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Bi0.5Na0.5TiO3 (BNT) emerges as a promising ferroelectric and piezoelectric lead-free candidate to substitute the contaminant Pb[TixZr1−x]O3 (PZT). However, to obtain optimal ferroelectric and piezoelectric properties, BNT must be sintered at high temperatures. In this work, the reduction of sintering temperature by using iron added to BNT is demonstrated, without significant detriment to the dielectric properties. BNT-xFe with iron from x = 0 to 0.1 mol (∆x = 0.025) were synthesized using high-energy ball milling followed by sintering at 900 °C. XRD analysis confirmed the presence of rhombohedral BNT together with a new phase of NaFeTiO4 (NFT), which was also corroborated using optical and electronic microscopy. The relative permittivity, in the range of 400 to 500 across all the frequencies, demonstrated the stabilization effect of the iron in BNT. Additionally, the presence of iron elevates the transition from ferroelectric to paraelectric structure, increasing it from 330 °C in the iron-free sample to 370 °C in the sample with the maximum iron concentration (0.1 mol). The dielectric losses maintain constant values lower than 0.1. In this case, low dielectric loss values are ideal for ferroelectric and piezoelectric materials, as they ensure minimal energy dissipation. Likewise, the electrical conductivity maintains a semiconductor behavior across a range of 50 Hz to 1 × 106 Hz, indicating the potential of these materials for applications at different frequencies. Additionally, the piezoelectric constant (d33) values decrease slightly when low concentrations of iron are added, maintaining values between 30 and 48 pC/N for BNT-0.025Fe and BNT-0.05Fe, respectively. [ABSTRACT FROM AUTHOR]

Simple Summary: This study analyzed changes in the lactoferrin content of Murciano–Granadina goat colostrum in the first 96 h postpartum as a function of parity season. In addition, we evaluated production and composition (chemical and immunological), and the usefulness of a Brix refractometer for estimating the IgG content of colostrum. Lactoferrin is a protein present in colostrum that has antimicrobial properties, and its colostrum content was heavily affected by time since delivery, as was that of the other chemical and immunological components, except fat. The season influenced milk yield and the contents of lactoferrin, immunoglobulin G, fat, protein, and somatic cells. Lactoferrin contents were significantly lower in the winter season. The quality of goat colostrum estimated using the Brix refractometer vs. ELISA method evidenced a strong correlation. Our results confirm the critical role of colostrum feeding within the first postpartum day to the neonates, attributed to its superior quality, particularly for its contents in bioactive proteins, such as lactoferrin and immunoglobulin. Additionally, we substantiate the efficacy and cost-effectiveness of the Brix method as a rapid assay for evaluating colostrum quality, thus validating its practical utility. The aim of this research was to evaluate the effects of postpartum day and parity season on the lactoferrin (LF), immunoglobulin G (IgG), and chemical composition of Murciano–Granadina goat colostrum during the first 96 h after kidding, and the use of the Brix refractometer to estimate IgG content. A herd of 3500 intensively managed Murciano–Granadina dairy goats (45–50 kg body weight) was used. Colostrum samples were collected from days 1 to 4 postpartum in the winter, spring, summer, and autumn. The colostrum composition was assessed using an automated infrared method; the LF and IgG concentrations were measured using an ELISA, and for the Brix percentage, we used a digital refractometer. Colostrum taken on the first postpartum day showed the highest concentrations of LF, IgG, proteins and non-fat solids (NFSs). As the postpartum days progressed, a rapid decrease in the LF, IgG, protein, and NFS contents and the Brix value was observed. In contrast, the lactose content increased steadily until the fourth postpartum day (p < 0.001). The season influenced milk yield, LF, IgG, protein, fat, and somatic cell content (p < 0.05). LF contents were significantly higher in the spring season, IgG contents were higher in autumn colostrum, and fat components were higher in the winter season. The colostrum Brix value showed a positive correlation with the ELISA colostrum LF (r = 0.716, p < 0.001) and IgG (r = 0.894, p < 0.001) determination; a 20 mg IgG/mL colostrum concentration corresponded to 18 °Brix. Our results corroborate the importance of feeding colostrum to newborns on the first day after birth, not only because of its high level of IgG but also because of its greater presence of the other bioactive protein compounds such as lactoferrin. [ABSTRACT FROM AUTHOR]

Simple Summary: The European Union's poultry industry relies heavily on imported ingredients such as soybean meal. In this study, we tested three diets on 120 laying hens over 15 weeks: a soybean–corn diet, an alternative diet with locally sourced plant-based ingredients (peas, distillers' dried grains with solubles, and sunflower meal), and this alternative feed supplemented with 5% whole dried black soldier fly larvae. The results suggest that a novel alternative diet using fewer conventional ingredients could be developed into a flexible formulation that ensures productivity, sustainability, egg quality, and hen health. Given the significant environmental consequences of current poultry feed practices and the heavy dependence of the European Union on imported soybeans, studying alternatives is crucial. This study evaluated the potential benefits of using locally sourced alternative plant-based ingredients and whole dry black soldier fly larvae in the diet of laying hens. The experiment involved 120 Isazul hens at 23 weeks old, which were divided into three groups with five replicates each (eight hens per replicate): a control diet (CON) based on soybean meal and cereals, an alternative diet (ALT) replacing the soybean meal with locally sourced plant-based resources (peas, distillers' dried grains with solubles, and sunflower meal), and the ALT diet supplemented with 5% whole dry black soldier fly larvae (ALT+DBSFL). Over 15 weeks, the hens were fed ad libitum, and the production performance, egg quality, and plasma biochemical parameters were assessed across three experimental sub-periods. The results showed no significant differences in body weight, feed intake, egg production, egg weight, egg mass, or feed conversion ratio across the diets (p > 0.05). The egg quality remained consistent across all the groups; however, the hens fed the ALT+DBSFL diet exhibited higher Haugh units in the first experimental sub-period (p < 0.05) and lower plasma cholesterol and triglycerides at 32 weeks of age (p < 0.05). The findings of this study indicate that incorporating these alternative ingredients and whole DBSFL into layers' diets does not compromise production performance, egg quality, or biochemical parameters related to health status, supporting their potential as sustainable feed alternatives. [ABSTRACT FROM AUTHOR]

This work presents a disease detection classifier based on symptoms encoded by their severity. This model is presented as part of the solution to the saturation of the healthcare system, aiding in the initial screening stage. An open-source dataset is used, which undergoes pre-processing and serves as the data source to train and test various machine learning models, including SVM, RFs, KNN, and ANNs. A three-phase optimization process is developed to obtain the best classifier: first, the dataset is pre-processed; secondly, a grid search is performed with several hyperparameter variations to each classifier; and, finally, the best models obtained are subjected to additional filtering processes. The best-results model, selected based on the performance and the execution time, is a KNN with 2 neighbors, which achieves an accuracy and F1 score of over 98%. These results demonstrate the effectiveness and improvement of the evaluated models compared to previous studies, particularly in terms of accuracy. Although the ANN model has a longer execution time compared to KNN, it is retained in this work due to its potential to handle more complex datasets in a real clinical context. [ABSTRACT FROM AUTHOR]

Simple Summary: In intensive dairy goat farms, artificial lactation is used for kids, often with only the colostrum from the first milking being used, discarding the milk from the second milking, or transition milk. On the other hand, in modern pig breeds, the number of piglets born with low birth weight is increasing, mainly due to the growth in litter sizes. These piglets are less likely to survive in the first hours of life due to their low energy reserves, among other factors. The aim of this study was to improve the current knowledge of goat colostrum for its use as an alternative energy supplement for newborn piglets. In order to assess the similarity of sow and goat colostrum, the fatty acid (FA) composition of both was examined in detail. The major FAs (palmitic, oleic, and linoleic acids) were the same in both species, although they were found in different proportions. Goat colostrum is mainly characterized by a high proportion of short- and medium-chain FAs (4:0, 6:0, 8:0, and 10:0), which are absent in sow colostrum. This group of FAs may play an important role in colostrum, as they are a readily available source of energy and have also been attributed to strong antibacterial activity. Therefore, the surplus of goat colostrum and milk from the second milking not used for feeding kids could be a promising energy supplement for newborn piglets, especially for the weakest and smallest of the litter, which are the most in need. Currently, the utilization of hyperprolific sows has stimulated the search for supplements aimed at enhancing piglet survival, as these sows yield more offspring than they can adequately feed with their colostrum production. In contrast, intensive goat farming often yields surplus colostrum, thus necessitating its removal, since kids are exclusively fed colostrum through lactation solely within the initial day of birth. The objective of this study was to examine and compare the fatty acid (FA) profiles of colostrum from sows and goats, together with possible influencing factors such as sow parity and the postpartum day of the goat, for possible use as an energy supplement for neonatal piglets. Swine colostrum was collected from sows with a 0–5 parity. In addition, samples of goat colostrum were collected on their first (D1) and second (D2) days of postpartum milking. The FA profiles of the colostrum were analyzed via gas chromatography. The parity value of the sows did not affect (p > 0.05) the FA colostrum composition. High proportions of palmitic, oleic, and linoleic acids were found in both types of colostrum. Levels of palmitic, oleic, and linoleic acids were significantly higher in D1 goat colostrum, whereas saturated FAs of less than 14 carbons (4:0, 6:0, 8:0, 10:0, and 12:0) were found in higher proportions in D2. These FAs play an important role in colostrum as they are a readily available source of energy and have also been attributed strong antibacterial activity. Therefore, goat colostrum, especially D2, could be used as an alternative energy supplement for newborn piglets, in particular for the weakest and smallest of the litter, which are the most in need. [ABSTRACT FROM AUTHOR]

Influenza vaccination is the main method of preventing influenza. Vaccination is recommended for certain individuals with diseases that could cause complications in the case of flu infection. The objective of this retrospective observational study was to examine influenza vaccination coverage in patients with risk factors, to describe the characteristics of those vaccinated and to study the influence of COVID-19. The study population was children under 14 years old with risk factors between 2018/19 and 2022/23 in Central Catalonia, sourced through the electronic database of the Catalan Institute of Health. The association of influenza vaccination data with sociodemographic data and risk factors was performed by bivariate and multivariate analysis. A total of 13,137 children were studied. Of those, 4623 had received the influenza vaccine in at least one season. The average influenza vaccination rate was 28.8%. The statistically significant factors associated with vaccination were age and having certain risk factors: asthma, diabetes, haemoglobinopathies and clotting disorders. In all seasons, the immigrant population was vaccinated more than the native population p < 0.05, except for the COVID-19 season (2020/21), where no differences were observed. Of those vaccinated, 7.1% had been vaccinated for 5 consecutive years. Influenza vaccination coverage in the paediatric age group was low. Vaccination promotion measures must be implemented. COVID-19 meant an increase in vaccination of the native population to the same level as that of the immigrant population. [ABSTRACT FROM AUTHOR]

Simple Summary: Targeted biopsies of suspicious lesions detected in magnetic resonance imaging are crucial to discover clinically significant prostate cancer, especially those corresponding to index lesions. However, the optimal scheme for targeted biopsies remains unclear, despite the fact that a two- to four-core scheme is usually recommended. Saturated biopsies of the prostate gland have shown high efficiency in detecting significant PCa. In this article, we report a better efficacy for mapping using a 0.5 mm core biopsy scheme than that using the two- to four-core scheme for detecting clinically significant prostate cancer in magnetic resonance index lesions. Since the optimal scheme for targeted biopsies of magnetic resonance imaging (MRI) suspicious lesions remains unclear, we compare the efficacy of two schemes for these index lesions. A prospective trial was conducted in 1161 men with Prostate Imaging Reporting and Data System v 2.1 3–5 undergoing targeted and 12-core systematic biopsy in four centers between 2021 and 2023. Two- to four-core MRI-transrectal ultrasound fusion-targeted biopsies via the transperineal route were conducted in 900 men in three centers, while a mapping per 0.5 mm core method (saturated scheme) was employed in 261 men biopsied in another center. A propensity-matched 261 paired cases were selected for avoiding confounders other than the targeted biopsy scheme. CsPCa (grade group ≥ 2) was identified in 125 index lesions (41.1%) when the two- to four-core scheme was employed, while in 187 (71.9%) when the saturated biopsy (p < 0.001) was used. Insignificant PCa (iPCa) was detected in 18 and 11.1%, respectively (p = 0.019). Rates of csPCa and iPCa remained similar in systematic biopsies. CsPCa detected only in systematic biopsies were 5 and 1.5%, respectively (p = 0.035) in each group. The saturated scheme for targeted biopsies detected more csPCa and less iPCa than did the two- to four-core scheme in the index lesions. The rate of csPCa detected only in the systematic biopsies decreased when the saturated scheme was employed. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of this study was to evaluate 18 different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastrectomy for gastric adenocarcinoma. This is a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of preoperative biomarkers for OS and DFS. The most relevant preoperative biomarkers of poorer OS and DFS were high neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII) (for stages I and III), and low prognostic nutritional index (PNI) (regardless tumour stage). Background: The aim of this study was to evaluate different preoperative immune, inflammatory, and nutritional scores and their best cut-off values as predictors of poorer overall survival (OS) and disease-free survival (DFS) in patients who underwent curative gastric cancer resection. Methods: This was a retrospective observational multicentre study based on data of the Spanish EURECCA Esophagogastric Cancer Registry. Time-dependent Youden index and log-rank test were used to obtain the best cut-offs of 18 preoperative biomarkers for OS and DFS. An adjusted Cox model with variables selected by bootstrapping was used to identify the best preoperative biomarkers, which were also analysed for every TNM stage. Results: High neutrophil-to-lymphocyte ratio (NLR), high monocyte systemic inflammation index (moSII), and low prognostic nutritional index (PNI) were identified as independent predictors of poor outcome: NLR > 5.91 (HR:1.73; 95%CI [1.23–2.43]), moSII >2027.12 (HR:2.26; 95%CI [1.36–3.78]), and PNI >40.31 (HR:0.75; 95%CI [0.58–0.96]) for 5-year OS and NLR > 6.81 (HR:1.75; 95%CI [1.24–2.45]), moSII > 2027.12 (HR:2.46; 95%CI [1.49–4.04]), and PNI > 40.31 (HR:0.77; 95%CI [0.60,0.97]) for 5-year DFS. These outcomes were maintained in the whole cohort for NLR and moSII (p < 0.05) but not in stage II and for PNI in all tumoral stages. The associations of NLR-PNI and moSII-PNI were also a relevant prognostic factor for OS. Conclusions: High NLR, high moSII (for stages I and III), and low PNI (regardless of tumour stage) were the most promising preoperative biomarkers to predict poor OS and DFS in gastric cancer patients treated with curative intent. [ABSTRACT FROM AUTHOR]

The prevalence of dermatological conditions in primary care, coupled with challenges such as dermatologist shortages and rising consultation costs, highlights the need for innovative solutions. Artificial intelligence (AI) holds promise for improving the diagnostic analysis of skin lesion images, potentially enhancing patient care in primary settings. This systematic review following PRISMA guidelines examined primary studies (2012–2022) assessing AI algorithms' diagnostic accuracy for skin diseases in primary care. Studies were screened for eligibility based on their availability in the English language and exclusion criteria, with risk of bias evaluated using QUADAS-2. PubMed, Scopus, and Web of Science were searched. Fifteen studies (2019–2022), primarily from Europe and the USA, focusing on diagnostic accuracy were included. Sensitivity ranged from 58% to 96.1%, with accuracies varying from 0.41 to 0.93. AI applications encompassed triage and diagnostic support across diverse skin conditions in primary care settings, involving both patients and primary care professionals. While AI demonstrates potential for enhancing the accuracy of skin disease diagnostics in primary care, further research is imperative to address study heterogeneity and ensure algorithm reliability across diverse populations. Future investigations should prioritise robust dataset development and consider representative patient samples. Overall, AI may improve dermatological diagnosis in primary care, but careful consideration of algorithm limitations and implementation strategies is required. [ABSTRACT FROM AUTHOR]

This study delves into the intricate dynamics of urban mobility, a pivotal aspect for policymakers, businesses, and communities alike. By deciphering patterns of movement within a city, stakeholders can craft targeted interventions to mitigate traffic congestion peaks, optimizing both resource allocation and individual travel routes. Focused on Barcelona, Spain, this paper draws on data sourced from the city council's open data service. Through a blend of exploratory analysis, visualization techniques, and modeling methodologies—including time series analysis and the eXtreme Gradient Boosting (XGBoost) algorithm—the research endeavors to forecast traffic conditions. Additionally, a study of variable importance is carried out, and Shapley Additive Explanations are applied to enhance the interpretability of model outputs. Findings underscore the limitations of traditional forecasting methods in capturing the nuanced spatial and temporal dependencies present in traffic flows, particularly over medium- to long-term horizons. However, the XGBoost model demonstrates robust performance, with the area under ROC curves consistently exceeding 80%, indicating its efficacy in handling non-linear traffic data variables. [ABSTRACT FROM AUTHOR]

Simple Summary: Selenium and iodine are two microelements necessary for a normal thyroid hormone metabolism, and their deficiency in human diets can result in a significant health problem. Milk is a good vehicle for mineral enrichment and an available food for the general population. Thus, the main objective of this study was to evaluate the combined dietary intake of iodine and two chemical forms of selenium in dairy cows, at the maximum levels permitted in the European Union, in order to obtain milk, cheese, and yogurt naturally enriched in these microminerals. As a result, animal performance and the overall health status of cows were not negatively affected by the diets. However, selenium and iodine were successfully transferred to milk, increasing the level of both minerals in cheese and increasing the iodine level in yogurt, without harming the quality or acceptance. Therefore, the value-added products obtained could contribute in a realistic way to improve the current supply in the market to enhance the intake of selenium and iodine in the human population. This study evaluated the effects of dietary supplementation in dairy cows with two Se forms (organic and inorganic) and I at the maximum levels permitted in the European Union, with the aim to obtain naturally enriched milk and derived products. A total of 20 Holstein Friesian cows in lactation were fed 2 diets for 64 days: a control diet with a supply of 0.57 mg of inorganic Se and 0.57 mg of I per kg of ration in dry matter (DM), and an experimental diet (SeI) with a supply of 0.34 mg of inorganic Se, 0.23 mg of organic Se, and 5.68 mg of I per kg of ration in DM. The SeI diet did not modify the performance or, in general, the metabolic profile of cows. Se and I levels in milk were affected by diet type and time of measurement (p < 0.01). Thus, a marked increase of both microminerals was evident between the beginning and the end of the test, when the SeI diet was administered. For Se, this increase ranged from 1.95 to 3.29 μg/100 g of milk; and for I, from 19.69 to 110.06 μg/100 g of milk. The SeI diet increased (p < 0.01) the Se and I content in the cheese, reaching levels of 16.4 μg/100 g for Se and 269.7 μg/100 g for I. An increase in I was observed in yogurt from the SeI diet (p < 0.001). The supplementation of two forms of Se and I in the cows' ration, at the levels evaluated, produced milk and dairy products enriched in these microelements without altering their quality parameters. However, a responsible intake of these products is necessary to avoid risks of deficiencies or excesses that could negatively affect the health of consumers. [ABSTRACT FROM AUTHOR]

Simple Summary: ProAKAP4, as a AKAP4 precursor, is the main protein of the spermatozoa flagellum in mammals. AKAP4, A-kinase anchor protein, is involved in sperm motility. The objective of the present study was to evaluate the evolution of proAKAP4 in horse semen post-thawing conditions during 3 h and its relationship with motility descriptors and mitochondrial membrane potential in the same conditions. The evolution in post-thawing conditions is the same either in proAKAP4 and motility parameters which gather that proAKAP4 can predict the evolution of the motility over the time. ProAKAP4, a precursor of AKAP4 (A-kinase anchor protein) found in the flagellum of mammalian and non-mammalian spermatozoa, serves as a structural protein with established correlations to motility parameters across diverse species. This study aimed to determine the proAKAP4 level evolution in thawed stallion semen over a 3 h period, examining its correlation with motility descriptors and mitochondrial membrane potential. Utilizing sixteen ejaculates from four French warmblood stallions, this study involved maintaining thawed samples at 37 °C for 3 h, conducting proAKAP4 enzyme-linked immunosorbent assays (ELISA), computer-assisted sperm analysis (CASA), and mitochondrial membrane potential by JC-1 probe and flow cytometry at 0, 1, and 3 h post-thawing. The findings indicate significant positive correlations (p ≤ 0.05) between proAKAP4 levels and sperm total or progressive motility at all time points analyzed. Spermatozoa velocity descriptors (VAP, VCL, VSL) and spermatozoa lateral head displacement (ALH) display positive correlations (p ≤ 0.05) with ProAKAP4 at the 0 h post-thawing. ProAKAP4 concentration exhibits no discernible difference between batches with or without a cryoprotectant. Notably, proAKAP4 consumption remains insignificant within the initial hour after thawing but becomes significant (p ≤ 0.05) between 1 and 3 h post-thawing. In summary, proAKAP4 demonstrates positive correlations with total and progressive motility in stallion semen for up to 3 h after thawing, albeit showing a noticeable decrease starting from the first hour post-thawing, indicating a progressive consumption as a result of spermatozoa motile activity. [ABSTRACT FROM AUTHOR]

African swine fever (ASF) is a deadly disease of swine currently causing a worldwide pandemic, leading to severe economic consequences for the porcine industry. The control of disease spread is hampered by the limitation of available effective vaccines. Live attenuated vaccines (LAVs) are currently the most advanced vaccine prototypes, providing strong protection against ASF. However, the significant advances achieved using LAVs must be complemented with further studies to analyze vaccine-induced immunity. Here, we characterized the onset of cross-protective immunity triggered by the LAV candidate BA71ΔCD2. Intranasally vaccinated pigs were challenged with the virulent Georgia 2007/1 strain at days 3, 7 and 12 postvaccination. Only the animals vaccinated 12 days before the challenge had effectively controlled infection progression, showing low virus loads, minor clinical signs and a lack of the unbalanced inflammatory response characteristic of severe disease. Contrarily, the animals vaccinated 3 or 7 days before the challenge just showed a minor delay in disease progression. An analysis of the humoral response and whole blood transcriptome signatures demonstrated that the control of infection was associated with the presence of virus-specific IgG and a cytotoxic response before the challenge. These results contribute to our understanding of protective immunity induced by LAV-based vaccines, encouraging their use in emergency responses in ASF-affected areas. [ABSTRACT FROM AUTHOR]

Simple Summary: In the present framework of constraints on healthcare budgets, an assessment of costs of antineoplastic drugs is a crucial step in contributing to the sustainability of public-payer systems. This study evaluated the characteristics of cancer clinical trials and potential drug cost avoidance in a large population of adult cancer patients with solid tumors enrolled in clinical trials over a 10-year period (2010–2019). These trials were conducted at the Medical Oncology Department of Vall d'Hebron University Hospital in Barcelona (Spain), one of the largest tertiary care centers in the country. Based on the data of 2930 clinical trials with 10,488 participants, it was found that the total cost of antineoplastic drugs supplied by sponsors in the clinical trials setting was EUR 107,306,084, with a potential cost savings of EUR 92,662,609. Participation in sponsored clinical trials in which drugs are provided free of charge yields considerable cost savings, with benefits in clinical strategies to reduce drug expenditures. The objective of this single-center retrospective study was to describe the clinical characteristics of adult patients with solid tumors enrolled in cancer clinical trials over a 10-year period (2010–2019) and to assess drug cost avoidance (DCA) associated with sponsors' contributions. The sponsors' contribution to pharmaceutical expenditure was calculated according to the actual price (for each year) of pharmaceutical specialties that the Vall d'Hebron University Hospital (HUVH) would have had to bear in the absence of sponsorship. A total of 2930 clinical trials were conducted with 10,488 participants. There were 140 trials in 2010 and 459 in 2019 (228% increase). Clinical trials of high complexity phase I and basket trials accounted for 34.3% of all trials. There has been a large variation in the pattern of clinical research over the study period, whereas, in 2010, targeted therapy accounted for 79.4% of expenditure and cytotoxic drugs for 20.6%; in 2019, immunotherapy accounted for 68.4%, targeted therapy for 24.4%, and cytotoxic drugs for only 7.1%. A total of four hundred twenty-one different antineoplastic agents were used, the variability of which increased from forty-seven agents in 2010, with only seven of them accounting for 92.8% of the overall pharmaceutical expenditure) to three hundred seventeen different antineoplastic agents in 2019, with thirty-three of them accounting for 90.6% of the overall expenditure. The overall expenditure on antineoplastic drugs in clinical care patients not included in clinical trials was EUR 120,396,096. The total cost of antineoplastic drugs supplied by sponsors in a clinical trial setting was EUR 107,306,084, with a potential DCA of EUR 92,662,609. Overall, clinical trials provide not only the best context for the progress of clinical research and healthcare but also create opportunities for reducing cancer care costs. [ABSTRACT FROM AUTHOR]

This study introduces a deep learning surrogate model designed to predict the evolution of the mean pressure coefficient on the back face of a Windsor body across a range of yaw angles from 2. 5 ∘ to 10 ∘ . Utilizing a variational autoencoder (VAE), the model effectively compresses snapshots of back pressure taken at yaw angles of 2. 5 ∘ , 5 ∘ , and 10 ∘ into two latent vectors. These snapshots are derived from wall-modeled large eddy simulations (WMLESs) conducted at a Reynolds number of R e L = 2.9 × 10 6 . The frequencies that dominate the latent vectors correspond closely with those observed in both the drag's temporal evolution and the dynamic mode decomposition. The projection of the mean pressure coefficient to the latent space yields an increasing linear evolution of the two latent variables with the yaw angle. The mean pressure coefficient distribution at a yaw angle of 7. 5 ∘ is predicted with a mean error of e ¯ = 3.13 % when compared to the WMLESs results after obtaining the values of the latent space with linear interpolation. [ABSTRACT FROM AUTHOR]

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics. [ABSTRACT FROM AUTHOR]

In the field of aircraft engine diagnostics, many advanced algorithms have been proposed over the last few years. However, there is still wide room for improvement, especially in the development of more integrated and complete engine health management systems to detect, identify, and forecast complex faults in a short time. Furthermore, it is necessary to ensure that these systems preserve their capabilities over time despite engine deterioration. This paper addresses these necessities by proposing an integrated system that considers the joint operation of feature extraction, anomaly detection, fault identification, and prognostic algorithms for engines with long operation times. To effectively reveal the actual engine condition, light adaptive degraded engine models are computed along with different health indicators that are used as inputs to train and test recognition and prediction models. The system is developed and evaluated using a specialized NASA platform which provides data from a turbofan engine fleet simultaneously experiencing long-term performance deterioration and faults. Contrary to other compared solutions, our results show that the proposed system is robust against the effects of engine deterioration, maintaining its level of detection, recognition, and prediction accuracy over a total engine service life. The low computational cost algorithms has generally fast performance in all stages, making the system suitable for online applications. [ABSTRACT FROM AUTHOR]

Cryopreservation is a stressful process for sperm, as it is associated with an increased production of reactive oxygen species (ROS). Elevated ROS levels, which create an imbalance with antioxidant capacity, may result in membrane lipid peroxidation (LPO), protein damage and DNA fragmentation. This study aimed to determine whether the membrane LPO and DNA fragmentation of frozen–thawed horse sperm relies upon antioxidant activity, including enzymes (superoxide dismutase (SOD), glutathione peroxidase (GPX), catalase (CAT) and paraoxonase type 1 (PON1)); non-enzymatic antioxidant capacity (Trolox-equivalent antioxidant capacity (TEAC), plasma ferric reducing antioxidant capacity (FRAP) and cupric reducing antioxidant capacity (CUPRAC)); and the oxidative stress index (OSI) of their seminal plasma (SP). Based on total motility and plasma membrane integrity (SYBR14+/PI−) after thawing, ejaculates were hierarchically (p < 0.001) clustered into two groups of good- (GFEs) and poor-(PFEs) freezability ejaculates. LPO and DNA fragmentation (global DNA breaks) were higher (p < 0.05) in the PFE group than in the GFE group, with LPO and DNA fragmentation (global DNA breaks) after thawing showing a positive relationship (p < 0.05) with SP OSI levels and ROS production. In addition, sperm motility and membrane integrity after thawing were negatively (p < 0.05) correlated with the activity levels of SP antioxidants (PON1 and TEAC). The present results indicate that LPO and DNA fragmentation in frozen–thawed horse sperm vary between ejaculates. These differences could result from variations in the activity of antioxidants (PON1 and TEAC) and the balance between the oxidant and antioxidant components present in the SP. [ABSTRACT FROM AUTHOR]

Risk-stratified pathways (RSPs) are recommended by the European Association of Uro-logy (EAU) to improve the early detection of clinically significant prostate cancer (csPCa). RSPs can reduce magnetic resonance imaging (MRI) demand, prostate biopsies, and the over-detection of insignificant PCa (iPCa). Our goal is to analyze the efficacy and cost-effectiveness of several RSPs by using sequential stratifications from the serum prostate-specific antigen level and digital rectal examination, the Barcelona risk calculators (BCN-RCs), MRI, and Proclarix™. In a cohort of 567 men with a serum PSA level above 3.0 ng/mL who underwent multiparametric MRI (mpMRI) and targeted and/or systematic biopsies, the risk of csPCa was retrospectively assessed using Proclarix™ and BCN-RCs 1 and 2. Six RSPs were compared with those recommended by the EAU that, stratifying men from MRI, avoided 16.7% of prostate biopsies with a prostate imaging–reporting and data system score of <3, with 2.6% of csPCa cases remaining undetected. The most effective RSP avoided mpMRI exams in men with a serum PSA level of >10 ng/mL and suspicious DRE, following stratifications from BCN-RC 1, mpMRI, and Proclarix™. The demand for mpMRI decreased by 19.9%, prostate biopsies by 19.8%, and over-detection of iPCa by 22.7%, while 2.6% of csPCa remained undetected as in the recommended RSP. Cost-effectiveness remained when the Proclarix™ price was assumed to be below EUR 200. [ABSTRACT FROM AUTHOR]

TRPV4 channels, which respond to mechanical activation by permeating Ca2+ into the cell, may play a pivotal role in cardiac remodeling during cardiac overload. Our study aimed to investigate TRPV4 involvement in pathological and physiological remodeling through Ca2+-dependent signaling. TRPV4 expression was assessed in heart failure (HF) models, induced by isoproterenol infusion or transverse aortic constriction, and in exercise-induced adaptive remodeling models. The impact of genetic TRPV4 inhibition on HF was studied by echocardiography, histology, gene and protein analysis, arrhythmia inducibility, Ca2+ dynamics, calcineurin (CN) activity, and NFAT nuclear translocation. TRPV4 expression exclusively increased in HF models, strongly correlating with fibrosis. Isoproterenol-administered transgenic TRPV4−/− mice did not exhibit HF features. Cardiac fibroblasts (CFb) from TRPV4+/+ animals, compared to TRPV4−/−, displayed significant TRPV4 overexpression, elevated Ca2+ influx, and enhanced CN/NFATc3 pathway activation. TRPC6 expression paralleled that of TRPV4 in all models, with no increase in TRPV4−/− mice. In cultured CFb, the activation of TRPV4 by GSK1016790A increased TRPC6 expression, which led to enhanced CN/NFATc3 activation through synergistic action of both channels. In conclusion, TRPV4 channels contribute to pathological remodeling by promoting fibrosis and inducing TRPC6 upregulation through the activation of Ca2+-dependent CN/NFATc3 signaling. These results pose TRPV4 as a primary mediator of the pathological response. [ABSTRACT FROM AUTHOR]

This study evaluated the long-term changes in precipitation patterns and drought conditions in one of the key recharge areas of the hydrological system of southern and southeastern Spain, namely, the Sierra de Cazorla y Segura, which contains the headwater sectors of the catchment basins of two important rivers, namely, the Guadalquivir and the Segura. The research covered a period of 70 years (1952–2021) and undertook an exhaustive analysis of data from 348 pluviometric stations. The most relevant results are as follows: (1) most areas experienced a decrease in the precipitation volume and number of rainy days during the study period; (2) summer and winter showed the most significant decreases; (3) weak and moderate precipitation (<40 mm/d) showed significant decreases in both volume and frequency, while heavy precipitation (≥40 mm/d) showed the opposite behavior; (4) the durations of dry periods increased, while the durations of wet periods decreased in most areas; and (5) the SPEI showed an increase under drought conditions. This research underscores the need for water resource management and resilience strategies with interdisciplinary relevance in the face of changing hydrological patterns. [ABSTRACT FROM AUTHOR]

Concerns exist regarding the effects of 5-alpha reductase inhibitors (5-ARIs) on multipa-rametric magnetic resonance imaging (mpMRI) and clinically significant prostate cancer (csPCa) detection. Our objective is to analyze the effect of 5-ARI on the prostate imaging–reporting and data system (PI-RADS) distribution and csPCa and insignificant PCa (iPCa) detection. Among 2212 men with serum prostate-specific antigen levels of >3.0 ng/mL and/or suspicious digital rectal examinations who underwent mpMRI and targeted and/or systematic biopsies, 120 individuals exposed to 5-ARI treatment for over a year were identified. CsPCa was defined when the grade group (GG) was >2. The overall csPCa and iPCa detection rates were 44.6% and 18.8%, respectively. Since logistic regression revealed independent predictors of PCa, a randomized matched group of 236 individuals was selected for analysis. The PI-RADS distribution was comparable with 5-ARI exposure (p 0.685). The CsPCa detection rates in 5-ARI-naïve men and 5-ARI-exposed men were 52.6% and 47.4%, respectively (p 0.596). IPCa was detected in 37.6 and 62.5%, respectively (p 0.089). The tumor GG distribution based on 5-ARI exposure was similar (p 0.149) to the rates of csPCa and iPCa across the PI-RADS categories. We conclude that exposure to 5-ARI in suspected PCa men did not change the PI-RADS distribution and the csPCa and iPCa detection rates. [ABSTRACT FROM AUTHOR]

(Background) Esophagectomy (EPG) presents high morbidity and mortality. Omega-3 fatty acids (ω-3FA) are a pharmaconutrient with benefits for postoperative morbidity. Studies of ω-3FA administered parenterally after esophagectomy are scarce. This study proposes to investigate the effect of combining fish oil lipid emulsions (LE) administered parenterally with enteral nutrition support. (Methods) Randomization was 1:1:1 in three groups: Group A received a LE mixture of 0.4 g/kg/day of fish oil and 0.4 g/kg/day of LCT/MCT 50:50, Group B received 0.8 g/kg/day of fish oil LE, and Group C received 0.8 g/kg/day of LCT/MCT 50:50. Variables were measured at recruitment time and day +1, +3, and +5. Inflammatory variables studied were Interlukin-6, C-reactive protein (CRP), tumoral necrosis factor-α (TNF-α), IL-10, IL-8 and CD25s. Safety, nutritional parameters and complications were analyzed. (Results) Administration of ω-3LE in the immediate postoperative period did not modulate the earlier inflammatory response. Statistically significant differences were found in IL-6 and CRP overall temporal evolution but were not found when studying the type of LE administered or in patients needing critical care. Administration of ω-3 resulted in safe and improved hypertriglyceridemia, depending on the dose. (Conclusions) ω-3FA has no impact on the early inflammatory postoperative response assessed for a short period but was safe. More studies for longer periods are needed. [ABSTRACT FROM AUTHOR]

The magnitude and direction of inter-limb asymmetries in a change of direction (COD) have increased interest in scientific research in recent years. This present study aimed to investigate the magnitude of asymmetries in an elite youth female basketball sample (n = 18, age = 17.79 ± 0.67 y) and determine its directionality using force platform technology. Participants performed 70° and 180° COD tests analyzing the following variables: time, ground contact time (GCT) and ground reaction forces (GRF) along the anterior–posterior, mediolateral, and vertical axes. Inter-limb asymmetries were evident in both COD tests, with substantial differences observed between limbs (p < 0.01). The asymmetry values ranged from 3.02% to 24.31% in COD 180° and from 1.99% to 21.70% in COD 70°, with anterior–posterior GRF consistently exhibiting the highest asymmetry magnitude. Additionally, the directionality exhibited variability between the tests, indicating poor agreement and suggesting the independent directionality of asymmetries across tasks. Moreover, players required more time to complete the COD 180°, the GCT was noticeably longer for the COD 180° than for the COD 70°, and GRF varied across the axis, suggesting that players adapt uniquely to the specific demands of each task. The utilization of force platforms presents a comprehensive approach to assess asymmetries and COD variables performance variables which are "angle-dependent", which could have important implications for COD screening and effective training interventions. [ABSTRACT FROM AUTHOR]

Primary care antimicrobial stewardship program (ASP) interventions can reduce the over-prescription of unnecessary antibiotics, but the impact on the reduction in bacterial resistance is less known, and there is a lack of available data. We implemented a prolonged educational counseling ASP in a large regional outpatient setting to assess its feasibility and effectiveness. Over a 5-year post-implementation period, which was compared to a pre-intervention period, a significant reduction in antibiotic prescriptions occurred, particularly those associated with greater harmful effects and resistance selection. There was also a decrease in methicillin-resistant Staphylococcus aureus (MRSA) strains and in their co-resistance to other antibiotics, particularly those with an ecological impact. [ABSTRACT FROM AUTHOR]

Simple Summary: There is an increasing interest in measuring biomarkers from saliva, as samples can be obtained noninvasively. This is particularly true in pigs where blood sampling is technically complicated and stressful. In pigs, studies regarding how the absorbent material used for collection affects analytical results are scarce. The aim of this study was to evaluate how the material used for saliva collection can affect the results of analyses for the different types of biomarkers that can be measured in the saliva of pigs. In this report, polypropylene sponges gave higher sample saliva volumes and, in some salivary analytes, provided different values compared with cotton rolls. Therefore, it can be concluded that the type of material used can influence the results of saliva analysis. The use of saliva as a biological sample from pigs is of high practical interest because blood collection from pigs is difficult and stressful. In this study, the influence of two different materials, a cotton roll and a polypropylene sponge, in porcine saliva collection was evaluated. For this purpose, the effect of the material used for sampling was evaluated in a panel of 13 analytes, including those related to stress (cortisol and oxytocin), inflammation and immunity (adenosine deaminase, haptoglobin and myeloperoxidase), redox homeostasis (the cupric reducing ability of saliva, the ferric reducing activity of saliva, and the Trolox equivalent antioxidant capacity), and sepsis (procalcitonin), as well as other routine analytes related to metabolism and different tissues and organs, such as lactate dehydrogenase, creatine kinase, urea, and total protein concentration. The polypropylene sponge provided a higher sample volume than the cotton roll. Although the results of some salivary analytes were equivalent for both materials, other analytes, such as creatine kinase, haptoglobin and total proteins, showed significant differences depending on the material used for saliva collection. Therefore, the type of material used for salivary collection in pigs should be considered when interpreting the results of analyses of the salivary analytes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Redistribution hypothermia occurs during anesthesia despite active intraoperative warming. Prewarming increases the heat absorption by peripheral tissue, reducing the central to peripheral heat gradient. Therefore, the addition of prewarming may offer a greater preservation of intraoperative normothermia as compared to intraoperative warming only. Materials and Methods: A single-center clinical trial of adults scheduled for non-cardiac surgery. Patients were randomized to receive or not a prewarming period (at least 10 min) with convective air devices. Intraoperative temperature management was identical in both groups and performed according to a local protocol. The primary endpoint was the incidence, the magnitude and the duration of hypothermia (according to surgical time) between anesthetic induction and arrival at the recovery room. Secondary outcomes were core temperature on arrival in operating room, surgical site infections, blood losses, transfusions, patient discomfort (i.e., shivering), reintervention and hospital stay. Results: In total, 197 patients were analyzed: 104 in the control group and 93 in the prewarming group. Core temperature during the intra-operative period was similar between groups (p = 0.45). Median prewarming lasted 27 (17–38) min. Regarding hypothermia, we found no differences in incidence (controls: 33.7%, prewarming: 39.8%; p = 0.37), duration (controls: 41.6% (17.8–78.1), prewarming: 45.2% (20.6–71.1); p = 0.83) and magnitude (controls: 0.19 °C · h−1 (0.09–0.54), prewarming: 0.20 °C · h−1 (0.05–0.70); p = 0.91). Preoperative thermal discomfort was more frequent in the prewarming group (15.1% vs. 0%; p < 0.01). The interruption of intraoperative warming was more common in the prewarming group (16.1% vs. 6.7%; p = 0.03), but no differences were seen in other secondary endpoints. Conclusions: A preoperative prewarming period does not reduce the incidence, duration and magnitude of intraoperative hypothermia. These results should be interpreted considering a strict protocol for perioperative temperature management and the low incidence of hypothermia in controls. [ABSTRACT FROM AUTHOR]

Simple Summary: In recent years, the pig industry has focused on genetic selection based on prolificacy. However, this has resulted in heterogeneous litters, more low-birth-weight piglets, and an increase in the incidence of piglets being born with intrauterine growth restriction (IUGR), decreasing the survival rate. Thus, the aim of this study was to advance the haematological and biochemical knowledge of IUGR piglets in the first days of life and evaluate their possible changes compared to normal piglets. At 72 h of life, we found differences in the parameters studied. IUGR piglets showed changes in red and white blood cells, reticulocytes indices, and some biochemical parameters, which indicated immaturity. The results provide information on the analytical profile of IUGR piglets and suggest that the divergence of the two groups of piglets is evident a few hours after birth. Intrauterine growth restriction in piglets has been a problem in the pig industry due to genetic selection based on hyperprolificacy. This has led to an increase in the number of underweight piglets and a worsening of the survival rate. The goal of this study was to enhance the knowledge of differences between normal and IUGR piglets a few hours after birth in terms of haematological variables, biochemical parameters, and immunoglobulin levels. Two groups of 20 piglets each were assessed. The control group (N) was made up of piglets with weights greater than 1500 g, and the IUGR group consisted of piglets weighing 500–1000 g and with at least two IUGR features. Blood samples were collected 72 h after birth for analysis of the red and white blood cell parameters, reticulocyte indices, platelet indices, biochemical parameters, and immunoglobulin levels. Alterations in red blood cells and reticulocytes, a lower lymphocyte count, hyperinsulinemia, and high oxidative stress were observed in IUGR piglets (p < 0.05). In contrast, differences were not observed (p > 0.05) in the serum immunoglobulin level. It can be concluded that the haematological and biochemical differences in IUGR piglets with respect to normal-weight piglets are present at birth indicating possible alterations in immunity, metabolism, and redox status; therefore, IUGR piglets could be more vulnerable to illness and future disorders, such as metabolic syndrome. [ABSTRACT FROM AUTHOR]

We investigated differences in mpox clinical outcomes in people with HIV (PWH) and without HIV (PWoH) and the impact of vaccination in Catalonia, Spain. We used surveillance data and the PISCIS HIV cohort. We included all confirmed mpox cases (May–December 2022). Of 2122 mpox cases, the majority had mild disease, 56% were Spanish, and 24% were from Latin America. A total of 40% were PWH, with a median CD4+T-cell of 715 cells/μL; 83% had HIV-RNA < 50 copies/mL; and 1.8% CD4+T-cell < 200 cells/μL. PWH had no increased risk for complications, except those with CD4+T-cell < 200 cells/μL. PWH with CD4+T-cell < 200 cells/μL were more likely to be from Latin America, had more generalized exanthema, and required hospitalization more frequently (p = 0.001). Diagnosis of other sexually transmitted infections (STIs) was common, both at mpox diagnosis (17%) and two years before (43%). Dose-sparing smallpox intradermal vaccination was accompanied by a sharp decrease in mpox incidence in both populations (p < 0.0001). In conclusion, unless immunosuppressed, PWH were not at increased risk of severe disease or hospitalization. Mpox is a marker of high-risk sexual behavior and was associated with high HIV and STI rates, supporting the need for screening in all mpox cases. Ethnicity disparities demonstrate the need for interventions to ensure equitable healthcare access. Dose-sparing smallpox vaccination retained effectiveness. [ABSTRACT FROM AUTHOR]

Asphalt is an essential material in the construction of asphalt pavements. Due to its high demand and dependence on petroleum, it is crucial to use greener materials that can fully or partially replace petroleum-based binders. The characteristics of asphalt cause the bio-binder obtained through a hydrothermal liquefaction process from swine manure to have great potential to be used as a modifier due to its similarities with asphalt, contributing to the construction of more sustainable roads. Thus, this paper characterizes an asphalt binder modified with a new bio-binder obtained from swine manure at different rates (0%, 10%, and 20%). Several characterization tests were performed, including penetration, ring and ball, Fraass, viscosity, Cleveland open cup, and the UCL method. Furthermore, the possible leaching of the bio-binder was studied, showing no environmental problems. Results from the rheological tests showed that as the content of bio-binder increases, the softening temperature, Fraass breaking point, and viscosity of the bio-modified asphalt binder decrease, indicating the lower consistency of the bio-modified binder and its greater thermal susceptibility. [ABSTRACT FROM AUTHOR]

Photoluminescent materials used on street and road pavements could absorb solar energy during the day and emit it at night, which will save energy and improve visibility with a consequent improvement in road safety. The aim of this study is to evaluate the luminance of different photoluminescent applications for pavements (bituminous mixes, mortars, and paints) in which strontium aluminate and glass beads were used. Sunlight was simulated with two bulbs, one LED and one UV bulb, inside a measuring apparatus specially developed for this work. The luminance of the different designed solutions was determined at different time periods after their excitation. The results obtained showed that luminescent paints can reach higher luminance than bituminous mixes and mortars. The colour of the base surface on which the paints are applied had a great influence on the obtained luminance, which increases with the aluminate and glass beads content. Among all the solutions evaluated, the paint made with 60% aluminate and 6% glass beads, spread on a white surface, allowed the highest luminance values to be obtained. This study leads to the conclusion that it is possible to achieve a good photoluminescent level while economising on the amount of materials necessary. [ABSTRACT FROM AUTHOR]

Simple Summary: Insects are valuable alternatives to traditional protein sources for animal feed. Certain species have demonstrated that they can efficiently convert low-nutrient materials into quality body mass, making these species a viable protein and fat source. This study explores the effect of three agricultural by-products (broccoli by-product, tigernut pulp, and grape pomace) on the performance, digestive use, and proximate composition of Tenebrio molitor larvae. The growth and composition of the larvae were influenced by the type of by-product used, with the most protein-rich by-product resulting in larger larval biomass. However, diets based solely on a single by-product may penalize larval productivity and diet digestibility. The amino acid profiles of the insects were similar in all larvae, regardless of the diet, suggesting that these by-products can be used for insect rearing, achieving a sustainable production system aligning with the circular economy approach adopted globally. Humanity's growing demand for animal protein exceeds the capacity of traditional protein sources to support growing livestock production. Insects offer promising partial substitutes, converting low-nutritional quality materials into high-value biomass. Hence, the bioconversion ability of Tenebrio molitor larvae was assessed by using three types of agricultural by-products (broccoli by-product, tigernut pulp, and grape pomace) at different inclusion levels (0%, 25%, 50%, and 100%) in a carbohydrate-based diet. Ten diets were formulated to assess their impact on the growth, diet digestibility, and nutritional composition of the larvae. For each treatment, eight replicates were employed: five for the growth-performance-digestibility trial and three for the complementary test of uric acid determination. The growth was influenced by the type of diet administered. The broccoli by-product resulted in higher larvae weight and a better feed conversion ratio. However, diets based solely on a single by-product (100%) compromised the productivity and diet digestibility. The larvae changed their nutritional composition depending on the rearing substrate, although the amino acid profile remained consistent. In conclusion, the studied by-products have the potential for use in T. molitor rearing as part of the diet but not as the exclusive ingredients, indicating promising opportunities for using agricultural by-products in T. molitor rearing and production. [ABSTRACT FROM AUTHOR]

This study aimed to characterize patients admitted to critical care following Emergency Department (ED) presentation with acute recreational drug toxicity and to identify determinants of admission to critical care. A retrospective multicenter matched case-control study was conducted by the European Drug Emergency Network Plus (Euro-DEN Plus) over the period 2014–2021. The cases were ED presentations with acute recreational drug toxicity admitted to critical care, the controls consisted of ED presentations with acute recreational drug toxicity medically discharged directly from the ED. The potential determinants of admission to critical care were assessed through multivariable conditional stepwise logistic regression analysis and multiple imputation was used to account for the missing data. From 2014 to 2021, 3448 Euro-DEN Plus presentations involved patients admitted to critical care (76.9% males; mean age 33.2 years; SD 10.9 years). Patient age ≥35 years (as compared to ≤18 years) was a determinant of admission to critical care following acute recreational drug toxicity (adjusted odds ratio, aOR, 1.51, 95% confidence interval, CI, 1.15–1.99), along with polydrug use (aOR 1.39, 95% CI 1.22–1.59), ethanol co-ingestion (aOR 1.44, 95% CI 1.26–1.64), and the use of gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL, aOR 3.08, 95% CI 2.66–3.57). Conversely, lower odds of admission to critical care were associated with the use of cocaine (aOR 0.85, 95% CI 0.74–0.99), cannabis (aOR 0.44, 95% CI 0.37–0.52), heroin (aOR 0.80, 95% CI 0.69–0.93), and amphetamine (aOR 0.65, 95% CI 0.54–0.78), as was the arrival to the ED during the night (8 p.m.–8 a.m., aOR 0.88, 95% CI 0.79–0.98). These findings, which deserve confirmation and further investigation, could contribute to a more complete understanding of the decision-making process underlying the admission to critical care of patients with acute recreational drug toxicity. [ABSTRACT FROM AUTHOR]

Camposeco et al. [[14]] developed highly efficient Au/ZnO-ZrO SB 2 sb catalysts for CO oxidation at a low temperature. The catalysts were evaluated for total propane oxidation, with the Fe SB 0.50 sb Mn SB 0.50 sb O SB x sb catalyst being the most active for propane oxidation. 10.3390/catal13050834 6 Shah P.M., Bailey L.A., Morgan D.J., Taylor S.H. The Effect of Metal Ratio and Precipitation Agent on Highly Active Iron-Manganese Mixed Metal Oxide Catalysts for Propane Total Oxidation. It is shown that the catalysts obtained with treated ZSM-5 exhibit higher activity in the reactions of propane, and that n-hexane completes oxidation as opposed to the catalyst samples containing un-treated zeolite. [Extracted from the article]

Background: Cancer is one of the leading causes of morbidity and mortality in the world. Its growing incidence and prevalence, as well as the advances in diagnostic and treatment tools, motivate an open debate about the economic burden it may place on health systems and have raised concerns about access to this technological innovation. There is a lack of information on the detailed costs of pharmacological treatment of cancer in our health setting. In this context, it is necessary to know the use of drugs in cancer treatment in conditions of real clinical practice. A real-word, evidence-based retrospective cohort study was conducted at Vall d'Hebron University Hospital (VHUH), the largest hospital complex in Catalonia, Spain, in order to determine the use of drugs and the associated cost in real clinical practice for the treatment of solid tumors in adult patients attended at this institution over 10 years (2010–2019). Methods: This was a single-center retrospective cohort study of adult cancer patients attended in clinical practice at the Medical Oncology Department of VHUH between 1 January 2010 and 31 December 2019. Data of prescription, preparation, and cost of antineoplastic treatments were analyzed by pharmacological class (cytotoxic drugs, immunotherapy, targeted therapy, radiopharmaceuticals, and others), by antineoplastic agent, and by type of tumor. The number of patients and the pharmaceutical expenditure corresponding to all these subgroups were recorded. The cost per patient in each tumor location was also calculated. Results: The study population included 13,209 patients with an overall pharmaceutical antineoplastic expenditure of EUR 120,396,097, increasing from 7.67% in relation to the total HUVH pharmaceutical expenditure in 2010 to 12.82% in 2019. By pharmacological class, the specific weight of the cost of targeted therapy is relevant (75.22% of pharmaceutical antineoplastic expenditure, 21.3% of patients) compared to the group of conventional cytotoxics (17.25% of pharmaceutical antineoplastic expenditure, 76.37% of patients), while immunotherapy has represented the largest relative increase, from 5% in 2014 to 12% in 2019. Eight targeted therapy drugs represented 50% of the costs of the targeted therapy drug class (palbociclib, trastuzumab, pertuzumab, bevacizumab, nivolumab, cetuximab, pembrolizumab, and trastuzumab emtansine). Eleven tumor sites accounted for 90% of the expenditure in 71% of all patients. Breast cancer had the highest expenditure during the study period (EUR 34,332,210) and at each individual year. Melanoma showed the highest increase, with 9.7% of total pharmaceutical antineoplastic expenditure in 2019 (2% of patients), representing a paradigm of the rising costs of cancer treatment due to the incorporation of new high-cost therapies. The average annual cost per patient was highly variable depending on the pathology. There was a growing increase in costs per patient in most tumor locations, particularly in patients with melanoma (from EUR 1922 in 2010 to EUR 37,020 in 2019), prostate cancer (from EUR 2992 in 2010 to EUR 14,118 in 2019), and non-small cell lung cancer (from EUR 3545 in 2010 to EUR 8371 in 2019). The relevance of the difference in monthly cost per patient that has been identified for the different intrinsic subtypes in breast cancer patients during 2019 (HER2+ EUR 2661/month, Luminal EUR 881/month, Triple negative EUR 386/month) makes us consider suggesting differentiated reimbursement rates for certain clinical conditions. Finally, support treatment with antiemetic drugs, erythropoietin stimulating agents, granulocyte-colony stimulating factor (G-CSF), and bone resorption inhibitors has involved a cost of EUR 5,751,910, which represents 4.6% of the overall pharmacological cost of cancer treatment. Conclusion: This study provides detailed insights on the oncological pharmaceutical expenditure for the treatment for solid tumors in the VHUH, based on real cost information from our hospital practice and for all antineoplastic therapies and types of solid tumors. This type of information on all the different types of cancer can be useful to better understand the economic burden of the disease and can be decisive for allocating public resources and funds for research, especially in those areas where information is scarce and therefore where further studies are needed. The contribution to knowledge of the cost of oncology therapy is of great value due to its realism and scope. [ABSTRACT FROM AUTHOR]

The rapid generation of data from various sources by the public sector, private corporations, business associations, and local communities is referred to as big data. This large and complex dataset is often regarded as the 'new oil' by public administrations (PAs), and data-driven approaches are employed to transform it into valuable insights that can improve governance, transparency, digital services, and public engagement. The government's big-data ecosystem (GBDE) is a result of this initiative. Effective data management is the first step towards large-scale data analysis, which yields insights that benefit your work and your customers. However, managing big data throughout its life cycle is a daunting challenge for public agencies. Despite its widespread use, big data management is still a significant obstacle. To address this issue, this study proposes a hybrid approach to secure the data management life cycle for GBDE. Specifically, we use a combination of the ECC algorithm with AES 128 BITS encryption to ensure that the data remain confidential and secure. We identified and analyzed various data life cycle models through a systematic literature review to create a data management life cycle for data-driven governments. This approach enhances the security and privacy of data management and addresses the challenges faced by public agencies. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer is a leading cause of death, both in the general population and in people with HIV. We aimed to assess temporal trends of cancer from 2006 to 2021 in two international HIV cohort collaborations (D:A:D and RESPOND). We assessed overall cancer, AIDS-defining cancers (ADCs), non-ADCs (NADCs), infection-related cancers, body mass index (BMI)-related cancers, and smoking-related cancers. Amongst almost 65,000 individuals, we found that the age-standardised incidence of all cancers remained fairly constant over time; however, the incidence of ADCs and infection-related cancers both decreased, whilst the incidence of NADCs, smoking-related cancers, and BMI-related cancers increased. Trends were similar after adjusting for demographics, comorbidities, and HIV-related factors. Our results highlight the need for better prevention strategies to reduce the incidence of NADCs, smoking-related cancers, and BMI-related cancers. Despite cancer being a leading comorbidity amongst individuals with HIV, there are limited data assessing cancer trends across different antiretroviral therapy (ART)-eras. We calculated age-standardised cancer incidence rates (IRs) from 2006–2021 in two international cohort collaborations (D:A:D and RESPOND). Poisson regression was used to assess temporal trends, adjusted for potential confounders. Amongst 64,937 individuals (31% ART-naïve at baseline) and 490,376 total person-years of follow-up (PYFU), there were 3763 incident cancers (IR 7.7/1000 PYFU [95% CI 7.4, 7.9]): 950 AIDS-defining cancers (ADCs), 2813 non-ADCs, 1677 infection-related cancers, 1372 smoking-related cancers, and 719 BMI-related cancers (groups were not mutually exclusive). Age-standardised IRs for overall cancer remained fairly constant over time (8.22/1000 PYFU [7.52, 8.97] in 2006–2007, 7.54 [6.59, 8.59] in 2020–2021). The incidence of ADCs (3.23 [2.79, 3.72], 0.99 [0.67, 1.42]) and infection-related cancers (4.83 [4.2, 5.41], 2.43 [1.90, 3.05]) decreased over time, whilst the incidence of non-ADCs (4.99 [4.44, 5.58], 6.55 [5.67, 7.53]), smoking-related cancers (2.38 [2.01, 2.79], 3.25 [2.63–3.96]), and BMI-related cancers (1.07 [0.83, 1.37], 1.88 [1.42, 2.44]) increased. Trends were similar after adjusting for demographics, comorbidities, HIV-related factors, and ART use. These results highlight the need for better prevention strategies to reduce the incidence of NADCs, smoking-, and BMI-related cancers. [ABSTRACT FROM AUTHOR]

The Streptococcus mitis-oralis subgroup of viridans group streptococci are important human pathogens. We previously showed that a substantial portion of S. mitis-oralis strains (>25%) are 'destined' to develop rapid, high-level, and stable daptomycin (DAP) resistance (DAP-R) during DAP exposures in vitro. Such DAP-R is often accompanied by perturbations in distinct membrane phenotypes and metabolic pathways. The current study evaluated two S. oralis bloodstream isolates, 73 and 205. Strain 73 developed stable, high-level DAP-R (minimum inhibitory concentration [MIC] > 256 µg/mL) within 2 days of in vitro DAP passage ("high level" DAP-R [HLDR]). In contrast, strain 205 evolved low-level and unstable DAP-R (MIC = 8 µg/mL) under the same exposure conditions in vitro ("non-HLDR"). Comparing the parental 73 vs. 73-D2 (HLDR) strain-pair, we observed the 73-D2 had the following major differences: (i) altered cell membrane (CM) phospholipid profiles, featuring the disappearance of phosphatidylglycerol (PG) and cardiolipin (CL), with accumulation of the PG-CL pathway precursor, phosphatidic acid (PA); (ii) enhanced CM fluidity; (iii) increased DAP surface binding; (iv) reduced growth rates; (v) decreased glucose utilization and lactate accumulation; and (vi) increased enzymatic activity within the glycolytic (i.e., lactate dehydrogenase [LDH]) and lipid biosynthetic (glycerol-3-phosphate dehydrogenase [GPDH]) pathways. In contrast, the 205 (non-HLDR) strain-pair did not show these same phenotypic or metabolic changes over the 2-day DAP exposure. WGS analyses confirmed the presence of mutations in genes involved in the above glycolytic and phospholipid biosynthetic pathways in the 73-D2 passage variant. These data suggest that S. oralis strains which are 'destined' to rapidly develop HLDR do so via a conserved cadre of genotypic, membrane phenotypic, and metabolic adaptations. [ABSTRACT FROM AUTHOR]

Urbanisation leading to habitat change and fragmentation is a recognised global threat to biodiversity. However, it may also offer opportunities for some species. Genetic diversity, one of the three components of biodiversity, is often overlooked in conservation planning and policy. In the present study, we used a panel of seven microsatellite markers to compare the genetic structure of 34 common frog (Rana temporaria) populations residing in urban and suburban drainage ponds in Inverness (Scotland) with populations from rural surroundings. As a main finding, the levels of genetic variation were indiscernible between (sub)urban and rural populations. Significant isolation-by-distance was observed only for rural populations, with measures of pairwise genetic differentiation (Fst) that were, on average, lower than those in urban and suburban areas. The mean numbers of alleles remained stable between two temporal sets of samples collected at intervals broadly representing one R. temporaria generation, but with a tendency of decreasing allelic richness, irrespectively of the site characteristics. Taking these results together, our study revealed that the elevated levels of differentiation between R. temporaria populations inhabiting (sub)urban drainage ponds did not lead to increased levels of genetic erosion. Our findings support the importance of well-designed blue–green infrastructure in urban landscapes for the retention of within-species genetic diversity and can help to inform future biodiversity management policies. [ABSTRACT FROM AUTHOR]

Background: Simultaneous liver resection and peritoneal cytoreduction with hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial today. The aim of the study was to analyze the postoperative outcomes and survival of patients with advanced metastatic colon cancer (peritoneal and/or liver metastases). Methods: Retrospective observational study from a prospective maintained data base. Patients who underwent a simultaneous peritoneal cytoreduction and liver resection plus HIPEC were studied. Postoperative outcomes and overall and disease free survival were analyzed. Univariate and multivariate analyses were performed. Results: From January 2010 to October 2022, 22 patients operated with peritoneal and liver metastasis (LR+) were compared with 87 patients operated with peritoneal metastasis alone (LR−). LR+ group presented higher serious morbidity (36.4 vs. 14.9%; p: 0.034). Postoperative mortality did not reach statistical difference. Median overall and disease free survival was similar. Peritoneal carcinomatosis index was the only predictive factor of survival. Conclusions: Simultaneous peritoneal and liver resection is associated with increased postoperative morbidity and hospital stay, but with similar postoperative mortality and OS and disease free survival. These results reflect the evolution of these patients, considered inoperable until recently, and justify the trend to incorporate this surgical strategy within a multimodal therapeutic plan in highly selected patients. [ABSTRACT FROM AUTHOR]

The precise prediction of power estimates of wind–solar renewable energy sources becomes challenging due to their intermittent nature and difference in intensity between day and night. Machine-learning algorithms are non-linear mapping functions to approximate any given function from known input–output pairs and can be used for this purpose. This paper presents an artificial neural network (ANN)-based method to predict hybrid wind–solar resources and estimate power generation by correlating wind speed and solar radiation for real-time data. The proposed ANN allows optimization of the hybrid system's operation by efficient wind and solar energy production estimation for a given set of weather conditions. The proposed model uses temperature, humidity, air pressure, solar radiation, optimum angle, and target values of known wind speeds, solar radiation, and optimum angle. A normalization function to narrow the error distribution and an iterative method with the Levenberg–Marquardt training function is used to reduce error. The experimental results show the effectiveness of the proposed approach against the existing wind, solar, or wind–solar estimation methods. It is envisaged that such an intelligent yet simplified method for predicting wind speed, solar radiation, and optimum angle, and designing wind–solar hybrid systems can improve the accuracy and efficiency of renewable energy generation. [ABSTRACT FROM AUTHOR]

Interventions such as forest bathing (slow, mindful nature walks) have been shown to increase our connection to nature and be an effective intervention for improving health and well-being. However, there is variation in the activities delivered during forest bathing and the guidance given. Few researchers have evaluated which activities, elements of nature, and senses are responsible for improvements in well-being. The current evaluation addresses this gap and also monitors the emotional state and nature connection following guided forest bathing walks. Participants (N = 1142) across 35 countries completed post-walk evaluation surveys online. Results suggest that well-being and nature connection were rated very highly following forest bathing activities. Experiencing happy feelings and trusting emotions were especially highly rated. The natural elements perceived as contributing the most to well-being were sound-related elements. In terms of sociodemographics, women had higher well-being and nature connection ratings than men; ratings were higher in specialised nature resort areas, with little difference between natural and urban park areas; higher scores were seen in the southern hemisphere and during hot or long-day seasons. This has implications for forest bathing, forest therapy, and nature-based training organisations and their guides who want to improve their method of intervention delivery, maximise well-being, and enhance nature connection. [ABSTRACT FROM AUTHOR]