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Abstract Background Several studies have compared the pros and cons of simultaneous bilateral versus staged bilateral hip and knee replacement but the outcomes of these two surgical options remains a matter of controversy. This study aimed to evaluate demographic features, incidence and hospitalization rates of bilateral one stage total hip and knee arthroplasty in Italy. Methods The Italian Ministry of Health’s National Hospital Discharge Reports (SDO) were used to gather data. This study referred to the adult population (+ 20 years of age) from 2001 to 2015 for hip arthroplasty and from 2001 to 2016 for knee arthroplasty. Results Overall, 1,544 bilateral simultaneous hip replacement were carried out. The incidence rate was 0.21 cases per 100,000 adult Italian residents. Male/female ratio was 1.1. The average days of hospital stay was 11.7 ± 11.8 days. The main primary codified diagnosis was: osteoarthrosis, localized, primary, pelvic region and thigh (ICD code: 715.15). 2,851 bilateral simultaneous knee replacement were carried out. The incidence rate was 0.37 cases per 100,000 adult Italian residents. Male/female ratio was 0.6. The average days of hospital stay was 7.7 ± 5.8 days. The main primary codified diagnosis was: osteoarthrosis, localized, primary, lower leg (ICD code: 715.16). Conclusions The burden of hip and knee osteoarthrosis as a leading cause of bilateral joint replacement is significant in Italy. The national registers’ longitudinal analysis may provide data for establishing international guidelines regarding the appropriate indications for one stage bilateral simultaneous hip or knee replacement versus two stage.

El presente artículo busca contribuir al desarrollo y consolidación de los estudios sobre la gourmetización y la gentrificación alimentaria, enfatizando los efectos que estos procesos tienen en ámbitos que exceden a la vida urbana. En ese marco, se propone recuperar los engranajes de la cadena de valor y sus localizaciones –desde los barrios gentrificados hasta las comunidades rurales agrícolas–, indicando los procesos de valorización y desvalorización y cómo estos afectan de forma desigual a los actores involucrados. Se enfatiza sobre este punto, estableciendo un diálogo interdisciplinar. A partir de una revisión bibliográfica, el artículo se basa en cuatro casos que se recuperan de fuentes secundarias y que ilustran la forma en la que operan estos procesos en distintos niveles, territorios y escalas: el café de autor en cuanto símbolo de distinción en los barrios gentrificados; la palta o aguacate a partir de su manifestación gastronómica en el avocado toast; el vino, desde la turistificación de su producción hasta las estrategias de valorización en su consumo urbano; y la quinoa desde el patentamiento de nuevas variedades hasta el desarrollo de mercados expulsivos de amplios sectores de población. Se concluye que el auge de estos alimentos tiene efectos de acumulación del capital por desposesión en los ámbitos rural y urbano al igual que en los procesos de producción y de consumo.

The organic carbon (Corg) stored in seagrass meadows is globally significant and could be relevant in strategies to mitigate increasing CO2 concentration in the atmosphere. Most of that stored Corg is in the soils that underlie the seagrasses. We explored how seagrass and soil characteristics vary among seagrass meadows across the geographic range of turtlegrass (Thalassia testudinum) with a goal of illuminating the processes controlling soil organic carbon (Corg) storage spanning 23° of latitude. Seagrass abundance (percent cover, biomass, and canopy height) varied by over an order of magnitude across sites, and we found high variability in soil characteristics, with Corg ranging from 0.08 to 12.59% dry weight. Seagrass abundance was a good predictor of the Corg stocks in surficial soils, and the relative importance of seagrass-derived soil Corg increased as abundance increased. These relationships suggest that first-order estimates of surficial soil Corg stocks can be made by measuring seagrass abundance and applying a linear transfer function. The relative availability of the nutrients N and P to support plant growth was also correlated with soil Corg stocks. Stocks were lower at N-limited sites than at P-limited ones, but the importance of seagrass-derived organic matter to soil Corg stocks was not a function of nutrient limitation status. This finding seemed at odds with our observation that labile standard substrates decomposed more slowly at N-limited than at P-limited sites, since even though decomposition rates were 55% lower at N-limited sites, less Corg was accumulating in the soils. The dependence of Corg stocks and decomposition rates on nutrient availability suggests that eutrophication is likely to exert a strong influence on carbon storage in seagrass meadows.

Las representaciones visuales ayudan a las personas a comprender mejor conceptos complejos. Este estudio analiza el diseño gráfico como herramienta efectiva en la comunicación de términos sobre sostenibilidad y economía circular, facilitando la adopción de sus principios. A través de un análisis bibliográfico y comparativo de modelos visuales, se investiga cómo el diseño gráfico simplifica la representación de ecosistemas de diseño circular. Los resultados muestran que el uso de gráficos mejora la claridad y accesibilidad de estos modelos, revelando conexiones entre procesos complejos. Se concluye que las representaciones gráficas hacen que los enfoques sostenibles sean más prácticos y aplicables.

IntroductionSolid organ transplant (SOT) recipients display weak seroconversion and neutralizing antibody (NAb) responses after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and remain at risk of severe coronavirus disease 2019 (COVID-19). While B-cell memory is the hallmark of serological immunity, its role in driving successful vaccine responses and providing immune protection in SOT patients remains unclear.MethodsWe investigated the function and interplay of SARS-CoV-2-specific memory B cells (mBc), different cytokineproducing T cells, and cross-reactive NAb in driving seroconversion and protection against COVID-19 in two cohorts. First, we studied a large cohort of 148 SOT recipients and 32 immunocompetent individuals who underwent several vaccinations. Subsequently, we assessed 25 SOT patients participating in a randomized controlled trial to compare two different immunosuppressive strategies for allowing successful seroconversion and memory-cell responses after booster vaccination.ResultsWe corroborate previous findings that B- and T-cell memory responses are weaker and more delayed in SOT patients than in immunocompetent (IC) individuals; however, within the SOT cohort, we found that these responses are relatively stronger and more robust in patients not receiving mycophenolate mofetil (MMF)-based therapies. Anti- spike IgG titers strongly correlated with RBD-specific IgG-producing mBc, with both displaying broad viral cross reactivity. Prebooster SARS-CoV-2-specific mBc and IL-2- producing T cells accurately predicted Nab seroconversion (AUC, 0.828) and protection against severe COVID-19. While switching unresponsive SOT patients from calcineurin inhibitors (CNI)/MMF to a low-exposure CNI/mTOR-i regimen favored wider SARS-CoV-2-specific immune responses after a fourth booster vaccination, preformed RBD-specific mBc predicted NAb seroconversion.DiscussionOur study adds new insights into the pathobiology of immune memory and highlights the pivotal role of SARS-CoV-2-specific mBc in promoting immune protection inSOT patients.

Introducción: La importancia del conocimiento del impacto del trabajo en la salud de las personas se ha acrecentado tras la pandemia por COVID-19. El síndrome de Burn Out (BO) nace de la tensión emergente de la interacción conflictiva entre el trabajador y su empleo. El objetivo fue describir la prevalencia y frecuencia de diagnóstico del BO en el recurso humano en salud de servicios críticos del Hospital Municipal de Bahía Blanca en el contexto de la pandemia COVID-19. Métodos: Estudio descriptivo, de corte transversal. La población de estudio fue el personal médico y de enfermería de los servicios de Terapia intensiva (TI), Médico de Urgencias (SMU) y Clínica que trabajaron con COVID-19 durante el 2021. Se empleó el cuestionario Maslach Burnout Inventory (MBI) y preguntas cerradas complementarias para identificar, entre estos casos, aquellos que fueron diagnosticados y tratados por la institución. Resultados: De los 219 trabajadores, el 55,3% (121/219) fueron enfermeros. En el SMU el 25% (24/96) de encuestados tenía BO, seguido por un 20,4% (11/54) en Clínica y un 8.7% (6/69) en TI (valor p=0.004). Sólo el 5,5% (12/219) del total fue diagnosticado con BO por la institución y de este grupo, dos personas (0,9%) habían consultado previamente por síntomas característicos. Discusión: Se evidenció una elevada prevalencia de BO y un marcado sub-diagnóstico a nivel institucional durante la pandemia. A pesar de que el Servicio de TI tuvo la mayor demanda de atención, fue el que presentó los valores más bajos de BO en relación a otros servicios.

Summary: Background: Severe and prolonged mpox courses have been described during the 2022–2023 outbreak. Identifying predictors of severe evolution is crucial for improving management and therapeutic strategies. We explored the predictors of mpox severity and tested the association between mpox severity and viral load in biological fluids. We also analysed the predictors of disease duration and kinetics of inflammatory markers and described the viral presence and duration of shedding in biological fluids. Methods: This multicentre historical cohort study included adults diagnosed with laboratory-confirmed mpox diagnosis between May 2022 and September 2023 at 15 Italian centres. Patients were followed up from the day of diagnosis until clinical recovery. Biological fluids (blood, urine, saliva, and oropharyngeal and rectal swabs) were collected from each subgroup during the course of the disease and after healing. The primary outcomes were disease severity (presence of mucosal involvement, extended rash, or need for hospitalisation) and its association with the cycle threshold value (Ct-value, surrogate of viral load) in biological fluids, using standard linear and linear mixed-effect logistic regression models. Among the secondary outcomes, predictors of disease duration were assessed using a linear regression model. Findings: A total of 541 patients were enrolled, including four (0.74%) women, with a median age of 38 years (IQR 33–44). Among the 235 people living with HIV (PLWH) (43.44%), 22 (4.07%) had a CD4 count lower than 350 cells/μL. Severe mpox was reported in 215 patients (39.74%). No patient died. Multivariable analysis showed that, severe mpox was more likely among Caucasians (OR 1.82; 95% CI 1.14–2.90, p = 0.012) and patients who had an onset of fever (1.95; 1.27–2.99, p = 0.002), lymphadenopathy (2.30; 1.52–3.48, p

Envisioning trajectories towards sustainability encompasses enacting significant changes in multiple spheres (i.e., infrastructure, policy, practices, behaviors). These changes unfold within the intricate landscapes of wicked problems, where diverse perspectives and potential solutions intersect and often clash. Advancing more equitable and sustainable trajectories demands recognition of and collaboration with diverse voices to uncover meaningful synergies among groups striving to catalyze substantial change. Projects of this nature necessitate the exploration of varied tools and methodologies to elicit, convey, and integrate ideas effectively. Creating spaces for reflexivity is essential for catalyzing more meaningful impact as individuals engage in discussions aimed at sharing and questioning the coherence of their projects while forging synergies, identifying common objectives, and planning long-term outcomes. We present the initial phase of an endeavor in which we developed a software that elicits causal networks based on mapping relations between projects’ actions and outcomes. To illustrate our approach, we describe the results of using this software within collaborative workshops with groups spearheading projects initiated by a government entity in Mexico City. By adapting elements of the Theory of Change model, this software transcends the dominant linear project logic by guiding participants in designing causation networks that unveil how different projects can articulate to identify potential common elements and find new possibilities for coordination among initiatives. We discuss the potential of such software application as a dynamic tool to guide and promote reflection and coherence when crafting projects that aim to more meaningfully address sustainability problems.

Abstract This review outlines the current state of anthelmintic resistance (AHR) of gastrointestinal nematodes (GINs) among cattle in Argentina and Brazil, emphasizing the economic repercussions, animal health and welfare. The analysis explores factors associated with AHR and proposes a potential solution: the use of drug combinations. Both countries are grappling with a severe AHR scenario in cattle, having progressed through incipient, established, and advanced phases, leading to extreme cases of animal mortality due to ineffective control strategies. Genera such as Cooperia and Haemonchus have the highest reports of resistance, with Oesophagostomum radiatum also posing significant problems. While oral benzimidazoles and levamisole remain effective in most herds, moxidectin is entering an advanced resistance phase, and avermectins are increasingly deemed ineffective. The review explores the impact ofclimate, mixed grazing, animal movement and other husbandry practices, and the relationship between ectoparasite control and the emergence of resistant helminths. Notably, the discussion includes the strategic use of drug combinations as a valuable approach to address resistant GINs control in livestock, highlighting its significant potential to mitigate the challenges posed by AHR in the cattle industry of these countries.

AbstractThe decision-making process for potential college students in the United States is overwhelming because of the volume of information available and the complexity of higher education systems. Prospective students must consider institutional rankings, academic programs, and financial aid opportunities in addition to completing numerous forms. For some students, there exist personal and professional advisors and resources to assist with navigating the process. Others with less social and cultural capital must figure out the system with little or no assistance while facing other barriers. Public libraries can be a resource for the college-bound community; however, research shows that public libraries are not actively engaged in supporting this user group. To provide focused, quality information services to any demographic, it is important to understand the perspectives of public-facing information workers. Through a cross-sectional online questionnaire of library staff across four states, this study sought to learn staff perspectives on the role of public libraries in serving prospective college students. The survey received 160 responses of which 100 open-ended responses pertained to the role of public libraries. Qualitative inductive analysis point to three core themes on the role of public libraries in serving this population, that of connector, provider, and supporter. A fourth theme suggests staff see the role as one for others to meet. This article provides insight into past examinations of public library support of college literacy offering an opening to further discussions on serving this overlooked user group. [ABSTRACT FROM AUTHOR]