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Background Little is known about alterations of the rotator cuff (RC) macroscopic vasculature associated with medical conditions and/or habits that predispose a person to diseases of the peripheral microcirculation. The high frequency of cuff tear and re-tear in patients with diabetes, hypercholesterolemia, uncontrolled arterial hypertension, or metabolic syndrome may be due to tissue hypovascularity. Methods The macroscopic vasculature of both the articular and bursal sides of the posterosuperior RC was evaluated arthroscopically in 107 patients (mean age, 58.2 years) with no RC tear. Patients were divided into three groups according to medical comorbidities and lifestyle factors (group I, none; group II, smokers and/or drinkers and one comorbidity; and group III, two or more comorbidities). Pulsating vessels originating from both the myotendinous and osteotendinous junctions were assessed as “clearly evident,” “poorly evident,” or “not evident.” Results Groups I, II, and III comprised 36, 45, and 26 patients, respectively. Within the myotendinous junction, vessels were visualized in 22 group I patients (61%), 25 group II patients (55%), and 6 group III patients (23%) (P=0.007). Pulsating arterial vessels originating from the osteotendinous junction were seen in 42%, 36%, and 0% of patients, respectively (P

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.

Objective/context: In 2009, the law of mandatory, simultaneous, and open primaries (PASO, for its acronym in Spanish) was enacted in Argentina. Among others, this regulation seeks to democratize party structures. From a gender perspective, this paper studies the effect of PASO on women’s access to the Chamber of Deputies (2003-2023). To this end, it analyzes how the final lists are assembled, the places assigned to women candidates, the ease with which they gain access to expectable positions, and the permeability of groupings towards their participation since the implementation of PASO. Methodology: This is an exploratory and descriptive study of the effect of PASO on the allocation of seats for the category of female deputies in Argentina, considering all female legislators elected in successive elections (2011-2023). Conclusion: The findings show that PASO’s objective of democratizing party structures and making their components more representative does not seem to have impacted the country’s existing political and party traditions prior to implementing the law regarding the place given to women in a party. Originality: The article presents a study on the democratization effect of PASO on party structures from a gender perspective.

Francesca Alberton,1 Laura Galli,2 Riccardo Lolatto,2 Caterina Candela,1 Nicola Gianotti,2 Matteo Chiurlo,2 Martina Ranzenigo,2 Martina Strano,2 Alessia Uglietti,3 Antonella Castagna1,2 1Infectious Diseases Unit, Vita Salute San Raffaele University, Milan, Italy; 2Infectious Diseases Unit, San Raffaele Scientific Institute, Milan, Italy; 3Medical Affairs Department, Infectious Diseases and Vaccines & Rare Diseases, Johnson&Johnson, Milan, ItalyCorrespondence: Alessia Uglietti, Medical Affairs Department, Infectious Disease and Vaccines & Rare Diseases, Johnson&Johnson, viale Fulvio Testi 280/6, Milan, 20126, Italy, Tel +39-344 2665502, Email augliett@its.jnj.comObjective: To evaluate the virological outcome of darunavir–cobicistat (DRVc)‐based regimens in adults living with HIV who had experienced virological failure (VF) on any previous drug combination.Methods: This was a retrospective cohort study (CSLHIV Cohort) of adults living with HIV who started a DRVc‐based regimen with HIV‐RNA > 50 copies/mL after VF on any previous drug combination. Data on demographics, antiretroviral treatment since HIV diagnosis, and immunological and metabolic parameters from baseline (start of DRVc) to 48 weeks were analyzed in order to assess the cumulative proportion of those who achieved virological success (VS), defined as at least one instance of HIV‐RNA < 50 copies/mL within 12 months from baseline. Follow-up lasted from the start of the DRVc-based regimen (baseline) to the first instance of HIV-RNA < 50 copies/mL, last available visit, or loss to follow‐up or death, whichever occurred first. Univariate and multivariate Cox proportional-hazard regression models were used to identify baseline factors associated with VS.Results: A total of 176 individuals were included, and 120 (68.2%) achieved < 50 HIV‐RNA copies/mL within 12 months since baseline. On multivariate analysis, baseline HDL cholesterol was independently associated with the occurrence of VS (adjusted HR 1.021, 95% CI 1.004– 1.038; p=0.014). Among the 120 subjects with VS, 27 (22.5%) had had VF during a median follow-up of 20.8 months since the first undetectable HIV-RNA. Resistance testing after VF was available in two cases, which harboured the HIV variant–bearing protease inhibitor–resistance mutations D30N, I50V, and N88D. During a median follow-up of 38.4 months, 65 of 176 (36.9%) individuals discontinued DRVc for any reason (37 of 120, 30.8%) and achieved VS vs. 28 of 56 (50%) without VS (p=0.019). Time to discontinuation was longer in people with VS (41.5 vs. 23.0 months, p=0.0007). No statistically significant changes were observed in immunological or lipid profiles during follow-up.Conclusion: Most individuals in this study achieved VS within 12 months from the beginning of a DRVc-based regimen; therefore, this treatment represent a viable option for people who have experienced VF on other regimens.Keywords: HIV infection, antiretroviral therapy, ART, darunavir–cobicistat, DRVc, virological failure, VF

Background/purpose: Amoxicillin and clindamycin are the most effective decontaminants for intraoral bone grafts before their application in bone regeneration without cytotoxic effects on osteoblasts, but their effects on the gene expression of markers involved in osteoblast growth and differentiation remain unclear. The study objective was to determine the effects of amoxicillin and clindamycin on the gene expression of markers involved in osteoblast growth and differentiation. Materials and methods: Real-time polymerase chain reaction (RT-PCR) was performed to explore the effect of 150 μg/mL clindamycin or 400 μg/mL amoxicillin on the gene expression by primary human osteoblasts (HOBs) of runt-related transcription factor 2 (Runx-2), osterix (OSX), alkaline phosphatase (ALP), osteocalcin (OSC), osteoprotegerin (OPG), receptor activator for nuclear factor κ B ligand (RANKL), type I collagen (Col-I), bone morphogenetic proteins 2 and 7 (BMP-2 and BMP-7), TGF-β1 and TGF-β receptors (TGF-βR1, TGF-βR2, and TGF-βR3), and vascular endothelial growth factor (VEGF). Results: Treatment with 150 μg/mL clindamycin significantly increased the gene expression of TFG-β1, TGF-βR1, TGF-βR2, TGF-βR3, RUNX-2, Col-1, OSX, OSC, BMP-2, BMP-7, ALP, VEGF, and RANKL by HOBs. Treatment with 400 μg/mL amoxicillin significantly increased the gene expression of TGF-β R1, Col-I, OSC, RANKL, and OPG alone. Conclusion: These findings suggest that 150 μg/mL clindamycin is the decontaminant of choice to treat intraoral bone grafts before their application in bone regeneration. The osteogenic and antibacterial properties of clindamycin can favor and accelerate the integration of bone grafts in the oral cavity.

Purpose: To assess the relationship between clinical and semen characteristics and assisted reproductive technology (ART) outcomes with different birth weight (BW) categories in a cohort of infertile men. Materials and Methods: Data from 1,063 infertile men were analyzed. Patients with BW ≤2,500, 2,500–4,000, and ≥4,000 g were considered as having low BW (LBW), normal BW (NBW), and high BW (HBW), respectively. Testicular volume (TV) was assessed with a Prader orchidometer. Serum hormones were measured in all cases. Semen analyses were categorized based on 2021 World Health Organization reference criteria. Sperm DNA fragmentation (SDF) was tested in every patient and considered pathological for SDF >30%. ART outcomes were available for 282 (26.5%) patients. Descriptive statistics and logistic regression analyses detailed the association between semen parameters and clinical characteristics and the defined BW categories. Results: Of all, LBW, NBW, and HBW categories were found in 79 (7.5%), 807 (76.0%), and 177 (16.5%) men, respectively. LBW men had smaller TV, presented higher follicle-stimulating hormone (FSH) but lower total testosterone levels compared to other groups (all p30% (odd ratio [OR] 3.7; p30% (OR 2.9; p

Abstract Background Antimicrobial resistance has been identified as a major threat to global health. The pig food chain is considered an important source of antimicrobial resistance genes (ARGs). However, there is still a lack of knowledge on the dispersion of ARGs in pig production system, including the external environment. Results In the present study, we longitudinally followed one swine farm located in Italy from the weaning phase to the slaughterhouse to comprehensively assess the diversity of ARGs, their diffusion, and the bacteria associated with them. We obtained shotgun metagenomic sequences from 294 samples, including pig feces, farm environment, soil around the farm, wastewater, and slaughterhouse environment. We identified a total of 530 species-level genome bins (SGBs), which allowed us to assess the dispersion of microorganisms and their associated ARGs in the farm system. We identified 309 SGBs being shared between the animals gut microbiome, the internal and external farm environments. Specifically, these SGBs were characterized by a diverse and complex resistome, with ARGs active against 18 different classes of antibiotic compounds, well matching antibiotic use in the pig food chain in Europe. Conclusions Collectively, our results highlight the urgency to implement more effective countermeasures to limit the dispersion of ARGs in the pig food systems and the relevance of metagenomics-based approaches to monitor the spread of ARGs for the safety of the farm working environment and the surrounding ecosystems.

In this review, we describe evidence that supports building a metaverse to promote healthy longevity. We propose that the metaverse offers several physical advantages (architecture, music, and nature), social (accessibility, affordability, community-building, and relief of social anxiety), and therapeutic (immersive, anti-inflammatory, and adjunctive use in complementary and integrative medicine). Lifelogging by patients may help clinicians personalize interventions by matching data to therapeutic outcomes. Although the metaverse cannot entirely replace our current model of care, a strategic approach will ensure adequate resource allocation and value assessment. In a collaborative effort between Reulay, Inc and Mayo Clinic, we are building a platform for the delivery of personalized and idiographic interventions to promote healthy longevity. To this end, we are using specific science-informed art design to reduce stress and anxiety for patients, with the progressive addition of integrated care elements that connect to this framework and connect treatment response to biomarkers that are relevant to healthy longevity. This review is a commentary on the thought process behind this effort.

The Representations of science in mass media have shown a significant increase in the last years. However, mass media dissemination activities can extend to pseudoscience due to the fact that not all scientific news are published with the same rigour. Thus, we aimed to develop two theoretical-practical interventions among first-year university students with the purpose of improving their knowledge about scientific studies and original scientific sources, as well as to critically analyze dissemination of scientific research in media. The interventions had a positive impact on knowledge about scientific information sources, particularly Pubmed, in addition to reducing the number of incorrect features linked to both scientific and dissemination articles, suggesting the importance of interventions focused on misconceptions. However, students showed knowledge of correct features of scientific articles, independently of our intervention, and they made more mistakes when attributing incorrect features to scientific articles when compared to dissemination ones.

The Canary Islands, as an outermost region of Europe with fragmented territory, benefit from an exemption under Commission Regulation (EU) No 142/2011 allowing for animal by-products disposal in landfills. However, this practice has resulted in environmental and economic challenges, including reduced landfill capacity, increased greenhouse gas emissions, and missed opportunities for renewable energy production. Specifically, waste management in Tenerife faces significant challenges due to the burgeoning meat production and subsequent waste generation in its primary slaughterhouses. With an average annual production of 5,000 tons of waste, landfill capacity is nearing its limit. This study therefore aims to assess the biogas production potential from slaughterhouse waste in Tenerife and evaluate anaerobic digestion as an alternative approach. Various combinations of viscera, blood, and slaughterhouse sludge from cattle, pigs, goats, sheep, rabbits, and chickens were analyzed to determine their biogas potential. Results indicate that comprehensive valorization of these wastes could generate 12.86 GWh of energy, equivalent to approximately 20 % of the energy consumed in the municipality's industrial sector. Moreover, this approach could reduce emissions by 5.88 Gg of CO2 equivalent and alleviate landfill pressures, thereby mitigating current waste management impacts. Given the region's reliance on imported fuels and limited territorial space, anaerobic digestion presents an environmentally and economically sustainable solution for managing slaughterhouse waste within a closed-loop system.

Mycelial growth as biofilm structures and the activation of secondary metabolism leading to the release of low-molecular-weight molecules (known as secondary metabolites), are among the previously described strategies used by the filamentous fungi Aspergillus fumigatus to adapt and survive. Our study unveils that A. fumigatus strains can activate mechanisms linked to the production of gliotoxin, a crucial metabolite for Aspergillus, in the established in vitro biofilm model. Gliotoxin production exhibits strain- and time-dependent patterns and is associated -in a coordinated manner-with the expression levels of several genes involved in its regulation and synthesis. The transcriptional study of some of these genes by qPCR shows temporal inter-strain differences, which correlate with those obtained when evaluating the amounts of metabolites produced. Given that A. fumigatus forms biofilm structures within the site of infection, understanding the regulation of gliotoxin biosynthesis may have a role in the evolution of Aspergillus infection and guide diagnostic and treatment strategies.

Objective: To compare the natural history of C3 glomerulopathy (C3G) to acute post-infectious glomerulonephritis (APIGN) in a cohort of patients with a relative homogeneity of environment conditions and genetic background. Methods: We retrospectively reviewed the characteristics of all patients with biopsy proven C3G or APIGN referred in 2013–2019 to the only renal unit in French Polynesia. Results: Point prevalence of C3G is ∼23 cases per 100,000 inhabitants. A recurrent variation of CFI (p.Arg406His) was identified at the heterozygous state in 4/8 (50 %) patients with C3G but its pathogenicity remain elusive. Characteristics at presentation and kidney outcomes were roughly similar between C3G (n = 16) and APIGN (n = 20), excepted for the presence of humps on kidney biopsy. Conclusions: C3G is highly prevalent in French Polynesia suggesting specific genetic or environmental susceptibility factors. Systematic diagnosis workflow should be proposed to all patients with C3 predominant glomerulonephritis.

The Loop Current is the main mesoscale feature of the Gulf of Mexico oceanic circulation. With peak velocities above 1.5 m s–1, the Loop Current and its mesoscale eddies are of interest to fisheries, hurricane prediction and of special concern for the security of oil rig operations in the Gulf of Mexico, and therefore understanding their predictability is not only of scientific interest but also a major environmental security issue. Combining altimetric data and an eddy detection algorithm with 8 years of deep flow measurements through the Yucatan Channel, we developed a predictive model for the Loop Current extension in the following month that explains 74% of its variability. We also show that 4 clusters of velocity anomalies in the Yucatan Channel represent the Loop Current dynamics. A dipole with positive and negative anomalies towards the western side of the Channel represents the growing and retracted phases respectively, and two tripole shape clusters represent the transition phases, the one with negative anomalies in the center associated with 50% of the eddy separation events. The transition between these clusters is not equally probable, therefore adding predictability. Finally, we show that eddy separation probability begins when the Loop Current extends over 1800 km (~27.2°N), and over 2200 km of extension, eddy detachment and reattachment is more frequent than separation. These results represent a step forward towards having the best possible operational Loop Current forecast in the near future, incorporating near real-time data transmission of deep flow measurements and high resolution altimetric data.

Gender stereotypes are still present in the career choice. Students make decisions about future profession based on a stereotyped perception of studies. The under-representation of women in the field of science, technology, engineering and mathematics, can be explained by this gender gap in the career choice. This article explores the influence of gender stereotypes in the career choice of high school students and presents two aims: first, to analyze perceived stereotypes that boys and girls have towards studies and degrees; and second, to test the time evolution of these gender stereotypes. Statistical analysis was carried out to identify gender stereotypes, and cluster-based analysis to link stereotypes to cluster prototypes and identify hidden groups of behavior. A survey was used to collect data on gender stereotypes. The sample comprised 1844 students from Valencian Community high schools. According to previous studies, our results show that gender stereotypes showed influence on students' perception of professions. Boys have more stereotypes than girls, and this difference is even higher among students who intend to study engineering. Regarding to time evolution, an increase of gender stereotypes among students is detected, especially between girls and students who do not intend to study engineering. The conclusion determines the relationship between traditional gender roles and present professions. Students believe that there are more suitable careers for men or women: technology and engineering for men, education and psychology for women. In addition, these gender stereotypes have increased in the last 10 years. Therefore, the impact of gender stereotypes on career choice may have also increased.

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.

En este estudio exploramos síntomas de ansiedad, depresión y quejas subjetivas de memoria y el consumo de alimentos ricos en ácidos grasos Omega 3 (ω3) en estudiantes universitarios de Córdoba, Argentina, durante la pandemia por COVID-19, conociendo que los ω3 pueden ser benéficos ante estos síntomas. Participaron 303 estudiantes durante la segunda ola de COVID-19. Los resultados mostraron que el 56.8 % reportaron algún de síntoma de ansiedad y 60.7 % de depresión. No se reportaron fallas mnésicas significativas. Respecto al consumo de ω3, solo el 14.5 % lo consumían. En suma, se debe prestar especial atención a este tipo de población generando planes adecuados de prevención en relación con la salud mental y la promoción del beneficio del consumo de ω3.

Este texto responde a la invitación de reflexionar sobre el proceso de producción de mi tesis doctoral dedicada al análisis histórico y sociológico del trabajo y la vida de las cigarreras madrileñas entre 1888 y 1927. Mi primer empeño es reflexionar sobre lo que significó la experiencia de la tesis en mi formación investigadora. Con esta intención reviso algunos aspectos del proceso de fabricación de la investigación, los desafíos teóricos y metodológicos que tuve que afrontar para construir y comprender la compleja realidad histórica y sociológica de las cigarreras. Con esta práctica reflexiva he querido compartir preguntas que nos acompañan en esa transición que vivimos como investigadoras que hemos sido dirigidas y, ahora, dirigimos en la encrucijada del sistema académico actual, donde la situación de la formación inicial del personal investigador y el propio trabajo de dirigir y acompañar tesis doctorales ha cambiado notablemente y no siempre para mejor.

Summary: Aiming to shed light on the biology of wild ruminants, we investigated the gut microbiome seasonal dynamics of the Alpine ibex (Capra ibex) from the Central Italian Alps. Feces were collected in spring, summer, and autumn during non-invasive sampling campaigns. Samples were analyzed by 16S rRNA amplicon sequencing, shotgun metagenomics, as well as targeted and untargeted metabolomics. Our findings revealed season-specific compositional and functional profiles of the ibex gut microbiome that may allow the host to adapt to seasonal changes in available forage, by fine-tuning the holobiont catabolic layout to fully exploit the available food. Besides confirming the importance of the host-associated microbiome in providing the phenotypic plasticity needed to buffer dietary changes, we obtained species-level genome bins and identified minimal gut microbiome community modules of 11–14 interacting strains as a possible microbiome-based solution for the bioconversion of lignocellulose to high-value compounds, such as volatile fatty acids.

El presente trabajo busca explorar una serie de elementos constitutivos del mito del rapto de Europa en las versiones de Mosco (Europa), Ovidio (Metamorfosis 2. 833-875 y 6. 103-107; Fastos 5. 603-620), Aquiles Tacio (Leucipa y Clitofonte 1), Luciano de Samósata (“Céfiro y Noto”, Diálogos marinos) y Nono de Panópolis (Dionisíacas 1). El objetivo es intentar determinar la(s) fuente(s) que pudo haber utilizado cada autor, a partir de la mención u omisión de algunos de estos componentes en las distintas reelaboraciones, así como también los cambios en la forma de emplearlos.

Lacrosse, a sport of increasing popularity, is played with netted sticks and a firm rubber ball propelled at speeds frequently reaching over 100 miles/hour. While lacrosse injuries have been previously described, little published literature exists on lacrosse balls causing pulmonary contusion. We present a case of a 17-year-old male lacrosse player athlete who suffered a lacrosse ball strike to the left posterolateral chest, leading to a clinical presentation of local bruising, shortness of breath, and hemoptysis. Despite delayed arrival to the emergency room, where imaging revealed pulmonary contusion, multidisciplinary supportive management led to favorable clinical outcome with no residual effect on athletic ability and quality of life. Although pulmonary contusion may be a rare injury in the setting of thoracic trauma from lacrosse ball strikes, prompt evaluation and a high index of suspicion can rule out more life-threatening processes and ensure an excellent clinical prognosis.

Chest pain is one of the most prevalent causes of Emergency Department (ED) admission and could be a presenting symptom of Acute Coronary Syndrome (ACS). The aim of this review was to provide an overview of the research about troponin and its limitations and new biomarkers used in patients with cardiovascular diseases, with a special focus on soluble Suppression of Tumorigenicity 2 (sST2) and Soluble Urokinase Plasminogen Activator Receptor (suPAR). In January 2024, a PubMed and Reviews in Cardiovascular Medicine (RCM) search was carried out to identify all relevant papers in the past five years. 80 articles were included in the final review. ssT2 and suPAR are involved in both acute and chronic cardiovascular disease and can predict the risk of adverse events. sST2 and suPAR are promising biomarkers that, in combination with troponin, could help in the management of patients with chest pain in the ED. Further studies are needed to validate their role in management of ACS in this specific setting.

AimsTo assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain.DesignMulticentric, mixed method concurrent study.MethodsThis work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022).DiscussionThe study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic.Trial RegistrationIdentifier: NCT05249868 [ClinicalTrials.gov].

Background: The neck-preserving cementless short stem represents a valid therapeutic option for total hip replacement in high-functional-demand patients, but few studies are available about the use of modularity in the last-generation short stem. The aim of the study was to evaluate the mid-term survival of a specific implant design that combines partial collum short hip stem with neck modularity; assessing the functional status was the second endpoint. Methods: A retrospective single-center cohort study was conducted on 75 patients aged 35 to 80 years, with a minimum 6-year follow-up. Patients with neurological/rheumatic pathologies and previous hip surgeries were excluded. All the patients underwent total hip replacement with a short modular neck-preserving cementless hip stem. Clinical outcomes, complications, revisions, and the Western Ontario and McMaster Universities Osteoarthritis Index, Harris hip score, and Short Form 12-Item Health Survey (SF-12) questionnaires were evaluated. The results were compared with healthy population’s data extracted from the literature, stratified by age. Results: The Kaplan-Meier analysis revealed a 10-year implant survival rate of 96.7%, coupled with a revision rate of 1.3%. Results showed a Harris hip score and physical SF-12 significantly lower and a mental SF-12 higher when compared to healthy population. No statistically significant differences emerged when comparing groups based on neck modularity. Conclusions: The short modular neck-preserving cementless hip stem emerged as a reasonable choice for patients with elevated functional demands, ensuring good clinical outcomes while preserving bone integrity. The use of a modular neck in short stems didn’t show any mechanical problems in the mid-term.

Attribution of extreme climate events to global climate change as a result of anthropogenic greenhouse gas emissions has become increasingly important. Extreme climate events arise at the intersection of natural climate variability and a forced response of the Earth system to anthropogenic greenhouse gas emissions, which may alter the frequency and severity of such events. Accounting for the effects of both natural climate variability and the forced response to anthropogenic climate change is thus central for the attribution. Here, we investigate the reproducibility of probabilistic extreme event attribution results under more explicit representations of natural climate variability. We employ well-established methodologies deployed in statistical Earth System Model emulators to represent natural climate variability as informed from its spatio-temporal covariance structures. Two approaches towards representing natural climate variability are investigated: (1) where natural climate variability is treated as a single component; and (2) where natural climate variability is disentangled into its annual and seasonal components. We showcase our approaches by attributing the 2022 Indo-Pakistani heatwave to human-induced climate change. We find that explicit representation of annual and seasonal natural climate variability increases the overall uncertainty in attribution results considerably compared to established approaches such as the World Weather Attribution Initiative. The increase in likelihood of such an event occurring as a result of global warming differs slightly between the approaches, mainly due to different assessments of the pre-industrial return periods. Our approach that explicitly resolves annual and seasonal natural climate variability indicates a median increase in likelihood by a factor of 41 (95% range: 6-603). We find a robust signal of increased likelihood and intensification of the event with increasing global warming levels across all approaches. Compared to its present likelihood, under 1.5 °C (2 °C) of global near-surface air temperature increase relative to pre-industrial temperatures, the likelihood of the event would be between 2.2 to 2.5 times (8 to 9 times) higher. We note that regardless of the different statistical approaches to represent natural variability, the outcomes on the conducted event attribution are similar, with minor differences mainly in the uncertainty ranges. Possible reasons for differences are evaluated, including limitations of the proposed approach for this type of application, as well as the specific aspects in which it can provide complementary information to established approaches.

Eukaryotes have evolved multiple ATP-dependent chromatin remodelers to shape the nucleosome landscape. We recently uncovered an evolutionarily conserved SWItch/Sucrose Non-Fermentable (SWI/SNF) chromatin remodeler complex in plants reminiscent of the mammalian BAF subclass, which specifically incorporates the MINUSCULE (MINU) catalytic subunits and the TRIPLE PHD FINGERS (TPF) signature subunits. Here we report experimental evidence that establishes the functional relevance of TPF proteins for the complex activity. Our results show that depletion of TPF triggers similar pleiotropic phenotypes and molecular defects to those found in minu mutants. Moreover, we report the genomic location of MINU2 and TPF proteins as representative members of this SWI/SNF complex and their impact on nucleosome positioning and transcription. These analyses unravel the binding of the complex to thousands of genes where it modulates the position of the +1 nucleosome. These targets tend to produce 5-shifted transcripts in the tpf and minu mutants pointing to the participation of the complex in alternative transcription start site usage. Interestingly, there is a remarkable correlation between +1 nucleosome shift and 5 transcript length change suggesting their functional connection. In summary, this study unravels the function of a plant SWI/SNF complex involved in +1 nucleosome positioning and transcription start site determination.