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Relearning to walk requires progressive training in real scenarios—overground—along with assistance in basic tasks, such as balancing. In addition, user ability must be maximized through compliant robotic assistance as needed. Despite decades of research, gait rehabilitation robotic devices yield controversial results. This article presents the conceptual design of a novel walking assistance and rehabilitation robot, the NIMBLE robot, aimed at providing ambulatory, bodyweight-supported gait training, assisting the user’s center of mass trajectory to aid weight transfer and dynamic balance during walking. NIMBLE consists of a robotic mobile frame, a partial bodyweight support (PBWS) system, an ambulatory lower-limb exoskeleton (Exo-H3) and a cable-driven pelvis-assisting robot. Designed as a modular structure, it differentiates hierarchical communication levels through a Robot Operating System (ROS) 2 network. We present the mechatronic design and experimental results assessing the impact of the mechatronic coupling between the robotic modules on the walking kinematics and the frame movement control performance. The robotic frame hardly affects the walking kinematics up to 2 degrees in both the sagittal and frontal planes, making it feasible for lateral balance and weight translation training. Moreover, it successfully tracks and follows user trajectories. The NIMBLE robotic frame assessment shows promising results for ambulatory gait rehabilitation.

Background: In volleyball, the upper limb dimensions and grip strength greatly influence offensive and defensive movements during a match. However, the relationship between these parameters remains underexplored in elite female volleyball players. Objective: This study aimed to contrast the upper limb anthropometric characteristics and handgrip strength (HGS) of female elite volleyball players against a control group. Methods: Selected upper limb anthropometric parameters and maximal HGS of 42 female volleyball players and 40 non-athletes were measured. Results: Players exhibited higher values in almost all variables studied than non-athletes. The differences were statistically significant (p < 0.001) except for body mass index and elbow and wrist diameters. Players showed a moderate correlation between dominant HGS and hand parameters (length r = 0.43 and breadth r = 0.63; p < 0.05). Weak correlations were identified with height, upper arm length, elbow diameter, and hand shape index (r = 0.32 to 0.38; p < 0.05). In the non-dominant hand, a moderate correlation with handbreadth (r = 0.55, p ≤ 0.01) and weak correlations with upper arm length, wrist diameter, hand length, and hand shape index (r = 0.32 to 0.35; p ≤ 0.05) was found. Conclusions: These findings underscore the importance of the upper limb anthropometric parameters as predictors of HGS and their utility in athlete selection. Future research should investigate biomechanical factors influencing HGS and injury prevention.

The mechanisms underlying the sustained activation of the PI3K/AKT and Wnt/β-catenin pathways mediated by HOTAIR in cervical cancer (CC) have not been extensively described. To address this knowledge gap in the literature, we explored the interactions between these pathways by driving HOTAIR expression levels in HeLa cells. Our findings reveal that HOTAIR is a key regulator in sustaining the activation of both signaling pathways. Specifically, altering HOTAIR expression—either by knockdown or overexpression—significantly influenced the transcriptional activity of the PI3K/AKT and Wnt/β-catenin pathways. Additionally, we discovered that HIF1α directly induces HOTAIR transcription, which in turn leads to the epigenetic silencing of the PTEN promoter via DNMT1. This process leads to the sustained activation of both pathways, highlighting a novel regulatory axis involving HOTAIR and HIF1α in cervical cancer. Our results suggest a new model in which HOTAIR sustains reciprocal activation of the PI3K/AKT and Wnt/β-catenin pathways through the HOTAIR/HIF1α axis, thereby contributing to the oncogenic phenotype of cervical cancer.

This article presents the revision of the STEAM model originally proposed by Yakman, in 2008, introducing the Human variable, as an extremely important element for the model, which was defined as STEAM ∀H, where ∀H is for all Humanity. This proposal is motivated by several factors. On the one hand, the evolution of industrial design from the 19th century to present, going from designing objects focused on facilitating industrialization and focused on the user, to design focused on the human being and humanity. On the other hand, since the formulation of the STEAM model, different improvements have been proposed in the literature in order to introduce humanistic disciplines into the model, also seeking to introduce society as a fundamental element. For example, the literature has proposed the STREAM model, where R is religion, or STEAM-ED, where -ED implies an approach based on the constructivist social theory. The STEAMS model, where S is Society, has also been proposed to try to improve training in understanding society and the implications of designing for it. Initially Yakman introduces the “A” in the STEM model as the sum of different disciplines that use the word “art” in their description: Fine Arts, Physical Arts, Manual Arts and Liberal Arts. The first three disciplines are associated with the practical and also creative part, while the Liberal Arts approach various disciplines in the humanities and social areas. Yakman’s definition of STEAM was quickly accepted and assimilated by the scientific community. However, for the purposes of application, the “A” is treated fundamentally as that creative and artistic component transversal to the rest of the model, relegating humanistic and social learning to the background. In the first section of this article the redefinition of the “A” in the STEAM model is proposed, which was originally defined by Yakman, by integrating the areas of Fine Arts, Physical Arts and Manual Arts; adding ∀H, as STEAM ∀H, which integrates the Liberal Arts, defining the model as: “the learning of Science and Technology interpreted through Engineering and Art based on the language of Mathematics and taking into account the implications of Science, Technology, Engineering, Art and Math’ for all Humanity” The second section of this article proposes the implementation in detail of the STEAM ∀H model in higher education, specifically, in the first year of the Degree in Industrial Design Engineering and Product Development, where the STEAM areas represented by the subjects of Physics, Mathematics, Basic Design, Representation of Shapes, etc., must be integrated with the subject of Social Doctrine of the Church. The model has been tested in three consecutive courses. An empirical qualitative study, case study method was carried out thorugh multiple-question Likert scale questionnaries to analize the perpective and perception of the participants to the new method. The frequency of the results obtained are shown and analized at the end of the article.

Electrocorticography (ECoG) is a critical tool in preclinical neuroscience research for studying global network activity. However, integrating ECoG with functional magnetic resonance imaging (fMRI) has posed challenges, due to metal electrode interference with imaging quality and heating around the metallic electrodes. Here, we introduce recent advancements in ECoG grid development that utilize a polymer-thick film on an organic substrate (PTFOS). PTFOS offers notable advantages over traditional ECoG grids. Firstly, it significantly reduces imaging artifacts, ensuring minimal interference with MR image quality when overlaying brain tissue with PTFOS grids. Secondly, during a 30-min fMRI acquisition, the temperature increase associated with PTFOS grids is remarkably low, measuring only 0.4 °C. These findings suggest that utilizing ECoG with PTFOS grids has the potential to enhance the safety and efficacy of neurosurgical procedures. By providing clearer imaging results and mitigating risk factors such as excessive heating during MRI scans, PTFOS-based ECoG grids represent a promising advancement in neurosurgical technology. Furthermore, we describe a cutting-edge open-source system designed for simultaneous electrophysiology and fMRI. This system stands out due to its exceptionally low input noise levels (

Although, in randomized clinical trials, once-weekly subcutaneous semaglutide (OW s.c.) has demonstrated superior efficacy in comparison with placebo and active controls in terms of glycemic control and body weight reduction in patients with type 2 diabetes mellitus (T2DM), these results need to be confirmed in a real-world (RW) setting. An RW ambispective study (6 months retrospective and 6 months prospective) was conducted in 10 tertiary hospitals in Spain. We evaluated changes in HbA1c and body weight in patients with T2DM treated with semaglutide OW s.c. Additionally, we analyzed different subgroups of patients treated with semaglutide OW s.c. as an add-on to glucose-lowering therapy. A total of 752 patients with a mean age of 60.2 years, a mean HbA1c level of 8.5%, a mean body weight of 101.6 kg, and a mean T2DM duration of 10 years were included. At 12 months, compared with baseline, there was a mean difference of −2.1% in HbA1c levels (p < 0.001) and a mean difference of 9.2 kg in body weight (p < 0.001). Moreover, there were statistically significant differences (p < 0.001) between baseline and month 12 in both HbA1c and body weight in the four subgroups receiving semaglutide OW s.c. as an add-on to glucose-lowering therapy. Semaglutide OW s.c. was well tolerated, with gastrointestinal disorders being the most commonly reported side effects. In this RW study, 12 months of treatment with semaglutide OW s.c. in patients with T2DM was associated with significant and clinically relevant improvements in glycemic control and weight loss, regardless of the glucose-lowering therapy received, and the overall safety profile was positive.

Sacha inchi (Plukenetia volubilis L.) is an under-exploited crop with great potential due to its nutritional and medicinal characteristics. A Sacha inchi protein isolate (SII), obtained from defatted Sacha inchi flour (SIF), was hydrolyzed by Bioprotease LA 660 under specific conditions. The hydrolysates were characterized chemically, and their digestibility and antioxidant capacity were evaluated by in vitro cell-free experiments to select the hydrolysate with major antioxidant activity. Sacha inchi protein hydrolysate at 20 min (SIH20B) was selected, and the anti-inflammatory capacity was evaluated by RT-qPCR and ELISA techniques, using two different doses in monocytes THP-1 stimulated with lipopolysaccharide (LPS). The results obtained showed that the in vitro administration of SIH20B down-regulated the TNF-α gene and reduced the release of this cytokine, whereas the anti-inflammatory cytokines IL-10 and IL-4 were up-regulated in LPS-stimulated monocytes and co-administrated with SIH20B. The peptides contained in SIH20B were identified, and the 20 more relatively abundant peptides with a mass by 1 kDa were subjected to in silico analysis to hypothesize those that could be responsible for the bioactivity reported in the hydrolysate. From the identified peptides, the peptides AAGALKKFL and LGVKFKGGL, among others, are proposed as the most biologically actives. In conclusion, SIH20B is a novel, natural source of high-value-added biopeptides that could be used as an ingredient in formulations of food or nutraceutical compounds.

Summary: Antibiotics inhibiting the fatty acid synthesis pathway (FASII) of the major pathogen Staphylococcus aureus reach their enzyme targets, but bacteria continue growth by using environmental fatty acids (eFAs) to produce phospholipids. We assessed the consequences and effectors of FASII-antibiotic (anti-FASII) adaptation. Anti-FASII induced lasting expression changes without genomic rearrangements. Several identified regulators affected the timing of adaptation outgrowth. Adaptation resulted in decreased expression of major virulence factors. Conversely, stress responses were globally increased and adapted bacteria were more resistant to peroxide killing. Importantly, pre-exposure to peroxide led to faster anti-FASII-adaptation by stimulating eFA incorporation. This adaptation differs from reports of peroxide-stimulated antibiotic efflux, which leads to tolerance. In vivo, anti-FASII-adapted S. aureus killed the insect host more slowly but continued multiplying. We conclude that staphylococcal adaptation to FASII antibiotics involves reprogramming, which decreases virulence and increases stress resistance. Peroxide, produced by the host to combat infection, favors anti-FASII adaptation.

Medical education should foster professionals with knowledge and skills, professional attitudes, and social responsibilities. Undergraduate and postgraduate education and continuing professional development as specialist each have unique possibilities and responsibilities.The use of varied assessment formats assist progression towards the expected program outcomes. An analysis of the main methods for assessing clinical competence is done. This will support students, provide confidence, and document the competence acquired; needed for safe practise, professional life-long learning, being a member of the medical knowledge community and a catalyst for a health promoting society.Spanish medical schools have partially incorporated the Bologna Process, including the introduction of outcome-based medical education. With some exceptions however, they continue with non-integrated curricula, structured on independent subjects.Instead, integrated and progressive competence assessment programs in horizontally and vertically integrated curricula should be established based on the programmatic assessment paradigm. This supports feedback and summative decisions for each student, to help them progress and reach the expected outcomes. Resumen: La educación médica debe fomentar profesionales con conocimientos y habilidades, actitudes profesionales y responsabilidades sociales. La educación de pregrado y posgrado y el desarrollo profesional continuo como especialista tienen desarrollos y responsabilidades propios.El uso de formatos de evaluación variados ayuda a avanzar hacia los resultados esperados del programa. Se realiza un análisis de los principales métodos de evaluación de la competencia clínica. Esto apoyará a los estudiantes, les brindará confianza y documentará la competencia adquirida; Todo ello es necesario para el desarrollo de una práctica segura, un aprendizaje profesional permanente, considerarse miembro de la comunidad de conocimiento médico y es, además, un catalizador para una sociedad que promueva la salud.Las facultades de medicina españolas han incorporado parcialmente el Proceso de Bolonia, incluida la introducción de una educación médica basada en resultados. Sin embargo, salvo algunas excepciones, continúan con planes de estudios no integrados, estructurados en materias independientes.Se deben establecer programas integrados y progresivos de evaluación de competencias en currículos integrados horizontal y verticalmente con base al paradigma de evaluación programática. Esto respalda la retroalimentación y las decisiones sumativas para cada estudiante, para ayudarlos a progresar y alcanzar los resultados esperados.

En este trabajo abordamos la novela gráfica de Pedro Prado titulada: Santa María 1907. La marcha ha comenzado (2014). Prado se hace cargo de uno de los eventos históricos más duros de la memoria chilena: la matanza de los obreros en la escuela Domingo Santa María de Iquique el año 1907. Nos guía la pregunta por el aporte de lo visual entendido como una representación con características propias del medio del cómic. El análisis se centra en las técnicas específicas mediante las cuales se logra una clara emergencia de un sujeto colectivo (doble página, viñeta a página entera, uso de planos, focalización). En segunda instancia, se considera el recurso de la animalización y su posible función dentro de la lógica de la novela. Se cierra el análisis mediante la constatación de la temporalidad de la duración como resistencia mediante el uso de viñeta alargada. Las opciones de Prado realzan el aspecto de colectividad de la marcha, humanizan a las víctimas y anuncian una nueva legibilidad.

PurposeTo compare the clinical and hormonal characteristics of patients with familial hyperaldosteronism (FH) and sporadic primary aldosteronism (PA).MethodsA systematic review of the literature was performed for the identification of FH patients. The SPAIN-ALDO registry cohort of patients with no suspicion of FH was chosen as the comparator group (sporadic group).ResultsA total of 360 FH (246 FH type I, 73 type II, 29 type III, and 12 type IV) cases and 830 sporadic PA patients were included. Patients with FH-I were younger than sporadic cases, and women were more commonly affected (P = 0.003). In addition, the plasma aldosterone concentration (PAC) was lower, plasma renin activity (PRA) higher, and hypokalemia (P < 0.001) less frequent than in sporadic cases. Except for a younger age (P < 0.001) and higher diastolic blood pressure (P = 0.006), the clinical and hormonal profiles of FH-II and sporadic cases were similar. FH-III had a distinct phenotype, with higher PAC and higher frequency of hypokalemia (P < 0.001), and presented 45 years before sporadic cases. Nevertheless, the clinical and hormonal phenotypes of FH-IV and sporadic cases were similar, with the former being younger and having lower serum potassium levels.ConclusionIn addition to being younger and having a family history of PA, FH-I and III share other typical characteristics. In this regard, FH-I is characterized by a low prevalence of hypokalemia and FH-III by a severe aldosterone excess causing hypokalemia in more than 85% of patients. The clinical and hormonal phenotype of type II and IV is similar to the sporadic cases.

In this study, we present simultaneous multi-point observations of magnetospheric oscillations on a time scale of tens of minutes (forced-breathing mode) and modulated whistler-mode chorus waves, associated with concurrent energetic electron precipitation observed through enhanced BARREL X-rays. Similar fluctuations are observed in X-ray signatures and the compressional component of magnetic oscillations, spanning from ∼9 to 12 h in MLT and 5 to 11 in L shell. Such magnetospheric oscillations covering an extensive region in the pre-noon sector have been suggested to play a potential role in precipitating energetic electrons by either wave scattering or loss cone modulation, showing a high correlation with the enhancement in X-rays. In this event, the correlation coefficients between chorus waves (smoothed over 8 min), ambient magnetic field oscillations and X-rays are high. We perform an in-depth quasi-linear modeling analysis to evaluate the role of magnetic field oscillations in modulating energetic electron precipitation in the Earth’s magnetosphere through modulating whistler-mode chorus wave amplitude, resonance condition between chorus waves and electrons, as well as loss cone size. Model results further show that the modulation of chorus wave amplitude plays a dominant role in modulating the electron precipitation. However, the effect of the modulation in the resonant energy between chorus waves and energetic electrons due to the background magnetic field oscillations cannot be neglected. The bounce loss cone modulation, affected by the magnetic oscillations, has little influence on the electron precipitation modulation. Our results show that the low frequency magnetospheric oscillations could play a significant role in modulating the electron precipitation through modulating chorus wave intensity and the resonant energy between chorus waves and electron.

Gastrointestinal Stromal Tumors (GIST) are the most frequent mesenchymal neoplasia of the digestive tract. Genomic alterations in KIT, PDFGRA, SDH, and BRAF genes are essential in GIST oncogenesis. Therefore, the mutations in these genes have demonstrated clinical implications. Tumors with deletions in KIT-exon 11 or duplications in exon 9 are associated with a worse prognosis. In contrast, KIT-exon 11 substitutions and duplications are associated with a better clinical outcome. Moreover, mutations in Kit exon 9 and 11 are actionable, due to their response to imatinib, while mutations in PDGFRA respond to sunitinib and/or avapritinib. Although, molecular testing on tissue samples is effective; it is invasive, requires adequate amounts of tissue, and a long experimental process is needed for results. In contrast, liquid biopsy has been proposed as a simple and non-invasive method to test biomarkers in cancer. The most common molecule analyzed by liquid biopsy is circulating tumor DNA (ctDNA). GISTs ctDNA testing has been demonstrated to be effective in identifying known and novel KIT mutations that were not detected using traditional tissue DNA testing and have been useful in determining progression risk and response to TKI therapy. This allows the clinician to have an accurate picture of the genetic changes of the tumor over time. In this work, we aimed to discuss the implications of mutational testing in clinical outcomes, the methods to test ctDNA and the future challenges in the establishment of alternatives of personalized medicine.

BackgroundCarbapenem-resistant Klebsiella pneumoniae (CRKP) is a global threat. We therefore analysed the bacterial characteristics of CRKP infections and the clinical outcomes of patients with CRKP infections across different countries.MethodsIn this prospective, multicentre, cohort study (CRACKLE-2), hospitalised patients with cultures positive for CRKP were recruited from 71 hospitals in Argentina, Australia, Chile, China, Colombia, Lebanon, Singapore, and the USA. The first culture positive for CRKP was included for each unique patient. Clinical data on post-hospitalisation death and readmission were collected from health records, and whole genome sequencing was done on all isolates. The primary outcome was a desirability of outcome ranking at 30 days after the index culture, and, along with bacterial characteristics and 30-day all-cause mortality (a key secondary outcome), was compared between patients from China, South America, and the USA. The desirability of outcome ranking was adjusted for location before admission, Charlson comorbidity index, age at culture, Pitt bacteremia score, and anatomical culture source through inverse probability weighting; mortality was adjusted for the same confounders, plus region where relevant, through multivariable logistic regression. This study is registered at ClinicalTrials.gov, NCT03646227, and is complete.FindingsBetween June 13, 2017, and Nov 30, 2018, 991 patients were enrolled, of whom 502 (51%) met the criteria for CRKP infection and 489 (49%) had positive cultures that were considered colonisation. We observed little intra-country genetic variation in CRKP. Infected patients from the USA were more acutely ill than were patients from China or South America (median Pitt bacteremia score 3 [IQR 2-6] vs 2 [0-4] vs 2 [0-4]) and had more comorbidities (median Charlson comorbidity index 3 [IQR 2-5] vs 1 [0-3] vs 1 [0-2]). Adjusted desirability of outcome ranking outcomes were similar in infected patients from China (n=246), South America (n=109), and the USA (n=130); the estimates were 53% (95% CI 42-65) for China versus South America, 50% (41-61) for the USA versus China, and 53% (41-66) for the USA versus South America. In patients with CRKP infections, unadjusted 30-day mortality was lower in China (12%, 95% CI 8-16; 29 of 246) than in the USA (23%, 16-30; 30 of 130) and South America (28%, 20-37; 31 of 109). Adjusted 30-day all-cause mortality was higher in South America than in China (adjusted odds ratio [aOR] 4·82, 95% CI 2·22-10·50) and the USA (aOR 3·34, 1·50-7·47), with the mortality difference between the USA and China no longer being significant (aOR 1·44, 0·70-2·96).InterpretationGlobal CRKP epidemics have important regional differences in patients' baseline characteristics and clinical outcomes, and in bacterial characteristics. Research findings from one region might not be generalisable to other regions.FundingThe National Institutes of Health.

BackgroundLow-grade serous carcinoma of the ovary or peritoneum is characterised by MAPK pathway aberrations and its reduced sensitivity to chemotherapy relative to high-grade serous carcinoma. We compared the MEK inhibitor trametinib to physician's choice standard of care in patients with recurrent low-grade serous carcinoma.MethodsThis international, randomised, open-label, multicentre, phase 2/3 trial was done at 84 hospitals in the USA and UK. Eligible patients were aged 18 years or older with recurrent low-grade serous carcinoma and measurable disease, as defined by Response Evaluation Criteria In Solid Tumors version 1.1, had received at least one platinum-based regimen, but not all five standard-of-care drugs, and had received an unlimited number of previous regimens. Patients with serous borderline tumours or tumours containing low-grade serous and high-grade serous carcinoma were excluded. Eligible patients were randomly assigned (1:1) to receive either oral trametinib 2 mg once daily (trametinib group) or one of five standard-of-care treatment options (standard-of-care group): intravenous paclitaxel 80 mg/m2 by body surface area on days 1, 8, and 15 of every 28-day cycle; intravenous pegylated liposomal doxorubicin 40-50 mg/m2 by body surface area once every 4 weeks; intravenous topotecan 4 mg/m2 by body surface area on days 1, 8, and 15 of every 28-day cycle; oral letrozole 2·5 mg once daily; or oral tamoxifen 20 mg twice daily. Randomisation was stratified by geographical region (USA or UK), number of previous regimens (1, 2, or ≥3), performance status (0 or 1), and planned standard-of-care regimen. The primary endpoint was investigator-assessed progression-free survival while receiving randomised therapy, as assessed by imaging at baseline, once every 8 weeks for 15 months, and then once every 3 months thereafter, in the intention-to-treat population. Safety was assessed in patients who received at least one dose of study therapy. This trial is registered with ClinicalTrials.gov, NCT02101788, and is active but not recruiting.FindingsBetween Feb 27, 2014, and April 10, 2018, 260 patients were enrolled and randomly assigned to the trametinib group (n=130) or the standard-of-care group (n=130). At the primary analysis, there were 217 progression-free survival events (101 [78%] in the trametinib group and 116 [89%] in the standard-of-care group). Median progression-free survival in the trametinib group was 13·0 months (95% CI 9·9-15·0) compared with 7·2 months (5·6-9·9) in the standard-of-care group (hazard ratio 0·48 [95% CI 0·36-0·64]; p

Arabinoxylans (AXs) extracted from distillers dried grains with solubles (DDGSs) were treated with amylase, amyloglucosidase, and protease, to evaluate their effect on the polysaccharide capability to form covalent electro-sprayed nanoparticles. Enzymatically treated arabinoxylans (AXPPs) presented a significant decrease in protein content and molecular weight (31 and 37%, respectively), while the ferulic acid content and the arabinose-to-xylose ratio (A/X) were not statistically modified. The Fourier transform infrared spectra of the AXPPs showed a diminution in the intensity of amide I and amide II bands concerning AXs. The AXPP gels (1% w/v) induced via laccase registered a slight increase in the dimers of ferulic acid cross-linking content (9%) and the G’ value (27%) about the AX gels. The electro-sprayed nanoparticles of AXs and AXPPs (NAXs and NAXPPs, respectively) revealed a spherical and regular morphology via transmission electron microscopy. The nanoparticle diameter was not different for the NAXs and NAXPPs, while the NAXPPs show a significant reduction in Z potential value compared to NAXs. Confocal laser microscopy observations were conducted, to analyze the protein content in the AX network, and a decrease in illuminated areas was observed in the AXPP gels and the NAXPPs. These results indicate that the enzymatical treatment of an AX improves the polysaccharide gelling capability, but does not influence the fabrication of electro-sprayed covalent nanoparticles. NAXs and NAXPPs could be attractive biomaterials for diverse pharmaceutical and biomedical applications.

Abstract Novel materials such as fiber-metal laminates (FMLs) have demonstrated significant potential in a variety of applications. They must contend with problems such fatigue, creep, high-speed projectile impact, and deformation at high strain rates while in use. When employed as structural materials in aircraft, especially when exposed to shock wave impact and high velocity impact, fiber-metal laminates’ high strain rate characteristics become crucial. Shock impedance matching is a revolutionary approach used for shock-tuning the separate layers. The novelty of the current work is in developing custom shielding laminates, with in-depth analysis on the response of the shock impedance tuning of individual layers on the laminate behaviour at high strain rates. In the current study, five stackups of FMLs comprising metallic (AA 6061-T6) and fiber-reinforced polymer (FRP) plies, were formulated, incorporating shock impedance matching. The fiber-polymer plies used in the FMLs include ultra-high molecular weight polyethylene (UHMWPE), p-aramid for supplementing the impact resistance. Transmission loss functions (TL) estimated from the impedance tube experiments were used to indicate the shock tuning of the various laminates. The laminates underwent testing using a Split Hopkinson Pressure Bar (SHPB) apparatus to determine their properties at high strain rates ( $$350\, \textrm{s}^{-1}$$ 350 s - 1 to $$460\, \textrm{s}^{-1}$$ 460 s - 1 ). The variation in the Shock Energy (SE) absorbed by the laminates at various strain rates was analyzed as a function of the corresponding Transmission Loss employing regression. The dynamic stress-strain curves showed an increase in shock energy absorption at higher strain rates. The sequence SSP-IV and SSP-II showed the highest values of energy absorption as well as Transmission Loss.

Abstract High-grade serous ovarian carcinoma (HGSOC) is characterised by poor outcome and extreme chromosome instability (CIN). Therapies targeting centrosome amplification (CA), a key mediator of chromosome missegregation, may have significant clinical utility in HGSOC. However, the prevalence of CA in HGSOC, its relationship to genomic biomarkers of CIN and its potential impact on therapeutic response have not been defined. Using high-throughput multi-regional microscopy on 287 clinical HGSOC tissues and 73 cell lines models, here we show that CA through centriole overduplication is a highly recurrent and heterogeneous feature of HGSOC and strongly associated with CIN and genome subclonality. Cell-based studies showed that high-prevalence CA is phenocopied in ovarian cancer cell lines, and that high CA is associated with increased multi-treatment resistance; most notably to paclitaxel, the commonest treatment used in HGSOC. CA in HGSOC may therefore present a potential driver of tumour evolution and a powerful biomarker for response to standard-of-care treatment.

Abstract Background The variability in the effectiveness of type 2 diabetes (T2D) preventive interventions highlights the potential to identify the factors that determine treatment responses and those that would benefit the most from a given intervention. We conducted a systematic review to synthesize the evidence to support whether sociodemographic, clinical, behavioral, and molecular factors modify the efficacy of dietary or lifestyle interventions to prevent T2D. Methods We searched MEDLINE, Embase, and Cochrane databases for studies reporting on the effect of a lifestyle, dietary pattern, or dietary supplement interventions on the incidence of T2D and reporting the results stratified by any effect modifier. We extracted relevant statistical findings and qualitatively synthesized the evidence for each modifier based on the direction of findings reported in available studies. We used the Diabetes Canada Clinical Practice Scale to assess the certainty of the evidence for a given effect modifier. Results The 81 publications that met our criteria for inclusion are from 33 unique trials. The evidence is low to very low to attribute variability in intervention effectiveness to individual characteristics such as age, sex, BMI, race/ethnicity, socioeconomic status, baseline behavioral factors, or genetic predisposition. Conclusions We report evidence, albeit low certainty, that those with poorer health status, particularly those with prediabetes at baseline, tend to benefit more from T2D prevention strategies compared to healthier counterparts. Our synthesis highlights the need for purposefully designed clinical trials to inform whether individual factors influence the success of T2D prevention strategies.

Abstract Aim To develop and validate a questionnaire to assess satisfaction with teaching innovation, assess the student satisfaction with a video‐based microlearning intervention in its video‐based modality and to verify its impact on academic performance. Design A descriptive cross‐sectional study was conducted. The study used the COSMIN checklist for studies on measurement instruments. Methods One hundred and ten nursing students from Salus Infirmorum University Centre (Andalusia, Spain) participated in the study. The items of the instrument were designed based on a literature review and its validity and stability were analysed. After that, 6 weeks of video‐based microlearning intervention were implemented. Then students were asked to fill the satisfaction questionnaire and then took the subject exam. Results The resulting questionnaire consisted of 5 items with only one dimension. The questionnaire showed good validity and reliability. A direct correlation was observed between satisfaction with the video‐based microlearning intervention and the marks of the subject exam.

Purpose: The aim of this study was to evaluate the prevalence of autonomous cortisol secretion (ACS) in patients with primary aldosteronism (PA) and its implications on cardiometabolic and surgical outcomes. Methods: This is a retrospective multicenter study of PA patients who underwent 1 mg dexamethasone-suppression test (DST) during diagnostic workup in 21 Spanish tertiary hospitals. ACS was defined as a cortisol post-DST >1.8 μg/dL (confirmed ACS if >5 μg/dL and possible ACS if 1.8–5 μg/dL) in the absence of spe cific clinical features of hypercortisolism. The cardiometabolic profile was compared with a control group with ACS without PA (ACS group) matched for age and DST levels. Results: The prevalence of ACS in the global cohort of patients with PA (n = 176) was 29% (ACS–PA; n = 51). Ten patients had confirmed ACS and 41 possible ACS. The cardiometabolic profile of ACS–PA and PA-only patients was simil ar, except for older age and larger tumor size of the adrenal lesion in the ACS–PA group. When comparing the ACS–PA group (n = 51) and the ACS group (n = 78), the prevalence of hypertension (OR 7.7 (2.64–22.32)) and cardiovascular events (OR 5.0 (2.29–11.07)) was higher in ACS–PA patients than in ACS patients. The coexistence of ACS in patien ts with PA did not affect the surgical outcomes, the proportion of biochemical cure and clinical cure being similar between ACS–PA and PA-only groups. Conclusion: Co-secretion of cortisol and aldosterone affects almost one-thi rd of patients with PA. Its occurrence is more frequent in patients with larger tumors and advanced age. However, the cardiometabolic and surgical outcomes of patients with ACS–PA and PA-only are similar.