize relevant structural and microstructural properties of the composite coatings. The results showed that thermal gradients during coating deposition must be managed to avoid delamination due to the high temperature achieved (max 550 °C) and the differences in coefficients of thermal expansion. It was also found that both spraying distance and oxygen/fuel ratio allowed to keep the hydroxyapatite as the main phase in the coatings. In addition, in-vitro electrochemical studies were performed on the obtained HAp/S53P4 BG composite coatings and compared against the uncoated AZ31 alloy. The results showed a significant decrease in hydrogen evolution (at least 98%) when the bioactive coating was applied on the Mg alloy during evaluation in simulated body fluid (SBF). [ABSTRACT FROM AUTHOR]

Tropical coastal lagoons are valuable ecosystems that provide vital ecological services. Understanding vegetation health dynamics is essential to conserve and manage these environments effectively. Also, some landscape-related aspects suffer changes through time due to natural and human-driven factors. Analyzing a landscape's evolution allows getting to know the place's identity and underlying interactions with its population. This study employed satellite imagery from the Landsat 8 mission and advanced data analysis techniques to investigate vegetation health's temporal and spatial patterns in Ciénaga de Mallorquín , a coastal lagoon in Northern Colombia. The normalized difference vegetation index (NDVI) was calculated from the satellite data to quantify vegetation biomass and its health. The results show a significant decline in NDVI values between 2013 and 2018, followed by a recovery phase between 2018 and 2022. However, the NDVI levels in 2022 remain significantly lower than those in 2013, indicating the need for continued conservation efforts. This study demonstrates the power of remote sensing as a tool for monitoring vegetation dynamics and informing sustainable management practices in tropical coastal ecosystems. [ABSTRACT FROM AUTHOR]

Accurate chamber volumetry from gated, non-contrast cardiac CT (NCCT) scans can be useful for potential screening of heart failure. To validate a new, fully automated, AI-based method for cardiac volume and myocardial mass quantification from NCCT scans compared to contrasted CT Angiography (CCTA). Of a retrospectively collected cohort of 1051 consecutive patients, 420 patients had both NCCT and CCTA scans at mid-diastolic phase, excluding patients with cardiac devices. Ground truth values were obtained from the CCTA scans. The NCCT volume computation shows good agreement with ground truth values. Volume differences [95% CI ] and correlation coefficients were: -9.6 [–45; 26] mL, r ​= ​0.98 for LV Total, −5.4 [–24; 13] mL, r ​= ​0.95 for LA, −8.7 [-45; 28] mL, r ​= ​0.94 for RV, −5.2 [–27; 17] mL, r ​= ​0.92 for RA, −3.2 [–42; 36] mL, r ​= ​0.91 for LV blood pool, and −6.7 [–39; 26] g, r ​= ​0.94 for LV wall mass, respectively. Mean relative volume errors of less than 7% were obtained for all chambers. Fully automated assessment of chamber volumes from NCCT scans is feasible and correlates well with volumes obtained from contrast study. Cardiac chamber volume is known to be an excellent predictor of future heart failure events. According to recent guidelines, gated, non-contrast cardiac CT (NCCT) is recommended for CAD screening in asymptomatic individuals at low to intermediate risk. We validated a novel, fully automated, AI based method for cardiac chamber volume and myocardial mass quantification from gated NCCT scans used for coronary calcium scoring. NCCT based volume quantification shows excellent agreement with the volumes obtained from CCTA scans in the same patient. Thus, volume assessment from NCCT scans acquired for calcium scoring appears feasible for potential screening. [ABSTRACT FROM AUTHOR]

Trichosporon spp. usually cause systemic or superficial infections. Three cases of White Piedra produced by Trichosporon inkin are described. The in vitro antifungal activity to fluconazole, amphotericin B, ketoconazole and caspofungin against the three clinical isolates were evaluated. Sensitivity to fluconazole and ketoconazole was evidenced. However, the treatment of this mycosis is still a challenge. [ABSTRACT FROM AUTHOR]

A new point of care test (POC) was developed that is promising as a tool to enhance impact of prenatal care programs for toxoplasmosis, however, no reports exist about its use or acceptability for healthcare personnel and mothers in Colombia. This was a translational research - phase III study of the acceptability of a new POC test (Toxoplasma ICT IgG-IgM, LDBio) for qualitative diagnosis of toxoplasmosis in 783 pregnant women and 30 health personnel in primary health care sites in the city of Armenia, Quindío (Colombia). Along with collection of the results of diagnostic POC and confirmatory test and demographic information, we evaluated acceptability through measure of the willingness, credibility, and satisfaction by using questionnaires with a Likert scale during routine prenatal care visits. POC positivity was 46.5% among pregnant participants and was significantly related to socioeconomic factors, including education level (p = 0.00000000) and insurance status (p = 0.00000015). A total of 93–97% of healthcare personnel indicated agreement to positive statements regarding total satisfaction and total credibility of the LDBio test, but qualitative questions identified "Difficulty in the test procedure" as the most common response about barriers to apply the test. Greater than 90% of pregnant participants agree that POC test should be routine for all pregnant woman and permanently implemented. The test had near complete acceptability. In future studies it is necessary to examine the effect of non-differentiation between IgG and IgM isotypes. [ABSTRACT FROM AUTHOR]

• The use of the modified ACTION-ICU risk stratification tool to recommend admission to the ICU is useful in this Latin American sample. • The ACTION-ICU tool facilitated identification of a cohort of NSTEMI patients at low risk for complications following NSTEMI. • ACTION-ICU tool provides a reliable and valid tool that can be applied to all patients admitted with NSTEMI. • Reducing the number of patients ໿who do not require ICU surveillance could be a way to decrease the cost associated with the disease. European Society of Cardiology (ESC) guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation (NSTEMI) recommend Intensive Care Unit (ICU) surveillance during the first 24–48 h. Interestingly, the in-hospital mortality of NSTEMI patients has consistently decreased, giving some patients the option to be managed in general hospital wards. The ACTION ICU score has been proposed to identify high-risk patients with NSTEMI and guide the selective risk-based need for ICU care. To evaluate the usefulness of the ACTION ICU score to predict patients' risk of developing complications requiring ICU care in a Latin-American cohort with NSTEMI. We applied the ACTION ICU score in a retrospective cohort. A composite primary outcome included: cardiorespiratory arrest, shock, high-grade atrio-ventricular block, respiratory failure, stroke, or death. The predictive performance of this model was estimated with a conditional multivariable logistic regression analysis. Of 1,062 patients with NSTEMI, the primary outcome was present in 75 patients (7.1%), and 1,019 (96%) were admitted to ICU. The most common event was respiratory failure (4.0%), followed by cardiogenic shock (3.7%), and cardiac arrest (1.7%). The presence of heart failure signs or symptoms had the highest association with the primary outcome (OR:2.16; 95%CI:1.61–2.92). The best cut-off point for this population was 3 (complications risk: 4.0%, SEN:96%, SP:15.4%, NPV:98.1%, PPV:7.9%). The ACTION ICU score may be a promising tool to identify the need for ICU care in Latin-American patients with NSTEMI. Furthermore, additional research is needed to evaluate the cost-effectiveness of this strategy. [ABSTRACT FROM AUTHOR]

Risk factors for and postoperative results of the Fontan operation in patients living at high altitude (>2500 meters above sea level) in the Andean region remain unknown. This study was conducted to evaluate immediate postoperative outcomes and to assess short- and long-term functional class after the Fontan operation. From June 2003 to February 2019, 104 patients receiving the Fontan procedure at 2640 meters (8661 feet) above sea level were retrospectively studied. Preoperative catheterization, intraoperative variables, and postoperative outcomes were described. Functional class was evaluated in patients living permanently below (group I) and at or higher than 2500 meters (8202 feet) above sea level (group II). Risk factors for mortality were analyzed. Median age at operation was 8.5 ± 4.4 years; pulmonary artery pressure, 16.2 ± 3.6 mm Hg; end-diastolic systemic ventricular pressure, 13.3 ± 3.8 mm Hg; and pulmonary vascular resistance index, 2.1 (interquartile range, 07-3.7) Wood units. Chest tube duration was 8.5 (6-12) days. Mortality was 4.8%, with 0 in the last 5 years. Higher preoperative pulmonary pressure (16.2 ± 3.6 mm Hg vs 21.2 ± 3.40 mm Hg; P =.01), aortic cross-clamp time (P <.001), and renal failure (P <.01) were associated with mortality. Functional class improved to class I in 86.4%. Overall survival was 90.7% at 10 years of follow-up. Increased pulmonary pressure and pulmonary vascular resistance index are directly related to high altitude. The Fontan-Kreutzer operation performed at high altitude in the Andean region is feasible with good results. We routinely fenestrate all cases to avoid dysfunction in the early postoperative period. Functional status is adequate after the operation. [ABSTRACT FROM AUTHOR]

• HU for PCD-CT show variations below 6 HU in the COPDGene lung phantom. • HU accuracy was independent of CTDI vol , QIR and keV parameters. • Broad range of operating conditions in which HU values have low variability. • Quantitative lung density imaging biomarkers may be robust using PCD-CT. Accurate quantification of lung density, in Hounsfield Units (HU), is of high importance to monitor progression of diseases such as emphysema using chest CT imaging. Reproducibility of HU quantification on independent photon counting detector CT (PCD-CT) systems with a focus on lung imaging have not yet been evaluated. We thus aimed to evaluate HU reproducibility on 2 independent PCD-CT systems using a repeatable phantom setup with identical acquisition and image reconstruction settings. A COPDGene phantom comprising densities of air, water and lung was scanned on 2 independent PCCT systems using 3 different radiation exposures, 2 medium-sharpness reconstruction kernels (Br40 and Qr36), with and without iterative reconstruction (levels 0 vs 3). Our results demonstrate that acquisitions performed with full dose (3.2 mGy), half dose (1.6 mGy), and one-eighth dose (0.4 mGy) had minimal influence on HU accuracy (<6 HU) when using Br40 and Qr36 kernels. The level of iterative reconstruction also has a minimal impact (<6 HU) with the same kernels. Between the 2 PCD-CT systems evaluated, reproducible HU quantification was achieved for changes to CTDI vol , iterative reconstruction level and reconstruction kernel. [ABSTRACT FROM AUTHOR]

Due to the complexity of soundscapes, Ecological Acoustic Indices (EAI) are frequently used as metrics to summarize ecologically meaningful information from audio recordings. Recent technological advances have allowed the rapid development of many audio recording devices with significant hardware/firmware variations among brands, whose effects in calculating EAI have not yet been determined. In this work, we show how recordings of the same landscape with different devices effectively hinder reproducibility and produce contradictory results. To address these issues, we propose a preprocessing pipeline to reduce EAI variability resulting from different hardware without altering the target information in the audio. To this end, we tested eight EAI commonly used in soundscape analyses. We targeted three common cases of variability caused by recorder characteristics: sampling frequency, microphone gain variation, and frequency response. We quantified the difference in the probability density functions of each index among recorders according to the Kullback-Leibler divergence. As a result, our approach reduced up to 75% variations among recorders from different brands (AudioMoth and SongMeter) and identified the conditions in which these devices are comparable. In conclusion, we demonstrated that different devices effectively affect EAI and show how these variations can be mitigated. [Display omitted] • Addressing recorder-induced biases in acoustic indices for improved reproducibility. • Proposing effective method to mitigate intra and inter-brand recorder variability. • Evaluating the method performance via ecological acoustic index pdf analysis. [ABSTRACT FROM AUTHOR]

Between natural and social systems there are two-way interactions, which determine the path of change in the Socio-Ecological System. For example, the type of land use decisions that society makes could lead to the deterioration of the biophysical system and its ecological functioning, causing effects on social well-being. Conceptual and simulation models of socio-ecological systems allow an understanding of such interactions and the development of trajectories. In this manuscript we explore the link between three lines of research that overlap but have been studied separately (i) Governance, (ii) Socio-ecological systems, and (iii) social capital. This paper analyzes the dynamics of social capital and its influence on governance and Land Use and Land Cover Changes in a basin of the Colombian Andes. To this end, we develop a Systems Dynamics model (SD). This research contributes to the (i) understanding of how the institutions, their policies, the actors, and the interactions generated between them in a territory influence the management of natural resources, which is indispensable to supporting the decision-making process; and (ii) operationalization of the social capital elements on the SES model through an integrated analysis with consideration of feedback mechanisms between natural and social system. With this model, a scenario evaluation is developed to analyze the effect of different approaches of the social capital organization on land cover in the basin case study. • Few studies have been evident in the operationalization of the social systems. • A socio-ecological system model with elements of the social capital is developed. • The effect of different approaches of the social capital on land cover is modeled. • Understanding of social capital dynamics is key for best practices for management. [ABSTRACT FROM AUTHOR]

Toxoplasmosis is potentially avoidable, treatable, and curable by simple and direct preventive measures. Knowledge, attitudes, and practices (KAP) assessments concerning gestational toxoplasmosis were evaluated in a cohort of pregnant women from Armenia-Quindío (Colombia, South America). This cross-sectional descriptive KAP-type study was performed with informed consent between October 2021 and March 2022. The intervention involved a ten-minute talk administered by prenatal clinic nurses to pregnant women. This took place in the public health clinic RedSalud and the private clinic Happy Maternity with a post-KAP survey after pregnancy. The findings of the initial KAP survey revealed that approximately 42.8 % of the 250 mothers surveyed had IgG anti- T. gondii antibodies present. A strong correlation was observed between a lower frequency of antibodies and a higher level of education. Following an educational intervention, 73 seronegative women demonstrated a significant improvement in their knowledge and behavior. Among the 111 mothers who received the intervention, 42 (37 %) were followed until delivery. Unfortunately, their level of compliance with prenatal serological follow-up was lower compared to previous historical records of cohort of mothers in the same health center during pre-pandemic periods. No seroconversion occurred, although the small number of cases makes the outcome inconclusive with respect to statistical significance. Education plays a crucial role in imparting valuable knowledge and fostering effective practices. It holds significant potential to prevent toxoplasmosis in pregnant seronegative mothers. Prenatal check-ups have proven to be a critical determinant in leveraging the benefits of education for seronegative mothers. Reporting and observed behaviors differed, identifying areas for improvement. [ABSTRACT FROM AUTHOR]

Hypertrophic cardiomyopathy (HCM) with left ventricular outflow tract obstruction that doesn't improve with pharmacological management often requires septal myectomy. However, there are few centers with experience in the practice of this procedure in our country. We describe the clinical and echocardiographic characteristics and postoperative outcomes of patients with HCM indicated for septal myectomy at a reference center in Colombia. Retrospective cohort study. Patients undergoing septal myectomy between 2010 and 2023 were included. Data were collected before and two years after surgery. 18 patients were included. The mean age was 50 years. The predominant functional class was NYHA II/III (94 %). Asymmetric septal variant (83.3 %) was the most frequent as well as obstructive phenotype (88.8 %). After myectomy, 70.5 % improved to NYHA I and 62.4 % had no significant gradient (<30 mmHg), and the most of patient improved SAM. One patient died post-procedure, anymore complications were presented. Septal myectomy is a safe procedure, with clinical and echocardiographic improvement, with low complication rates. [ABSTRACT FROM AUTHOR]

• A novel energy community structure based on multiple aggregators is presented. • The different aggregators allow extracting fully potential from prosumers. • A robust day-ahead strategy for the presented community is developed. • The cost of robustness may increment the collective bill by 75 %. • Under risk-averse conditions, storage systems play a vital role. Future cities must play a vital role in reducing energy consumption and decarbonizing the electricity sector, thus evolving from passive structures towards more efficient smart cities. This transition can be facilitated by energy communities. This emerging paradigm consists of collectivizing a set of residential installations equipped with onsite renewable generators and storage assets (i.e., prosumers), which can eventually share resources to pursue collective welfare. This paper focuses on cooperative communities, where prosumers share resources without seeking selfish monetary counterparts. Despite their apparent advantages, energy management and scheduling of energy communities suppose a challenge for conventional tools due to the high level of uncertainty (especially due to intermittent renewable generation and random demand), and privacy concerns among prosumers. This paper addresses these issues. Specifically, a novel management structure based on multiple aggregators is proposed. This paradigm preserves users' confidential features while allowing them to extract the full potential of their assets. To efficiently manage the variety of assets available under uncertainty, an adaptive robust day-ahead scheduling model is developed, which casts as a solvable and portable Mixed Integer Linear Programming framework, which eases its implementation in real-world cases. The new proposal concerns uncertain generation and demand using a polyhedral representation of the uncertainty set. A case study is conducted to validate the developed model, showing promising results. Moreover, different results are obtained and analysed. Finally, it is worth remarking on how the level of robustness impacts the collective bill, incrementing it by 75 % when risk-averse conditions are assumed. In addition, the role of storage assets under pessimistic conditions is remarked, pointing out that these assets rule the scheduling plan of the community instead of renewable generators. [ABSTRACT FROM AUTHOR]

In this study, the physiological responses and kinetic parameters of Botryococcus braunii were analyzed during a highly irradiated fed-batch culture in a cylindrical photobioreactor. This work includes a model of photon distribution throughout the bioreactor, coupled with an analysis of photosynthetic performance to simulate the level of photosaturation, photolimitation, or photoinhibition during cell growth culture. Under this simulation, the kinetic and physiological behavior was evaluated during four cycles of fed-batch culture. Physiological responses showed cellular photoacclimation to high irradiance conditions, increasing the Electron Transport Rate (ETR) values 2.5 times from cycle 1 to cycle 4, while photoprotection mechanisms such as quantum yield Y II and non-photochemical quenching NPQ remained efficient. The total pigment content was low compared to other studies, and a gradual decrease in Chl a, Chl b, and carotenoids was evident between each fed-batch cycle (a 25 % reduction from cycle 1 to cycle 4). Kinetics showed a gradual increase in productivity, growth rates, and nutrient consumption between cycles. The maximum biomass concentration as dry weight (4.86 ± 0.26gL−1) was obtained in cycle 4, which also showed the highest values of productivity (0.45gL−1d−1), specific growth rate (0.134 d−1) and consumption rate (NO 3 , PO 4). The results correlate the engineering approach to the physiological characteristics of the species, indicating that it is possible to establish an efficient fed-batch system for microalgae production. • B. braunii has the ability to photo-adapted to high irradiance conditions by changing the pigment content. • A simulation of photosynthetic state during a fed-batch culture enables an efficient microalgae cultivation system. • A light distribution model coupled to a photosynthetic response is a valuable tool for microalgae cultivation. [ABSTRACT FROM AUTHOR]

Enthesitis is a cardinal feature of spondylarthritis (SpA), and the pelvis is a common site of enthesitis. This study aimed to establish the association between pelvic enthesis involvement on pelvic X-ray and SpA diagnosis through a radiographic enthesis index (REI) and to assess the reliability and accuracy of this REI. The participants were SpA patients and a control group composed of patients with chronic lumbar pain without SpA. Three blinded observers assessed each pelvic radiography three times. Three zones were used: Zone I (ZI), the iliopubic ramus; Zone II (ZII), the pubic symphysis, and Zone III (ZIII), the ischiopubic ramus. A grading system was created from 0 to 3 [Grade 0, normal; Grade 1, minimal changes (subcortical bone demineralization and/or periosteal wishkering, seen as radiolucency and trabeculation of the cortical bone upon tendon insertion); Grade 2, destructive changes (Grade 1 findings and erosions at the enthesis site); and Grade 3, findings of Grade 2 plus >2 mm whiskering out of the cortical bone) for the REI. The sum of the results of the three zones was called the total REI. For statistical analysis, we used the weighted kappa statistic adjusted for prevalence and bias using Gwet's agreement coefficient. We enrolled 161 patients, 111 of them with SpA (39.6 % with axial SpA and 47.7 % with peripheral SpA) and 50 without SpA. In the SpA group, 36.7 % and 25.7 % had REI Grades 2 and 3 in ZIII, respectively, while only 6 % of the controls had these grades. For ZI, the frequency of Grades 1 to 3 was 42.3 % in the SpA group (8.1 %, 14.4 %, and 19.8 %, respectively), compared to only 2 % in the controls. ZII was unaffected in most of the patients with SpA (82.9 %) and in the controls (98 %). In the control group, Grade 0 was the most common REI grade in all three zones. The agreement was almost perfect for each zone and between the independent readers. The ROC-curve analysis showed that the highest performance areas were the total REI, ZIII, and ZI. Most (75 %) of the SpA patients without sacroiliitis on X-ray were REI-positive. The sensitivity of the REI for SpA diagnosis was 82 %, while the sensitivity of sacroiliitis on X-ray was 38.7 %. The assessment of pelvic enthesis using the REI on pelvic radiography may be useful for SpA diagnosis. Total REI, ZIII, and ZI had the highest accuracy and almost perfect reliability. The REI is especially helpful in patients without sacroiliitis on imaging. [ABSTRACT FROM AUTHOR]

To compile evidence regarding the use of Machine Learning models to diagnose intraosseous lesions in gnathic bones, and to understand the impact and usefulness of these. The present SR was conducted following the guidelines of the PRISMA 2022 and registered in the PROSPERO database (CRD42022379298). The acronym PICOS was used to develop the focused review question "Should Computer vision be used to diagnose intraosseous lesions in radiographic images?" and the eligibility criteria. Electronic database search encompassed PubMed, Embase, Scopus, Cochrane Library, Web of Science, Lilacs, and IEEE Xplore, and Gray Literature (Google Scholar and ProQuest). Risk of Bias (RoB) was assessed through PROBAST, and the results were synthesized based on the task and according to the dataset sampling strategy. A total of 12 studies were included (21,146 radiographic images). Ameloblastomas, odontogenic keratocysts, dentigerous cysts, and periapical cysts were the most commonly investigated lesions. According to the TRIPOD, the majority of studies were classified as type 2 (randomly splited). Artificial intelligence application, safety, and generalization must be tested using more universal methodologies, since the diagnostic performance may differ according to the algorithms used. [ABSTRACT FROM AUTHOR]

The present study proposes to develop and implement a Deep Learning model for automatic classification of clinical photographs of salivary gland tumors in the palate into benign and malignant categories. A dataset of 100 clinical images of SGT from seven institutions was used to train and validate a ResNet50 (original architecture) implemented with a low learning rate of 10-5 for 75 epochs with 10-fold cross-validation. The proposed ResNet50 reached an accuracy of 70% and an AUC of 0.68 during training, showing the potential for learning. However, divergence in training and validation accuracy and loss curves displayed a clear overfitting, which is not uncommon when training Deep Learning algorithms with a small sample. The proposed DL-based model presented a capacity for learning with the potential of achieving a fair accuracy. To overcome overfitting and improve the results, further steps of the present investigation will consider transfer learning and data augmentation. [ABSTRACT FROM AUTHOR]

To evaluate Deep Learning performance for the classification of ameloblastoma and ameloblastic carcinoma. Materials and methods: digital slides were manually annotated to assign regions with the tumor to segment and further fragment into patches of 556x556 pixels, according to the models' kernels. The total sample was divided into sets of training, validation, and test sets. In the training stage, different hyperparameters of the Resnet 50, VGG 16, and DenseNet networks were studied. Results and Preliminary results revealed that the models have learning potential, but not generalization so far. The training and validation metrics did not show convergence, characterizing an overfit. In addition, the test assessment was unsatisfactory, with an average of 0.65, 0.67, 0.61, 0.68, and 0.63 for accuracy, precision, sensitivity, specificity, and F1 score, respectively. These results may be influenced by the overlapping of characteristics between the tumors. Further experiments will improve the models and test other techniques of sampling, data augmentation, use of different classes of tumors, and implementation of different convolutional neural networks. [ABSTRACT FROM AUTHOR]

This report aims to describe a case of white sponge nevus (WSN) diagnosed in a 9-year-old male patient who has been presenting multiple white intraoral lesions since he was eight months old. No other family member exhibited similar manifestations. The intraoral examination revealed generalized, non-scrapable, thick, irregular, white plaques affecting the lips, bilateral buccal mucosa, tongue, floor of the mouth, and oropharynx. His lower lip exhibited painful fissures. An incisional biopsy and exfoliative cytology were performed, and the findings revealed parakeratotic epithelial cells with dense perinuclear hyperchromatic condensation and cells with cytoplasmic vacuolization. A diagnosis of WSN was established, and topical clobetasol was administered to alleviate the patient's symptoms. The clinical appearance is currently stable. WSN is an uncommon benign disorder characterized by dyskeratotic hyperplasia of mucous membranes. Exfoliative cytology represents a non-invasive technique to aid in the diagnosis of WSN. [ABSTRACT FROM AUTHOR]

A 73-year-old man presented with a 4-month history of a rapidly growing exophytic mass in the right mandible. Imaging exams revealed a destructive radiolucency causing tooth resorption. An incisional biopsy was performed, and microscopic analysis revealed the proliferation of medium to large-sized anaplastic cells with abundant cytoplasm, eccentric nuclei, marked pleomorphism, and numerous mitoses. The neoplastic cells tested positive for CD138, VS138c, lambda, and MUM1, while testing negative for AE1/AE3, kappa, S100, synaptophysin, and EBV (in-situ hybridization). The Ki-67 labeling index was 70%. The patient's systemic clinical checkup ruled out other bone lesions, confirming the diagnosis of an anaplastic plasmacytoma (AP) of the mandible. Three weeks later, the patient returned with breathing difficulties due to a large increase in the lesion. The patient is currently undergoing oncological treatment. Although AP is a rare neoplasm, it should be considered in the differential diagnosis of anaplastic cell proliferations in the oral cavity of elderly patients. [ABSTRACT FROM AUTHOR]

Socioecological systems (SES) are complex and adaptive systems with variables and relationships that interact at different temporal and spatial scales. Identifying and analyzing these variables and interactions, as well as understanding the main leverage points and critical thresholds of the SES, are important to define the strategies and policies aimed at finding a sustainable SES. The Wayfinder Guide is a sustainability analysis and adaptive management planning tool to guide decision-making. The research question addressed in this study was regarding the challenges and opportunities of using the Wayfinder Guide to elucidate the complexity of sustainability trajectories and guide territorial planning in the challenging environmental conditions of the Global South, particularly the strategic mountain SES in the tropical Andes in Colombia. Using the Wayfinder Guide to begin an SES analysis may require a large number of resources and an extended period (years) to consolidate the effective implementation thereof, especially for the first phases of the guide. In this study, we propose methodological changes to apply the guidelines in the context of scarce SES information. • Analyzing Socioecological trajectories is key to design sustainability strategies. • We use Wayfinder Guide to analyze the complexity of socioecological trajectories. • The use of Wayfinder Guide was possible given the existing knowledge of the system. [ABSTRACT FROM AUTHOR]

Better time-resolved imaging of stent grafts in the ascending aorta and arch accounting for cardiac motion is necessary to understand device-related complications and endoleaks. This report describes dynamic time-resolved computed tomographic angiography (d-CTA) and its combination with electrocardiography gating (d-gated CTA) to image stent grafts in the ascending aorta and to characterize endoleaks more clearly. d-CTA involves multiple scans acquired at different time points along the contrast enhancement curve. d-Gated CTA involves concomitant electrocardiography gating in a predefined cardiac phase minimizing motion-induced artifacts. This report illustrates the utility of d-CTA and d-gated CTA in 2 clinical cases. d-CTA demonstrated a type 1A endoleak in a patient with an aortic arch aneurysm treated with total arch debranching and a thoracic stent graft. d-gated CTA demonstrated a type 1A endoleak in a patient with an ascending aortic pseudoaneurysm treated with aortic cuff placement. Dynamic, cardiac-gated CTA enables time-resolved angiographic imaging of the ascending aorta and arch without any cardiac motion–related artifacts. Such advanced imaging techniques help with better characterization of endoleaks after stent graft deployment in the ascending aorta and arch. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the incremental prognostic value of coronary computed tomography (CT) angiography (CCTA)-derived machine learning fractional flow reserve CT (ML-FFRct) versus that of ischemia detected on single-photon emission-computed tomography (SPECT) myocardial perfusion imaging (MPI) on incident cardiovascular outcomes. SPECT MPI and ML-FFRct are noninvasive tools that can assess the hemodynamic significance of coronary atherosclerotic disease. We studied a retrospective cohort of consecutive patients who underwent clinically indicated CCTA and SPECT MPI. ML-FFRct was computed using a ML prototype. The primary outcome was all-cause mortality and nonfatal myocardial infarction (D/MI), and the secondary outcome was D/MI and unplanned revascularization, percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) occurring more than 90 days postimaging. Multiple nested multivariate cox regression was used to model a scenario wherein an initial anatomical assessment was followed by a functional assessment. A total of 471 patients (mean age: 64 ± 13 year; 53% males) were included. Comorbidities were prevalent (78% hypertension, 66% diabetes, 81% dyslipidemia). ML-FFRct was <0.8 in at least 1 proximal/midsegment was present in 41.6% of patients, and ischemia on MPI was present in 13.8%. After a median follow-up of 18 months, 7% of patients (n = 33) experienced D/MI. On multivariate Cox proportional analysis, the presence of ischemia on MPI but not ML-FFRct significantly predicted D/MI (HR: 2.3; 95% CI: 1.0-5.0; P = 0.047; or HR: 0.7; 95% CI: 0.3-1.4; P = 0.306 respectively) when added to CCTA obstructive stenosis. Furthermore, the model with SPECT ischemia had higher global chi-square result and significantly improved reclassification. Results were similar using the secondary outcome and on several sensitivity analyses. In a high-risk patient cohort, SPECT MPI but not ML-FFRct adds independent and incremental prognostic information to CCTA-based anatomical assessment and clinical risk factors in predicting incident outcomes. [Display omitted] [ABSTRACT FROM AUTHOR]

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Diseases of small diameter blood vessels encompass the largest portion of cardiovascular diseases, with over 4.2 million people undergoing autologous vascular grafting every year. However, approximately one third of patients are ineligible for autologous vascular grafting due to lack of suitable donor vasculature. Acellular extracellular matrix (ECM) scaffolds derived from xenogeneic vascular tissue have potential to serve as ideal biomaterials for production of off-the-shelf vascular grafts capable of eliminating the need for autologous vessel harvest. A modified antigen removal (AR) tissue process, employing aminosulfabetaine-16 (ASB-16) was used to create off-the-shelf small diameter (< 3 mm) vascular graft from bovine saphenous vein ECM scaffolds with significantly reduced antigenic content, while retaining native vascular ECM protein structure and function. Elimination of native tissue antigen content conferred graft-specific adaptive immune avoidance, while retention of native ECM protein macromolecular structure resulted in pro-regenerative cellular infiltration, ECM turnover and innate immune self-recognition in a rabbit subpannicular model. Finally, retention of the delicate vascular basement membrane protein integrity conferred endothelial cell repopulation and 100% patency rate in a rabbit jugular interposition model, comparable only to Autograft implants. Alternatively, the lack of these important basement membrane proteins in otherwise identical scaffolds yielded a patency rate of only 20%. We conclude that acellular antigen removed bovine saphenous vein ECM scaffolds have potential to serve as ideal off-the-shelf small diameter vascular scaffolds with high in vivo patency rates due to their low antigen content, retained native tissue basement membrane integrity and preserved native ECM structure, composition and functional properties. The use of autologous vessels for the treatment of small diameter vascular diseases is common practice. However, the use of autologous tissue poses significant complications due to tissue harvest and limited availability. Developing an alternative vessel for use for the treatment of small diameter vessel diseases can potentially increase the success rate of autologous vascular grafting by eliminating complications related to the use of autologous vessel and increased availability. This manuscript demonstrates the potential of non-antigenic extracellular matrix (ECM) scaffolds derived from xenogeneic vascular tissue as off-the-shelf vascular grafts for the treatment of small diameter vascular diseases. [Display omitted] [ABSTRACT FROM AUTHOR]

This study embarks on the synthesis of activated carbon (AC) from cashew nut shells using a potassium carbonate (K 2 CO 3) activation process, with a specific focus on its practical application in high-pressure gas adsorption. Among the synthesized samples, MCAK85 emerged as the most efficient, demonstrating a specific surface area of 1693 m2/g and total and micropore volumes of 0.839 cm3/g and 0.641 cm3/g, respectively. Importantly, this bioorganic activated carbon exhibited high sorption capacities for CO 2 and CH 4 , with uptake values of 11.0 mmol/g and 5.5 mmol/g at 10 bar at 25°C, and a CO 2 /CH 4 selectivity range between 9.1 and 1.8. A comprehensive range of characterization techniques were employed to analyze the structural and chemical properties of the synthesized AC, providing valuable insights into the functional groups and molecular structure. The morphology of the AC was examined using SEM, while the point of zero charge was determined to understand the surface charge characteristics. Additionally, TGA was utilized to assess the thermal stability and composition of the AC. This study underscores the potential of utilizing agricultural waste, specifically cashew nut shells, in the creation of effective materials for gas storage and purification applications. The high-pressure adsorption capacity of the produced AC, coupled with its sustainable and eco-friendly nature, underscores its suitability for environmental and industrial applications, particularly in areas focusing on greenhouse gas capture and air purification, thereby inspiring further research and development in this field. [Display omitted] • Cashew shells transformed into activated carbon, optimizing waste utilization. • MCAK85: Outstanding textural features - 1693 m2/g surface, 0.839 cm3/g pore volume. • MCAK85 shows high adsorption: 11.0 mmol/g CO 2 , 5.5 mmol/g CH 4 uptake at 25°C, 10 bar. • MCAK85's attributes suggest environmental viability in gas storage and air purification. • Activated carbons exhibits CO 2 /CH 4 selectivity from 9.1 to 1.8. [ABSTRACT FROM AUTHOR]

Most monitoring systems and models in buildings assume homogeneous measurements of indoor variables such as temperature, relative humidity (RH), CO 2 concentration or water vapour content (Pv) throughout a thermal zone. However, these indoor variables may have different values within a thermal zone, depending on the physical location of the sensor. This spatial variability, which is not an error per se, depends on factors that cannot be controlled or eliminated, mainly due to air stratification. Consequently, if a hypothetical homogeneous value of the variable is assumed, the measurement may contain random errors. In this research, we use a statistical methodology to analyse and quantify the Overall Uncertainty (U X) when measuring these indoor variables. The U X comprises the inherent inaccuracies of the monitoring system, indicated as Systematic Uncertainty (U X(s)), and the random errors associated with the spatial variability of the variables, evaluated as Spatial Uncertainty (U X(sp)). We have found that the U X(sp) of the temperature and RH measurements are considerably higher than their U X(s). However, the spatial variabilities of the CO 2 concentration and Pv measurements are similar to the systematic uncertainty. Furthermore, we have compared the indoor and outdoor variable measurements. Spearman's correlation coefficient between the indoor and outdoor Pv indicates a strong positive correlation. This, together with the uncertainty analysis, confirms that the Pv (or RH) is not a suitable variable to detect presence in mechanically ventilated buildings. Conversely, as expected, there is no correlation between the indoor and outdoor CO 2 concentrations, confirming the advantages of this variable for occupancy detection. • Detailed Indoor Air Quality uncertainty analysis in mechanically ventilated offices. • The spatial uncertainty of the indoor water vapour pressure is negligible. • The water vapour pressure is not a suitable variable for detecting occupation. [ABSTRACT FROM AUTHOR]

COVID-19 has made the public aware that wearing masks is a simple yet effective protective measure when facing respiratory infectious diseases. However, despite this late stage of the pandemic, there have been few systematic studies of the physiological and subjective effects of wearing a mask, particularly on how they affect cognitive performance. To address this gap, we conducted an experiment simulating an office environment with three working conditions: no mask, surgical mask, and KN95 mask, 24 subjects and a comfortable ambient temperature of 23 °C; the exposure time to each condition was 160 min (mask was worn for 120 min). We collected data on cognitive performance, physiological parameters, and subjective feelings. The results revealed a significant decrease in the accuracy of a test of grammatical logic as the experiment progressed, regardless of the mask type worn; on average, accuracy was lower when wearing a surgical mask compared with no mask. After 80 min of exposure, the accuracy of a visual choice reaction time test significantly decreased when wearing a surgical mask compared to not wearing a mask, while Stroop accuracy improved slightly but significantly when wearing a KN95 mask. Regardless of mask type, pNN50, ETCO2, and facial skin temperature significantly increased compared to no mask, while wearing a mask reduced the subjects' evaluation of the quality of the thermal environment and the air quality and increased the intensity of some acute health symptoms. In summary, it was shown that wearing masks may impact cognitive performance, physiological responses and well-being. [Display omitted] • We examined the effects of wearing masks on human responses. • Wearing a mask had primarily negative effects on cognitive performance. • Wearing a mask increased pNN50, ETCO2, and facial skin temperature. • Wearing a mask increased the intensity of self-reported acute health symptoms. • Wearing a mask increased the intensity of self-reported fatigue. [ABSTRACT FROM AUTHOR]

Splenic abscess is a very rare pathology in the pediatric age, and the association with complications such as spontaneous drainage to the pleural cavity is even rarer. There is very little information in the literature regarding the best diagnostic and therapeutic approach. We present the case of an immunocompromised 16-year-old female patient with a splenic abscess that had spontaneous drainage to the left pleural cavity through the diaphragm and presented clinically as recurrent empyema. There was tomographic evidence of a significant pleural effusion on the left side and splenomegaly with a collection in the upper pole that extended to the left hemithorax through a defect in the diaphragm. Patient received successful treatment by laparoscopic splenectomy and transdiaphragmatic drainage of the pleural cavity. There were no complications and no recurrence of pleural effusion or subphrenic abscess on x-ray or ultrasound. At 6-month outpatient follow-up, she presented adequate clinical and radiological evolution. A trans -diaphragmatic pleural drain can be placed under laparoscopic vision in selected cases where a thoracic approach is not a safe option. This minimizes the probability of lung injury and air fistulas in a patient with severe inflammation and previous thoracic surgery. [ABSTRACT FROM AUTHOR]

• We use a combination of Extreme Gradient Boosting and SHAP Additive Explanations to uncover the determinants of sovereign risk. • We identify year-by-year determinants of sovereign credit risk. • Key variables driving sovereign risk have remained relatively stable over time and exhibit similarities in both liquidity and solvency components. • Various macroeconomic fundamentals play a crucial role. • After the GFC, the relative importance of macroeconomic variables has diminished, giving way to institutional variables. We use a combination of Extreme Gradient Boosting and SHAP Additive Explanations to uncover the determinants of sovereign risk across a wide range of countries from 2002 to 2021. By considering numerous variables established in existing literature within a single framework, we identify year-by-year determinants of sovereign credit risk. To gage the liquidity and solvency aspects of sovereign risk, we utilize 5- and 10-year yield spreads as proxies. Our findings show that the key variables driving sovereign risk have remained relatively stable over time and exhibit similarities in both liquidity and solvency components. Among the prominent variables, various macroeconomic fundamentals play a crucial role, including the current account, GDP growth, per capita GDP growth, and the real exchange rate. Prior to the Global Financial Crisis, macroeconomic variables, particularly the current account, held the highest importance in explaining sovereign risk. However, following the GFC, the relative importance of these variables diminished, giving way to institutional variables, especially the rule of law. [ABSTRACT FROM AUTHOR]

Immigration enforcement policies and negative rhetoric about immigrants harm the psychological well-being of Latinx youth in immigrant families, particularly those who are most vulnerable because of their own or their loved ones' legal status. According to the Integrative Model for the Study of Developmental Competencies among Minority Children, discrimination may be one pathway to explain how vulnerability to restrictive immigration policies affects Latinx youth mental health. We collected data from 306 Latinx high school students from immigrant families in Harris County, Texas, and Rhode Island to (1) determine the direct effect of immigration enforcement fear (a proxy for the social position of vulnerable legal status) on adolescents' anxiety; (2) explore the effect of immigration enforcement fear on anxiety through the pathway of perceived discrimination; and (3) test whether the different enforcement climates in the two study sites moderate these pathways. Total anxiety and subscales measuring separation, social, school, generalized, and somatic anxiety subtypes were analyzed. Immigration enforcement fear was related to increased somatic and separation anxiety in both first- and second-generation Latinx adolescents. Perceived discrimination partially mediated the association between immigration enforcement fear and separation and somatic anxiety; data collection site did not moderate these effects. Immigration policies and rhetoric have psychological consequences. Although the adolescents in our study face multiple stressors, immigration enforcement fear may heighten their perception of discrimination, in turn, likely elevating their physiological and family separation anxiety. [ABSTRACT FROM AUTHOR]

Aims: To study the observed trends in Diabetes Mellitus (DM) mortality rates according to educational level, age group and sex in Colombia between 1998 and 2015.Methods: A cross-sectional study was conducted based in official databases. Age-standardized mortality rates were calculated by age-gropus, educational level, sex and year. Rate Ratios (RR) were estimated with higher educational level as reference. The Relative Index of Inequality (RII) was estimated. Joinpoint regressions were applied to identify inflexion points in mortality trends, and Percent Annual Change (APC) between inflexion points.Results: 124,198 deaths caused by DM among adults (25+ years) were analysed, 57% among women (71,093); 74% of deaths occurred among those older than 45 years, especially senior adults (65+). The highest adjusted mortality rates were for those with primary and secondary educational levels. The highest mortality occurred in adult women (65 years or more) with primary education level. Relative Index of Inequality was higher for women than for men along the period.Conclusions: Educational levels were found to be strongly associated with death by DM in adults (25+). Intersectoral actions are required to influence the risk factors and to improve the treatment of the disease in groups with lower levels of education. [ABSTRACT FROM AUTHOR]

• The Microdosimetric Kinetic Model is implemented in a TPS to calculate RBE in proton radiotherapy. • Instead of using approximations based on LET, we compute analytical microdosimetry. • The radius of the domain is determined for different cell lines using data from clonogenic assays. • Microdosimetry-based MKM produced better agreements to in vitro experimental results than phenomenological models. To implement RBE calculations in treatment planning systems based on the Microdosimetric Kinetic Model (MKM) upon analytical calculations of dose-mean lineal energy (y D). MKM relies on the patterns of energy deposition in sub-nuclear structures called domains, whose radii are cell-specific and need to be determined. The radius of a domain (r d) can be determined from the linear-quadratic (LQ) curves from clonogenic experiments for different cell lines exposed to X-ray and proton beams with known y D. In this work, LQ parameters for two different human lung cell lines (H1299 and H460) are used, and y D among cells is calculated through an analytical algorithm. Once r d is determined, MKM-based calculations of RBE are implemented in a treatment planning system (TPS). Results are compared to those produced by phenomenological models of RBE, such as Carabe and McNamara. Differences between model-based predictions and experimentally determined RBE are analyzed for y D = 5 keV/μm. For the H1299 line, mean differences in RBE are 0.13, −0.29 and −0.27 for our MKM-based calculation, Carabe and McNamara models, respectively. For the H460 line, differences become −0.044, −0.091 and −0.048, respectively. RBE is computed for these models in a simple plan, showing MKM the best agreement with the experimentally obtained RBE, keeping deviations below 0.08. Microdosimetry calculations at the TPS-level provide tools to improve predictions of RBE using the MKM with actual values of y D instead of LET. The radius of the characteristic domain needs to be determined to tailor the RBE prediction for each cell or tissue. [ABSTRACT FROM AUTHOR]

• Acute mesenteric ischemia associated with pregnancy is a rare pathology that is difficult to treat. • Acute mesenteric ischemia can be caused by a venous thrombosis associated with gestation. • Acute mesenteric ischemia should be considered in pregnant woman. • Patient with intense intestinal necrosis, need a intestinal resection which would cause a short bowel syndrome. Mesenteric ischaemia associated with pregnancy is a rare disease with a high mortality rate and its prognosis depends on the time passing between diagnosis and final management. A 38-year-old Peruvian woman developed intestinal necrosis during week 35 of her pregnancy because of mesenteric ischaemia associated with her pregnancy. Given the findings of extensive intestinal necrosis, surgical resection was performed, causing short bowel syndrome. Histopathological analysis confirmed that the immediate cause of the patient's ischaemia was venous thrombosis associated with her gestation. Acute mesenteric ischaemia should be considered as a possible diagnosis in pregnant woman with risk factors for thrombophilia presenting with abdominal pain. [ABSTRACT FROM AUTHOR]

• Accurate radiobiological data are necessary to include biophysically optimized treatment plans in clinical proton therapy. • Low energy proton facilities provide perfect beams for conducting radiobiology experiments with mono-layer cell cultures. • A system for the irradiation of cell cultures has been designed and mounted at the CNA, Seville, Spain. • A dedicated Geant4 Monte Carlo simulation has been developed and validated towards experimental measurements. • The first irradiation of mono-layer cell cultures has been carried out successfully. Proton therapy has gained interest in recent years due to its excellent clinical outcomes. However, the lack of accurate biological data, especially in the Bragg peak region of clinical beams, makes it difficult to implement biophysically optimized treatment plans in clinical practice. In this context, low energy proton accelerator facilities provide the perfect environment to collect good radiobiological data, as they can produce high LET beams with narrow energy distributions. This study presents the radiobiology beam line that has been designed at the 18 MeV proton cyclotron facility at the National Centre of Accelerators (CNA, Seville, Spain), to perform irradiations of mono-layer cell cultures. To ensure that all the cells receive the same dose with a suitable dose rate, low beam intensities and broad and homogeneous beam profiles are necessary. To do so, at the CNA an unfocused beam has been used, broadened with a 500 μ m thick aluminium scattering foil. Homogeneous dose profiles, with deviations lower than 10% have been obtained over a circular surface of 35 mm diameter for an incident average energy of 12.8 MeV. Further, a Monte Carlo simulation of the beam line has been developed with Geant4, and benchmarked towards experimental measurements, with differences generally below 1%. Once validated, the code has been used, together with an ionization chamber, for dosimetry studies, to characterize the beam and monitor the dose. Finally, cultures of Human Bone Osteosarcoma cells (U2OS) have been successfully irradiated at the radiobiology beam line, investigating the effects of radiation in terms of DNA damage induction. [ABSTRACT FROM AUTHOR]

Background: People with visual impairment presents difficulties to access the labels information of medicines. In this sense, technological tools can contribute to improve access to this information and the appropriate use of medicines in this population. However, currently, in Colombia, there are no tools to facilitate this process.Objective: To design and development of a mobile app of drug information for people with visual impairment, which allows them to access information for the appropriate use of medicines.Methods: A user-centered design process is carried out in four phases was used: a) Identification the needs and barriers for appropriate use of medicines; b) Lifting of requirements, c) Interface design and prototyping, and development of the mobile app, and d) Usability test.Results: The study involved 48 people with visual disability, of which 69% required assistance for the use of medicines. The main barriers identified were access to information and dosing. A total of ten user requirements were identified, based on these and international accessibility standards FarmaceuticApp was designed and developed, incorporating the problems that were identified in the usability test.Conclusion: A mobile app of drug information for people with visual impairment using a user-centered design process was designed and developed, highlighting the importance of involving the users and other stakeholders in the design and development m-health technologies. FarmaceuticApp could contribute to the appropriate use of medicines and improve therapeutic adherence, as well as autonomy and independence in people with visual impairment. [ABSTRACT FROM AUTHOR]

Fan-delta deposits, an important sedimentary component of fan-delta complexes, are scarcely described in the ancient record because it is very difficult to distinguish them from other types of coarse-grained deposits (e.g., alluvial, fluvial, or deep marine deposits). This obstacle is overcome when a well-record of physical/biogenic sedimentary structures or fossils unambiguously marks the influence of the receiving basin. However, this is usually not the case. Here, we present the Ophiomorpha ichnofabric record as a key proxy of marine influence within a generally fluvial-dominated system for improving the paleoenvironmental understanding and reconstructing animal-substrate interplay during the evolution of a fan-delta complex. The ichnological record, together with detailed sedimentological analysis, allows us to define three ichnofabric types, distributed in four levels. The stratigraphic distribution of these features points to distal alluvial environments towards the base, dominated by debris and sheet flows deposits and locally shallow braided channels; they evolve upward into well-developed braided fluvial system whose facies arrangement is related to channel fills, locally influenced by debris flows. Subsequently, a basinward migration of the sedimentary system is recorded through the occurrence of the first level with Ophiomorpha ichnofabric A, and then ichnofabrics A and B in levels 2 and 3, respectively, suggesting marine-influenced mouth bar settings. Toward the top, another steep basinward migration is evidenced by Ophiomorpha ichnofabric C in level 4, indicating wave-dominated processes in distal mouth bars environments. The record of marine-influenced and dominated levels may indicate relative sea-level fluctuations related to local or autogenic processes at the basin scale. Furthermore, the present study demonstrates the ability of Ophiomorpha tracemaker to colonize challenging sedimentary environments. • Ichnological and sedimentological insights into the depositional fan-delta complex. • Ophiomorpha ichnofabric marks the influence of the marine receiving basin. • Ichnofabrics are the result of different range marine incursions. • Macrobenthic community ability to adapt to strong changes in sedimentary conditions. [ABSTRACT FROM AUTHOR]

The evidence supporting pharmacological heart failure treatment relies on randomized clinical trials with stringent inclusion and exclusion criteria. Objectives: Assess the eligibility of outpatients with chronic heart failure for the trials DAPA-HF, EMPEROR-reduced, and PARADIGM-HF, while exploring potential differences among study populations. By reviewing medical records, we determined the eligibility rate for each study and evaluated the incidence of heart failure hospitalizations and all-cause mortality during this period. A total of 446 patients were included in the cohort. Approximately 75% would be ineligible for the trials, mainly because of their comorbidities. Ineligible patients had a higher all-cause mortality, but a similar incidence of hospitalization. Approximately 1 in 4 patients from a heart failure clinic in Medellin, Colombia would meet the eligibility criteria for the DAPA-HF, EMPEROR-reduced, and PARADIGM-HF trials. These findings highlight the need to complement randomized clinical trials with real-world data. [ABSTRACT FROM AUTHOR]

Data about heart failure in Latin America is scarce. Women living in this region of the world are exposed to a mix of traditional risk factors for heart failure, neglected diseases, and social determinants of health. The aim of this review is to present what we know about heart failure in Latin American women and to establish the needs for future research. [ABSTRACT FROM AUTHOR]

The four pillars for treatment of heart failure with reduced ejection fraction (HFrEF) patients include angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin-receptor blocker (ARB)/angiotensin receptor-neprilysin inhibitor (ARNI), beta-blocker (BB), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter-2 inhibitor (SGLT2i), unless contraindicated or not tolerated. They should be started or up titrated to maximally tolerated doses recommended in current guidelines. Despite proven benefits and strong guideline recommendations, their use and dosing in routine clinical practice have traditionally fallen below the levels achieved in clinical trials. This analysis seeks to establish medication use and optimal dosage according to the clinical practice guidelines in HFrEF patients included in the RECOLFACA registry during recruitment and after six-month follow-up. Factors that limit its use could be identified in subsequent analysis. The RECOLFACA registry was performed between 2017 and 2019. A descriptive analysis is performed considering the medication used in HFrEF patients (ACE-I/ARB/ARNI, BB, and/or MRA) and their dosage (<50%, 50-100% or 100% of the dosage recommended in guidelines) during recruitment and at 6-month follow-up. SGLT2i are not included in this analysis because were not available during this period. The registry included 2528 patients, and this analysis included 1661 HFrEF patients from this registry. Among these patients 89.4%, 93.4% and 70.1% received ACE-I/ARB/ARNI, BB and ARM respectively during registry recruitment. At six-month follow-up, a decrease in its use was observed (57.9%, 53.3% and 44.2% respectively). Among patients with established medication during registry recruitment, only 10.4%, 16.5% and 4.7% received target doses of ACE-I/ARB/ARNI, BB or ARM respectively, which increased at six-month follow-up in ACE-I/ARB/ARNI and BB group (12.6% and 21.5% respectively) and decreased in ARM group (3.7%) (Figure 1). Less than 1% of patients were simultaneously receiving target doses of ACE-I/ARB/ARNI, BB and MRA during registry. In HFrEF patients included in this registry, the use and dosage of the three groups of medications evaluated (ACEI/ARB/ARNI, BB and ARM) and that are recommended in current guidelines is low and more worrisome is that after time (6-month follow-up), this percentage is lower, as mentioned in other trials. There is minor increases in the number of patients reaching maximal doses of those therapies during follow-up. We need to continue working to be able to identify factors associated with low adherence, access to medication, and using maximal recommended/tolerated doses. [ABSTRACT FROM AUTHOR]