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Abstract This paper addresses the often overlooked issue of fairness in the autonomous driving domain, particularly in vision-based perception and prediction systems, which play a pivotal role in the overall functioning of Autonomous Vehicles (AVs). We focus our analysis on biases present in some of the most commonly used visual datasets for training person and vehicle detection systems. We introduce an annotation methodology and a specialised annotation tool, both designed to annotate protected attributes of agents in visual datasets. We validate our methodology through an inter-rater agreement analysis and provide the distribution of attributes across all datasets. These include annotations for the attributes age, sex, skin tone, group, and means of transport for more than 90K people, as well as vehicle type, colour, and car type for over 50K vehicles. Generally, diversity is very low for most attributes, with some groups, such as children, wheelchair users, or personal mobility vehicle users, being extremely underrepresented in the analysed datasets. The study contributes significantly to efforts to consider fairness in the evaluation of perception and prediction systems for AVs. This paper follows reproducibility principles. The annotation tool, scripts and the annotated attributes can be accessed publicly at https://github.com/ec-jrc/humaint_annotator .

Abstract Monocytes, the circulating macrophage precursors, contribute to diseases like atherosclerosis and asthma. Long non-coding RNAs (lncRNAs) have been shown to modulate the phenotype and inflammatory capacity of monocytes. We previously discovered the lncRNA SMANTIS, which contributes to cellular phenotype expression by controlling BRG1 in mesenchymal cells. Here, we report that SMANTIS is particularly highly expressed in monocytes and lost during differentiation into macrophages. Moreover, different types of myeloid leukemia presented specific SMANTIS expression patterns. Interaction studies revealed that SMANTIS binds RUNX1, a transcription factor frequently mutated in AML, primarily through its Alu-element on the RUNT domain. RNA-seq after CRISPR/Cas9-mediated deletion of SMANTIS or RUNX1 revealed an association with cell adhesion and both limited the monocyte adhesion to endothelial cells. Mechanistically, SMANTIS KO reduced RUNX1 genomic binding and altered the interaction of RUNX1 with EP300 and CBFB. Collectively, SMANTIS interacts with RUNX1 and attenuates monocyte adhesion, which might limit monocyte vascular egress.

Abstract Background Chagas disease (CD), triggered by the Trypanosoma cruzi parasite, is originally endemic across Latin America, affecting millions. While cardiac complications are widely recognized, the association between CD and stroke remains underexplored. This systematic review aims to elucidate the relationship between CD and stroke, highlighting the cardioembolic origins of stroke in CD patients and assessing the elevated stroke risk compared to non-infected individuals. Methodology Adhering to the PRISMA guidelines, we conducted a comprehensive search in PubMed and Scopus databases without date restrictions, including articles in both Spanish and English. This approach enabled the identification and analysis of relevant studies to understand the interplay between CD and stroke risk. Results Our analysis of 25 selected studies indicates that strokes in CD patients predominantly arise from cardioembolic sources. The data underscore a significant increase in stroke risk among individuals infected with T. cruzi compared to uninfected counterparts. Additionally, CD patients face a higher stroke and mortality risk than those with other heart failure etiologies, irrespective of disease severity. Conclusion The review establishes CD as a critical contributor to stroke incidence, emphasizing the need for heightened awareness and diagnosis of CD in stroke patients, particularly in regions with high CD prevalence. Recognizing the increased stroke risk associated with T. cruzi infection is crucial for developing targeted educational and preventive strategies in endemic areas.

In this study, an Artificial Neural Network-Genetic Algorithm (ANN-GA) approach was successfully applied to optimise the physicochemical factors influencing the synthesis of unsaturated fatty acids (UFAs) in the microalgae P. kessleri UCM 001. The optimized model recommended specific cultivation conditions, including glucose at 29 g/L, NaNO3 at 2.4 g/L, K2HPO4 at 0.4 g/L, red LED light, an intensity of 1000 lx, and an 8:16-h light-dark cycle. Through ANN-GA optimisation, a remarkable 66.79% increase in UFAs production in P. kessleri UCM 001 was achieved, compared to previous studies. This underscores the potential of this technology for enhancing valuable lipid production. Sequential variations in the application of physicochemical factors during microalgae culture under mixotrophic conditions, as optimized by ANN-GA, induced alterations in UFAs production and composition in P. kessleri UCM 001. This suggests the feasibility of tailoring the lipid profile of microalgae to obtain specific lipids for diverse industrial applications. The microalgae were isolated from a high-mountain lake in Colombia, highlighting their adaptation to extreme conditions. This underscores their potential for sustainable lipid and biomaterial production. This study demonstrates the effectiveness of using ANN-GA technology to optimise UFAs production in microalgae, offering a promising avenue for obtaining valuable lipids. The microalgae's unique origin in a high-mountain environment in Colombia emphasises the importance of exploring and harnessing microbial resources in distinctive geographical regions for biotechnological applications.

Farm sabotage can cause massive fish escape events with significant ecological and socio-economic risks. This study examined the fate of Mediterranean seabass Dicentrarchus labrax escapees following a large-scale escape event caused by sabotage in the Western Mediterranean Sea. We monitored the escapee density and size structure over 3 mo after the escape at increasing distances from the escape point, up to 45 km away. Fish density adjacent to the escape location 5 d after the sabotage was, on average, 114 ± 44.7 (SE) fish per 100 m2. Our analyses showed that fish density decreased by 17% for every km away from the location, dropping to 2 and 1% after 1 and 2 mo, respectively, following the escape event. As escapee density declined throughout time and space, the size distribution of seabass shifted towards larger sizes. The rapid decrease in fish densities highlights the need for contingency plans focusing on fishing efforts in the coastal areas near the escape location (

Abstract Objectives Cryptococcosis remains a severe global health concern, underscoring the urgent need for rapid and reliable diagnostic solutions. Point-of-care tests (POCTs), such as the cryptococcal antigen semi-quantitative (CrAgSQ) lateral flow assay (LFA), offer promise in addressing this challenge. However, their subjective interpretation poses a limitation. Our objectives encompass the development and validation of a digital platform based on Artificial Intelligence (AI), assessing its semi-quantitative LFA interpretation performance, and exploring its potential to quantify CrAg concentrations directly from LFA images. Methods We tested 53 cryptococcal antigen (CrAg) concentrations spanning from 0 to 5000 ng/ml. A total of 318 CrAgSQ LFAs were inoculated and systematically photographed twice, employing two distinct smartphones, resulting in a dataset of 1272 images. We developed an AI algorithm designed for the automated interpretation of CrAgSQ LFAs. Concurrently, we explored the relationship between quantified test line intensities and CrAg concentrations. Results Our algorithm surpasses visual reading in sensitivity, and shows fewer discrepancies (p

Abstract The timing of spring onset is a particularly sensitive climate change indicator that also allows the study of weather interannual variations and extremes. This indicator can be derived from a suite of phenological models called the Extended Spring Indices (SI-x). These models transform daily minimum and maximum temperatures into a set of consistent indices that track the timing of first leaf and first bloom for key indicator plant species. The SI-x also enables the calculation of the so-called frost damage index. Using new computational technologies and high spatial resolution gridded weather data, here we present and evaluate a multi-decadal 1 km spatial resolution version of the SI-x models, which cover North American (1980 to 2022) and European areas (1950 to 2020). Because of the generally good agreement with ground phenological observations, this continental-scale and high spatial resolution product can support both scientists and decision makers in their quest to hind- and forecast weather and climate change impacts.

Public administrations are facing the challenge of continuous improvement of processes to meet both ethical and compliance standards. This study examines the extent to which non-job relevant factors (gender and tenure) may have a greater impact on managers’ positions than job-relevant factors (skills and job performance) in the public sector. Our study with 412 public incumbent managers in different rank positions revealed that tenure and the innovation orientation skill, and gender are the main predictors to upper positions. Moreover, men have shown higher levels of counterproductive performance than women. This highlights the need for a review of human resources processes and the implementation of competency-based management models to achieve fairer procedures and improved ethical public governance.

الملخص: حققت المملكة العربية السعودية تطورات كبيرة في البنية التحتية للرعاية الصحية للأطفال. ومع ذلك، لا تزال هناك فجوات في معالجة السلامة العاطفية للأطفال في المستشفيات، والاحتياجات النفسية، والاجتماعية. على المستوى الدولي، تطورت مهنة ''حياة الطفل'' على مدى عقود من الزمن لتلبية هذه الاحتياجات على وجه التحديد من خلال تدخلات مثل اللعب العلاجي، وتثقيف المريض بلغة تناسب المرحلة العمرية، ودعم الأسرة.تقيم هذه الورقة أهمية ادراج مهنة حياة الطفل في المملكة العربية السعودية لتعزيز جودة الرعاية الصحية للأطفال حيث يكشف تحليل الوضع الحالي عن وجود ثغرات في الرعاية النفسية للأطفال. تم إدراج هذه الفجوات المحددة كأولويات وطنية في برنامج التحول الصحي، الذي يهدف إلى تحسين جودة الرعاية الصحية وتعزيز الرفاهية.مهنة حياة الطفل يمكن أن تساعد في تحقيق هذه الأهداف للأطفال والأسر في المملكة العربية السعودية حيث تم اقتراح استراتيجيات للتنفيذ المرحلي، تشمل مؤسسات الرعاية الصحية، والشركاء الأكاديميين، والشركاء ذوي الصلة غير الربحين، وواضعي السياسات. تؤكد الورقة على الفوائد المتعددة الأوجه لـمهنة حياة الطفل في تحسين تجارب المرضى، وكفاءة تقديم الرعاية الصحية، وجودة الرعاية الصحية للأطفال، والرفاه للأطفال والأسر. Abstract: Saudi Arabia has made substantial advancements in its pediatric healthcare infrastructure. However, substantial gaps persist in addressing hospitalized children's emotional safety, and psychosocial and developmental needs. Internationally, the child life profession has evolved over decades to specifically address these needs, through interventions such as therapeutic play, age-appropriate patient education, and family support.This article evaluates the imperative for integrating the child life profession into healthcare services in Saudi Arabia to transform the quality of pediatric healthcare. An analysis of the current landscape revealed gaps in pediatric psychosocial care. These gaps are listed as national priorities in the health transformation program aimed at improving healthcare quality and enhancing well-being. Integrating the child life profession can help achieve these objectives for children and families in Saudi Arabia.This article highlights the multifaceted benefits of the child life profession in improving patient experiences, healthcare delivery efficiency, pediatric healthcare quality, and the overall well-being of children and families. Strategies for phased implementation, involving healthcare institutions, academic partners, relevant non-profit partners, and policymakers, are proposed.

Actualmente, la tecnología en el aula capta la atención de los estudiantes y aumenta su interés en el proceso de aprendizaje. Por ello, la infografía como recurso didáctico se presenta como un contenido visual y académico que facilita diferentes niveles de percepción, útil para el aprendizaje inicial de estudiantes de 8 a 9 años. En este estudio, se investigó la aplicación de infografías como recurso didáctico para mejorar la comprensión lectora en niños de educación general básica en Azogues. La metodología utilizada fue cuasiexperimental, basada en un enfoque mixto que combina elementos cuantitativos y cualitativos. Se aplicaron pretest y postest a los estudiantes para obtener datos variados y enriquecer el análisis. Los resultados esperados proporcionarán información valiosa sobre cómo este recurso didáctico puede mejorar el proceso de aprendizaje y la práctica docente, proporcionando una comprensión matizada del fenómeno investigado y contribuyendo al avance del conocimiento en el área de la comprensión lectora a través de recursos visuales educativos.

Cistus ladanifer L. (jara) es una especie arbustiva muy extendida en la región mediterránea y de gran interés para la industria cosmética, farmacológica y agroalimentaria. A pesar de su valor, este recurso se encuentra infrautilizado y presenta una gran variabilidad espacial y condiciones de extracción heterogéneas. El objetivo de este estudio es desarrollar una metodología de localización de zonas óptimas para la instalación de plantas de destilación de aceites esenciales de C. ladanifer que permitan su extracción de la manera más eficiente y rentable posible. Se han empleado técnicas de teledetección basadas en clasificaciones supervisadas de píxeles y objetos para determinar la distribución y superficie de este recurso. La clasificación se llevó a cabo con imágenes Sentinel-2 de 2018, modelos digitales de elevaciones y los siguientes seis algoritmos de clasificación: mínima distancia, distancia de Mahalanobis, máxima probabilidad, Spectral Angle Mapper, máquinas de vector soporte y redes neuronales. El uso de herramientas SIG como el análisis de evaluación multicriterio y los modelos de localización-asignación nos permitieron obtener y conectar los puntos de oferta de mayor aptitud de recurso y los emplazamientos idóneos de demanda de las instalaciones. Los clasificadores Máxima Probabilidad, máquinas de vector soporte y redes neuronales lograron precisiones de clasificación superiores al 90 % en fiabilidad global y coeficiente Kappa. La superficie total de jaras potencialmente explotable obtenida en la clasificación fue de 20 889 ha, de las cuales 15 241 ha (72,96 %) eran viables para la recolección. La instalación de dos plantas de destilación mostraba una distribución de cobertura espacial eficaz de aprovechamiento de este recurso en el área de estudio. La metodología se considera una herramienta valiosa para determinar de forma eficiente y sostenible la ubicación óptima de plantas de destilación.

Abstract The importance of incorporating lumbo-pelvic stability core and controlling motor exercises in patients with chronic low back pain (CLBP) reinforces the use of strategies to improve biopsychosocial beliefs by reducing biomedical postulations. However, clinical practice guidelines recommend multimodal approaches incorporating exercise and manual therapy (MT), and instead reject the application of kinesiotape (KT) in isolation. Therefore, the objectives of this study were to analyze the effects of 12 weeks of exercises combined with MT or KT on perceived low back pain using the visual analog scale (VAS) and muscle electric activity measured with electromyography (EMG) of the rectus abdominis and multifidus in CLBP (mild disability) and to explore the relationship between the rectus abdominis and multifidus ratios and pain perception after intervention. A blinded, 12-week randomized controlled trial (RCT) was carried out, involving three parallel groups of patients with CLBP. The study was registered at Clinicaltrial.gov and assigned the identification number NCT05544890 (19/09/22). The trial underwent an intention-to-treat analysis. The primary outcome revealed a multimodal treatment program supplemented by additional therapies such as MT and KT, resulting in significant reductions in perceived low back pain. The subjective assessment of individuals with CLBP indicated no discernible distinction between exclusive core stability exercises and control-motor training when combined with MT or KT. Notably, our findings demonstrated positive alterations in both the mean and peak EMG values of the right rectus abdominis in the exercise group, suggesting a beneficial impact on muscle activation. This study focused on assessing the activation levels of the trunk musculature, specifically the rectus abdominis (RA) and multifidus (MF), in individuals with CLBP exhibiting mild disability according to the Oswestry Disability Index. Importantly, improvements in the VAS values were observed independently of changes in muscle electrical activity.

Abstract Emergency medical services (EMSs) face critical situations that require patient risk classification based on analytical and vital signs. We aimed to establish clustering-derived phenotypes based on prehospital analytical and vital signs that allow risk stratification. This was a prospective, multicenter, EMS-delivered, ambulance-based cohort study considering six advanced life support units, 38 basic life support units, and four tertiary hospitals in Spain. Adults with unselected acute diseases managed by the EMS and evacuated with discharge priority to emergency departments were considered between January 1, 2020, and June 30, 2023. Prehospital point-of-care testing and on-scene vital signs were used for the unsupervised machine learning method (clustering) to determine the phenotypes. Then phenotypes were compared with the primary outcome (cumulative mortality (all-cause) at 2, 7, and 30 days). A total of 7909 patients were included. The median (IQR) age was 64 (51–80) years, 41% were women, and 26% were living in rural areas. Three clusters were identified: alpha 16.2% (1281 patients), beta 28.8% (2279), and gamma 55% (4349). The mortality rates for alpha, beta and gamma at 2 days were 18.6%, 4.1%, and 0.8%, respectively; at 7 days, were 24.7%, 6.2%, and 1.7%; and at 30 days, were 33%, 10.2%, and 3.2%, respectively. Based on standard vital signs and blood test biomarkers in the prehospital scenario, three clusters were identified: alpha (high-risk), beta and gamma (medium- and low-risk, respectively). This permits the EMS system to quickly identify patients who are potentially compromised and to proactively implement the necessary interventions.

In the context of the Patient-Centred Care paradigm (Epstein et al., 2005; Suojanen et al., 2012) and the shift toward the psychobiological model (Dean & Street, 2015; Muñoz & García-Izquierdo, 2020), there is a growing demand for the patient to be an active agent in the management of their health. Clinical communication should be conveyed accurately and empathetically (Bellés Fortuño & García-Izquierdo, forthcoming), especially in complex legal genres such as the Informed Consent (IC). The research carried out by the Gentt research group up-to-date has revealed that there is no specific monitoring with the use of IC protocols in clinical practice. In this paper, we present the results of a qualitative pilot study with a group of practitioners from the Valencian Community (Spain). A focus group was conducted where the articulation of communication with patients was analyzed. The study tries to define the practical insights of using the IC to draw conclusions that can improve clinical communication. Results show that MPs generally consider that the IC process needs improvement, especially when considering closeness with patients to enhance communication.

Abstract The available evidence on the impact of specific non-pharmacological interventions on glycaemic control is currently limited. Consequently, there is a need to determine which interventions could provide the most significant benefits for the metabolic health of young individuals with type 1 diabetes mellitus. The aim of this study was to identify optimal nonpharmacological interventions on glycaemic control, measured by glycated haemoglobin (HbA1c), in children and adolescents with type 1 diabetes. Systematic searches were conducted in PubMed, Web of Science, Scopus, and SPORTDiscus from inception to July 1, 2023. Randomised clinical trials (RCT) investigating nonpharmacological interventions (e.g., physical activity, nutrition, and behavioural therapies) were included. Primary outcome was change in HbA1c levels. Secondary outcome was change in daily insulin dose requirement. Seventy-four RCT with 6,815 participants (49.43% girls) involving 20 interventions were analysed using a network meta-analysis. Most interventions showed greater efficacy than standard care. However, multicomponent exercise, which includes aerobic and strength training (n = 214, standardised mean difference [SMD] =– 0.63, 95% credible interval [95% CrI] – 1.09 to – 0.16) and nutritional supplements (n = 146, SMD =– 0.49, – 0 .92 to – 0.07) demonstrated the greatest HbA1c reductions. These interventions also led to the larger decreases in daily insulin needs (n = 119, SMD =– 0.79, 95% CrI – 1.19 to – 0.34) and (n = 57, SMD =– 0.62, 95% CrI – 1.18 to – 0.12, respectively). The current study underscores non-pharmacological options such as multicomponent exercise and nutritional supplements, showcasing their potential to significantly improve HbA1c in youth with type 1 diabetes. Although additional research to confirm their efficacy is required, these approaches could be considered as potential adjuvant therapeutic options in the management of type 1 diabetes among children and adolescents.

Introduction Electronic cigarettes (e-cigarettes) have emerged as a new paradigm in nicotine delivery systems. Although they are marketed as safer alternatives to tobacco, public perceptions of their safety and utility vary widely. This study aims to understand the percentage of use, factors associated, perceptions, and attitudes about e-cigarettes among Ecuadorian adults. Methods A cross-sectional survey was conducted among the Ecuadorian population aged 18–65 years through a convenience sample, using a structured online questionnaire designed to collect responses from voluntary participants over three months, from February to April 2023. The questionnaire assessed the respondents’ attitudes and perceptions towards e-cigarettes. Data were analyzed using descriptive statistics, chi-squared tests, and adjusted logistic regression analyses to identify factors associated with e-cigarette use. Results Out of a total of 3047 Ecuadorian adults, the percentage of e-cigarette ever use was 27.9% (n=850), with 19.4% being current users and 8.5% former users. A negative stance towards e-cigarettes was predominant, with 66.3% considering e-cigarette use a public health problem in Ecuador. A significant association was observed between e-cigarette use and perceived harmfulness (p

RATIONALE: Bronchiectasis is common among those with heavy smoking histories, but risk factors for bronchiectasis, including alpha-1 antitrypsin deficiency, and its implications for COPD severity are uncharacterized in such individuals. OBJECTIVES: To characterize the impact of bronchiectasis on COPD and explore alpha-1antitrypsin as a risk factor for bronchiectasis. METHODS: SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) participants (N=914; ages 40-80 years; ≥20-pack-year smoking) had high-resolution computed tomography (CT) scans interpreted visually for bronchiectasis, based on airway dilation without fibrosis or cicatrization. We performed regression-based models of bronchiectasis with clinical outcomes and quantitative CT measures. We deeply sequenced the gene encoding -alpha-1 antitrypsin, SERPINA1, in 835 participants to test for rare variants, focusing on the PiZ genotype (Glu366Lys, rs28929474). MEASUREMENTS AND MAIN RESULTS: We identified bronchiectasis in 365 (40%) participants, more frequently in women (45% versus 36%, p=0.0045), older participants (mean age=66[standard deviation (SD)=8.3] versus 64[SD=9.1] years, p=0.0083), and those with lower lung function (forced expiratory volume in 1 second [FEV1 ] percentage predicted=66%[SD=27] versus 77%[SD=25], p

The need to develop consistent theoretical frameworks for the teaching and learning of discrete mathematics, specifically of graph theory, has attracted the attention of the researchers in mathematics education. Responding to this demand, the scope of the Van Hiele model has been extended to the field of graphs through a proposal of four levels of reasoning whose descriptors need to be validated according to the structure of this model. In this paper, the validity of these descriptors has been approached with a theoretical analysis that is organized by means of the so-called processes of reasoning, which are different mathematics abilities that students activate when solving graph theory problems: recognition, use and formulation of definitions, classification, and proof. The analysis gives support to the internal validity of the levels of reasoning in graph theory as the properties of the Van Hiele levels have been verified: fixed sequence, adjacency, distinction, and separation. Moreover, the external validity of the levels has been supported by providing evidence of their coherence with the levels of geometrical reasoning from which they originally emerge. The results thus point to the suitability of applying the Van Hiele model in the teaching and learning of graph theory.

In this exploratory work, the discourse of first-year computer engineering undergraduate students of graph theory was analyzed with the aim of improving the teaching of this branch of mathematics. The theoretical framework used is the theory of commognition, specifically, we focus on commognitive conflicts because they are learning opportunities since they foster the learning process when resolved by students, and so teachers should consider them in their practice. A qualitative analysis of the written responses to a questionnaire dealing with definitions and the concepts of path and cycle graphs was performed. Thus, several commognitive conflicts were found, coming from the confluence of discourses governed by different discursive rules. Furthermore, the conflicts encountered were classified according to their origin, into object-level and metalevel conflicts. Concretely, the object-level conflicts had to do with the school discourse of geometry or sequences, and with the discourse of directed graphs; the metalevel commognitive conflicts were associated with the school discourse of the mathematical practice of defining. Finally, our findings are contrasted with related works in the literature, and also a series of implications for the teaching of graph theory are presented.

By the end of October 2022, the US HL-LHC Accelerator Upgrade Project (AUP) had completed fabrication of ten MQXFA magnets and tested eight of them. The MQXFA magnets are the low-beta quadrupole magnets to be used in the Q1 and Q3 Inner Triplet elements of the High Luminosity LHC. This AUP effort is shared by BNL, Fermilab, and LBNL, with strand verification tests at NHMFL. An important step of the AUP QA plan is the testing of MQXFA magnets in a vertical cryostat at BNL. The acceptance criteria that could be tested at BNL were all met by the first four production magnets (MQXFA03-MQXFA06). Subsequently, two magnets (MQXFA07 and MQXFA08) did not meet some of the criteria and were disassembled. Lessons learned during the disassembly of MQXFA07 caused a revision to the assembly specifications that were used for MQXFA10 and subsequent magnets. In this article, we present a summary of: 1) the fabrication and test data for all the MQXFA magnets; 2) the analysis of MQXFA07/A08 test results with characterization of the limiting mechanism; 3) the outcome of the investigation, including the lessons learned during MQXFA07 disassembly; and 4) the finite element analysis correlating observations with test performance.

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Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors derived from chromaffin cells, with 80–85% originating in the adrenal medulla and 15–20% from extra-adrenal chromaffin tissues (paragangliomas). Approximately 30–40% of PPGLs have a hereditary component, making them one of the most genetically predisposed tumor types. Recent advances in genetic research have classified PPGLs into three molecular clusters: pseudohypoxia-related, kinase-signaling, and WNT-signaling pathway variants. Specifically, the detection of SDHB-related tumors indicates an increased risk of metastatic disease, which may impact decisions regarding functional imaging in patients with high suspicion of metastasis and influence targeted treatment strategies. Diagnosis of PPGLs primarily relies on biochemical testing, measuring catecholamines or their metabolites in plasma or urine. However, molecular testing, functional imaging, and targeted therapies have greatly enhanced diagnostic precision and management. Personalized treatment approaches based on genetic profiling are becoming integral to the clinical management of these tumors. In South American countries like Colombia, functional imaging techniques such as positron emission tomography/computed tomography (PET/CT) with tracers like 18F-DOPA, 18F-fluorodeoxyglucose (18F-FDG), and 68Ga-DOTA-conjugated somatostatin receptor-targeting peptides (68Ga-DOTA-SST) are used to guide follow-up and treatment strategies. Radionuclide therapy with lutetium-177 DOTATATE is employed for patients showing uptake in 68Ga-DOTA-SST PET/CT scans, while access to 131-MIBG therapy remains limited due to high costs and availability. Recent clinical trials have shown promise for systemic therapies such as sunitinib and cabozantinib, offering potential new options for patients with slow or moderate progression of PPGLs. These advancements underscore the potential of personalized and targeted therapies to improve outcomes in this challenging patient population.

BackgroundIron overload disorders, including hereditary hemochromatosis (HH), are characterized by excessive iron accumulation, which can cause severe organ damage. HH is most associated with the C282Y mutation in Caucasian populations, but its prevalence and genetic profiles in Latin American populations remain underexplored.ObjectivesTo describe the clinical manifestations, genetic profiles, and biochemical characteristics of patients with suspected iron overload disorders in a specialized hematology center in Cali, Colombia.MethodsA retrospective observational study was conducted on 70 patients diagnosed with iron overload disorders between 2014 and 2024. Data on clinical presentation, laboratory results, imaging, and genetic mutations were collected. Statistical analyses, including chi-square tests and logistic regression, were used to evaluate factors associated with HH diagnosis.ResultsMale patients constituted 64.3% of the sample, with a mean age of 56.1 years at diagnosis. Fatigue (27.1%) and joint pain (17.1%) were the most common symptoms. Of the total sample, 32.9% were diagnosed with hemochromatosis. The H63D mutation was the most prevalent (52.2%), while the C282Y mutation was rare. A predominance of both slight (100.0%) and limitrophe (58.3%) iron overload was identified among patients with hemochromatosis (p = 0.036).ConclusionColombian patients with iron overload disorders show clinical, epidemiological, and biochemical profiles consistent with global patterns, yet exhibit distinct genetic diversity. Notably, they have a low prevalence of the C282Y mutation and a higher prevalence of the H63D mutation, differing from European HH profiles. Despite elevated ferritin and transferrin saturation, no significant clinical symptoms were observed, suggesting potential delays in diagnosis. These findings highlight the need for early, region-specific diagnostic approaches to prevent complications like cirrhosis and underscore the importance of further genetic research across Latin America.

Conflict of interest: No Introduction and Objectives: Cholangiocarcinoma (CCA) represents a global health challenge, with rising incidence and mortality rates. This study aimed to elucidate the clinical course and practices of CCA in Latin America. Patients / Materials and Methods: This observational cohort study investigated individuals diagnosed with CCA between 2010-2023 in five referral centers across Latin America. Demographic, biochemical, and clinical data were analyzed. Results and Discussion: A total of 309 patients were enrolled, demonstrating a balanced distribution of CCA subtypes (intrahepatic, perihilar, and distal), with Hispanics and Caucasians as the predominant ethnic groups, followed by Africans. Major risk factors identified included age, diabetes, obesity, MASLD, bile duct stones, and cholecystitis. Disparities in overweight/obesity prevalence were noted among CCA subtypes and ethnicities, with higher rates in extrahepatic CCAs and among Hispanics and Caucasians. At diagnosis, 72% of patients had ECOG-PS scores of 0-1, with disease presentations ranging from localized (47%) to locally advanced (19%) and metastatic (34%). Patients who did not receive any anti-cancer therapy exhibited a median survival of 2.3 months. Survival rates significantly improved across treatment modalities, with surgery yielding the longest (34 months), followed by chemotherapy (8 months). Notably, Africans presented with worse ECOG-PS scores and more advanced disease, while Hispanics were less frequently treated with chemotherapy, contributing to lower survival rates. Conclusions: The high prevalence of late-stage CCA diagnosis in Latin America, particularly among Africans, alongside a substantial proportion of Hispanic patients not receiving chemotherapy, underscores a dismal prognosis for patients. These findings highlight structural challenges in cancer screening and healthcare access among diverse ethnic backgrounds and lower socioeconomic statuses in the region. Urgent measures are warranted, including identifying preventable risk factors, increasing awareness among high-risk populations, and establishing equitable health coverage to address these disparities.

Abstract The objective of the present study was to determine the effects of spray‐dried and fresh forms of the microalgae Nannochloropsis oculata and other commonly used commercial diets on vitamin and mineral compositions of rotifer produced under commercial conditions. Experimental rotifers groups were fed Protein‐Plus® (PP treatment), Inactive Beaker's Yeast® (INBY treatment), Algome® (Algome treatment), freshly cultured N. oculata (FA treatment), and spray‐dried N. oculata (SDN treatment). At the end of the experiment, seven essential vitamins, nine macro‐ and micro‐minerals, and two pigments were analyzed in diets and rotifers. All the treatments tested provided adequate levels of Ca, P, Mg, and Co to the rotifers, but insufficient levels of I, Zn, and vitamins B2 and E. Moreover, PP diet produced rotifers with high levels of vitamins B1, B3 and B9, and P; the SDN diet produced rotifers with high levels of P and Cu; the Algome diet produced rotifers high in vitamins B3 and B9, and Ca; the INBY diet produced rotifers with high levels of vitamin B1 and Ca; and the FA diet produced rotifers with more vitamin B6, Se, and Cu. In conclusion, specific minerals or vitamins corrections are required in these feeds for rotifers to adequately meet the nutritional needs for marine larvae.

BackgroundThe current standard of interpretation provision is not efficacious or not acceptable to Deaf patients who communicate using sign language. In-person or video relay interpretation (VRI) sign language interpretation is largely unavailable. There are no clear data on the availability of VRI or in-person interpretation. Given the limited number of available sign language interpreters and the cost, VRI may be more available than in-person. Existing evidence tends to focus on assessing personal preferences of Deaf users regarding interpretation and interpreters’ preferences. Although respecting preferences is essential, there is a vacuum of knowledge on how the format of access to interpretation impacts the quality of communication between Deaf persons and health personnel. ObjectiveThis study aims to look at the effectiveness of the VRI system in improving communication outcomes between Deaf patients and doctors versus the available standard of care of the usual communication tools, including informal interpretation, lip- or note-reading, and using their mobile phones to contact a formal or informal interpreter, for Deaf patients aged 18 years and older in Bogota, Colombia. MethodsThis is a randomized controlled trial with a total sample size of 216 participants, divided into 2 groups: an intervention group, which receives a medical appointment using VRI, and a control group, which receives a medical appointment using standard communication. Both the Deaf participants and the health care professionals will be blinded to the allocation, as they will not know whether the appointment will involve VRI or standard communication until they arrive at the office. The primary outcome measure will be an assessment of communication using a Doctor-Patient Communication Scale. This scale was translated into Colombian Sign Language following a rigorous cultural adaptation and translation procedure. Furthermore, the database contains key clinical variables and recommendations provided by the doctor during a general medicine appointment. We will compute associations. ResultsRecruitment opened on August 24, 2023. As of July 2024, 180 participants had been enrolled. The intervention and data collection were finalized in October 2024. The findings of this study are expected to be submitted for publication in early 2025. ConclusionsThis study will provide rigorous evidence regarding information and communications technology intervention in health care, addressing empirical challenges in using inclusive research designs in public health. In addition, effective VRI models that address the challenges faced by Deaf people will be tested, implemented, and maintained in low- and middle-income countries. A disability-inclusive evaluative tool for quality communication mediated by VRI in health care is also tested. Ultimately, this will lead to evidence-based recommendations for implementing the Convention on the Rights of Persons with Disabilities (CRPD) in mobile health contexts. Trial RegistrationClinicalTrials.gov NCT05966623; https://clinicaltrials.gov/study/NCT05966623 International Registered Report Identifier (IRRID)DERR1-10.2196/64590

Heavy chain-only antibodies have found many applications where conventional heavy-light heterodimeric antibodies are not favorable. Heavy chain-only antibodies with their single antigen-binding domain offer the advantage of a smaller size and higher stability relative to conventional antibodies, and thus, the potential for novel targeting modalities. Domain antibodies have commonly been sourced from camelids with ex-vivo humanization or transgenic rodents expressing heavy chains without light chains, but these host species are all mammalian, limiting their capacity to elicit robust immune responses to conserved mammalian targets. We have developed transgenic chickens expressing heavy chain-only antibodies with a human variable region to combine the superior target recognition advantages of a divergent, non-mammalian host with the ability to discover single-domain binders. These birds produce robust immune responses, consisting of antigen-specific antibodies targeting diverse epitopes with a range of affinities. Biophysical attributes are favorable, with good developability profiles and low predicted immunogenicity.

Oocytes spontaneously resume meiosis following their liberation from follicles, preventing full competence acquisition. Biphasic IVM (CAPA-IVM) maintains oocytes in meiotic arrest to improve developmental competence, and it specially affects poorly developed oocytes. We assessed the effect of CAPA-IVM on oocytes from small (3mm) follicles of prepubertal goats. Oocytes were cultured for 6h in pre-IVM with C-type natriuretic peptide (CNP) and estradiol as meiotic inhibitors, and germinal vesicle (GV) rate and chromatin configuration were assessed. Then, oocytes were cultured in conventional IVM (c-IVM) or CAPA-IVM (pre-IVM + c-IVM) and EGF receptor (EGFR) protein expression, intra-oocyte ROS and blastocyst development were assessed. GV rate was higher in CNP groups than control (69% vs 28%, and 67% vs 31%, small and large follicles, respectively), but GV chromatin configuration was similar. In large follicles, EGFR expression was higher in oocytes and cumulus cells after CAPA-IVM, and ROS levels were lower. In small follicles these differences were not observed. c-IVM and CAPA-IVM produced similar blastocyst rates in small (3.7% vs 2.6%, respectively) and large follicles (8.3% vs 2.5%). Overall, CAPA-IVM enhanced EGFR expression for EGF peptide signalling and antioxidant capacity in oocytes from large follicles but oocytes from small follicles were too immature to benefit from it.

Approximately 1 million scorpion stings are recorded annually worldwide, resulting in 3000 deaths. Scorpion venom has various effects on the human body, with neurological complications occurring in about 2% of cases. Among these complications, stroke—whether ischemic or hemorrhagic—is particularly significant. A systematic literature review was conducted through a bibliographic search using key terms in the PubMed, Scopus, Scielo, Latin American and Caribbean Literature in Health Sciences (LILACS) and Google Schoolar databases without date restrictions. Articles related to stroke due to scorpion stings in Spanish, English, and Portuguese were included. Our protocol was registered in PROSPERO. A total of 24 articles met the inclusion criteria for this review. The primary neurological symptoms caused by scorpion stings include hemiplegia, hemiparesis, seizures, and limb weakness. Stroke should be suspected in the presence of these symptoms, as scorpion stings can lead to both hemorrhagic and ischemic strokes in both adults and pediatric populations. While stroke is a rare complication of scorpion stings, it is crucial to consider this diagnosis in patients presenting with neurological symptoms, necessitating the use of computed tomography or magnetic resonance imaging if stroke is suspected.

Sewage sludge is an alternative source of phosphorus, but high metal contents limit its application. This study investigated the effect of temperature, combustion environment (muffle furnace and bubbling fluidized bed reactor), and Cl-donors use (singularly or combined) on heavy metal removal during the thermal treatment of sewage sludge. The highest heavy metal removal rates were achieved primarily in the muffle furnace compared to the reactor, with 850 °C being identified as the optimal temperature. Moreover, single Cl-donors demonstrated higher removal efficiencies than their combinations, which was markedly apparent in the case of Pb.

Timely and accurate crop acreage information is essential for food security and the informed decision-making by governmental bodies and stakeholders in the agro-economic system. Surveys and fieldwork are expensive and time consuming, and the information is usually only released after the cropping season. Remote sensing technology is inexpensive, scales well for large areas, and offers the opportunity to gather within-season information. However, environmental and technical constraints complicate model applications to larger scales. For example, clouds and snow introduce data gaps, and the weather-driven crop development creates highly variable spectral-temporal signatures. This study determines the earliest possible month that permits the accurate classification of the major crops in the CONUS using gap-filled data, transfer learning, and cloud computing technology. The resulting within-season, annual crop classifications are generated with precision rates of up to 80%, presented as annual crop maps and county-level area statistics. The crop classification products presented in this work are unique, in that they were created with shorter records for the first time, using data within a concise time-range (i.e. a few months) and at a 30-meter spatial resolution, while covering continental scale. This novel prospect allows for potential new applications in forecasting regional crop productions.