Search

ABSTRACT Recent research provides new insights into the early establishment of the infant gut microbiome, emphasizing the influence of breastfeeding on the development of gastrointestinal microbiomes. In our study, we longitudinally examined the taxonomic and functional dynamics of the oral and gastrointestinal tract (GIT) microbiomes of healthy infants (n = 30) in their first year, focusing on the often-over-looked aspects, the development of archaeal and anaerobic microbiomes. Breastfed (BF) infants exhibit a more defined transitional phase in their oral microbiome compared to non-breastfed (NBF) infants, marked by a decrease in Streptococcus and the emergence of anaerobic genera such as Granulicatella. This phase, characterized by increased alpha-diversity and significant changes in beta-diversity, occurs earlier in NBF infants (months 1–3) than in BF infants (months 4–6), suggesting that breastfeeding supports later, more defined microbiome maturation. We demonstrated the presence of archaea in the infant oral cavity and GIT microbiome from early infancy, with Methanobrevibacter being the predominant genus. Still, transient patterns show that no stable archaeome is formed. The GIT microbiome exhibited gradual development, with BF infants showing increased diversity and complexity between the third and eighth months, marked by anaerobic microbial networks. NBF infants showed complex microbial co-occurrence patterns from the start. These strong differences between BF and NBF infants’ GIT microbiomes are less pronounced on functional levels than on taxonomic levels. Overall, the infant microbiome differentiates and stabilizes over the first year, with breastfeeding playing a crucial role in shaping anaerobic microbial networks and overall microbiome maturation.IMPORTANCEThe first year of life is a crucial period for establishing a healthy human microbiome. Our study analyses the role of archaea and obligate anaerobes in the development of the human oral and gut microbiome, with a specific focus on the impact of breastfeeding in this process. Our findings demonstrated that the oral and gut microbiomes of breastfed infants undergo distinct phases of increased dynamics within the first year of life. In contrast, the microbiomes of non-breastfed infants are more mature from the first month, leading to a steadier development without distinct transitional phases in the first year. Additionally, we found that archaeal signatures are present in infants under 1 year of age, but they do not form a stable archaeome. In contrast to this, we could track specific bacterial strains transitioning from oral to gut or persisting in the gut over time.

BackgroundAdolescents and young adults (AYA) with cystic fibrosis (CF) are at risk for deviating from their daily treatment regimen due to significant time burden, complicated daily therapies, and life stressors. Developing patient-centric, effective, engaging, and practical behavioral interventions is vital to help sustain therapeutically meaningful self-management. ObjectiveThis study aimed to devise and refine a patient-centered telecoaching intervention to foster self-management in AYA with CF using a combination of intervention development approaches, including an evidence- and theory-based approach (ie, applying existing theories and research evidence for behavior change) and a target population–centered approach (ie, intervention refinement based on the perspectives and actions of those individuals who will use it). MethodsAYA with CF, their caregivers, and health professionals from their CF care teams were recruited to take part in focus groups (or individual qualitative interviews) through a video call interface to (1) obtain perspectives on the overall structure and logistics of the intervention (ie, Step 1) and (2) refine the overall framework of the intervention and obtain feedback on feasibility, content, materials, and coach training (ie, Step 2). Qualitative data were analyzed using a reflexive thematic analysis process. Results were used to create and then modify the intervention structure and content in response to community partner input. ResultsFor Step 1, a total of 31 AYA and 20 clinicians took part in focus groups or interviews, resulting in 2 broad themes: (1) video call experience and (2) logistics and content of intervention. For Step 2, a total of 22 AYA, 18 clinicians, and 11 caregivers completed focus groups or interviews, yielding 3 major themes: (1) intervention structure, (2) intervention materials, and (3) session-specific feedback. Our Step 1 qualitative findings helped inform the structure (eg, telecoaching session frequency and duration) and approach of the telecoaching intervention. Step 2 qualitative results generally suggested that community partners perceived the feasibility and practicality of the proposed telecoaching intervention in promoting self-management in the face of complex treatment regimens. Extensive specific feedback was used to refine our telecoaching intervention before its efficacy testing in subsequent research. The diverse community partner input was critical in optimizing and tailoring our telecoaching intervention. ConclusionsThis study documents the methods and results for engaging key community partners in creating an evidence-based behavioral intervention to promote self-management in AYA with CF. Incorporating the lived experiences and perspectives of community partners is essential when devising tailored and patient-centered interventions.

ObjectivesTo evaluate the impact of rapid diagnostic testing (RDT) combined with immediate infectious disease (ID) consultation on the treatment of septic patients with positive blood cultures in intensive care units in a setting without 24/7 service.MethodsAdult ICU patients in a tertiary care hospital with positive blood cultures were included from January 2019 to December 2020. The control group underwent routine laboratory testing, and for the intervention group, RDT was applied with immediate ID consultation.ResultsIn 77 out of the 91 patients in the intervention group, the pathogen was identified by RDT. Regarding antimicrobial susceptibility testing (AST), genotypic testing (ePlex®) was successful for Gram-positive cocci, but inadequate for Gram-negative rods. Phenotypic resistance testing with the Accelerate PhenoTest® took too long to be successfully integrated into the intervention. Adaptation of empirical antibiotic therapy was recommended for 72.7% of the patients. Adherence to the ID consultation post-RDT results was high at 82.3%. In the control group, adaptation of the initial antibiotic therapy would have been recommended for 81.8% of patients, if the species identification had been available. Overall adherence to the local antibiotic therapy guideline for sepsis was significantly lower in the control than in the intervention group (27.8% versus 89.3%, p

Background Operative mortality for high-grade liver injury (HGLI) remains 42% to 66%, with near-universal mortality after retrohepatic caval injury. The objective of this study was to evaluate mortality and complications of operative and nonoperative management (OM and NOM) of HGLI at our institution, characterized by a trauma surgery–liver surgery collaborative approach to trauma care.Methods This was an observational cohort study of adult patients (age ≥16) with HGLI (The American Association for Surgery of Trauma (AAST) grades IV and V) admitted to an urban level I trauma center from January 2010 to November 2021. Data were obtained from the electronic medical record and state trauma registry. Patients were categorized by management strategy: immediate OM or planned NOM. The primary outcome was 30-day mortality.Results Our institution treated 179 patients with HGLI (78% blunt, 22% penetrating); 122 grade IV (68%) and 57 grade V (32%) injuries. All abdominal gunshot wounds and 49% of blunt injuries underwent initial OM; 51% of blunt injuries were managed initially by NOM. Procedures at the initial operation included hepatorrhaphy±packing (66.4%), nonanatomic resection (5.6%), segmentectomy (9.3%), and hepatic lobectomy (7.5%). Thirty-day mortality in the OM group was substantially lower than prior reports (23.4%). Operative mortality attributable to the liver injury was 15.7%. 19.4% of patients failed NOM with one death (1.4%).Conclusion We report an operative mortality of 23.4% for HGLI in a trauma care system characterized by a collaborative approach by trauma surgeons and liver surgeons.Level of evidence III

Se definen las competencias curatoriales en el ámbito de las artes que tienen convergencia con aquellas que son gestionadas por profesionales de la información en su práctica bibliotecológica. Estas se determinaron a partir de tres (3) experiencias desarrolladas en el Centro Cultural y de Recursos para el Aprendizaje y la Investigación de la Universidad Católica Andrés Bello. La investigación se planteó con un enfoque cualitativo de tipo introspectivo vivencial y su diseño fue el estudio descriptivo. La recolección de la información se realizó a través de la observación participante y la revisión documental. Como resultado del proceso se definieron catorce (14) competencias específicas distribuidas en cinco (5) categorías que propiciarán el desarrollo de la práctica curatorial en las exposiciones como espacio para el aprendizaje, la investigación y la experimentación artística.

Hyphopichia pseudoburtonii, is emerging as a potential biocontrol agent against various phytopathogens. These traits have been attributed to the production of various antifungal compounds in the presence of target pathogens. However, the broad molecular mechanisms involved in the antifungal activity are not yet understood. This study employed RNA sequencing to assess the temporal changes in H. pseudoburtonii Y963 gene expression patterns when co-cultivated with Botrytis cinerea. Genes differentially expressed in H. pseudoburtonii in co-culture with B. cinerea, compared to the monoculture were evaluated after 24, 48, and 120 h of growth. Up-regulation of genes encoding major core histones (H2A, H3, H4) and ribosomes in the first 24 h suggested an abundance of cells in the S phase of the cell cycle. At 48 h, the genes up-regulated highlight mitotic cell cycle activity and induction of filamentous growth, while in later stages, up-regulation of genes encoding high affinity transporters of sugars, copper and iron, as well as those involved in the retention and utilization of siderophore-iron was evident. Altogether, the data allude to competition for space and nutrients as key mechanisms activated in H. pseudoburtonii in the presence of B. cinerea. This research offers new insights into H. pseudoburtonii transcriptomic response to B. cinerea and illuminates the adaptive strategies and molecular mechanisms behind its antifungal activity.

While the public health emergency is over, telehealth and telepractice will continue to play a pivotal role in supporting health equity for diverse and vulnerable individuals in underserved communities. The American Occupational Therapy Association, the American Physical Therapy Association, the American Speech-Language-Hearing Association, and the American Telemedicine Association are professional associations representing the interests of more than 564,000 rehabilitation services professionals in the United States. These organizations have shared priorities including legislative, regulatory, and state-based advocacy efforts. Continued advocacy and promotion by professional organizations, providers and patients alike is necessary to ensure that all rehabilitation providers are included in any telehealth lists of federally and state approved providers. In addition, key health care industry stakeholders want telehealth to be a permanent option for care delivery and ensure that telehealth will remain widely available to support health equity and access to critical rehabilitation services for all.

La diabetes mellitus es un grupo de trastornos metabólicos comunes que comparten el fenotipo de hiperglucemia. El polimorfismo Pro12Ala en el exón B del gen que codifica para PPARg2 ha sido asociado en algunas poblaciones con diabetes tipo 2. El objetivo de este estudio fue determinar si existe asociación del polimorfismo Pro12Ala de PPARg2 y la diabetes mellitus tipo 2 en una muestra de la población panameña. Se evaluó la posible asociación del polimorfismo Pro12Ala en una muestra de 195 individuos (99 controles y 96 experimentales) de la población panameña. El polimorfismo Pro12Ala se detectó mediante análisis de reacción en cadena de la polimerasa y polimorfismo de longitud de fragmentos de restricción (PCR-RFLP). Se observó una mayor frecuencia del genotipo Pro12Ala en el grupo experimental (DM2) con respecto al grupo control (0.114 vs 0.010). La frecuencia del alelo Ala12 (alelo de menor frecuencia) en nuestro estudio fue de 2.8%. Este trabajo representa el primer estudio sobre asociación entre diabetes mellitus tipo 2 y el polimorfismo Pro12Ala (rs18012829) en una muestra de casos y controles. La razón de momios (OR) evidenció asociación con un riesgo relativo de 1.9735 en aquellos con genotipo Pro12Ala. La frecuencia del genotipo Pro12Ala fue mayor en mujeres lo cual sugiere que éstas pueden estar más predispuestas a desarrollar esta condición.

A 22-year-old woman presented with an ulcer on her right earlobe 2 months ago, with inflammation and enlarged ipsilateral lymph nodes in her neck. She was treated with antibiotics without success and then was referred to an infectious disease specialist. She has a cat at home with sporotrichosis, but without direct contact with the lesion, she did not remember any scratching by the cat. She also mentioned wearing a semi-jewel earring. This is a rare and unusual case of sporotrichosis in the earlobe, probably caused by wearing an earring contaminated by the cat's fungus that was present in the home environment. The delay in diagnosis and treatment led to the worsening of the injury and loss of the earlobe.

PURPOSEMetastatic urothelial carcinoma (mUC) poses a challenge to health care systems, given its treatment complexity and mortality. We aimed to describe the characteristics, treatment patterns, and survival outcomes of Mexican patients with mUC.METHODSA retrospective study was conducted across eight centers for adults with mUC from January /2001 to December 2021. We recorded medical history, eligibility for first-line platinum therapy, treatment lines received, and access to novel drugs. Descriptive statistics were used and survival analysis, including Kaplan-Meier curves and Cox proportional hazards model, was performed.RESULTSWe identified 379 patients with mUC; 37 were excluded, and 76% was male, with a median age of 67 years. The median follow-up was 8.4 months. Among those who received a first-line treatment (65%), cisplatin-based chemotherapy (45%) was the most common followed by carboplatin (39%). Causes of cisplatin ineligibility were Eastern Cooperative Oncology Group ≥2 (41%) and glomerular filtration rate

UN Women identified gender-based Violence (GBV) as the shadow pandemic of the COVID-19 pandemic between 2020 and 2022. For almost two years, women and girls worldwide were sheltering in homes with abusive intimate partners and experiencing violent trauma and even death. The United States (US) was among the nations that experienced lockdown-related spikes in GBV. Indeed, the Centers for Disease Control and Prevention (CDC) reports that the domestic violence crisis peaked in early 2021 during the COVID-19 lockdown, mostly among women and children who were having to shelter with their abusers. Among this population of women living in the US who were experiencing the shadow pandemic were female college/university students who experienced either intimate partner violence (IPV) while sheltering with abusive partners and/or cyber intimate partner aggression (IPA) via technology and social media. Black female college students were not only victims of IPV and IPA but also of femicide during the COVID-19 pandemic. Using a case study of an HBCU chaplain, this article explores intervention in and prevention of IPV, IPA, and femicide during the COVID-19 pandemic at the intersection of race, gender, class, and religion for African-descended female college students. Specifically, this article will investigate what role historical black college/university (HBCU) chaplains play in intervening in lockdown IPV, IPA, and femicide. Using the concept of positionality, the author argues that the HBCU chaplain is a key on-campus figure who can intervene and prevent sexual assault on college and university campuses. The article concludes with suggestions for necessary further research needed to address GBV on HBCU campuses.

BackgroundIn high-burden settings, most tuberculosis (TB) transmission likely occurs outside the home. Our qualitative study in Zambia explored the acceptability and preferences for designing TB active case finding (ACF) strategies to reach non-household contacts of people with TB.MethodsWe conducted 56 in-depth interviews with persons with TB (n = 12), TB healthcare workers (HCWs) (n = 10), TB lay HCWs (n = 10), and leaders/owners (n = 12) and attendees (n = 12) of community venue types identified as potential TB transmission locations. Interviews explored TB attitudes and beliefs, and perceptions toward two ACF strategies targeting non-household contacts: (1) “social-network strategy”—persons with newly diagnosed TB reach out to their close non-household contacts and (2) “venue-based strategy”—HCWs conduct screening at community venues frequented by persons with newly diagnosed TB. We used the Consolidated Framework for Implementation Research (CFIR) framework to develop interview topic guides and analyze data using a rapid deductive approach.ResultsAll participants felt that TB was an important issue in their community and that new detection strategies were needed. A “social-network strategy” was perceived as acceptable and feasible, where participants noted it was a caring act and could facilitate early diagnosis. For a “venue-based strategy,” most participants suspected TB transmission occurred at bars/taverns due to heavy alcohol use and prolonged time spent in crowded spaces; churches and betting halls were also commonly mentioned locations. Nearly all owners/leaders and patrons/attendees of bars, churches, and betting halls expressed acceptance of a venue-based strategy. They also indicated an interest in participating, citing many benefits, including increased TB knowledge/awareness, early diagnosis, convenience, and possibly reduced transmission, and recommended that the strategy incorporate sensitization, consent, volunteerism, and respectful, confidential, private services. For both strategies, most participants preferred the use of and being approached by trained peer TB survivors to facilitate ACF, given their prior TB patient experience and trust among community members.ConclusionStakeholders found social-network and venue-based TB-ACF strategies highly acceptable, recognizing their potential benefits for individuals and the broader community. Future research should evaluate the feasibility and effectiveness of TB ACF strategies for reaching non-household contacts.

El artículo tiene por objetivo analizar la problemática de la violencia de género, haciendo énfasis en el contexto latinoamericano y caribeño, considerando los desafíos legales que supone afrontar esta problemática humana. Se destaca la complejidad de esta patología social, que va más allá de las agresiones físicas, sino que incluye la agresión sexual y psicológica, el control, la manipulación y demás formas sutiles de coaccionar y afectar la vida de mujeres y niñas. Tal escenario deja en evidencia los múltiples efectos adversos de la violencia de género sobre sus víctimas, que incluyen trastornos mentales, lesiones físicas e íntimas, abortos, enfermedades de transmisión sexual e, incluso, la muerte en el caso del feminicidio. En tal sentido, el contexto latinoamericano y caribeño, junto con sus problemas estructurales, se convierte en un escenario que hace proliferar la violencia de género, como consecuencia del agigantamiento de las brechas y desigualdades sociales por toda la región. No obstante, las respuestas legales y los marcos regulatorios, se presentan como oportunidades para prevenir, sancionar y erradicar toda forma de violencia contra la mujer, siendo un desafío constante para la transformación de la sociedad. El método utilizado es el hermenéutico-documental. Se concluye que la lucha de la violencia de género es tarea de todos, que amerita un enfoque integral, que ataque las causas subyacentes a esta problemática mediante acciones conjuntas que conduzcan al cambio social.

Carbonaceous aerosols (CA), composed of black carbon (BC) and organic matter (OM), significantly impact the climate. Light absorption properties of CA, particularly of BC and brown carbon (BrC), are crucial due to their contribution to global and regional warming. We present the absorption properties of BC (bAbs,BC) and BrC (bAbs,BrC) inferred using Aethalometer data from 44 European sites covering different environments (traffic (TR), urban (UB), suburban (SUB), regional background (RB) and mountain (M)). Absorption coefficients showed a clear relationship with station setting decreasing as follows: TR > UB > SUB > RB > M, with exceptions. The contribution of bAbs,BrC to total absorption (bAbs), i.e. %AbsBrC, was lower at traffic sites (11–20 %), exceeding 30 % at some SUB and RB sites. Low AAE values were observed at TR sites, due to the dominance of internal combustion emissions, and at some remote RB/M sites, likely due to the lack of proximity to BrC sources, insufficient secondary processes generating BrC or the effect of photobleaching during transport. Higher bAbs and AAE were observed in Central/Eastern Europe compared to Western/Northern Europe, due to higher coal and biomass burning emissions in the east. Seasonal analysis showed increased bAbs, bAbs,BC, bAbs,BrC in winter, with stronger %AbsBrC, leading to higher AAE. Diel cycles of bAbs,BC peaked during morning and evening rush hours, whereas bAbs,BrC, %AbsBrC, AAE, and AAEBrC peaked at night when emissions from household activities accumulated. Decade-long trends analyses demonstrated a decrease in bAbs, due to reduction of BC emissions, while bAbs,BrC and AAE increased, suggesting a shift in CA composition, with a relative increase in BrC over BC. This study provides a unique dataset to assess the BrC effects on climate and confirms that BrC can contribute significantly to UV–VIS radiation presenting highly variable absorption properties in Europe.

Given the current trend, English as a second language has become increasingly essential due to globalization. In this context, self-questioning has emerged as a contemporary approach to its teaching. This study aimed to determine the influence of self-questioning as a learning strategy for literary texts in English. Methodologically, the research employed a quantitative, pre-experimental, cross-sectional, and descriptive design with intentional non-probabilistic sampling. The sample consisted of 34 students from the third cycle of the language program (translation and interpretation) during the first semester of 2019 at César Vallejo University, Lima, Peru. The students were randomly divided into three groups. The interventions included a self-questioning strategy through group discussion, student-led questioning based on prompts from the teacher, and a control group, which involved individual reading and free analysis of the text. A pre and post-test opinion questionnaire with Likert-scale response options was administered to collect data, validated by expert judgment. Results showed statistically significant differences across all groups. Conclusion: Self-questioning as a learning strategy significantly impacts the acquisition of English as a second language.

Objectives Hypertension is one of the most prevalent non-communicable diseases in West Africa, which responds to effective primary care. This scoping review explored factors influencing primary care access, utilisation and quality for patients with hypertension in West Africa.Design Scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews.Data sources Published literature from PubMed, Embase, Scopus, Cairn Info and Google Scholar, between 1 January 2000 and 31 December 2023.Eligibility criteria Systematic reviews, observational studies and reports involving participants aged 18 years and above, written in English, French or Portuguese, were included. Clinical case series/case reports, short communications, books, grey literature, randomised control trials, clinical trials, quasi-experiments, conference proceedings and papers on gestational hypertension and pre-eclampsia were excluded.Data extraction and synthesis Data from included studies were extracted onto an Excel spreadsheet and synthesised qualitatively using thematic analysis structured by the components of the overall review question.Results The search yielded a total of 5846 studies, 45 papers were selected for full review and 16 papers were eventually included. Macro (contextual) barriers included economic, funding and geographical barriers. Meso (health system) factors include access to medications, tools, equipment and other supplies, out-of-pocket payments, availability of health insurance, health workers numbers, capacity and distribution. Micro (community and patient factors) barriers included financial barriers and limited knowledge, whereas facilitators included the availability of alternative providers and community and household support. These factors are interconnected and complex and should be addressed as a whole to reduce the burden of hypertension in West Africa.Conclusion Multiple complex and interrelated factors at contextual, health systems, community and patient levels act as barriers and enablers to access, utilisation and quality of primary care for hypertension in West Africa. Improving primary care and outcomes will, therefore, require multilevel multifaceted interventions.

Category: Bunion; Lesser Toes Introduction/Purpose: Hallux Valgus (HV) is a common forefoot deformity that can cause pain and difficulty with walking. There are a range of surgical techniques to treat HV deformity, but there is a risk of recurrence. This paper reviews the clinical assessment and management of recurrent HV as well as a detailed description of how percutaneous surgical techniques can be used to treat recurrent HV. This paper identifies technical challenges of percutaneous HV surgery for recurrent HV deformity as well as strategies to address and mitigate these. Methods: This was a multicenter retrospective review of adult patients who had recurrent hallux valgus deformity (defined as hallux valgus angle>15° and having previously undergone primary surgical intervention for HV deformity correction) who were treated with a percutaneous metatarsal extra-capsular transverse osteotomy (META) technique between 5/12/2013 and 8/1/2022, with at least one year of follow-up data. Demographic information, hallux valgus angle, 1-2 intermetatarsal angle, Manchester-Oxford Foot Questionnaire (MOXFQ;validated for hallux valgus surgery), visual analog scale (VAS), and EQ-5D-5L scores were collected. All p-values < 0.05 were considered significant. Results: We retrospectively evaluated 34 feet from 32 patients with a mean age of 63.1±9.2 (range 41-82) who underwent revision hallux valgus surgery using a percutaneous technique. The mean follow up was 3.6±2.3 (range 0.5-8.7 years. The breakdown of index HV surgeries was: 17 Chevron, 9 Scarf/Akin, 6 medial bunionectomy, 1 Lapidus, 1 proximal rotation osteotomy. There was a statistically significant improvement in both clinical foot function and radiographic deformity after surgery. The mean hallux valgus angle decreased from 32.9±8.6° to 13.4±7.3°, and the intermetatarsal angle decreased from 12.7±3.8° degrees to 3.8±3.1°(p< 0.05). The mean MOXFQ Index score significantly improved from 49.4±23.1 to 14.6±19.4 (p< 0.05). Conclusion: This paper suggests that percutaneous surgical techniques using a transverse osteotomy and screw fixation can successfully treat a wide range of recurrent HV deformity severities with significant improvement in clinical and radiographic outcomes.

Category: Bunion; Lesser Toes Introduction/Purpose: Fourth-generation percutaneous or minimally invasive hallux valgus surgery utilises a transverse osteotomy to achieve deformity correction. There are only a small number of series reporting the clinical and radiological outcomes of transverse osteotomies, many of which have methodological limitations such as small sample size, limited radiographic follow up or use of non-validated outcome measures. The aim of this study was to provide a methodological robust investigation into percutaneous transverse osteotomies for hallux valgus deformity. Methods: A prospective case series of consecutive patients undergoing fourth generation metatarsal extra-capsular transverse osteotomy (META) performed by a single surgeon (PL) between November 2017 and January 2023. The primary outcomes were radiographic deformity correction and clinical foot function assessed using the Manchester-Oxford Foot questionnaire (MOXFQ-a validated patient reported outcome measure). Radiographic deformity (Hallux valgus angle (HVA) and 1-2 Intermetatarsal angle(IMA), sesamoid position) was assessed according to AOFAS guidelines. Secondary outcomes included Visual Analogue Scale for Pain and radiographic deformity recurrence (defined as HVA >20° at final radiographic follow up). All p-values < 0.05 were considered significant. Results: 729 feet from 483 patients (456 Female, 27 Male, mean age 57.9±11.9 years) underwent META. Radiographic data (minimum 12 months post-surgery) was available for all feet with mean follow up of 2.6±1.3 years (range 1.0-5.7). There was a statistically significant improvement (p< 0.05) in both HVA; 29.5±8.5° to 7.3±6.7°, and IMA, 12.9±3.4° to 4.6±2.5°. All MOXFQ domains showed significant improvement (p< 0.05); Index 36.6±19.1 to 11.8±13.8, Pain 40.1±22.1 to 15.6±16.4, Walking/Standing 32.2±23.2 to 10.2±15.8 and Social Interaction 40.0±20.6 to 9.7±14.0. The recurrence rate was 4.6% (n=33) with a significantly higher proportion of sesamoids in Grade 2 and 3 in the recurrence group (p< 0.05). There was 1 non-union, 1 deep infection and 20 cases of superficial infection. No avascular necrosis of the first metatarsal head occurred. Conclusion: This is the largest consecutive series of any percutaneous osteotomy technique to correct hallux valgus deformity. This study demonstrates that the technique leads to significant improvement in clinical and radiographic outcomes with a low rate of recurrence. Recurrence may be linked to incomplete sesamoid reduction at the time of surgery.

Introdu Introducción: el cáncer afecta el estado nutricional de los pacientes, destacando la necesidad de buscar estrategias nutricionales para abordarlo. Objetivo: evaluar la eficacia de la suplementación con aceite o cápsulas de omega 3 a nivel de parámetros nutricionales e inflamatorios de pacientes oncológicos en tratamiento activo. Métodos: se realizó revisión sistemática para identificar ensayos clínicos controlados. El desenlace primario fue el cambio de peso. Se realizó metaanálisis usando software RevMan. Resultados: se incluyeron siete estudios (participantes n=262). La dosis administrada osciló entre 0,60 a 2,45 g y la intervención se extendió entre 45 días y tres meses. Se observó que los pacientes suplementados perdieron menos peso que aquellos no expuestos al omega 3 (Diferencia Estandarizada de Medias (SMD)= 3,99; IC 95,00 % 2,40-5,57), pero no se encontraron diferencias significativas en el índice de masa corporal (IMC) (SMD= 0,73; IC 95,00% -0,11-1,58) ni en los valores de albúmina (SMD= -0,23; IC 95,00 % -0,26-0,71) y proteína C reactiva (PCR) (SMD= -4,01; IC 95,00 % -15,59-7,57). Los resultados están limitados por el número de estudios incluidos y la heterogeneidad de los mismos. Conclusiones: la suplementación con omega 3 mostró aminorar la pérdida de peso de los pacientes oncológicos en tratamiento activo (quimioterapia y/o radioterapia), pero no presentó efectos beneficiosos en el IMC ni en los valores de albúmina y PCR.

Category: Bunion; Midfoot/Forefoot Introduction/Purpose: One of the most important complications of hallux valgus surgery (when performed either through an open or minimally invasive technique) is recurrence of deformity. Recurrence is often multifactorial due to patient factors such as anatomy, pre-operative deformity, soft tissues, comorbidities and compliance with instructions and surgical factors such as choice of surgical technique, implant and technical competency. The aim of this study was to investigate the role of sesamoid position and impact on recurrence of hallux valgus deformity following percutaneous minimally invasive hallux valgus surgery. Methods: A prospectively maintained research registry of fourth-generation percutaneous metatarsal extra-capsular transverse osteotomy (META) for hallux valgus between 2017-2023 was retrospectively analysed to identify feet that had recurrence of hallux valgus deformity (defined as HVA>20°). Comparative analysis was then performed to assess the impact of pre-operative deformity and sesamoid position on recurrence. Radiographic deformity and sesamoid position (including ‘Round sign’) were assessed according to AOFAS guidelines. Secondary outcomes included clinical patient reported outcome measures including the Manchester-Oxford Foot Questionnaire (MOXFQ) and Visual Analogue Scale for Pain. All p-values < 0.05 were considered significant. Results: Between November 2017 and January 2023, 729 feet underwent META with minimum 12-month radiographic follow up (mean 2.6±1.3 years). There were 33 cases with HVA>20° at final radiographic follow up (4.5%). There was a statistically significant difference in sesamoid position between feet which had recurrence with higher rates of Grade 2 and 3 compared to those which didn’t (p < 0.05). There was no significant difference in Round sign assessment between cases which recurred and those that did not (p=0.27). The mean pre-operative deformity in cases which underwent recurrence was significantly greater than those which did not recur (p < 0.05), (HVA:44.3±6.5, IMA:15.6±3.7° compared to HVA:28.8±8.0°, IMA:12.8±3.3°). Of the 33 cases which had recurrence, 13 demonstrated HVA>20° at 6 month XR suggesting incomplete deformity reduction. Conclusion: Incomplete reduction of sesamoids appears to be a risk factor for recurrence. Incomplete deformity reduction at the time of surgery, particularly in cases of severe deformity (HVA>40°) is an important factor to acknowledge when considering risk of recurrence. The deformity correction achieved through bony correction (using the fourth-generation META technique) appears to be maintained from 6-months to final radiographic follow up suggesting that recurrence is predominantly linked to incomplete deformity reduction and sesamoid position at the time of surgery.

ABSTRACT Sesame cultivation was until recently restricted to the northwestern part of Benin. The yield is relatively low, as there are no improved varieties introduced and widely adopted so far. This study aimed to assess the molecular diversity, genetic differentiation, and the agronomic performance of a collection of local cultivars and introduced lines of sesame from China. The agronomic evaluation was conducted across eight environments during the 2020 cropping season using 14 descriptors on 19 accessions, including 6 introduced lines arranged in a randomized complete bloc design. Twelve simple sequence repeat markers were used to assess the molecular diversity. The analysis of variance showed significant variation among accessions for all the traits, except the number of lodges per capsule. Principal component analysis (PCA) followed by hierarchical clustering indicated that the accessions could be classified into three groups. The first group included accessions from China with the local accession SI09, characterized by early flowering and low seed yields (on average 380.13 kg ha−1). The second group included late flowering accessions and intermediate seed yield (on average 548.68 kg ha−1). The third group included higher yielding accessions (on average 715.7 kg ha−1). The PCA identified key traits such as days to 50% emergence, days to 50% flowering, collar diameter, plant height, number of branches, and seed yield as the most discriminative among accessions for agromorphological characterization. The SSR markers were polymorphic, with polymorphic information content values between 0.17 and 0.92. A total of 62 alleles were detected, with each locus exhibiting 2 to 15 alleles. The gene diversity ranged from 0.18 to 0.92, with an average value of 0.55. Cluster analysis based on the unweighted pair group method with arithmetic mean revealed that accessions were grouped in three clusters, with the coefficients of similarity/dissimilarity ranging between 0.60 and 0.92. Most of the Chinese lines were clustered together, except accession Y01. This study provided useful knowledge about local sesame cultivars in Benin and their similarities and differences with the lines introduced from China, therefore contributing to the advancement of the sesame‐breeding program in the country.

O presente artigo é resultado do Plano de Trabalho intitulado “O Teatro como ação política junto a Mulheres Periféricas da comunidade do Emaús”, realizado com mulheres da comunidade do Movimento República de Emaús, no bairro do Benguí, na cidade de Belém do Pará. Esta iniciativa faz parte do Projeto de Extensão "Teatro, Memória, Música e Poesia na Melhor Idade", coordenado pela Prof.ª Dra. Ivone Maria Xavier de Amorim Almeida. O objetivo principal foi estimular e desenvolver as habilidades físicas e mentais de mulheres periféricas atendidas na República da Comunidade do Emaús, por meio do teatro, da música e da escrita. A base paradigmática adotada encontrou amparo nas reflexões teórico-metodológicas de Viola Spolin e Augusto Boal. Durante as atividades extensionistas as participantes exploraram técnicas de improvisação, construção de personagens e narração de histórias, oportunizando que suas vozes e vivências fossem compartilhadas. Também puderam aprender técnicas vocais e o exercício de escrita criativa e desenho poético. O resultado foi uma oficina na ETDUFPA, fazendo a conexão entre a comunidade e a universidade, trazendo atuantes do projeto para dentro do âmbito universitário. A prática teatral se revelou uma poderosa ferramenta de empoderamento, possibilitando as integrantes se perceberem como agentes de suas histórias.

El presente estudio se centró en la importancia de la afectividad en el desarrollo socioemocional de los estudiantes y la formación de las características sociales desde el hogar para vincularse con la comunidad educativa, donde se pone en práctica las capacidades emocionales ante diversas situaciones de conflicto. Se plantea el siguiente objetivo: Identificar los factores que influyen en la violencia escolar, mediante una revisión bibliográfica y colocando al núcleo familiar como indicador principal del desarrollo socioemocional de los niños y niñas, para proponer estrategias que generen un ambiente de afectividad en el aula. El enfoque de la investigación fue cualitativo, basado en la revisión bibliográfica, con análisis comparativo de estudios, métodos, resultados y conclusiones de fuentes bibliográficas de diferentes revistas científicas; finalmente, se sintetizan las ideas centrales de varios autores y se dividieron en tres aspectos importantes como: La afectividad como solución ante los conflictos escolares, la influencia del núcleo familiar en los comportamientos violentos en el aula y las estrategias para generar un ambiente de afectividad en el aula que ayude a la disminución de las conductas agresivas de los estudiantes en el contexto escolar. Se concluyó afirmando la importancia de la afectividad en el desarrollo de habilidades sociales y emocionales en educación, se establecieron ciertos factores familiares que desencadenan comportamientos violentos en el aula y se propusieron indicadores evaluativos para reconocer ambientes de convivencia y una cultura de paz en las instituciones educativas.

Este artigo tem como objetivo responder a seguinte questão norteadora: quais são os impactos socioeconômicos da uberização para os trabalhadores de aplicativos na Bahia? A pesquisa busca analisar os impactos da Uberização no contexto específico do Estado, investigando as condições de trabalho, as percepções e as perspectivas futuras dos trabalhadores de aplicativos. O propósito é contribuir para o debate sobre a regulamentação do trabalho em plataformas digitais e a necessidade de políticas públicas que assegurem a proteção social a esses trabalhadores. O presente trabalho baseou-se em pesquisa bibliográfica para abordar as teorias e as legislações relacionadas ao tema.

ABSTRACT Introduction There are many recognised benefits of public involvement, including more relevant research. The COVID‐19 pandemic highlighted the existing health inequalities and disparities in access to care and treatment for under‐served groups, necessitating meaningful and sustainable approaches to engaging them in health research. However, there is limited guidance to suggest what groundwork and processes are necessary for initiating such projects. This paper outlines the practical approaches taken to initiate a community involvement project scheme and offers key recommendations from this work. Methods The National Institute for Health and Care Research (NIHR) Health Protection Research Unit established a community involvement scheme in 2021, funding four community involvement projects enabling researchers to engage with under‐served communities. Reflections were captured through regular quarterly meeting group discussions, meeting notes and email correspondence. Results The paper presents the steps taken to initiate a scheme that provided funding for a diverse range of projects working with under‐served communities. The projects demonstrated the value of allocating time to build relationships and trust, maintaining flexibility, and providing short‐term benefits such as remuneration and training to the community. Discussion This paper has highlighted the need for research organisations to allocate funding and resources within their infrastructures for building trusting relationships with community leaders and communities. Conclusion This paper has outlined the steps undertaken to engage with under‐served communities to bridge the gap between public health research and those communities. We present key recommendations to guide future initiatives aspiring to engage under‐served communities in health research. Patient or Public Contribution Public contributors have been involved in all of the four community involvement projects mentioned in this paper. Two public contributors are also co‐authors and have provided input to the writing and review of this manuscript.

Este artículo explora el impacto de la inteligencia artificial (IA) en las campañas de adopción de animales desde una perspectiva crítica y filosófica. La investigación se justifica en un contexto internacional donde los escenarios digitales y la IA se entrelazan dialécticamente con prácticas sociales para la participación en el espacio público. Se plantea la hipótesis de que la IA puede modificar, en determinadas condiciones, la forma en que se gestionan estas campañas y la forma como las personas se expresan en el espacio público. Metodológicamente, nuestro enfoque plantea cuestiones filosóficas sobre la autonomía y el determinismo en la toma de decisiones, cuestionando hasta qué punto las tecnologías algorítmicas pueden o deben influir en el comportamiento humano y la ética de la adopción responsable. A modo de conclusión, se evidencia que, en términos filosóficos, se debe comprender con más cuidado que la Inteligencia Artificial puede mantener prejuicios preexistentes de tipo antropocéntrico y, en consecuencia, perjudicar a los animales si no se aplican con un consistente marco ético, de cara al verdadero interés de los animales no humanos.

La acción sinérgica de las cuatro crisis planetarias: cambio climático, contaminación, pérdida de biodiversidad y crisis hídrica, genera escenarios marcados por la presencia de sindemias, donde las condiciones sociales, culturales, ambientales y sanitarias preexistentes se ven afectadas de manera integrada. En los escenarios sindémicos, el bienestar integral, el goce de las libertades y los procesos de desarrollo se ven limitados por la falta de capacidades, la ausencia de políticas públicas y la carencia de esquemas comunitarios locales. Siendo la niñez, las mujeres y los trabajadores en precariedad laboral, los grupos más susceptibles. Ante este panorama, nuestro grupo generó una estrategia basada en las capacidades comunitarias que lleva a la instalación de Espacios Cívicos Ambientales (ECAs). La estrategia busca a través de la prevención, que se promueva y proteja el disfrute de los derechos humanos, desde el derecho a la salud y el derecho a un ambiente limpio, sano y sostenible. La estrategia requiere de un esquema de implementación basado en seis fases: i) planificación para establecer antecedentes sobre la sindemia identificada; ii) participación de la comunidad; iii) priorización de riesgos acumulados, rutas e impactos en derechos humanos; iv) prevención de riesgos a través de la creación de diversas capacidades y alternativas basadas en comunidad; v) la promoción y divulgación local; y vi) protección con medidas que llevan a construir los ECAs. Nuestra propuesta ha sido aplicada en diferentes contextos con el objetivo de promover el derecho de las comunidades a una vida libre de sindemia.

Introduction The absence of standardized reporting for sleep medicine exams across different laboratories can lead to misinterpretation, diagnostic inconsistencies, and suboptimal treatment strategies. This document seeks to establish guidelines for the development of sleep study reports, covering recordings from studies of types 1 to 4, and represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the standardization of polysomnography (PSG) and cardiorespiratory polygraphies.

IntroductionPosttransplant cyclophosphamide (PTCy) has revolutionized the landscape of human leukocyte antigen (HLA)-haploidentical hematopoietic cell transplantation (haplo-HCT), providing a pivotal therapeutic option for patients with hematological malignancies who lack an HLA-matched donor.MethodsIn this retrospective analysis involving 54 adult patients undergoing PTCy-based haplo-HCT, we evaluated the impact of inhibitory killer immunoglobulin-like receptor (KIR)/HLA mismatch, alongside patient, donor, and transplant factors, on clinical outcomes within a homogeneous cohort characterized by a myeloablative conditioning regimen and bone marrow graft.ResultsWith a median follow-up of 73.2 months, our findings reveal promising outcomes: 6-year overall survival, relapse-free survival, and graft-versus-host disease (GVHD) and relapse-free survival rates were 63% (95% CI: 51–79), 58% (95% CI: 46–74), and 42% (95% CI: 30–58), respectively. Notably, the cumulative incidence rates of relapse and non-relapse mortality at 6 years post-haplo-HCT were 29% (95% CI: 19–45) and 12% (95% CI: 6–26), respectively. Acute GVHD at day 100 posttransplantation occurred with a cumulative incidence of 33% (95% CI: 22– 49) for grades II–IV and 9% (95% CI: 3–23) for grades III–IV. Furthermore, 41% of patients developed chronic GVHD within 1 year posttransplantation, distributed as follows: 28% mild, 9% moderate, and 4% severe.ConclusionWithin our cohort, several variables were associated with outcomes following PTCy-based haplo-HCT. However, inhibitory KIR/HLA mismatch did not influence these outcomes.

The mainstay for malaria treatment is drug, but currently, the treatment is failing and making malaria infection worrisome. The alkaloid extract of the plant Phyllanthus amarus has been demonstrated to possess antimalarial activity. This present study evaluated the changes in semen quality, hormone profile and gonadal histomorphometric features in Berghei-induced mice treated with alkaloid extract of Phyllanthus amarus. Thirty-six BALB/c mice were divided into six groups (n=6 per group). The first two groups were positive (not infected, not treated) and negative (infected, but not treated) control mice, while the remaining groups (Groups 3–6) were the experimental mice infected with Plasmodium berghei (NK 65) malaria parasite and respectively treated with standard drug Lonart® DS (20 mg/kg) with 75 mg/kg, 150 mg/kg and 225 mg/kg of the Phyllanthus amarus alkaloid extract (PAAE) for 4 days. Then, 10 days later, the animals were euthanized and blood samples were collected for biochemical investigation. Testes tissues were harvested for histological assessment and semen samples were collected for analysis using standard procedures and documented methods. Data from our study revealed that Plasmodium berghei malaria-induced infection significantly (p

IntroductionBrucellosis and Rift Valley fever (RVF) are neglected zoonotic diseases (NZD) that threaten public health, animal health, and production in resource-limited countries including Namibia.MethodsThe objective of this cross-sectional study was to determine Brucella spp. and RVFV seroprevalence in cattle at the wildlife-livestock interface in the Kabbe South constituency (Zambezi region) of Namibia. Cattle sera (n = 371) were randomly collected from 18 cattle herds in six constituency areas and tested for antibodies against Brucella [complement fixation test (CFT) and indirect enzyme-linked immunosorbent (ELISA) assay in parallel] and Rift Valley fever virus (competitive ELISA).ResultsApparent individual animal prevalence for Brucella spp. was 5.9% (95% CI: 3.95%−8.81%, 22/371) and 20.8% (95% CI: 16.9%−25.2%, 77/371) based on the CFT and I-ELISA, respectively. For RVFV, apparent and true animal prevalence were 41.0% (95% CI: 36.1%−46.0%, 152/371) and 47.6% (95% CI: 41.8%−53.6%), respectively. Animal and true prevalence of Brucella spp. based on the CFT and ELISA in parallel were 22.6% (95% CI: 18.7%−27.2%, 84/371) and 19.7% (95% CI: 15.6%−24.4%), respectively. About 10.8% (40/371) of cattle tested positive for both Brucella spp. and RVFV antibodies. Prevalence of Brucella-positive cattle herds was 83.3% (15/18). Within herd Brucella spp. seroprevalence was 0%−70%. All cattle herds tested positive for RVFV, with prevalence of 1.7% to 70%. Binomial logistic regression revealed that sex was a significant predictor (p < 0.05) for RVFV seropositivity, but not for Brucella spp. seropositivity (p > 0.05). Test agreement between CFT and I-ELISA when used for the detection of anti-Brucella antibodies was poor (k = 0.2322).DiscussionBrucella spp. and RVFV infections were prevalent in communal pastoral cattle at the human-wildlife-livestock interface in the Zambezi region suggesting a higher likelihood of occurrence of reproduction losses in cattle and zoonotic disease in humans. We recommend the enforcement of the requirements for the vaccination of heifers against brucellosis in the affected communal areas to reduce the risk of human infection. The use of One Health principles for the surveillance, prevention and control of Brucella spp. and RVFV infections can promote the effective control of these zoonotic infections at the interface.

Osteocephalus cabrerai is an arboreal anuran widely distributed in South America. However, there are no parasitological studies conducted on the species, resulting in a parasite fauna completely unknown. Thus, this study aims to characterize the parasitic community structure of O. cabrerai in the municipality of Pedra Branca do Amapari, Amapá state, Amazon region, Brazil. We collected and necropsied 84 specimens of O. cabrerai to search for helminths. Parasite community structure was analyzed using helminth parasite richness, diversity, and abundance. The helminth component community of O. cabrerai comprises six nematode species: Cosmocerca parva, Cosmocerca podicipinus, Oxyascaris oxyascaris, Oswaldocruzia chabaudi, and Physaloptera sp. (larvae). Most helminth species represent the first record for the genus Osteocephalus, except Physaloptera sp. The helminth infections in the host showed a typical aggregated distribution pattern for parasites. We only found a positive correlation between the host weight and total intensity. Our bibliography revision reinforces the need for further studies on the helminth fauna of Osteocephalus spp.

RESUMO O presente artigo objetivou descrever a experiência da construção do curso de especialização para gestores da Estratégia Saúde da Família enquanto papel inovador para uma Atenção Primária à Saúde (APS) de qualidade e resolutiva no Distrito Federal. A metodologia orientou-se pelas seguintes etapas: mapeamento de normativas educacionais e de saúde no contexto do governo do Distrito Federal; revisão da literatura sobre o trabalho e as competências gerenciais na APS; e observação in loco das discussões realizadas em eventos da gestão da Secretaria de Estado de Saúde do Distrito Federal. Os resultados identificaram as competências e as temáticas a serem trabalhadas durante o curso de especialização a partir da realidade de trabalho desses gestores nos territórios. Com base nos achados, elaborou-se o percurso pedagógico do curso, tendo como base os pressupostos da Educação Permanente em Saúde, articulados ao referencial da ergoformação, às diretrizes da educação a distância na saúde e às bases normativas da APS.

El objetivo principal de este artículo es examinar la situación actual respecto de las medidas cautelares decretadas en los procedimientos de medidas de protección de NNA con perspectiva de género. El método empleado ha sido verificar la normativa vigente; la doctrina y jurisprudencia específica sobre esta materia. El resultado ha sido la constatación de que, en el derecho de familia, la amplia potestad cautelar del juez, como la ausencia de una perspectiva de género, a la hora de adoptar una medida cautelar en esa clase de procedimientos, han generado grandes problemas de desigualdad material en la aplicación del derecho hacia las mujeres, a propósito de los estereotipos preconcebidos respecto de su rol como madres.

Taurine, a normal dietary component that is found in many tissues, is considered important for a number of physiological processes. It is thought to play a particular role in eye development and in the maturation of both the muscular and nervous systems, leading to its suggested use as a therapeutic for Alzheimer’s and Parkinson’s diseases. Taurine increases metabolism and has also been touted as a weight loss aid. Due to its possible benefits to health and development, taurine is added as a supplement to a wide array of products, including infant formula and energy drinks. Despite its pervasive use as a nutritional additive and implied physiological actions, there is little consensus on how taurine functions. This is likely because, mechanistically, taurine has been demonstrated to affect multiple metabolic pathways. Simple models and straightforward assay systems are required to make headway in understanding this complexity. We chose to begin this work using the planarian because these animals have basic, well-understood muscular and nervous systems and are the subjects of many well-tested assays examining how their physiology is influenced by exposure to various environmental, nutritional, and therapeutic agents. We used a simple behavioral assay, the planarian locomotor velocity test (pLmV), to gain insight into the stimulant properties of taurine. Using this assay, we observed that taurine is a mild stimulant that is not affected by sugars or subject to withdrawal. We also provide evidence that taurine makes use of the dopamine D1 receptor to mediate this stimulant effect. Given the pervasiveness of taurine in many commercial products, our findings using the planarian system provide needed insight into the stimulant properties of taurine that should be considered when adding it to the diet.

El objetivo de la investigación es establecer el impacto de las técnicas de evaluación formativa en el desempeño académico de los estudiantes de bachillerato. Se determinó que en contextos donde las técnicas formativas se implementan con mayor frecuencia, los estudiantes logran mejores resultados. La metodología aplicada, fue con una investigación de nivel correlacional causal, con enfoque cuantitativo, La muestra fue de 100 estudiantes y se recolectó la información por medio de dos cuestionarios de 10 preguntas cada uno. Entre los resultados se destaca que, el 61% de los estudiantes perciben con nivel bajo la aplicación de las técnicas de evaluación formativa, al mismo tiempo que su desempeño académico es bajo. El coeficiente de correlación de Spearman de 0,916, lo que indica una relación muy alta entre ambas variables y con un 91,1% de impacto entre variables. Se concluye que existe un impacto significativo y una correlación muy alta de las técnicas de evaluación formativa en la mejora del desempeño de los estudiantes de bachillerato.

Neurodegenerative diseases (NDDs) affect millions of lives worldwide. They constitute a group of neurological disorders with shared common features, including impaired cognition, behavior, memory, and motor functions. These conditions arise due to the gradual degeneration of neurons within the nervous system. Even though, each pathology presents diverse etiologies and develops in different brain sites, they may share cellular and molecular mechanisms, such as inflammation, protein aggregation, and DNA and RNA defects. Heavy metal contamination is a global public health concern, given that anthropogenic activities like paint manufacturing, mining, and oil refining contribute substantially to heavy metal pollution. Consequently, studies have investigated its potential etiological factors in neurodegenerative diseases. This review examines the impact of dietary exposure to heavy metals, specifically mercury, cadmium, lead, chromium, arsenic, and zinc, on the development and progression of neurodegenerative diseases. Evidence from a range of studies indicates that these metals play a significant role in advancing these diseases by disrupting essential cellular and molecular functions, including the induction of oxidative stress and impairments in mitochondrial function. These findings underscore the need for further research to elucidate toxicological mechanisms and develop preventive strategies, such as chelation therapies and environmental remediation. Addressing these risks is especially critical to protect neurocognitive health, particularly in aging populations.

Cognitive radio network (CRN) uses the available spectrum resources wisely. Spectrum sensing is the central element of a CRN. However, spectrum sensing is susceptible to multiple security breaches caused by malicious users (MUs). These attackers attempt to change the sensed result in order to decrease network performance. In our proposed approach, with the help of blockchain-based technology, the fusion center is able to detect and prevent such criminal activities. The method of our model makes use of blockchain-based MU detection with SHA-3 hashing and energy detection-based spectrum sensing. The detection strategy takes place in two stages: block updation phase and iron out phase. The simulation results of the proposed method demonstrate 3.125%, 6.5%, and 8.8% more detection probability at −5 dB signal-to-noise ratio (SNR) in the presence of MUs, when compared to other methods like equal gain combining (EGC), blockchain-based cooperative spectrum sensing (BCSS), and fault-tolerant cooperative spectrum sensing (FTCSS), respectively. Thus, the security of cognitive radio blockchain network is proved to be significantly improved.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by widespread inflammation and organ damage. Studies indicate that diet significantly influences the gut microbiota, which, in turn, affects the immune system. This article explores gut microbiota dysbiosis in SLE patients and potential mechanisms related to dietary interventions and immune function. It highlights specific dietary patterns, such as a high-fibre diet and the Mediterranean diet, that may modulate the diversity and activity of the gut microbiota. The interaction between altered microbiota and immune responses, including the regulation of inflammatory cytokines, intestinal barrier permeability, and autoantibody production is examined. This review highlights the importance of personalized dietary strategies to modulate the diversity and activity of the gut microbiota by enhancing the immune response and potentially mitigating disease progression.

Abstract Background 13 000 cases of skin cancer are diagnosed annually in Ireland, with ultraviolet (UV) radiation exposure the strongest risk factor. Public health primary prevention campaigns focus on encouraging safe sun protective measures and skin cancer awareness. We designed a novel, digitally‐animated hospital‐based campaign targeting all aspects of sun‐protective behaviour. Objectives To explore the sun‐protective attitudes and behaviours of healthcare workers, and the effect of a digital hospital‐based campaign on these findings. Methods This was a cross‐sectional prospective observational study involving hospital staff across the six hospitals that form the University of Limerick Hospital Group (ULHG). A two‐phase online survey, the first taking place before campaign launch, and the second upon campaign completion. The digital campaign was displayed across all hospital sites from June to September 2021. Surveys comprised questions on sun‐related attitudes and behaviours, including the internationally validated Sun Exposure Protection Index (SEPI) questionnaire. Results Eight hundred fifty‐seven staff members completed survey 1 and 704 completed survey 2; 90% in each were female; 79% were aged 25–54; 71% reported skin types I–III. Best sun‐protective habits pre‐campaign included sunscreen use and avoiding sunburn, while wearing hats, protective clothing and seeking shade were least adopted. For 177 matched participants, there were small improvements in SEPI scores. SEPI Part 1 scores, reflecting improved risk behaviour, pre‐campaign had a median of 11 (IQR 7), and 11 (IQR 6) post campaign. SEPI Part 2 scores, reflecting readiness to adopt sun‐protective behaviours, improved from median 7 (IQR 8) to 6 (IQR 6). Post‐campaign, small improvements were seen across some individual sun‐protective behaviours and attitudes, particularly reducing time spent in the midday sun and on sun‐seeking holidays, and improved readiness to seek shade and reduce sunbathing; 79% of all respondents post‐campaign (n = 556) reported raised skin cancer awareness, and 65% (n = 458) said it influenced them to discuss sun protection with others. Conclusions Positive improvements in attitudes and behaviours related to sun protection were seen following the digital campaign in this population of healthcare workers. These improvements along with increased willingness to discuss sun protection with others, including patients, has the potential to further benefit wider society, and supports future digital health promotion initiatives.

Summary: Background: Facial recognition software (FRS) has historically been perceived as lacking the capability to identify individuals from cross-sectional medical images. Utilising such data for identification purposes was considered infeasible due to the substantial computational power and specialised technical expertise it would require. However, recent advancements in accessible artificial intelligence-based (AI-based) software and open-source tools have made these applications widely available and easy to use, raising new privacy concerns. Methods: This proof-of-concept was designed as a cross-sectional study and included participants with a verified online presence. Standard magnetic resonance imaging (MRI) head scans were performed on these participants, from which three-dimensional rendering (3DR) images were created using free and publicly available software. These images were used for face searches by free and publicly available FRS. Different head orientations and hairstyles were applied to the 3DR images to assess whether non-facial features influenced the FRS results. All results were obtained between the 10th of February 2024 and the 1st of March 2024. Findings: Face searches of 3DR images in a database containing over 800 million images from the World Wide Web (WWW) yielded correct matches for 50% of the participants in less than 10 min. The user-friendly software required minimal computational knowledge or resources, making this process broadly accessible. Modifying elements such as hairstyles or the orientation of the 3DR to better resemble actual photographs of the participants improved FRS matches. Interpretation: Current existing FRS can swiftly and accurately identify individuals from MRI head scans. This poses a significant privacy risk for participants in enrolled clinical trials and highlights the urgent need for improved data protection measures and increased sensitivity to ensure participant confidentiality. Funding: There was no funding source for this study.

Interferon regulatory factor 4 (IRF4) is a master transcription factor that regulates T helper cell (Th) differentiation. It interacts with the Basic leucine zipper transcription factor, ATF-like (BATF), depletion of which in CD4+ T cells abrogates acute graft-versus-host disease (aGVHD)-induced colitis. Here, we investigated the immune-regulatory role of Irf4 in a mouse model of MHC-mismatched bone marrow transplantation. We found that recipients of allogenic Irf4-/- CD4+ T cells developed less GVHD-related symptoms. Transcriptome analysis of re-isolated donor Irf4-/- CD4+ T helper (Th) cells, revealed gene expression profiles consistent with loss of effector T helper cell signatures and enrichment of a regulatory T cell (Treg) gene expression signature. In line with these findings, we observed a high expression of the transcription factor BTB and CNC homolog 2; (BACH2) in Irf4-/- T cells, which is associated with the formation of Treg cells and suppression of Th subset differentiation. We also found an association between BACH2 expression and Treg differentiation in patients with intestinal GVHD. Finally, our results indicate that IRF4 and BACH2 act as counterparts in Th cell polarization and immune homeostasis during GVHD. In conclusion, targeting the BACH2/IRF4-axis could help to develop novel therapeutic approaches against GVHD.

Introduction Tuberculosis is a major cause of mortality worldwide. Prisoners in Guiana have multiple risk factors. The primary objective of this study was to describe tuberculosis occurring in prison and after release in French Guiana between 2008 and 2020. Secondary objectives were to identify tuberculosis risk factors and determine annual incidences.Methods: A retrospective cohort study of tuberculosis cases was carried out at the Guiana prison between 2008 and 2020. Data were collected from prison registers and cross-referenced with the list of tuberculosis notifications in French Guiana.Results: A total of 36 cases of tuberculosis were studied. Incidence was high, at 263/100,000 per year, higher than elsewhere in France and comparable to that in Brazil. Despite visibly effective screening on entry, with little evidence of intra-prison circulation of tuberculosis, 39% of patients were diagnosed within two years of leaving prison (76% were symptomatic). This could be explained by the high prevalence of latent forms (LTI).Discussion Continued screening on entry, in combination with annual radiological and clinical screening, and reinforced follow-up on release seem indicated to improve patient management and the search for possible LTI.

AbstractThis study investigates the complex relationship between small- and medium-sized enterprises (SMMEs) and socio-economic factors in post-apartheid South Africa. Hence, we use a robust econometric framework to assess how SMME proliferation affects job creation, income redistribution, infrastructural development and GDP growth during two pivotal periods (1995–2010 and 1995–2023). We employed an ordinary least squares (OLS) regression model technique for analyzing relevant secondary datasets using the free EViews 12 student version (SV) x64 statistical software analytical package. During the period 1995–2010, we find that heightened SMME proliferation correlates positively and significantly with job creation, particularly in cases of opportunity-driven entrepreneurship. Moreover, the study underscores a direct link between SMME expansion and increased GDP growth, underscoring the vital role of these enterprises in shaping the economic landscape. However, in the extended period spanning 1995–2023, which encompasses both economic booms and recessions, the potential of opportunity-driven SMMEs wanes, attributed partly to business closures amid a recession. The major contribution of this study is that a combination of factors influences the impact SMMEs have on various socio-economic indicators. The insights gleaned from this research deepen our understanding of the intricate connections between SMMEs and broader socio-economic factors, offering valuable implications for policymakers and practitioners aiming to foster sustainable economic development.

Research capacity strengthening (RCS) can empower individuals, institutions, networks, or countries to define and prioritize problems systematically; develop and scientifically evaluate appropriate solutions; and reinforce or improve capacities to translate knowledge into policy and practice. However, how to embed RCS into multi-country studies focusing on sexual and reproductive health and rights (SRHR) is largely undocumented. We used findings from a qualitative study, from a review of the literature, and from a validation exercise from a panel of experts from research institutions that work on SRHR RCS. We provide a framework for embedded RCS; suggest a set of seven concrete actions that research project planners, designers, implementers, and funders can utilise to guide embedded RCS activities in low- and middle-income countries; and present a practical checklist for planning and assessing embedded RCS in research projects.

Soybean (Glycine max) is the most important plant protein source, and Fall Armyworm (FAW, Spodoptera frugiperda) is considered a major pest. This study aimed to examine the impact of FAW feeding on soybean accessions that vary in their water use efficiency (WUE) traits, by examining FAW growth and life history parameters along with plant growth response to pest damage. Soybean accessions were grown in a greenhouse and exposed to FAW larval feeding for 48 h at three different soybean growth stages: V3, R3, and R6. The growth and development of the FAW and soybeans were monitored. Results showed that faster wilting soybean accessions grow taller and have more leaves than slower wilting accessions, but yield was higher in slower wilting soybean accessions. FAW experienced the highest mortality on mid-stage (R3) soybean plants, but they gained the least mass on early stage (V3) soybean plants. These results can assist in better understanding plant insect-interactions at different life stages in both soybean and FAW with implications for management.

This study investigated the effect of clove essential oil used prior to stunning by cranial percussion and hypothermia on Nile tilapia (Oreochromis niloticus) welfare and fillet quality. A total of 100 tilapias were divided into four groups in a 2 × 2 factorial design, exploring two stunning methods with and without clove essential oil. Behavioral responses, glucose, lactate, pH, water holding capacity, color parameters, lipid and protein oxidation, and oxidative stress were analyzed. The application of clove essential oil resulted in 100% numbing in swimming and stimulus response behaviors, and 96% in balance and eye vestibule reflex variables. Significant reductions in glucose (12.12 mg dL−1) for hypothermia group (p = 0.001) and lactate (3.36 mmol L−1) for cranial percussion (p = 0.004), 0.028 nmol lipid oxidation in hypothermia treatment (p = 0.009), and 0.134 nmol carbonyls/mg protein (p = 0.001) were observed. There was a reduction in luminosity (p = 0.010) and red intensity (p = 0.001) in the group of fish fillet that received cranial percussion, however, there was no difference in the group stunned by hypothermia. Clove essential oil demonstrates effectiveness in pre-slaughter stress mitigation, influencing the antioxidant system positively. Its usage in pre-slaughter protocols could contribute to improved fillet quality, presenting a promising alternative for enhancing tilapia welfare during slaughter.