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Research on school improvement and effectiveness has marked the development of educational reforms to decentralise educational systems, professionalise the management function, increase training programmes for leaders, and develop skills profiles and standards across the globe. This preliminary study explores the practices, challenges and opportunities for school governance and educational leadership in Spain. A qualitative exploratory approach was utilised involving 17 semi-structured interviews with national and internationally recognised key education agents from different sectors. The results show a common view regarding the lack of real school autonomy and the persistence of an excessively bureaucratic leadership model. Participants fully agree on the need to promote pedagogical and distributed leadership and, consequently, the personal, social and professional competences required to exercise it. The opportunities envisioned by key education agents to achieve it refer to flexibility, accountability and the provision of more material and human resources for an effective leadership. Additionally, challenges and opportunities for using frameworks or standards systems that define effective school leaders’ functions and skills are identified. Schools must become learning organisations by creating spaces for reflection and continuous improvement, and by involving different agents of the educational community to enhance school governance.

Leukocyte-shed extracellular vesicles (EVs) can play effector roles in the pathophysiological mechanisms of different diseases. These EVs released by membrane budding of leukocytes have been found in high amounts locally in inflamed tissues and in the circulation, indicating immunity cell activation. These EVs secreted by immune cell subsets have been minimally explored and deserve further investigation in many areas of disease. In this study we have investigated whether in heart failure there is innate and adaptive immune cell release of EVs. Patients with chronic heart failure (cHF) (n = 119) and in sex- and age-matched controls without this chronic condition (n = 60). Specifically, EVs were quantified and phenotypically characterized by flow cytometry and cell-specific monoclonal antibodies. We observed that even in well medically controlled cHF patients (with guideline-directed medical therapy) there are higher number of blood annexin-V+ (phosphatidylserine+)-EVs carrying activated immunity cell-epitopes in the circulation than in controls (p < 0.04 for all cell types). Particularly, EVs shed by monocytes and neutrophils (innate immunity) and by T-lymphocytes and natural-killer cells (adaptive immunity) are significantly higher in cHF patients. Additionally, EVs-shed by activated leukocytes/neutrophils (CD11b+, p = 0.006; CD29+/CD15+, p = 0.048), and T-lymphocytes (CD3+/CD45+, p < 0.02) were positively correlated with cHF disease severity (NYHA classification). Interestingly, cHF patients with ischemic etiology had the highest levels of EVs shed by lymphocytes and neutrophils (p < 0.045, all). In summary, in cHF patients there is a significant immune cell activation shown by high-release of EVs that is accentuated by clinical severity of cHF. These activated innate and adaptive immunity cell messengers may contribute by intercellular communication to the progression of the disease and to the common affectation of distant organs in heart failure (paracrine regulation) that contribute to the clinical deterioration of cHF patients.

Objetivo: Identificar la asociación entre empatía general y empatía médica. Detectar predictores del nivel de empatía médica a partir de la empatía general. Determinar el perfil psicosocial que describa la relación entre empatía general, empatía médica y características demográficas y académicas en estudiantes de medicina. Método: Estudio transversal descriptivo. Estudiantes de medicina completaron el Índice de Reactividad Interpersonal (IRI) y la Escala de Empatía Médica de Jefferson versión estudiantil (EEMJ-E). Resultados: Se detectaron niveles relativamente altos de empatía general y médica. El puntaje total del IRI y la EEMJ-E y sus dimensiones se correlacionaron positivamente (r = 0.14-0.52), excepto para la dimensión malestar personal del IRI. El puntaje en la dimensión preocupación empática del IRI fue el mejor predictor del puntaje de la EEMJ-E y sus dimensiones (β = 0.27-0.54). Se detectaron cuatro perfiles: 1) hombres, preferencia por especialidad orientada a la tecnología, menor empatía; 2) estudiantes del periodo preclínico, menor empatía; 3) estudiantes del periodo clínico, mayor empatía; y 4) mujeres, preferencia por especialidad orientada al paciente, mayor empatía. Conclusiones: La empatía general y la empatía médica se encuentran asociadas. Unos perfiles empáticos diferenciados permitirán el diseño de estrategias de instrucción en empatía acordes con las necesidades específicas de cada uno.

Global change is an important driver of the increase in emerging infectious diseases in recent decades. In parallel, interest in nature has increased, and different citizen science platforms have been developed to record wildlife observations from the general public. Some of these platforms also allow registering the observations of dead or sick birds. Here, we test the utility of live, sick and dead observations of birds recorded on the platform Observation.org for the early detection of highly pathogenic avian influenza virus (HPAIV) outbreaks in the wild in Belgium and The Netherlands. There were no significant differences in the morbidity/mortality rate through Observation.org one to four weeks in advance. However, the results show that the HPAIV outbreaks officially reported by the World Organisation for Animal Health (WOAH) overlapped in time with sudden increases in the records of sick and dead birds in the wild. In addition, in two of the five main HPAIV outbreaks recorded between 2016 and 2021, wild Anseriformes mortality increased one to two months before outbreak declaration. Although we cannot exclude that this increase was related to other causes such as other infectious diseases, we propose that Observation.org is a useful nature platform to complement animal health surveillance in wild birds. We propose possible approaches to improve the utility of the platform for pathogen surveillance in wildlife and discuss the potential for HPAIV outbreak detection systems based on citizen science to complement current surveillance programs of health authorities.

Abstract Background Route choice and travel performance of fly-forage migrants are partly driven by large-scale habitat availability, but it remains unclear to what extent wind support through large-scale wind regimes moulds their migratory behaviour. We aimed to determine to what extent a trans-equatorial fly-forage migrant engages in adaptive drift through distinct wind regimes and biomes across Africa. The Inter-tropical Front (ITF) marks a strong and seasonally shifting climatic boundary at the thermal equator, and we assessed whether migratory detours were associated with this climatic feature. Furthermore, we sought to disentangle the influence of wind and biome on daily, regional and seasonal travel performance. Methods We GPS-tracked 19 adult Eleonora’s falcons Falco eleonorae from the westernmost population on the Canary Islands across 39 autumn and 36 spring migrations to and from Madagascar. Tracks were annotated with wind data to assess the falcons’ orientation behaviour and the wind support they achieved in each season and distinct biomes. We further tested whether falcon routes across the Sahel were correlated with the ITF position, and how realized wind support and biome affect daily travel times, distances and speeds. Results Changes in orientation behaviour across Africa’s biomes were associated with changes in prevailing wind fields. Falcons realized higher wind support along their detours than was available along the shortest possible route by drifting through adverse autumn wind fields, but compromised wind support while detouring through supportive spring wind fields. Movements across the Sahel-Sudan zone were strongly associated to the ITF position in autumn, but were more individually variable in spring. Realized wind support was an important driver of daily travel speeds and distances, in conjunction with regional wind-independent variation in daily travel time budgets. Conclusions Although daily travel time budgets of falcons vary independently from wind, their daily travel performance is strongly affected by orientation-dependent wind support. Falcons thereby tend to drift to minimize or avoid headwinds through opposing wind fields and over ecological barriers, while compensating through weak or supportive wind fields and over hospitable biomes. The ITF may offer a climatic leading line to fly-forage migrants in terms of both flight and foraging conditions.

Abstract Background Hereditary transthyretin (TTR) amyloidosis (ATTRv) is a heterogeneous disease with a clinical presentation that varies according to geographical area and TTR mutation. The symptoms of Val50Met-ATTRv are mainly neuropathic and progress to complete disability and death in most untreated patients within 10 to 15 years of diagnosis. The neurological effects may also be accompanied by gastrointestinal impairment, cardiomyopathy, nephropathy and/or ocular deposition. The disease is thus associated with a high degree of patient disability. Accordingly, we aimed to describe the psychosocial burden associated with ATTRv in a group of patients, asymptomatic Val50Met carriers, relatives and caregivers in the endemic focus of the disease in Majorca via a survey addressing various aspects related to psychosocial burden. We performed a an observational, descriptive, cross-sectional and multicentre study in order to analyze the prevalence of self-reported impact of ATTRv disease upon their daily life. In addition to the self-knowledge, fear and burden related to the disease. The survey was disseminated during the regular follow up at the outpatient clinic of the Hospital Universitario Son Llàtzer and during the meetings organized by the Andrade’s Disease patients’ advocacy group from the Balearic Islands. These meetings were attended also by subjects followed up by the Hospital Universitario Son Espases and their caregivers and relatives. Survey was self-administrated. No intervention was done by the investigators. 85 subjects completed the survey: 61 carrying the TTR-V50M variant and 24 caregivers or relatives. Results Our study revealed that, although most of the population studied had had prior contact with ATTRv through affected relatives, there was still a lack of information regarding disease diagnosis. Fear of the genetic test result and psychological issues were common in our population. Moreover, the disease had a stronger impact on the daily life of our patients than that of our asymptomatic carriers. Autonomic symptoms were the main source of burden for relatives and caregivers. Conclusion Our survey results show high psychosocial burden associated with Val50Met-ATTRv in our area.

Children with autism spectrum disorders show higher food selectivity, which restricts consumption of some foods and may cause nutritional deficiencies. The aims of this meta-analysis are to determine the overall differences in nutritional intake and food consumption between children with autism spectrum disorder and control (typical development) children, as well as determine the extent to which the nutritional intake and food consumption of autistic children comply with the dietary recommendations. Children with autism spectrum disorder consume less protein (standardized mean difference = -0.27, 95% confidence interval (-0.45, -0.08)), calcium (-0.56 (-0.95, -0.16)), phosphorus (-0.23 (-0.41, -0.04)), selenium (-0.29 (-0.44, -0.13)), vitamin D (-0.34 (-0.57, -0.11)), thiamine (-0.17 (-0.29, -0.05)), riboflavin (-0.25 (-0.45, -0.05)) and vitamin B12 (-0.52 (-0.95, -0.09)) and more polyunsaturated fat acid (0.27 (0.11, 0.44)) and vitamin E (0.28 (0.03, 0.54)) than controls. Autistic children also consume less omega-3 (-0.83 (-1.53, -0.16)) and more fruit (0.35 (0.12, 0.59)) and vegetables (0.35 (0.09, 0.61)) than control children; however, these results must be considered with care due to the low number of studies included in the analysis and the high heterogeneity. The results also suggest a lower intake of calcium, vitamin D and dairy and a higher intake of fruit, vegetables, protein, phosphorus, selenium, thiamine, riboflavin and vitamin B12 than recommended.

Sub-Antarctic islands are expected to show a high degree of endemicity due to their remoteness. However, biogeographic affinities in the sub-Antarctic remain poorly understood, especially in the marine realm. Sub-Antarctic islands being at the crossroads between Antarctic and cold temperate regions, biodiversity characterization and biogeographic analyses are a priority for monitoring and rapidly assessing variations associated with environmental changes. One underexplored sub-Antarctic area is Crozet, a protected archipelago located halfway between Antarctica and South Africa. In this study, we investigated the shallow-water Crozet macrofaunal diversity, distribution patterns and biogeographic affinities based on the examination of fieldwork specimens via a thorough morphological identification and a genetic characterisation. The resulting dataset provides an important baseline for further studies and conservation strategies, compiling the first genetic and taxonomic database for the Crozet archipelago. In total, 100 morphotypes were found, belonging to nine different phyla, among which arthropods (32), molluscs (18) and echinoderms (17) were the richest. Forty-seven morphotypes were identified to the species level, among which 20 were reported in Crozet for the first time. This confirms that Crozet is a poorly known region, even compared to other sub-Antarctic areas. A large proportion of species (62%) had circum Southern Ocean or circum subAntarctic distributions. These species were mostly shared with Kerguelen (72%), the Magellan Province (64%), and Prince Edward Islands (64%), confirming the patterns found in macroalgae and specific macrofaunal groups. However, this large-distribution statement needs to be counterbalanced by the detection (genetic data) of more restricted distributions than expected in four study cases (the tanaid Apseudes spectabilis, the nudibranch Doris kerguelenensis, the polychaete Neanthes kerguelensis and the chiton Hemiarthrum setulosum). Considering that most morphotypes had no genetic data available from other regions, the proportion of morphotypes with restricted distribution is likely to increase alongside future investigations. In addition, we also found a few cases of unrecognized diversity that might lead to the descriptions of new species, some likely to be endemic to Crozet (e.g., within the polychaete genus Harmothoe and the bryozoan genus Antarctothoa). Altogether, this stresses the need to maintain conservation efforts in Crozet and pursue integrative investigations in order to highlight and protect its unusual diversity. [ABSTRACT FROM AUTHOR]

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Catalina Bover-Bauza,1,2 Maria Antonia Rosselló Gomila,1 David Díaz Pérez,1 Aina Rosa Millán Pons,3 Jose Antonio Gil Sánchez,1,2 Jose Antonio Peña-Zarza,1,4 Joan Figuerola Mulet,1,2 Borja Osona1,2 1Division of Pediatric Respiratory Medicine, Department of Pediatrics, University Hospital Son Espases, Palma, Balearic Islands, Spain; 2Multidisciplinary Research Group in Pediatrics, Balearic Islands Health Research Institute (IdISBa), Palma, Balearic Islands, Spain; 3Department of Statistic and Methodological Support, Balearic Islands Health Research Institute (IdISBa), Palma, Balearic Islands, Spain; 4Research Group in Sleep Apnea and Hypopnea Syndrome, Balearic Islands Health Research Institute (IdISBa), Palma, Balearic Islands, SpainCorrespondence: Catalina Bover-BauzaDivision of Pediatric Respiratory Medicine, Department of Pediatrics, University Hospital Son Espases Carretera Valldemossa 79, Palma, 07120, SpainTel +34 871205000Fax +34 871909712Email catalina.bover2@ssib.esIntroduction: Asthma exacerbation is among the commonest causes for pediatric emergency room visits, and respiratory viruses are frequent triggers of such exacerbations. Few studies have evaluated the consequences of the novel human coronavirus that causes the illness currently known as COVID-19, in the pediatric population.Purpose: The objective of this study was to analyze the impact of the COVID-19 pandemic and lockdown measures on the emergency department in the pediatric asthmatic patient.Patients and Methods: This retrospective observational study evaluated pediatric patients treated at the Pediatric Emergency Service for wheezing episodes. Changes in the number and characteristics of these patients over the same period of 2019 as compared to 2020 during the month following the alarm declaration (March 14 to April 15) were evaluated.Results: In total, data of 30 asthma patients managed in the period after the declaration of the coronavirus pandemic and of 158 asthma patients managed in the pre-COVID-19 period were included. In 2020, patient visits decreased by 82% in 2019. No statistically significant differences among age, sex, oxygen saturation, fever status, or number of severe bronchospasm episodes were found. Nebulized medication usage was reduced significantly since the alarm declaration. No significant increase in requests for complementary testing in the COVID-19 period was found. No patient requiring hospital admission was found to be PCR SARS-CoV-2 positive. Median time spent in the emergency department decreased from 180 minutes in 2019 to 85 minutes in the COVID-19 era.Conclusion: The COVID-19 pandemic and ensuing lockdown measures have led to an extraordinary reduction in emergency visits to the pediatric service. The ongoing pandemic has also led to improvements in the approach to asthma exacerbations and wheezing, to reduce the risk of exposure to the virus, such as increased use of pressurized metered dose inhaler and decreased time in the Emergency Department.Keywords: COVID-19, pandemic, asthma, wheezing, children

Abstract Whilst the immune system often varies seasonally and exhibits differences between males and females, the general patterns in seasonality and sex differences across taxa have remained controversial. Birds are excellent model organisms to assess these patterns, because the immune system of many species is well characterised. We conducted a meta-analysis using 41 wild bird species from 24 avian families to investigate sex differences and seasonal (breeding/non-breeding) variations in immune status, including white blood cell counts, phytohaemagglutinin (PHA) test, bacteria-killing ability (BKA), haemolysis and haemagglutination assays. We found male-biased macrophage concentration, BKA and haemolysis titers, but only during the breeding season. Sex-specific heterophil concentrations, heterophil/lymphocyte ratios and PHA responses differed between breeding and non-breeding, suggesting larger changes in males than in females. Importantly, sex differences in immune status are stronger during the breeding period than during the non-breeding period. Taken together, our study suggests that both seasonal variation and sex differences in immune system are common in birds, although their associations are more complex than previously thought.

Financial market participants can benefit from understanding how shocks affect equity mispricings. Energy corporates have been exposed to multiple structural changes over the past decades. This paper applies the pairs trading algorithm of Figuerola-Ferretti et al. (2018) (Journal of Futures Markets, 2018) to analyze mean reversion of cointegrated stocks in global energy equity markets. Using daily data covering the US, Europe and Asia we report positive risk adjusted returns that supersede their corresponding equity index counterparts. Pairs trading profitability is enhanced when filtering stocks with the measure of capital expenditure (CAPEX).