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Abstract Bladder cancer (BCa) poses a significant health challenge, particularly affecting men with higher incidence and mortality rates. Addressing the need for improved predictive models in BCa treatment, this study introduces an innovative 3D in vitro patient-derived bladder cancer tumor model, utilizing decellularized pig bladders as scaffolds. Traditional 2D cell cultures, insufficient in replicating tumor microenvironments, have driven the development of sophisticated 3D models. The study successfully achieved pig bladder decellularization through multiple cycles of immersion in salt solutions, resulting in notable macroscopic and histological changes. This process confirmed the removal of cellular components while preserving the native extracellular matrix (ECM). Quantitative analysis demonstrated the efficacy of decellularization, with a remarkable reduction in DNA concentration, signifying the removal of over 95% of cellular material. In the development of the in vitro bladder cancer model, muscle invasive bladder cancer patients’ cells were cultured within decellularized pig bladders, yielding a three-dimensional cancer model. Optimal results were attained using an air–liquid interface technique, with cells injected directly into the scaffold at three distinct time points. Histological evaluations showcased characteristics resembling in vivo tumors derived from bladder cancer patients’ cells. To demonstrate the 3D cancer model’s effectiveness as a drug screening platform, the study treated it with Cisplatin (Cis), Gemcitabine (Gem), and a combination of both drugs. Comprehensive cell viability assays and histological analyses illustrated changes in cell survival and proliferation. The model exhibited promising correlations with clinical outcomes, boasting an 83.3% reliability rate in predicting treatment responses. Comparison with traditional 2D cultures and spheroids underscored the 3D model’s superiority in reliability, with an 83.3% predictive capacity compared to 50% for spheroids and 33.3% for 2D culture. Acknowledging limitations, such as the absence of immune and stromal components, the study suggests avenues for future improvements. In conclusion, this innovative 3D bladder cancer model, combining decellularization and patient-derived cells, marks a significant advancement in preclinical drug testing. Its potential for predicting treatment outcomes and capturing patient-specific responses opens new avenues for personalized medicine in bladder cancer therapeutics. Future refinements and validations with larger patient cohorts hold promise for revolutionizing BCa research and treatment strategies.

Abstract Complex behavior in nonlinear dynamical systems often arises from resonances, which enable intricate energy transfer mechanisms among modes that otherwise would not interact. Theoretical, numerical and experimental methods are available to study such behavior when the resonance arises among modes of the linearized system. Much less understood are, however, resonances arising from nonlinear modal interactions, which cannot be detected from a classical linear analysis. Academic examples of such phenomena have been known, but no systematic method has been developed to detect and model nonlinear resonant interactions purely from numerical or experimental data. Here, we develop such a data-driven methodology that identifies nonlinear resonant response on low-dimensional spectral submanifolds (SSMs) of the dynamical system. Our approach is generally applicable to nonlinear resonances, but we specifically focus here on one particular behavior: subharmonic response in forced nonlinear systems without any resonance among the linearized frequencies of the unforced system. We first illustrate analytically how such a response is born out of a nonlinear resonance hidden in the conservative limit of the system. We then show how this effect can be identified and modeled purely from data. As our main example, we isolate and model previously unexplained response patterns in fluid sloshing experiments.

Objetivo: Reportar la experiencia con las esofagectomías en pacientes con cáncer de esófago, en el Servicio de Cirugía General del Hospital Nacional de Itauguá, periodo 2015-2020. Metodología: Estudio descriptivo, retrospectivo, transversal, donde se revisaron los expedientes clínicos de pacientes con diagnóstico de neoplasia en el esófago sometidos a esofagectomía en el Hospital Nacional de Itauguá, período 2015-2020. Resultados: El estudio incluyó 18 expedientes clínicos. El 78% fueron del sexo masculino, la edad media fue de 62,6 años. El IMC promedio fue de 19. La frecuencia de los síntomas fueron la disfagia en un 86%, pérdida de peso en un 83% y epigastralgia en un 28%. El carcinoma escamoso predominó en un 67% sobre el adenocarcinoma. La ubicación de los tumores se distribuyó con más frecuencia en tercio medio. El 78% de los pacientes fueron sometidos a una esofagectomía total transhiatal por técnica de Orringer y el restante por vía transtorácica por técnica de Mc Keown. Las complicaciones de la anastomosis esofagogástrica correspondieron al 34% y las respiratorias a un 28%. La tasa de mortalidad perioperatoria fue de 17%. Conclusión: La esofagectomía sigue siendo el único tratamiento curativo para el cáncer de esófago a pesar de su alta tasa de morbimortalidad. Es importante el diagnóstico precoz para poder ofrecer un tratamiento curativo. Es infortunado que los pacientes estudiados no tuvieran un seguimiento, de manera que resulta imposible la evaluación objetiva de los resultados a mediano y largo plazo.

Abstract With a growing global population and ageing demographics, the food industry stands at a pivotal crossroads, necessitating bespoke solutions and groundbreaking innovations. In vitro experiments can help understanding food oral processing and formulating products meeting the specific needs of different populations. However, current in vitro models do not reproduce well human oral anatomy and tongue biomechanics, essential for assessing the behaviour of novel and texturized foods under physiologically relevant oral conditions. In response, we unveil a novel 3D biomimetic artificial mouth, showcasing a pneumatic multi-degree-of-freedom artificial tongue meticulously crafted to mirror the mechanical properties and wettability of the human tongue. This cutting-edge technology, featuring tongue surface papillae, is capable of performing lifelike movements. The comparison with in vivo data demonstrates that it accurately reproduces oral processing of three, vastly different, soft foods. Textural characteristics (firmness, adhesive and cohesive properties) and shear viscosities—measured at oral and oropharyngeal-relevant shear rates—of in vitro food boli closely mirrored those observed in vivo. This in vitro device presents unprecedented opportunities for studying the dynamics of food transformation in the mouth, to adapt texture towards food that can be swallowed with ease and to improve food palatability, accommodating specific health needs critical for older adults (e.g., reduced salivary secretion, tongue weakness or poor coordination).

Abstract This study explores a potential solution to the shortage of kidneys for transplantation in end-stage renal disease (ESRD). Currently, kidney transplantation stands as the optimal option, yet the scarcity of organs persists. Employing tissue engineering, researchers sought to assess the feasibility of generating kidneys for transplantation. Pig kidneys were utilized since they possess higher similarities to human kidneys. Cells were removed via decellularization, which maintains the organ’s microarchitecture. Subsequently, pig kidney cells and human red blood cells were perfused into the vacant kidney structure to reconstitute it. The methodologies employed showed promising results, suggesting a viable approach to increase the recellularization rate in whole pig kidneys. This proof-of-concept establishes a groundwork for potentially extending this technology to human kidneys, tackling the organ shortage, thus positively enhancing outcomes for ESRD patients by increasing the availability of transplantable organs.

Abstract Heatwaves (HWs) pose a severe threat to human and ecological systems. Here we assess the projected changes in heatwaves over Latin America using bias corrected high-resolution regional climate simulations under two Representative Concentration Pathway scenarios (RCPs). Heatwaves are projected to be more frequent, long-lasting, and intense in the mid-century under both RCP2.6 and RCP8.5 scenarios, with severe increases under the RCP8.5 scenario. Even under the low emissions scenario of RCP2.6, the frequency of heatwaves doubles over most of the region. A three- to tenfold rise in population exposure to heatwave days is projected over Central and South America, with climate change playing a dominant role in driving these changes. Results show that following the low emission pathway would reduce 57% and 50% of heatwave exposure for Central and South American regions respectively, highlighting the need to control anthropogenic emissions and implement sustainable practices.

Abstract The significant advances in the differentiation of human pluripotent stem (hPS) cells into pancreatic endocrine cells, including functional β-cells, have been based on a detailed understanding of the underlying developmental mechanisms. However, the final differentiation steps, leading from endocrine progenitors to mono-hormonal and mature pancreatic endocrine cells, remain to be fully understood and this is reflected in the remaining shortcomings of the hPS cell-derived islet cells (SC-islet cells), which include a lack of β-cell maturation and variability among different cell lines. Additional signals and modifications of the final differentiation steps will have to be assessed in a combinatorial manner to address the remaining issues and appropriate reporter lines would be useful in this undertaking. Here we report the generation and functional validation of hPS cell reporter lines that can monitor the generation of INS+ and GCG+ cells and their resolution into mono-hormonal cells (INS eGFP , INS eGFP /GCG mCHERRY ) as well as β-cell maturation (INS eGFP /MAFA mCHERRY ) and function (INS GCaMP6 ). The reporter hPS cell lines maintained strong and widespread expression of pluripotency markers and differentiated efficiently into definitive endoderm and pancreatic progenitor (PP) cells. PP cells from all lines differentiated efficiently into islet cell clusters that robustly expressed the corresponding reporters and contained glucose-responsive, insulin-producing cells. To demonstrate the applicability of these hPS cell reporter lines in a high-content live imaging approach for the identification of optimal differentiation conditions, we adapted our differentiation procedure to generate SC-islet clusters in microwells. This allowed the live confocal imaging of multiple SC-islets for a single condition and, using this approach, we found that the use of the N21 supplement in the last stage of the differentiation increased the number of monohormonal β-cells without affecting the number of α-cells in the SC-islets. The hPS cell reporter lines and the high-content live imaging approach described here will enable the efficient assessment of multiple conditions for the optimal differentiation and maturation of SC-islets.

Abstract Textile dyes are frequently disposable in aqueous effluents, making it difficult to remove them from industrial effluents before their release to natural waters. This paper deals with the fabrication of cellulose-based adsorbents by reacting nanocelulose crystalline (nanocel) with N-[3-(trimethoxysilyl)propyl]ethylenediamine (TMSPEDA), forming the hybrid (silylpropyl)ethylenediamine@nanocellulose (SPEDA@nanocel), which was employed as adsorbent for the uptake of reactive yellow 2 dye (RY-2) from aqueous effluents. Characterisation of SPEDA@nanocel was carried out using FTIR, SEM–EDS, XRD, TGA, surface area, pHpzc, and hydrophobicity/hydrophilicity ratio (HI). Also, adsorption studies were thoroughly investigated. The effect of initial pH indicated that the maximum uptake of RY-2 takes place at pH 2, which is an indication of the electrostatic mechanism. The kinetic data carried out with 250 and 500 mg L−1 RY-2 with SPEDA@nanocel followed better the nonlinear fractional-like pseudo-first-order model. The t0.5 and t0.95 for the dye uptake were about 30 and 141 min, respectively. The equilibrium data from 10 to 45 °C indicated that the Liu isotherm model was the best-fitted isothermal model. The maximum sorption capacity attained was 112.3 mg g−1 at 45 °C. The thermodynamic data have shown that the equilibrium was favorable and endothermic, and the ΔH° was compatible with an electrostatic attraction between RY-2 and SPEDA@nanocel. Experiments of desorption of loaded adsorbent showed promising results for real applications since at least 5 adsorption/desorption cycles could be employed without significant changes in the recovery and with high precision.

Abstract Demequina, commonly found in coastal and marine environments, represents a genus of Actinomycetes. In this study, strains Demequina PMTSA13T and OYTSA14 were isolated from the rhizosphere of Capsicum annuum, leading to the discovery of a novel species, Demequina capsici. Bacteria play a significant role in plant growth, yet there have been no reports of the genus Demequina acting as plant growth-promoting bacteria (PGPB). Comparative genomics analysis revealed ANI similarity values of 74.05–80.63% for PMTSA13T and 74.02–80.54% for OYTSA14, in comparison to various Demequina species. The digital DNA-DNA hybridization (dDDH) values for PMTSA13T ranged from 19 to 39%, and 19.1–38.6% for OYTSA14. Genome annotation revealed the presence of genes associated with carbohydrate metabolism and transport, suggesting a potential role in nutrient cycling and availability for plants. These strains were notably rich in genes related to ‘carbohydrate metabolism and transport (G)’, according to their Cluster of Orthologous Groups (COG) classification. Additionally, both strains were capable of producing auxin (IAA) and exhibited enzymatic activities for cellulose degradation and catalase. Furthermore, PMTSA13T and OYTSA14 significantly induced the growth of Arabidopsis thaliana seedlings primarily attributed to their capacity to produce IAA, which plays a crucial role in stimulating plant growth and development. These findings shed light on the potential roles of Demequina strains in plant–microbe interactions and agricultural applications. The type strain is Demequina capsici PMTSA13T (= KCTC 59028T = GDMCC 1.4451T), meanwhile OYTSA14 is identified as different strains of Demequina capsici.

Abstract With a national prevalence of 0.9%, Burundi is close to achieving UNAIDS’ 2025 targets. Despite this, different types of crises periodically disrupt its HIV health services. The community-based program EPIC measured the impact of the COVID-19 health crisis on people living with HIV (PLHIV) in Burundi in 2021. Specifically, it assessed ART interruption and associated factors since the beginning of the pandemic. The study questionnaire was administered to PLHIV in three cities between October and November 2021. Participants were recruited using convenience sampling. Logistic regression models helped identify factors associated with ART interruption. Of the 317 respondents, 37 (11.7%) reported interruption. The majority (79.2%) self-identified as belonging to key populations. Interruption was significantly associated with: fewer HIV medical follow-up visits (adjusted Odds Ratio, aOR = 7.80, p = 0.001) and forced HIV status disclosure (aOR = 4.10, p = 0.004). It was inversely associated with multi-month ART dispensing (aOR = 0.36, p = 0.017) since the beginning of the pandemic and the perception of not having been sufficiently informed by the HIV medical team about the risk of COVID-19 infection (aOR = 0.11, p

Summary: Background: Over 40% of pregnant women in the USA are obese which negatively affects fetal development and offspring health. Maternal obesity (MO) leads to fibrotic infiltration in multiple tissues and organs of offspring during their adulthood although the origin and mechanisms are unclear. Methods: C57BL/6J female mice were fed a control and high-fat diet to mimic MO condition. Embryonic somatic tissues were obtained at E9.5, E11.5, and E13.5 (equivalent to 6 weeks of human pregnancy) from control (CON) and MO mice for single-cell RNA-sequencing (scRNA-seq). To explore the role of AMP-activated protein kinase (AMPK), AMPK was activated by metformin and A769662, and knocked out in embryonic mesenchymal cells (EMC) using AMPKα1 floxed mice. Findings: Using unsupervised clustering, we identified three major cell populations with fibrogenic capacity. Compared to CON, the population of fibrogenic cells increased dramatically (by ∼125%) due to MO, supporting an embryonic origin of fibrosis in the offspring. MO induced inflammatory response and elevated expression of transforming growth factor β (TGFβ) signalling and fibrogenic genes in embryos. MO inhibited AMPK and its activation by metformin and A769662 inhibited TGFβ signalling and fibrogenesis. Interpretation: MO profoundly enhances embryonic fibrogenesis, explaining the origin of fibrosis in the offspring of mothers living with obesity. Our data underscore the importance of early intervention, before 5–6 weeks of pregnancy, in improving embryonic development, and AMPK is an amiable target for suppressing excessive fibrogenesis in MO embryos to assist increasing populations of obese mothers having healthy children. Funding: This work was funded by National Institutes of Health Grant R01HD067449.

Granulomatosis with polyangiitis is an ANCA-positive vasculitis primarily affecting small to medium-sized vessels, typically involving the lungs and kidneys. This article presents a remarkable case of a patient with an unusual pyoderma gangrenosum-like ulcer on the face and granulomatosis with polyangiitis. A 28-year-old man, previously diagnosed with granulomatosis with polyangiitis presented at a dermatology clinic with a 6-month-old ulcer in the right preauricular region following a traumatic incident. A spindle biopsy revealed suppurative granulomatous dermatitis with secondary vascular damage, while cultures showed no signs of infection. The patient was subsequently treated with rituximab, leading to a positive clinical response. This case underscores the challenge of diagnosing this rare manifestation of granulomatosis with polyangiitis and suggests that rituximab could be a valuable treatment option.

Summary: Background: Bacterial biofilm communities are embedded in a protective extracellular matrix comprised of various components, with its' integrity largely owed to a 3-dimensional lattice of extracellular DNA (eDNA) interconnected by Holliday Junction (HJ)-like structures and stabilised by the ubiquitous eubacterial DNABII family of DNA-binding architectural proteins. We recently showed that the host innate immune effector High Mobility Group Box 1 (HMGB1) protein possesses extracellular anti-biofilm activity by destabilising these HJ-like structures, resulting in release of biofilm-resident bacteria into a vulnerable state. Herein, we showed that HMGB1's anti-biofilm activity was completely contained within a contiguous 97 amino acid region that retained DNA-binding activity, called ‘mB Box-97’. Methods: We engineered a synthetic version of this 97-mer and introduced a single amino acid change which lacked any post-translational modifications, and tested its activity independently and in combination with a humanised monoclonal antibody that disrupts biofilms by the distinct mechanism of DNABII protein sequestration. Findings: mB Box-97 disrupted and prevented biofilms, including those formed by the ESKAPEE pathogens, and importantly reduced measurable proinflammatory activity normally associated with HMGB1 in a murine lung infection model. Interpretation: Herein, we discuss the value of targeting the ubiquitous eDNA-dependent matrix of biofilms via mB Box-97 used singly or in a dual host-augmenting/pathogen-targeted cocktail to resolve bacterial biofilm infections. Funding: This work was supported by NIH/NIDCD R01DC011818 to L.O.B. and S.D.G. and NIH/NIAID R01AI155501 to S.D.G.

A 4.1 kg male neonate with a diagnosis of double-inlet left ventricle with dextro-transposition of the great arteries was intubated shortly after birth due to respiratory insufficiency. The initial management consisted of a successful Stage I hybrid procedure. Persistent respiratory insufficiency led to cross-sectional imaging and bronchoscopy that demonstrated severe airway compression from a dilated main pulmonary artery. A Norwood procedure with Blalock–Thomas–Taussig shunt was performed at 1 month of age to relieve the airway obstruction. The patient was discharged home on room air at 2 months of age. This case highlights a unique single-ventricle anatomic variant with airway compression, which was successfully managed with deferred Norwood palliation.

Abstract Neuronal aging may be, in part, related to a change in DNA methylation. Thus, methyl donors, like folate and methionine, may play a role in cognitive changes associated to neuronal aging. To test the role of these metabolites, we performed stereotaxic microinjection of these molecules into the dentate gyrus (DG) of aged mice (an average age of 21 month). Folate, but not S-Adenosyl-Methionine (SAM), enhances cognition in aged mice. In the presence of folate, we observed partial rejuvenation of DG cells, characterized by the expression of juvenile genes or reorganization of extracellular matrix. Here, we have also tried to identify the mechanism independent of DNA methylation, that involve folate effects on cognition. Our analyses indicated that folate binds to folate receptor α (FRα) and, upon folate binding, FRα is transported to cell nucleus, where it is acting as transcription factor for expressing genes like SOX2 or GluN2B. In this work, we report that a FRα binding peptide also replicates the folate effect on cognition, in aged mice. Our data suggest that such effect is not sex-dependent. Thus, we propose the use of this peptide to improve cognition since it lacks of folate-mediated side effects. The use of synthetic FRα binding peptides emerge as a future strategy for the study of brain rejuvenation.

Abstract Future state prediction for nonlinear dynamical systems is a challenging task. Classical prediction theory is based on a, typically long, sequence of prior observations and is rooted in assumptions on statistical stationarity of the underlying stochastic process. These algorithms have trouble predicting chaotic dynamics, “Black Swans” (events which have never previously been seen in the observed data), or systems where the underlying driving process fundamentally changes. In this paper we develop (1) a global and local prediction algorithm that can handle these types of systems, (2) a method of switching between local and global prediction, and (3) a retouching method that tracks what predictions would have been if the underlying dynamics had not changed and uses these predictions when the underlying process reverts back to the original dynamics. The methodology is rooted in Koopman operator theory from dynamical systems. An advantage is that it is model-free, purely data-driven and adapts organically to changes in the system. While we showcase the algorithms on predicting the number of infected cases for COVID-19 and influenza cases, we emphasize that this is a general prediction methodology that has applications far outside of epidemiology.

Abstract This study examined the interplay between bacterial and fungal communities in the human gut microbiota, impacting on nutritional status and body weight. Cohorts of 10 participants of healthy weight, 10 overweight, and 10 obese individuals, underwent comprehensive analysis, including dietary, anthropometric, and biochemical evaluations. Microbial composition was studied via gene sequencing of 16S and ITS rDNA regions, revealing bacterial (bacteriota) and fungal (mycobiota) profiles. Bacterial diversity exceeded fungal diversity. Statistically significant differences in bacterial communities were found within healthy-weight, overweight, and obese groups. The Bacillota/Bacteroidota ratio (previously known as the Firmicutes/Bacteroidetes ratio) correlated positively with body mass index. The predominant fungal phyla were Ascomycota and Basidiomycota, with the genera Nakaseomyces, Kazachstania, Kluyveromyces, and Hanseniaspora, inversely correlating with weight gain; while Saccharomyces, Debaryomyces, and Pichia correlated positively with body mass index. Overweight and obese individuals who harbored a higher abundance of Akkermansia muciniphila, demonstrated a favorable lipid and glucose profiles in contrast to those with lower abundance. The overweight group had elevated Candida, positively linked to simple carbohydrate consumption. The study underscores the role of microbial taxa in body mass index and metabolic health. An imbalanced gut bacteriota/mycobiota may contribute to obesity/metabolic disorders, highlighting the significance of investigating both communities.

A phase 1–2, prospective, multicenter, randomized, open-label clinical trial (Code RPCEC00000382), with parallel groups, involving 1161 participants, was designed to assess the safety and immunogenicity of two Cuban COVID-19 vaccines (Mambisa and Abdala) in boosting COVID-19 immunity of convalescent adults after receiving one dose of either vaccine. The main safety outcome was severe vaccination adverse events occurring in 55% of vaccinees in Phase 1 and >70% in Phase 2. Neutralizing antibody titers against SARS-CoV-2 variants were evaluated. Both vaccines were safe—no deaths or severe adverse events occurred. Mild intensity adverse events were the most frequent (>73%); headaches predominated for both vaccines. Phase 1 responders were 83.3% (p = 0.0018) for Abdala. Mambisa showed similar results. Phase 2 responders were 88.6% for Abdala (p < 0.0001) and 74.2% for Mambisa (p = 0.0412). In both phases, anti-RBD IgG titers, inhibition percentages and neutralizing antibody titers increased significantly after the booster dose. Both vaccines were safe and their immunogenicity surpassed the study endpoints.

Introduction Therapeutic exercise has an important role in the population living with cancer as it improves function and quality of life and reduces the symptoms of cancer treatment. There is little clinical evidence on the effects of hypopressive exercise in women with gynecological cancer. Objective Evaluate the effects of 4 weeks of hypopressive exercise associated with muscle strength training and aerobic exercises on fatigue, urinary incontinence symptoms, sexual function, and quality of life in women treated for gynecological cancer compared to a group that will perform conventional training. Methods This randomized, single-blinded clinical trial study is set in the Clinical Research Laboratory, Department of Kinesiotherapy, at a Chilean University. Patients will be randomly assigned to an experimental group of hypopressive exercises associated with muscle strength training and aerobic exercises or a control group of muscle strength training and aerobic exercises. Twelve tele-rehabilitation sessions will be performed. Women over 18 years of age with gynecologic cancer who have been prescribed radiotherapy or chemotherapy will participate. Fatigue, quality of life, urinary incontinence symptoms, and sexual function will be assessed before and after the intervention. Expected results The results of this clinical trial have important implications for specific treatment for the cancer population and generate new techniques in the practice of oncology-specialized kinesiologists. Hypopressive exercise is expected to reduce incontinence symptoms due to neuromuscular activation of the pelvic floor muscles. However, more studies are needed to confirm the beneficial effects of hypopressive exercises in face-to-face or remote rehabilitation.

Objetivo: avaliar o microclima da pele em calcâneos de pacientes hospitalizados em unidade de tratamento intensivo, usando espuma multicamadas de poliuretano com silicone comparada ao filme transparente de poliuretano. Método: ensaio clínico paralelo randomizado autocontrolado de superioridade. Cada paciente recebeu a intervenção experimental (espuma multicamadas de poliuretano com silicone) e a intervenção controle (filme transparente de poliuretano), totalizando 184 sítios cutâneos (92 pacientes). O estudo foi desenvolvido em um hospital universitário do interior do estado do Rio Grande do Sul, no período de julho de 2017 a março de 2018. Resultados: não se identificou diferença estatisticamente significativa quanto à temperatura da pele dos calcâneos que desenvolveram lesão por pressão (LP), bem como dos calcâneos em uso do filme transparente de poliuretano entre a avaliação inicial e final. Conclusão: o microclima da pele sofre alterações em seus valores quando em uso de coberturas para prevenção de LP.

ABSTRACT Muscle weakness has been associated to insulin resistance and metabolic syndrome in the general population. However, it is still unclear whether this association is maintained in older adults. This study investigated correlations between low handgrip strength (HGS) and metabolic syndrome, or some of its components, in older adults through a systematic review of the literature. Searches were conducted in the Virtual Health Library Regional Portal, Scopus, Cochrane, Embase, MEDLINE/PubMed, SciELO, and Web of Science databases for relevant studies investigating muscle weakness (measured by hand dynamometer) and metabolic syndrome or its components in older adult populations, published up to September 2023. From the 2050 references initially identified, 20 studies, comprising a total of 31,264 older adults of both genders, completely met the inclusion/exclusion criteria. Eighteen studies showed that lower HGS was associated with metabolic syndrome or some of its risk factors, such as abdominal obesity, hyperglycemia, insulin resistance, dyslipidemia, or high blood pressure. Two studies found that older men with high blood pressure had increased HGS. Most studies included in this systematic review revealed a significant correlation between reduced HGS and metabolic syndrome or some of its components, especially abdominal obesity and insulin resistance. We conclude that below-average HGS can be associated with metabolic syndrome in older adults.

BackgroundThousands of hospitals worldwide have adopted mobile artificial intelligence (AI)-based stroke care coordination platforms. Studies exploring the benefit of these platforms have been scrutinized due to small sample size, serial cohort design, and measurement of metrics with multiple determinants. In this large multi-center study, we evaluated the ability of an AI-based stroke care coordination platform to expedite contact with the interventionalist (NIR) for potential thrombectomy.MethodsAcute stroke consultations seen by TeleSpecialists, LLC physicians at 166 facilities (17 states) utilizing Viz.ai software (AI) vs. no AI software (non-AI) were extracted from the TeleCare by TeleSpecialists™ database from December 1, 2021, through March 31, 2022. The primary outcome was time from patient arrival to first contact with the interventionalist to discuss need for potential thrombectomy (Arrival-to-NIR notification).ResultsA total of 14,116 cases were analyzed. Compared to the non-AI cohort, Arrival-to-NIR notification in the AI cohort was: (1) 39.5 min faster (44.13% reduction, p < 0.001) in the overall analysis; (2) 33.0 min faster (34.0% reduction, p < 0.001) in the non-thrombectomy (non-TC) facility subgroup analysis; and (3) 34.0 min faster (43.59% reduction, p < 0.001) in the thrombectomy capable (TC) facility subgroup analysis. IQR range comparison demonstrated a significant improvement in uniformity of stroke workflow across all AI subgroups. Significant, albeit small, confounding biases were revealed in the data. The presence of AI within the non-TC subgroup correlated with a lower acceptance rate for thrombectomy by the NIR (delta = −10.79% absolute and 23.17% relative reduction, p < 0.0001).ConclusionsWhile this study was limited by our inability to capture detailed neuroimaging timelines and patient outcomes, it suggests a potential significant benefit of AI-based stroke care coordination platforms and underscores the critical need to development robust “big data” systems to study the effects of AI, and other emerging technologies, on stroke systems of care.

Objectives This study aimed to evaluate cytogenetic damage in the buccal mucosa of non-exposed subjects (N = 33) and insecticide-exposed fumigators (N = 31) in the urban area of Cali, Colombia. Material and Methods Through a questionnaire sociodemographic data, anthropometric measurements, state of health, and lifestyle were collected. Buccal micronucleus cytome (BMCyt) assay was using for evaluate cytogenetic damage. Results The study showed that all fumigators used adequate personal protective equipment (PPE) and had low alcohol consumption. The authors did not find significant differences in BMCyt biomarkers between the groups (p > 0.05). Multivariate analysis showed a 13% increase in micronucleus (MN) frequency for every year of increasing age (OR = 1.13, p = 0.029), and higher MN with the decrease in daily fruit consumption (OR = 4.71, p = 0.084), without statistical significance. Conclusions The results between groups could be related to healthy habits and PPE use among the subjects. Int J Occup Med Environ Health. 2024;37(1):128–37

Background: Pneumococcal disease (PD) is a major cause of morbidity and mortality in young children in Asia and globally. Pneumococcal conjugate vaccines (PCVs) have significantly reduced the burden of PD when included in pediatric national immunization programs (NIPs). This study estimates the clinical and economic burden of PD due to serotypes contained in different PCVs in children aged < 5 years in eight Asian countries/territories. Methods: Based on published data, a cohort-based decision analytic model was used to estimate annual PD cases, deaths, and direct medical costs associated with serotypes contained in PCV10, PCV13, PCV15, and PCV20. Results: PD incidence rates were lower in regions with PCV13 in their NIP than those without. Serotypes contained in higher but not lower valency PCVs resulted in a significant incremental clinical and economic burden, although the difference between PCV13 and PCV15 serotypes was generally small. Moving from PCV13 to PCV20 was estimated to result in greater clinical and economic burden reductions. Conclusions: This study demonstrates the remaining and incremental burden of PD from PCV10 to PCV20 serotypes in young children in selected Asian regions. Extending NIP access to higher-valency PCVs with broader serotype coverage and improving vaccine uptake will help prevent morbidity and deaths and save healthcare costs.

Fibromyalgia (FM) is a disorder characterized by widespread chronic pain, significant depression, and various neural abnormalities. Recent research suggests a reciprocal exacerbation mechanism between chronic pain and depression. In patients with FM, dysregulation of tryptophan (Trp) metabolism has been identified. Trp, an essential amino acid, serves as a precursor to serotonin (5-HT), a neuromodulator that influences mood, appetite, sleep, and pain perception through the receptors 5-HT1, 5-HT2, and 5-HT3. Additionally, Trp is involved in the kynurenine pathway, a critical route in the immune response, inflammation, and production of neuroactive substances and nicotinamide adenine dinucleotide (NAD+). The activation of this pathway by pro-inflammatory cytokines, such as tumor necrosis factor α (TNF-α) and interferon gamma (IFN-γ), leads to the production of kynurenic acid (KYNA), which has neuroprotective properties, and quinolinic acid (QA), which is neurotoxic. These findings underscore the crucial balance between Trp metabolism, 5-HT, and kynurenine, where an imbalance can contribute to the dual burden of pain and depression in patients with FM. This review proposes a novel therapeutic approach for FM pain management, focusing on inhibiting QA synthesis while co-administering selective serotonin reuptake inhibitors to potentially increase KYNA levels, thus dampening pain perception and improving patient outcomes.

Late onset combined immunodeficiency (LOCID) is a rare variant of common variable immunodeficiency (CVID), typically affecting adult patients who present with opportunistic infections (OI) and/or low CD4+ T lymphocytes. Diagnostic delay is common due to the rareness of this entity, increasing morbidity and mortality. We report on a 66-year-old male who developed a severe gastrointestinal cytomegalovirus (CMV) infection, refractory to antiviral treatment and anti-cytomegalovirus specific human immunoglobulin administration, with a fatal outcome due to an undiagnosed LOCID.

La embolia cerebral paradójica siempre requiere la presencia de foramen oval; en nuestro caso, este evento sucedió por un fenómeno temporal, el cual fue la sobrecarga aguda de cavidades derechas, y apertura de foramen oval por aumento de presiones como consecuencia de un tromboembolismo pulmonar masivo. Luego de una artroscopia, nuestra paciente presento perdida de campo visual y la disnea, esta última progresiva, hasta llegar a la ventilación mecánica, shock obstructivo grave. Se realizó una Angiotomografía, donde se evidencio un trombo obstructivo en la arterial pulmonar derecha, la paciente fue trombolisada con éxito, fue dada de alta de la unidad de cuidados intensivos luego de 45 días. Finalmente, se le diagnostico deficiencia de proteína C, fue anticoagulada de manera permanente. La presencia de déficit motor y disnea una paciente post cirugía de rodilla, debe hacer sospechar de una tromboembolia pulmonar, la trombolisis sigue siendo el tratamiento de elección, su indicación debe ser precoz.

Antecedentes: El traumatismo craneoencefálico es una de las principales causas de discapacidad en todo el mundo. Las afecciones después del traumatismo son tanto físicas como neurales, ocasionando respuestas como pirexia y alteración en la neurotransmisión. Objetivo: Evaluar los cambios de temperatura y en la neurotransmisión GABAérgica y glutamatérgica estriatal durante el déficit y la recuperación motora en un modelo de lesión cerebral traumática. Método: En ratas Wistar, se registraron la conducta motora y la temperatura durante 20 días tras una lesión, y con la técnica de microdiálisis cerebral se midieron los niveles de glutamato y de GABA estriatales. Resultados: El traumatismo produce un mayor déficit las primeras 24 horas (p < 0.05) y una recuperación motora después de 192 horas (p > 0.5). Produce un incremento en la temperatura mayormente los primeros 4 días (p < 0.001), con un restablecimiento al día 8 (p > 0.05) posterior a la lesión. Se presenta una reducción en los niveles de GABA y de glutamato al día 3, seguida de un restablecimiento durante el tiempo de la recuperación motora. Conclusiones: Los análisis de correlación sugieren que los cambios en la neurotransmisión GABAérgica y glutamatérgica estriatal, y el incremento de la temperatura, después de una lesión cerebral no están asociados con el déficit motor ni con la recuperación funcional motora.

Background Glaucoma and diabetic retinopathy (DR) are the leading causes of irreversible retinal damage leading to blindness. Early detection of these diseases through regular screening is especially important to prevent progression. Retinal fundus imaging serves as the principal method for diagnosing glaucoma and DR. Consequently, automated detection of eye diseases represents a significant application of retinal image analysis. Compared with classical diagnostic techniques, image classification by convolutional neural networks (CNN) exhibits potential for effective eye disease detection. Methods This paper proposes the use of MATLAB – retrained AlexNet CNN for computerized eye diseases identification, particularly glaucoma and diabetic retinopathy, by employing retinal fundus images. The acquisition of the database was carried out through free access databases and access upon request. A transfer learning technique was employed to retrain the AlexNet CNN for non-disease (Non_D), glaucoma (Sus_G) and diabetic retinopathy (Sus_R) classification. Moreover, model benchmarking was conducted using ResNet50 and GoogLeNet architectures. A Grad-CAM analysis is also incorporated for each eye condition examined. Results Metrics for validation accuracy, false positives, false negatives, precision, and recall were reported. Validation accuracies for the NetTransfer (I-V) and netAlexNet ranged from 89.7% to 94.3%, demonstrating varied effectiveness in identifying Non_D, Sus_G, and Sus_R categories, with netAlexNet achieving a 93.2% accuracy in the benchmarking of models against netResNet50 at 93.8% and netGoogLeNet at 90.4%. Conclusions This study demonstrates the efficacy of using a MATLAB-retrained AlexNet CNN for detecting glaucoma and diabetic retinopathy. It emphasizes the need for automated early detection tools, proposing CNNs as accessible solutions without replacing existing technologies.

BackgroundEpidemiological findings regarding the association of particulate matter ≤2.5 μm (PM2.5) exposure with hypertensive disorders in pregnancy (HDP) are inconsistent; evidence for HDP risk related to PM2.5 components, mixture effects, and windows of susceptibility is limited. We aimed to investigate the relationships between HDP and exposure to PM2.5 during pregnancy.Methods and findingsA large retrospective cohort study was conducted among mothers with singleton pregnancies in Kaiser Permanente Southern California from 2008 to 2017. HDP were defined by International Classification of Diseases-9/10 (ICD-9/10) diagnostic codes and were classified into 2 subcategories based on the severity of HDP: gestational hypertension (GH) and preeclampsia and eclampsia (PE-E). Monthly averages of PM2.5 total mass and its constituents (i.e., sulfate, nitrate, ammonium, organic matter, and black carbon) were estimated using outputs from a fine-resolution geoscience-derived model. Multilevel Cox proportional hazard models were used to fit single-pollutant models; quantile g-computation approach was applied to estimate the joint effect of PM2.5 constituents. The distributed lag model was applied to estimate the association between monthly PM2.5 exposure and HDP risk. This study included 386,361 participants (30.3 ± 6.1 years) with 4.8% (17,977/373,905) GH and 5.0% (19,381/386,361) PE-E cases, respectively. In single-pollutant models, we observed increased relative risks for PE-E associated with exposures to PM2.5 total mass [adjusted hazard ratio (HR) per interquartile range: 1.07, 95% confidence interval (CI) [1.04, 1.10] p < 0.001], black carbon [HR = 1.12 (95% CI [1.08, 1.16] p < 0.001)] and organic matter [HR = 1.06 (95% CI [1.03, 1.09] p < 0.001)], but not for GH. The population attributable fraction for PE-E corresponding to the standards of the US Environmental Protection Agency (9 μg/m3) was 6.37%. In multi-pollutant models, the PM2.5 mixture was associated with an increased relative risk of PE-E ([HR = 1.05 (95% CI [1.03, 1.07] p < 0.001)], simultaneous increase in PM2.5 constituents of interest by a quartile) and PM2.5 black carbon gave the greatest contribution of the overall mixture effects (71%) among all individual constituents. The susceptible window is the late first trimester and second trimester. Furthermore, the risks of PE-E associated with PM2.5 exposure were significantly higher among Hispanic and African American mothers and mothers who live in low- to middle-income neighborhoods (p < 0.05 for Cochran's Q test). Study limitations include potential exposure misclassification solely based on residential outdoor air pollution, misclassification of disease status defined by ICD codes, the date of diagnosis not reflecting the actual time of onset, and lack of information on potential covariates and unmeasured factors for HDP.ConclusionsOur findings add to the literature on associations between air pollution exposure and HDP. To our knowledge, this is the first study reporting that specific air pollution components, mixture effects, and susceptible windows of PM2.5 may affect GH and PE-E differently.

Introduction The waiting list for elective surgery in England recently reached over 7.8 million people and waiting time targets have been missed since 2010. The high-volume low complexity (HVLC) surgical hubs programme aims to tackle the backlog of patients awaiting elective surgery treatment in England. This study will evaluate the impact of HVLC surgical hubs on productivity, patient care and the workforce.Methods and analysis This 4-year project consists of six interlinked work packages (WPs) and is informed by the Consolidated Framework for Implementation Research. WP1: Mapping current and future HVLC provision in England through document analysis, quantitative data sets (eg, Hospital Episodes Statistics) and interviews with national service leaders. WP2: Exploring the effects of HVLC hubs on key performance outcomes, primarily the volume of low-complexity patients treated, using quasi-experimental methods. WP3: Exploring the impact and implementation of HVLC hubs on patients, health professionals and the local NHS through approximately nine longitudinal, multimethod qualitative case studies. WP4: Assessing the productivity of HVLC surgical hubs using the Centre for Health Economics NHS productivity measure and Lord Carter’s operational productivity measure. WP5: Conducting a mixed-methods appraisal will assess the influence of HVLC surgical hubs on the workforce using: qualitative data (WP3) and quantitative data (eg, National Health Service (NHS) England’s workforce statistics and intelligence from WP2). WP6: Analysing the costs and consequences of HVLC surgical hubs will assess their achievements in relation to their resource use to establish value for money. A patient and public involvement group will contribute to the study design and materials.Ethics and dissemination The study has been approved by the East Midlands—Nottingham Research Ethics Committee 23/EM/0231. Participants will provide informed consent for qualitative study components. Dissemination plans include multiple academic and non-academic outputs (eg, Peer-reviewed journals, conferences, social media) and a continuous, feedback-loop of findings to key stakeholders (eg, NHS England) to influence policy development.Trial registration Research registry: Researchregistry9364 (https://www.researchregistry.com/browse-the-registry%23home/registrationdetails/64cb6c795cbef8002a46f115/).

BackgroundOverweight and obesity pose a global public health challenge and have a multifactorial origin. One of these factors includes obesogenic environments, which promote ultraprocessed foods characterized by being high in calories, saturated fats, added sugars, and sodium. In Mexico, it has been estimated that 30% of the total energy consumed comes from processed foods. The Modification to the Official Mexican Standards introduces nutritional information through black octagonal seals that alert consumers about products with excessive amounts of some components for a better food selection in the population. However, the effects of warning labels on processed food selection and purchases among children remain unknown. ObjectiveWe aimed to evaluate the impact of a digital educational intervention focusing on front-of-package warning labels on the food selection and purchasing behavior of elementary schoolchildren and their caregivers. MethodsChildren from 4 elementary schools in Mexico City, 2 public and 2 private schools, will participate in a randomized controlled trial. The schools will be chosen by simple random sampling. Schools will be randomized into 2 groups: intervention and control. In the control group, the dyads (caregiver-schoolchildren) will receive general nutritional education, and in the intervention group, they will receive guidance on reading labels and raising awareness about the impact of consuming ultraprocessed products on health. The educational intervention will be conducted via a website. Baseline measurements will be taken for both groups at 3 and 6 months. All participants will have access to an online store through the website, allowing them to engage in exercises for selecting and purchasing food and beverages. In addition, other measures will include a brief 5-question exam to evaluate theoretical understanding, a 24-hour reminder, a survey on food habits and consumption, application of a food preference scale, anthropometric measurements, and recording of school lunch choices. ResultsRegistration and funding were authorized in 2022, and we will begin data collection in September 2024. Recruitment has not yet taken place, but the status of data analysis and expected results will be published in April 2025. ConclusionsThe study is expected to contribute to evaluating whether reinforcing front-of-package warning labels with education enhances its effects and makes them more sustainable. Conducting this study will allow us to propose whether or not it is necessary to develop new intervention strategies related to front-of-package labeling for a better understanding of the population, improved food choices, and better health outcomes. Trial RegistrationClinicalTrials.gov NCT06102473; https://clinicaltrials.gov/study/NCT06102473 International Registered Report Identifier (IRRID)PRR1-10.2196/54783

Summary: Background: Lung function trajectories (LFTs) have been shown to be an important measure of long-term health in asthma. While there is a growing body of metabolomic studies on asthma status and other phenotypes, there are no prospective studies of the relationship between metabolomics and LFTs or their genomic determinants. Methods: We utilized ordinal logistic regression to identify plasma metabolite principal components associated with four previously-published LFTs in children from the Childhood Asthma Management Program (CAMP) (n = 660). The top significant metabolite principal component (PCLF) was evaluated in an independent cross-sectional child cohort, the Genetic Epidemiology of Asthma in Costa Rica Study (GACRS) (n = 1151) and evaluated for association with spirometric measures. Using meta-analysis of CAMP and GACRS, we identified associations between PCLF and microRNA, and SNPs in their target genes. Statistical significance was determined using an false discovery rate-adjusted Q-value. Findings: The top metabolite principal component, PCLF, was significantly associated with better LFTs after multiple-testing correction (Q-value = 0.03). PCLF is composed of the urea cycle, caffeine, corticosteroid, carnitine, and potential microbial (secondary bile acid, tryptophan, linoleate, histidine metabolism) metabolites. Higher levels of PCLF were also associated with increases in lung function measures and decreased circulating neutrophil percentage in both CAMP and GACRS. PCLF was also significantly associated with microRNA miR-143-3p, and SNPs in three miR-143-3p target genes; CCZ1 (P-value = 2.6 × 10−5), SLC8A1 (P-value = 3.9 × 10−5); and TENM4 (P-value = 4.9 × 10−5). Interpretation: This study reveals associations between metabolites, miR-143-3p and LFTs in children with asthma, offering insights into asthma physiology and possible interventions to enhance lung function and long-term health. Funding: Molecular data for CAMP and GACRS via the Trans-Omics in Precision Medicine (TOPMed) program was supported by the National Heart, Lung, and Blood Institute (NHLBI).

Introducción: El ejercicio físico ha demostrado tener un impacto favorable en la salud del individuo. Su combinación con otros estilos de vida saludable, puede impactar de forma positiva diversas áreas entre las que se encuentra la calidad del sueño. Objetivo: Determinar la frecuencia de somnolencia diurna excesiva en adultos mayores de un programa municipal de actividad física de Santiago de Cali, Colombia. Metodología: Estudio de corte trasversal que incluyó 605 adultos mayores de un programa comunitario de la Secretaría de Recreación y Deporte de la Ciudad de Cali, Colombia, durante octubre de 2018 y junio de 2019. Para determinar la presencia de somnolencia diurna excesiva se usó la escala de somnolencia Epworth. Resultados: El 81,5% de la población era de sexo femenino con una edad promedio de 73±8 años. La prevalencia de somnolencia diurna excesiva fue del 10,5%. Sólo se encontró diferencias significativas en la frecuencia de somnolencia diurna excesiva por estrato socioeconómico, siendo más habitual en el bajo (13% vs 4% P=0,03). Conclusión: La somnolencia diurna excesiva es un fenómeno que afecta los adultos mayores, sin embargo, su frecuencia puede ser menor en aquellos que realizan actividad física.

Abstract Voice assistants are potentially helpful when working in a scientific laboratory. A big challenge is the extremely specific use of language in every laboratory. As with any voice assistant, another concern is data security. Here, we present Rainbow—an open source voice user interface (VUI) for scientific laboratories, that is adaptable to any Windows PC with Internet access. We used Google Translate Site (GTS) as a voice input and output system to ensure communication to the user. The scripting language AutoIt controls GTS, executes all actions and builds the VUI. Rainbow performs tasks from three different areas—general Microsoft Windows tasks, lab-specific tasks, and device-specific tasks. We achieved significantly higher speech recognition accuracy with our VUI than with GTS alone (91.3% versus 85.1%). Because of Rainbow's architecture, it is possible to improve the voice assistant in terms of functionality and accuracy, allowing each laboratory to optimize its own Rainbow system in a user-friendly way. In a test setup, this led to a speech recognition accuracy of 98.6%. Taken together, Rainbow provides an opportunity for every scientist to implement highly specific scientific terms and tasks to this open source voice assistant system in a very user-friendly way.

Abstract YKL-40 increase according to the aging process, and its functions have been associated with tissue remodeling and systemic inflammation. In Rheumatoid Arthritis (RA) it has been proposed as a possible biomarker of activity and severity, however; in the field of idiopathic inflammatory myopathies (IIM) the role of YKL-40 in IIM is not clear. Thus, we aimed to evaluate if there is an association between the serum levels and muscle tissue expression of YKL-40 with age, IIM phenotype, muscle strength and myositis disease activity. The main finding was that age is the most important variable that affects the YKL-40 serum levels. In muscle biopsy, we observed that YKL-40 is mainly expressed in infiltrating lymphoid cells than in muscle tissue. Using ANCOVA according to the b-coefficients, YKL-40 serum levels are predicted by inflammatory state, age, and IIM diagnosis.

Approximately 90% of patients with arthritis exhibit forefoot deformities, including deformities within the metatarsophalangeal and proximal interphalangeal joints. Current pharmacological treatment with Disease Modifying Antirheumatic Drugs (DMARDs) consists of two groups: synthetic drugs (sDMARDs) and biological drugs (bDMARDs). The objective of our study was to investigate foot anthropometry changes in RA patients based on the administered treatment over a five-year period Method: A longitudinal analysis was conducted with RA patients who were grouped based on their pharmacological treatment. The pharmacological treatment groups were categorized into (I) methotrexate (MTX), (II) MTX plus biological treatments (including all variables), (III) biological treatment alone, and (IV) a miscellaneous group comprising patients with diverse treatments, including patients for whom various drugs had failed or who had not achieved remission with pharmacological treatment. For the anthropometric measurements, a foot measurement platform validated by McPoil et al. was used. Post hoc analyses with Bonferroni correction were performed to identify pairwise differences between the treatment groups while controlling for Type I errors due to multiple comparisons. Results: In the period from 2018 to 2023, significant changes were observed in several foot measurements. For instance, the MTX group showed a statistically significant increase in left heel width (p = 0.026). The MTX group experienced a slight increase in left foot length, while the Biologics and MTX + Bio groups exhibited more substantial increases in both maximum medial arch height and midfoot width. Conclusions: Different RA treatments can have a significant impact on foot structure over a five-year period, showing notable changes in heel width and overall foot morphology. Combined treatments with MTX and biologics potentially offer better management of RA.

Follicular helper CD4hi T cells (TFH) are a major cellular pool for the maintenance of the HIV reservoir. Therefore, the delineation of the follicular (F)/germinal center (GC) immune landscape will significantly advance our understanding of HIV pathogenesis. We have applied multiplex confocal imaging, in combination with the relevant computational tools, to investigate F/GC in situ immune dynamics in viremic (vir-HIV), antiretroviral-treated (cART HIV) People Living With HIV (PLWH) and compare them to reactive, non-infected controls. Lymph nodes (LNs) from viremic and cART PLWH could be further grouped based on their TFH cell densities in high-TFH and low-TFH subgroups. These subgroups were also characterized by different in situ distributions of PD1hi TFH cells. Furthermore, a significant accumulation of follicular FOXP3hiCD4hi T cells, which were characterized by a low scattering in situ distribution profile and strongly correlated with the cell density of CD8hi T cells, was found in the cART-HIV low-TFH group. An inverse correlation between plasma viral load and LN GrzBhiCD8hi T and CD16hiCD15lo cells was found. Our data reveal the complex GC immune landscaping in HIV infection and suggest that follicular FOXP3hiCD4hi T cells could be negative regulators of TFH cell prevalence in cART-HIV.

One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, which is possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, and cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence had a negative impact on satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships.

Background: COVID-19 is an infectious disease caused by SARS-CoV-2. It is unclear whether influenza vaccination reduces the severity of disease symptoms. Previous studies have suggested a beneficial effect of influenza vaccination on the severity of COVID-19. The aim of this study was to evaluate the possible protective effect of the influenza vaccine on the occurrence of SARS-CoV-2 infection symptoms and prognosis in patients hospitalized with COVID-19. Methods: This was a retrospective cohort study of patients who tested positive for SARS-CoV-2, identified by quantitative real-time polymerase chain reaction. Chi-square tests, Kaplan–Meier analysis, and multivariate analysis were performed to assess the association between influenza vaccination and the presence of symptoms in hospitalized patients with COVID-19 and their outcome. Results: In this study, 1712 patients received positive laboratory tests for SARS-CoV-2; influenza vaccination was a protective factor against the presence of characteristic COVID-19 symptoms such as polypnea, anosmia, dysgeusia, and fever (p < 0.001). Influenza-vaccinated patients had fewer days of hospitalization (p = 0.029). Conclusions: The findings of this study support that influenza vaccination is associated with a decrease in the number of symptoms in patients hospitalized due to COVID-19, with fewer days of hospitalization, but not with the outcome of disease.

Introduction: psychological stress in university students studying Bachelor of Tourism can cause negative manifestations in the psychological, physical and social order. Objective: to present the validity of a therapeutic massage procedure that contributes to reducing psychological stress in Bachelor of Tourism students at the University of Holguín. Methods: a quantitative research was carried out, theoretical and empirical methods were used. Mathematical statistics were used to process the data. 17 experts were selected to evaluate the procedure used, with an average experience of 17 years. The research was from September 2019 to July 2022. A sample of 82 students was selected, to whom a pre-test was applied before treatment, with therapeutic massage, and a post-test at the end. Results: by observing the students in the different contexts of action and reviewing the sources of information, results indicative of psychological stress were evident. In a survey administered to teachers, little theoretical and methodological knowledge was demonstrated for the application of therapeutic massage for university students with psychological stress. Conclusions: the procedure developed to reduce stress was applied and demonstrate its effectiveness on the health and well-being of the selected sample.

Las aves, por su adaptación al vuelo, han podido desarrollarse en una amplia variedad de hábitats, lo que ha facilitado el aprovechamiento de una amplia gama de alimentos merced a sus desplazamientos y migraciones periódicas a diferentes ecosistemas'. Las migraciones de muchas especies de aves constituyen el movimiento masivo masivo más extraordinario que acontece entre las criaturas vivientes. Las aves se adaptaron a una variedad de dietas. Muchas especies son exclusivamente herbívoras (consumidoras primarias) siendo escasos los vegetales o sus fragmentos, como las partes leñosas, que no son ingeridos. Otras recurren al néctar, nutriente importante pero limitado. No obstante, las aves nectívoras no dependen exclusivamente del mismo ya que introducen además artrópodos pequeños los cuales son atraídos por las flores al igual que ellas 2-4 Muchas aves son consumidoras secundarias (carnívoras que comen herbívoras) alimentándose de presas animales cuidadosamente seleccionadas. De esta manera ingieren vertebrados e incluso ellas mismas se convierten en presas de otras aves. Las especies necrófagas o carroñeras incorporan tanto la musculatura como los restos óseos de animales muertos, higienizando los campos y evitando la propagación de epidemias. Los pájaros pueden acceder a lugares recónditos y elevados gracias a su capacidad de volar y actuar como freno biológico contra especies que pueden llegar a constituir verdaderas plagas. Las aves granívoras son sumamente beneficiosas ya que colaboran para mantenerel equilibrio natural devorando gran cantidad de semillas de plantas invasoras, como el cardo, evitando de esa manera su gran próliferación. Pero los pájaros también contribuyen a la expansión de especies vegetales. Las aves sembradoras ingieren frutas carnosas, digieren su cutícula y queda así desnuda la semilla, la cual es arrojada con las deyecciones y puede germinar. La enorme variedad de medios han capacitado a las aves para encontrar su alimento en los ambientes más diversos. Así, podemos observar como algunas especies exploran la tierra en busca de insectos que se desplazan sobre su superficie. También las hay que escarban el terreno capturando larvas y huevos que estaban ocultos en el rnisMo Muchos insectos que se refugian en las anfractuosidades de la corteza de los árboles son descubiertos por aves que golpetean e introducen su pico en la madera. Aves acuáticas devoran pequeños moluscos, crustáceos e insectos acuáticos. Gran cantidad de aves modifican sus preferencias alimentarias en las distintas estaciones del año al igual que sus exigencias fisiológicas en concordancia con las variaciones de sus funciones metabólicas. Las aves se ven limitadas en su peso corporal por lo cual no pueden acumular muchas reservas en su organismo y como su consumo de energía es muy importante deben ingerir mucho con una frecuencia elevada. Además, como consecuencia de su dieta variada los órganos del tubo digestivo se modifican no sólo estructural sino también funcionalmente. Se describen así cambios morfológicos, morfométricos, estructurales y

La calidad de la enseñanza en el área de salud se apoya en tres pilares fundamentales: la educación del pregrado, la formación de postgrado y la educación continua o permanente a las cuales se accede a través de la formación de recursos humanos en docencia, investigación y servicio. Debido a la complejidad del trabajo médico/ odontológico y al cúmulo de conocimientos específicos, los cuales desbordan la capacidad de dominio 1)0V parte de los profesionales de todas las áreas de las Ciencias de la Salud, han sufrido las especialidades y postgrados en un campo de acción determinado dentro de la Medicina y la Odontología. Sin embargo, la fonnación de los recursos humanos para investigación y docencia en Ciencias Básicas Biomédicas es crítica y los programas que existen son insuficientes en cantidad y calidad. En base a lo expuesto proponemos un Plan de Especialización en Ciencias Básicas (PECB) cuyo fin es brindar al egresado de Medicina y Odontología las posibilidades de formarse y capacitarse en investigación, docencia y servicio respondiendo al perfil profesional que la comunidad requiere. Dicho plan tendrá caracter tutorial. La función del tutor será la de responder por el graduado desde su ingreso al PECB hasta la finalización de su especialización. El tutor se encargará de orientar e instruir al egresado desde el momento de su ingreso al plan iniciando así su trabajo de invetigación.

Viral populations in natural infections can have a high degree of sequence diversity, which can directly impact immune escape. However, antibody potency is often tested in vitro with a relatively clonal viral populations, such as laboratory virus or pseudotyped virus stocks, which may not accurately represent the genetic diversity of circulating viral genotypes. This can affect the validity of viral phenotype assays, such as antibody neutralization assays. To address this issue, we tested whether recombinant virus carrying SARS-CoV-2 spike (VSV-SARS-CoV-2-S) stocks could be made more genetically diverse by passage, and if a stock passaged under selective pressure was more capable of escaping monoclonal antibody (mAb) neutralization than unpassaged stock or than viral stock passaged without selective pressures. We passaged VSV-SARS-CoV-2-S four times concurrently in three cell lines and then six times with or without polyclonal antiserum selection pressure. All three of the monoclonal antibodies tested neutralized the viral population present in the unpassaged stock. The viral inoculum derived from serial passage without antiserum selection pressure was neutralized by two of the three mAbs. However, the viral inoculum derived from serial passage under antiserum selection pressure escaped neutralization by all three mAbs. Deep sequencing revealed the rapid acquisition of multiple mutations associated with antibody escape in the VSV-SARS-CoV-2-S that had been passaged in the presence of antiserum, including key mutations present in currently circulating Omicron subvariants. These data indicate that viral stock that was generated under polyclonal antiserum selection pressure better reflects the natural environment of the circulating virus and may yield more biologically relevant outcomes in phenotypic assays. Thus, mAb assessment assays that utilize a more genetically diverse, biologically relevant, virus stock may yield data that are relevant for prediction of mAb efficacy and for enhancing biosurveillance.

Abstract Introduction: Community-Engaged Research (CEnR) and Community-Based Participatory Research (CBPR) require validated measures and metrics for evaluating research partnerships and outcomes. There is a need to adapt and translate existing measures for practical use with diverse and non-English-speaking communities. This paper describes the Spanish translation and adaptation of Engage for Equity’s Community Engagement Survey (E2 CES), a nationally validated and empirically-supported CEnR evaluation tool, into the full-length “Encuesta Comunitaria,” and a pragmatic shorter version “Fortaleciendo y Uniendo EsfueRzos Transdisciplinarios para Equidad de Salud” (FUERTES). Methods: Community and academic partners from the mainland US, Puerto Rico, and Nicaragua participated in translating and adapting E2 CES, preserving content validity, psychometric properties, and importance to stakeholders of items, scales, and CBPR constructs (contexts, partnership processes, intervention and research actions, and outcomes). Internal consistency was assessed using Cronbach’s alpha and convergent validity was assessed via a correlation matrix among scales. Results: Encuesta Comunitaria respondents (N = 57) self-identified as primarily Latinos/as/x (97%), female (74%), and academics (61%). Cronbach’s alpha values ranged from 0.72 to 0.88 for items in the context domain to 0.90–0.92 for items in the intervention/research domain. Correlations were found as expected among subscales, with the strongest relationships found for subscales within the same CBPR domain. Results informed the creation of FUERTES. Conclusions: Encuenta Comunitaria and FUERTES offer CEnR/CBPR practitioners two validated instruments for assessing their research partnering practices, and outcomes. Moreover, FUERTES meets the need for shorter pragmatic tools. These measures can further strengthen CEnR/CBPR involving Latino/a/x communities within the US, Latin America, and globally.

Background and objectivesSevere pneumonia is the leading cause of death among young children worldwide, disproportionately impacting children who lack access to advanced diagnostic imaging. Here our objectives were to develop and test the accuracy of an artificial intelligence algorithm for detecting features of pulmonary consolidation on point-of-care lung ultrasounds among hospitalized children.MethodsThis was a prospective, multicenter center study conducted at academic Emergency Department and Pediatric inpatient or intensive care units between 2018-2020. Pediatric participants from 18 months to 17 years old with suspicion of lower respiratory tract infection were enrolled. Bedside lung ultrasounds were performed using a Philips handheld Lumify C5-2 transducer and standardized protocol to collect video loops from twelve lung zones, and lung features at both the video and frame levels annotated. Data from both affected and unaffected lung fields were split at the participant level into training, tuning, and holdout sets used to train, tune hyperparameters, and test an algorithm for detection of consolidation features. Data collected from adults with lower respiratory tract disease were added to enrich the training set. Algorithm performance at the video level to detect consolidation on lung ultrasound was determined using reference standard diagnosis of positive or negative pneumonia derived from clinical data.ResultsData from 107 pediatric participants yielded 117 unique exams and contributed 604 positive and 589 negative videos for consolidation that were utilized for the algorithm development process. Overall accuracy for the model for identification and localization of consolidation was 88.5%, with sensitivity 88%, specificity 89%, positive predictive value 89%, and negative predictive value 87%.ConclusionsOur algorithm demonstrated high accuracy for identification of consolidation features on pediatric chest ultrasound in children with pneumonia. Automated diagnostic support on an ultraportable point-of-care device has important implications for global health, particularly in austere settings.

Patients with rheumatoid arthritis (RA) who receive immunosuppressive medications have a heightened risk of infection. The goal of our study was to calculate the pooled cumulative incidence and risk of infection in patients with RA treated with Janus kinase inhibitors (JAKi). The PubMed and EMBASE databases were queried for randomized controlled trials comparing patients with RA treated with JAKi (upadacitinib, baricitinib, tofacitinib, peficitinib, or filgotinib), defined as the treatment group, compared with control subjects, defined as participants receiving placebo or treatment regimen that was similar to that of participants in the treatment group, with the exception of JAKi. The primary study endpoint was the relative risk (RR) of any-grade and severe infection. The secondary endpoints were RR and cumulative incidence of opportunistic infections, herpes zoster, and pneumonia. The Stata v17 software was used for all data analysis. Results showed that treatment with baricitinib was associated with an increased risk of any-grade (RR 1.34; 95% CI: 1.19-1.52) and opportunistic (RR 2.69; 95% CI: 1.22-5.94) infection, whereas treatment with filgotinib (RR 1.21; 95% CI: 1.05-1.39), peficitinib (RR 1.40; 95% CI: 1.05-1.86) and upadacitinib (RR 1.30; 95% CI: 1.09-1.56) was associated with increased risk of any-grade infection only. Analysis based on type of infection showed a pooled cumulative incidence of 32.44% for any-grade infections, 2.02% for severe infections, 1.74% for opportunistic infections, 1.56% for herpes zoster, and 0.49% for pneumonia in patients treated with any JAKi during the follow-up period. Treatment with specific JAKi in patients with RA is associated with an increased risk of any-grade and opportunistic infections but not severe infection. Close clinical monitoring of patients with RA treated with JAKi is required to establish the long-term infection risk profile of these agents.

[This corrects the article DOI: 10.1371/journal.pone.0288235.].