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Objectives: The use of cephalosporins combined with clavulanate for the treatment of ESBL-harbouring Enterobacteriaceae has been scarcely described. We aimed to describe the effect of different concentrations of clavulanate in the MIC of cefixime and ceftibuten of ESBL-producing Escherichia coli and Klebsiella pneumoniae. Methods: ESBL-producing E. coli and K. pneumoniae isolates were studied. Fixed concentrations of cefixime and ceftibuten (ranges of 32–0.25 and 64–0.5 ng/ml, respectively) were used. Combinations of cefixime/clavulanate and ceftibuten/clavulanate in different ratios (1:0, 1:1, 2:1, 4:1, 8:1, 16:1, 32:1) were tested. MIC were determined by broth microdilution. Results: A total of 6 ESBL-producing E. coli, 6 ESBL-producing K. pneumoniae and 2 control E. coli were tested. When different quantities of clavulanate were added to cefixime and ceftibuten, greater than two-fold decreases in the MIC were observed. When testing the 1:1 cefixime/clavulanate ratio, 10/12 isolates were susceptible. When the ratios 2:1, 4:1, 8:1 and 16:1 were tested, susceptibility was noted for 9/12, 8/12, 4/12 and 5/12 isolates, respectively. Only 2/12 K. pneumoniae isolates were susceptible when the ratio 32:1 was tested. When testing ceftibuten/clavulanate, all isolates remained susceptible across all experiments. Conclusions: Clavulanic acid has a favourable effect in reducing the MIC of cefixime and ceftibuten in isolates of ESBL-producing E. coli and K. pneumoniae. Combining clavulanate with ceftibuten or cefixime could be a useful treatment strategy.

Abstract Background To evaluate transparency practices in randomized controlled trials (RCTs) in dentistry. Methods This meta-research study included RCTs in dentistry regardless of topic, methods, or level of detail reported. Only studies in English were considered. We searched PubMed for RCTs in dentistry published in English from December 31, 2016, to December 31, 2021. The screening was performed in duplicate, and data extracted included journal and author details, dental specialty, protocol registration, data and code sharing, conflict of interest declaration, and funding information. A descriptive analysis of the data was performed. We generated maps illustrating the reporting of transparency items by country of the corresponding author and a heat table reflecting reporting levels by dental specialty. Results A total of 844 RCTs were included. Only 12.86% of studies reported any information about data and code sharing. Protocol registration was reported for 50.36% of RCTs. Conflict of interest (83.41%) and funding (71.68%) declarations were present in most studies. Conflicts of interest and funding were consistently reported regardless of country or specialty, while data and code sharing had a low level of reporting across specialties, as well as low dissemination across the world. Protocol registration exhibited considerable variability. Conclusions Considering the importance of RCTs for evidence-based dentistry, it is crucial that everyone who participates in the scientific production and dissemination process actively and consistently promotes adherence to transparent scientific standards, particularly registration of protocols, and sharing of data and code.

Abstract Purpose Metabolic bone disease of prematurity (MBDP) remains a significant cause of morbidity in extremely premature newborns. In high-risk patients, suspected diagnosis and subsequent treatment modifications, with limitations in terms of sensitivity and specificity, rely on low phosphorus levels and/or high levels of alkaline phosphatase (ALP). We investigated the potential of fibroblast growth factor-23 (FGF23) as an early marker for MBDP when measured at 3–4 weeks of life in at-risk patients. Methods A single-center prospective observational non-interventional study including preterm newborns of both sexes, with a gestational age of less than 32 weeks and/or a birth weight of less than 1500 g. In the standard biochemical screening for MBDP performed between 3 and 4 weeks of life within a nutritional profile, the determination of FGF23 was included along with other clinical and metabolic studies. The study was conducted at Marqués de Valdecilla University Hospital in Santander, Spain, from April 2020 to March 2021. Participants provided informed consent. Biochemical analyses were conducted using various platforms, and follow-up evaluations were performed at the discretion of neonatologists. Patients at high risk for MBDP received modifications in treatment accordingly. The sample was descriptively analyzed, presenting measures of central tendency and dispersion for continuous variables, and absolute numbers/percentages for categorical ones. Tests used included t-tests, Mann‒Whitney U tests, chi-square tests, logistic regressions, Pearson correlation, and ROC curve analysis (IBM SPSS Statistics version 19). Significance level: P

Objective: to map the competencies of aerospace nurses in disaster situations. Method: a scoping review following the steps recommended by the JBI and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The review was conducted in three phases by two independent reviewers, with blinding, and supported by a third reviewer to resolve disagreements. Selection was based on the analysis of titles, descriptors, and abstracts, with specific eligibility criteria, followed by the full-text reading. At the end of the selection phase, 37 publications were included. Results: the results highlighted the need for the development of technical skills, knowledge of flight physiology, familiarity with aeronautical emergency procedures, communication skills, leadership, and responsibilities in aircraft preparation. During transport, nurses perform patient history taking (anamnesis), physical examinations, patient monitoring, clinical procedures, and manage in-flight complications. After the flight, they conduct documentation, develop procedures, sanitize clinical equipment, and replenish consumable materials. Conclusion: given the complexity of aerospace nursing practices in disaster situations, it is essential for professionals to develop competencies to ensure safe and effective care. There is a need to develop technologies, regulatory frameworks, and legal provisions for legal support, as well as future studies to validate and deepen the mapped competencies.

ABSTRACT Background Few studies regarding infectious causes of febrile neutropenia (FN) in Mexico are available. Aims We aimed to describe clinical and microbiological characteristics of FN episodes during induction chemotherapy in adults with acute leukemia. Methods and Results This retrospective cohort from a Mexican tertiary care center included adults with newly diagnosed acute leukemia between January 2014, and December 2018. Clinical and microbiological characteristics were summarized using descriptive statistics. Univariate analyses for associations between clinical characteristics and FN and/or death were made; logistic regression analysis was performed to assess relationships with FN. Kaplan–Meier survival estimates were modeled for antimicrobial prophylaxis and FN. Ninety‐five patients were included. Median age was 28 (IQR 20–43), 49 (52%) were males, and 74 (78%) developed FN (74/95). Among these, 98% had an identified source of infection (73/74) and 65% had >1. Common infections were urinary tract infection (24%), bacterial sinusitis (20%), and bacterial pneumonia (19%). Gram‐negatives were the most frequently isolated microorganisms (69%), followed by Gram‐positives (21%), and fungi (9%). Antimicrobial prophylaxis was inversely associated with FN (aOR = 0.07, CI 0.008–0.060, p = 0.02). Invasive fungal diseases were associated with 30‐day mortality (aOR = 9.46, 95% CI 1.66–54.05). Conclusion Infections caused 98% of the FN episodes. Gram‐negative bacteria are the most common pathogens.

Abstract Mutations in PINK1 and Parkin cause early-onset Parkinson’s Disease (PD). PINK1 is a kinase which functions as a mitochondrial damage sensor and initiates mitochondrial quality control by accumulating on the damaged organelle. There, it phosphorylates ubiquitin, which in turn recruits and activates Parkin, an E3 ubiquitin ligase. Ubiquitylation of mitochondrial proteins leads to the autophagic degradation of the damaged organelle. Pharmacological modulation of PINK1 constitutes an appealing avenue to study its physiological function and develop therapeutics. In this study, we used a thermal shift assay with insect PINK1 to identify small molecules that inhibit ATP hydrolysis and ubiquitin phosphorylation. PRT062607, an SYK inhibitor, is the most potent inhibitor in our screen and inhibits both insect and human PINK1, with an IC50 in the 0.5–3 µM range in HeLa cells and dopaminergic neurons. The crystal structures of insect PINK1 bound to PRT062607 or CYC116 reveal how the compounds interact with the ATP-binding pocket. PRT062607 notably engages with the catalytic aspartate and causes a destabilization of insert-2 at the autophosphorylation dimer interface. While PRT062607 is not selective for PINK1, it provides a scaffold for the development of more selective and potent inhibitors of PINK1 that could be used as chemical probes.

This study describes the synthesis and characterization of the lead-free organic ferroelectric perovskite N-methyl-N’-diazabicyclo [2.2.2]octonium)-ammonium trichloride (MDABCO-NH4Cl3). The electrospinning technique was employed to obtain nanofibers embedded with this perovskite in a PVC polymer for hybrid fiber production. The dielectric, piezoelectric, and pyroelectric properties of these fibers were carefully examined. Based on measurements of the dielectric permittivity temperature and frequency dependence, together with the pyroelectric results, a transition from a high temperature paraelectric to a ferroelectric phase that persisted at room temperature was found to occur at 438 K. The measured pyroelectric coefficient yielded values as high as 290 μC K−1 m−2, which is in between the values reported for MDABCO-NH4I3 and the semiorganic ferroelectric triglycine sulfate (TGS). The hybrid nanofibers exhibited good morphological characteristics and demonstrated very good piezoelectric properties. Specifically, a piezoelectric coefficient of 42 pC/N was obtained when applying a periodical force of 3 N and a piezoelectric voltage coefficient of geff = 0.65 V mN−1. The performance of these fibers is on par with that of materials discussed in the existing literature for the fabrication of nano energy-harvesting generators. Importantly, the perovskite nanocrystals within the fibers are protected from degradation by the surrounding polymer, making them a promising environmentally friendly platform for flexible mechanical energy harvesting.

We report the first record of Pontoporia blainvillei (Gervais & d’Orbigny, 1844), Franciscana or La Plata River Dolphin, along the coast of Arraial do Cabo, southeastern Brazil. On 8 October 2017, a newborn was stranded in the surf zone of Prainha Beach and was returned to the sea. Although an occasional record, fills a distribution gap of the species’ occurrence on the coast of Rio de Janeiro state and, consequently, helps clarify the distribution pattern of P. blainvillei along the coast of the Brazil.

Background: The COVID-19 pandemic forced governments across the world to consider how to prioritize resource allocation. Most countries produced pandemic preparedness plans that guide and coordinate healthcare, including how to allocate scarce resources such as ventilators, human resources, and therapeutics. The objective of this study was to compare and contrast the extent to which established parameters for effective priority setting (PS) were incorporated into COVID-19 pandemic response planning in several countries around the world. Methods: We used the Kapriri and Martin framework for effective priority setting and performed a quantitative descriptive analysis to explore whether and how countries’ type of health system, political, and economic contexts impacted the inclusion of those parameters in their COVID-19 pandemic plans. We analyzed 86 country plans across six regions of the World Health Organization. Results: The countries sampled represent 40% of nations in AFRO, 54.5% of EMRO, 45% of EURO, 46% of PAHO, 64% of SEARO, and 41% of WPRO. They also represent 39% of all HICs in the world, 39% of Upper-Middle, 54% of Lower-Middle, and 48% of LICs. No pattern in attention to parameters of PS emerged by WHO region or country income levels. The parameters: evidence of political will, stakeholder participation, and use of scientific evidence/ adoption of WHO recommendations were each found in over 80% of plans. We identified a description of a specific PS process in 7% of the plans; explicit criteria for PS in 36.5%; inclusion of publicity strategies in 65%; mention of mechanisms for appealing decisions or implementing procedures to improve internal accountability and reduce corruption in 20%; explicit reference to public values in 15%; and a description of means for enhancing compliance with the decisions in 5%. Conclusion: The findings provide a basis for policymakers to reflect on their prioritization plans and identify areas that need to be strengthened. Overall, there is little consideration for explicit prioritization processes and tools and restricted attention to equity considerations; this may be a starting point for policymakers interested in improving future preparedness and response planning. Although the study focused on the COVID-19 pandemic, priority setting remains one of the policymakers’ most prominent challenges. Policymakers should consider integrating systematic priority setting in their routine decision-making processes.

Humans have long relied on microbial communities to create products, produce energy, and treat waste. The microbiota residing within our bodies directly impacts our health, while the soil and rhizosphere microbiomes influence the productivity of our crops. However, the complexity and diversity of microbial communities make them challenging to study and difficult to develop into applications, as they often exhibit the emergence of unpredictable higher-order phenomena. Synthetic ecology aims at simplifying complexity by constituting synthetic or semi-natural microbial communities with reduced diversity that become easier to study and analyze. This strategy combines methodologies that simplify existing complex systems (top-down approach) or build the system from its constituent components (bottom-up approach). Simplified communities are studied to understand how interactions among populations shape the behavior of the community and to model and predict their response to external stimuli. By harnessing the potential of synthetic microbial communities through a multidisciplinary approach, we can advance knowledge of ecological concepts and address critical public health, agricultural, and environmental issues more effectively.

Summary:. Granular cell tumor (GCT), a rare Schwann cell–derived lesion, typically manifests as a benign skin or soft tissue growth. We report a case of GCT mimicking cellulitis on a woman’s foot at first presentation. Despite initial misdiagnosis, histological examination confirmed GCT, guiding successful excision and reconstruction. Our case underscores the importance of considering granular cell tumors in atypical presentations and highlights the role of histological evaluation in accurate diagnosis and management.

The prevalence of antibiotic-resistant pathogens has become a major threat to public health, requiring swift initiatives for discovering new strategies to control bacterial infections. Hence, antibiotic stewardship and rapid diagnostics, but also the development, and prudent use, of novel effective antimicrobial agents are paramount. Ideally, these agents should be less likely to select for resistance in pathogens than currently available conventional antimicrobials. The usage of antimicrobial peptides (AMPs), key components of the innate immune response, and combination therapies, have been proposed as strategies to diminish the emergence of resistance. Herein, we investigated whether newly developed random antimicrobial peptide mixtures (RPMs) can significantly reduce the risk of resistance evolution in vitro to that of single sequence AMPs, using the ESKAPE pathogen Pseudomonas aeruginosa (P. aeruginosa) as a model gram-negative bacterium. Infections of this pathogen are difficult to treat due the inherent resistance to many drug classes, enhanced by the capacity to form biofilms. P. aeruginosa was experimentally evolved in the presence of AMPs or RPMs, subsequentially assessing the extent of resistance evolution and cross-resistance/collateral sensitivity between treatments. Furthermore, the fitness costs of resistance on bacterial growth were studied and whole-genome sequencing used to investigate which mutations could be candidates for causing resistant phenotypes. Lastly, changes in the pharmacodynamics of the evolved bacterial strains were examined. Our findings suggest that using RPMs bears a much lower risk of resistance evolution compared to AMPs and mostly prevents cross-resistance development to other treatments, while maintaining (or even improving) drug sensitivity. This strengthens the case for using random cocktails of AMPs in favour of single AMPs, against which resistance evolved in vitro, providing an alternative to classic antibiotics worth pursuing.

Summary:. Wartenberg syndrome, also known as Cheiralgia paresthetica, is an uncommon neuropathy affecting the superficial branch of the radial nerve. Typically caused by external compression, it manifests as paresthesia or pain in the radial side of the hand. We present a case of Wartenberg syndrome resulting from combat shrapnel injury, illustrating an uncommon etiology. A 21-year-old soldier was presented with allodynia and paresthesia after a shrapnel explosion, with positive clinical findings and radiographic evidence supporting the diagnosis. Nonoperative management led to significant improvement, highlighting the importance of conservative treatment in such cases. This report underscores the significance of considering unconventional causes in nerve entrapment syndromes post combat trauma, emphasizing adherence to established therapeutic guidelines.

Mutations in the PINK1 and PRKN genes are the most frequent genetic cause of early-onset Parkinson disease. The pathogenic p.R275W substitution in PRKN is the most frequent substitution observed in patients, and thus far has been characterized mostly through overexpression models that suggest a possible gain of toxic misfunction. However, its effects under endogenous conditions are largely unknown. We used patient fibroblasts, isogenic neurons, and post-mortem human brain samples from carriers with and without PRKN p.R275W to assess functional impact. Immunoblot analysis and immunofluorescence were used to study mitophagy activation, and mitophagy execution was analyzed by flow cytometry of the reporter mitoKeima. The functional analysis was accompanied by structural investigation of PRKN p.R275W. We observed lower PRKN protein in fibroblasts with compound heterozygous p.R275W mutations. Isogenic neurons showed an allele-dose dependent decrease in PRKN protein. Lower PRKN protein levels were accompanied by diminished phosphorylated ubiquitin and decreased MFN2 modification. Mitochondrial degradation was also allele-dose dependently impaired. Consistently, PRKN protein levels were drastically reduced in human brain samples from p.R275W carriers. Finally, structural simulations showed significant changes in the closed form of PRKN p.R275W. Our data suggest that under endogenous conditions the p.R275W mutation results in a loss-of-function by destabilizing PRKN.

This study aimed to determine the distributions of number of shots per point, point duration, point pace and technical actions during the match in professional men and women padel players. A total of 35,145 hits (3239 points; men = 1602 and women = 1637) were analyzed in 20 matches corresponding to quarterfinal, semifinal and final matches of the World Padel Tour 2020 season. The observations were conducted through systematic observation and involved a total of 32 players (16 men and 16 women). Men’s points lasted 13.5–14.8 s, comprising 10–11 hits, resulting in a ratio of 0.80 shots per second, with no differences between sets. Women’s points lasted longer than men’s (14.4 to 16.2 s, p = 0.011) but included a similar number of shots per point, resulting in a lower rhythm of play (0.73–0.75 shots per second, p < 0.001), particularly in the third set (p = 0.004). Volleys, lobs and directs were used in >60% of the points, with a frequency of one to three times per point. Bandejas were used in 50–60% of the points, with a frequency of one to two times per point. Backwalls and flat smashes were used at least once in 30–48% of the points. Selective actions had a greater frequency of use in the third set (i.e., flat smash and smash x3 in women; forehand/backhand volleys and side-wall forehand in men), suggesting occasional changes in the style of play, but likely explained by the onset of fatigue. In conclusion, game volumes, intensity and actions remained broadly similar throughout professional padel matches.

Sorafenib is a multikinase inhibitor indicated for first-line treatment of unresectable hepatocellular carcinoma. Despite its widespread use in the clinic, the existing knowledge of sorafenib mode-of-action remains incomplete. To build upon the current understanding, we used the Cellular Thermal Shift Assay (CETSA) coupled to Mass Spectrometry (CETSA-MS) to monitor compound binding to its target proteins in the cellular context on a proteome-wide scale. Among the potential sorafenib targets, we identified aldehyde dehydrogenase 2 (ALDH2), an enzyme that plays a major role in alcohol metabolism. We validated the interaction of sorafenib with ALDH2 by orthogonal methods using pure recombinant protein, proving that this interaction is not mediated by other cellular components. Moreover, we showed that sorafenib inhibits ALDH2 activity, supporting a functional role for this interaction. Finally, we were able to demonstrate that both ALDH2 protein expression and activity were reduced in sorafenib-resistant cells compared to the parental cell line. Overall, our study allowed the identification of ALDH2 as a novel sorafenib target and sheds light on its potential role in both hepatocellular carcinoma and sorafenib resistance condition.

Leishmaniasis is a disease caused by Leishmania spp., affecting millions of people around the world. For decades, its treatment has been based on pentavalent antimonials, which notoriously cause toxic side effects in patients. In this study, epoxy-α-lapachone incorporated into an oil-in-water-type microemulsion (ELAP-ME) and meglumine antimoniate (MA) were assayed in monotherapy and in combination (ELAP-ME/MA) in BALB/c mice infected with Leishmania (Leishmania) amazonensis. In general, there was a reduction in paw lesion size (up to 37% reduction) and decreases of parasite loads in the footpad (∼40%) and lymph nodes (∼31%) of animals treated with ELAP-ME/MA, when compared to the non-treated control groups. Analyses of serum biochemical parameters revealed that the ELAP-ME/MA showed lower renal and hepatic toxicity when compared to MA 2-doses/week monotherapy. These findings indicate that the ELAP-ME/MA combination may be a promising approach for the treatment of cutaneous leishmaniasis.

Background: Even though worldwide death rates from coronavirus disease 2019 (COVID-19) have decreased, the threat of disease progression and death for high-risk groups continues. Few direct comparisons between the available severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antivirals have been made. Objective: We aimed to compare two SARS-CoV-2 antivirals (nirmatrelvir/ritonavir and remdesivir) against all-cause hospitalization or death. Design: This is a propensity score-matched cohort study. Methods: We included all high-risk outpatients with COVID-19 in a tertiary referral center in Mexico City from 1 January 2022 to 31 July 2023. The primary outcome was all-cause hospitalization or death 28 days after symptom onset. The secondary outcome was COVID-19-associated hospitalization or death 28 days after symptom onset. Logistic regression analysis for characteristics associated with the primary outcome and a multi-group comparison with Kaplan–Meier survival estimates were performed. Results: Of 1566 patients analyzed, 783 did not receive antiviral treatment, 451 received remdesivir, and 332 received nirmatrelvir/ritonavir. The median age was 60 years (interquartile range: 46–72), 62.5% were female and 97.8% had at least one comorbidity. The use of nirmatrelvir/ritonavir was associated with an absolute risk reduction of 8.8% and a relative risk reduction of 90% for all-cause hospitalization or death. The use of remdesivir was associated with an absolute risk reduction of 6.4% and a relative risk reduction of 66% for all-cause hospitalization or death. In multivariable analysis, both antivirals reduced the odds of 28-day all-cause hospitalization or death [nirmatrelvir/ritonavir odds ratio (OR) 0.08 – 95% confidence interval (CI): 0.03–0.19, remdesivir OR 0.29 – 95% CI: 0.18–0.45]. Conclusion: In high-risk COVID-19 outpatients, early antiviral treatment with nirmatrelvir/ritonavir or remdesivir was associated with lower 28-day all-cause hospitalization or death.

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in 2019 following prior outbreaks of coronaviruses like SARS and MERS in recent decades, underscoring their high potential of infectivity in humans. Insights from previous outbreaks of SARS and MERS have played a significant role in developing effective strategies to mitigate the global impact of SARS-CoV-2. As of January 7, 2024, there have been 774,075,242 confirmed cases of COVID-19 worldwide. To date, 13.59 billion vaccine doses have been administered, and there have been 7,012,986 documented fatalities (https://www.who.int/)Despite significant progress in addressing the COVID-19 pandemic, the rapid evolution of SARS-CoV-2 challenges human defenses, presenting ongoing global challenges. The emergence of new SARS-CoV-2 lineages, shaped by mutation and recombination processes, has led to successive waves of infections. This scenario reveals the need for next-generation vaccines as a crucial requirement for ensuring ongoing protection against SARS-CoV-2. This demand calls for formulations that trigger a robust adaptive immune response without leading the acute inflammation linked with the infection.Key mutations detected in the Spike protein, a critical target for neutralizing antibodies and vaccine design —specifically within the Receptor Binding Domain region of Omicron variant lineages (B.1.1.529), currently dominant worldwide, have intensified concerns due to their association with immunity evasion from prior vaccinations and infections.As the world deals with this evolving threat, the narrative extends to the realm of emerging variants, each displaying new mutations with implications that remain largely misunderstood. Notably, the JN.1 Omicron lineage is gaining global prevalence, and early findings suggest it stands among the immune-evading variants, a characteristic attributed to its mutation L455S. Moreover, the detrimental consequences of the novel emergence of SARS-CoV-2 lineages bear a particularly critical impact on immunocompromised individuals and older adults. Immunocompromised individuals face challenges such as suboptimal responses to COVID-19 vaccines, rendering them more susceptible to severe disease. Similarly, older adults have an increased risk of severe disease and the presence of comorbid conditions, find themselves at a heightened vulnerability to develop COVID-19 disease. Thus, recognizing these intricate factors is crucial for effectively tailoring public health strategies to protect these vulnerable populations. In this context, this review aims to describe, analyze, and discuss the current progress of the next-generation treatments encompassing immunotherapeutic approaches and advanced therapies emerging as complements that will offer solutions to counter the disadvantages of the existing options. Preliminary outcomes show that these strategies target the virus and address the immunomodulatory responses associated with COVID-19. Furthermore, the capacity to promote tissue repair has been demonstrated, which can be particularly noteworthy for immunocompromised individuals who stand as vulnerable actors in the global landscape of coronavirus infections. The emerging next-generation treatments possess broader potential, offering protection against a wide range of variants and enhancing the ability to counter the impact of the constant evolution of the virus. Furthermore, advanced therapies are projected as potential treatment alternatives for managing Chronic Post-COVID-19 syndromeand addressing its associated long-term complications.

Summary: Background: In June 2018, a type 1 circulating vaccine-derived poliovirus (cVDPV1) outbreak was declared in Papua New Guinea (PNG), resulting in a total of 26 paralytic confirmed cases. Eight vaccination campaign rounds with bivalent oral poliovirus vaccine (bOPV) were carried out in response. Prevalence of neutralizing polio antibodies in children was assessed two years after the outbreak response was completed. Methods: We conducted a cross-sectional serological survey among children aged 6 months–10 years selected from six provinces in PNG to evaluate seroprevalence of neutralizing polio antibodies to the three poliovirus serotypes and analyse sociodemographic risk factors. Findings: We included 984 of 1006 enrolled children in the final analysis. The seroprevalence of neutralizing polio antibodies for serotype 1, 2 and 3 was 98.3% (95% CI: 97.4–98.9), 63.1% (95% CI: 60.1–66.1) and 95.0% (95% CI: 93.6–96.3), respectively. Children

Abstract Osteoporosis is a skeletal disease that can increase the risk of fractures, leading to adverse health and socioeconomic consequences. However, current clinical methods have limitations in accurately estimating fracture risk, particularly in older adults. Thus, new technologies are necessary to improve the accuracy of fracture risk estimation. In this observational study, we aimed to explore the association between serum cytokines and hip fracture status in older adults, and their associations with fracture risk using the FRAX reference tool. We investigated the use of a proximity extension assay (PEA) with Olink. We compared the characteristics of the population, functional status and detailed body composition (determined using densitometry) between groups. We enrolled 40 participants, including 20 with hip fracture and 20 without fracture, and studied 46 cytokines in their serum. After conducting a score plot and two unpaired t-tests using the Benjamini-Hochberg method, we found that Interleukin 6 (IL-6), Lymphotoxin-alpha (LT-α), Fms-related tyrosine kinase 3 ligand (FLT3LG), Colony stimulating factor 1 (CSF1), and Chemokine (C-C motif) ligand 7 (CCL7) were significantly different between fracture and non-fracture patients (p

Abstract Hybrid bionanomaterials were produced through electrospinning, incorporating the dipeptide Boc-l-phenylalanyl-l-leucine into nanofibers of biocompatible polymers. Scanning electron microscopy confirmed the uniformity of the nanofibers, with diameters ranging from 0.56 to 1.61 µm. The dielectric properties of the nanofibers were characterized using impedance spectroscopy, assessing temperature and frequency dependencies. Notably, the composite micro/nanofibers exhibited semiconducting dielectric behavior with bandgap energies of 4–5 eV, and their analysis revealed increased dielectric constant with temperature due to enhanced charge mobility. The successful incorporation of the dipeptide was verified by Maxwell–Wagner interfacial polarization, and the Havriliak–Negami model disclosed insights into electric permittivity. Furthermore, the fibers demonstrated pyroelectric and piezoelectric responses, with Boc-Phe-Leu@PLLA nanofibers having the highest piezoelectric coefficient of 85 pC/N. These findings highlight the influence of dipeptide nanostructures on dielectric, pyroelectric, and piezoelectric properties, suggesting the potential of polymeric micro/nanofibers as efficient piezoelectric energy generators for portable and wearable devices. Graphical Abstract

Deep learning approaches have been gaining importance in several applications. However, the widespread use of these methods in safety-critical domains, such as Autonomous Driving, is still dependent on their reliability and trustworthiness. The goal of this paper is to provide a review of deep learning-based uncertainty methods and their applications to support perception tasks for Autonomous Driving. We detail significant Uncertainty Quantification and calibration methods, and their contributions and limitations, as well as important metrics and concepts. We present an overview of the state of the art of out-of-distribution detection and active learning, where uncertainty estimates are commonly applied. We show how these methods have been applied in the automotive context, providing a comprehensive analysis of reliable AI for Autonomous Driving. Finally, challenges and opportunities for future work are discussed for each topic.

Abstract Short-wave infrared (SWIR) fluorescence could become the new gold standard in optical imaging for biomedical applications due to important advantages such as lack of autofluorescence, weak photon absorption by blood and tissues, and reduced photon scattering coefficient. Therefore, contrary to the visible and NIR regions, tissues become translucent in the SWIR region. Nevertheless, the lack of bright and biocompatible probes is a key challenge that must be overcome to unlock the full potential of SWIR fluorescence. Although rare-earth-based core-shell nanocrystals appeared as promising SWIR probes, they suffer from limited photoluminescence quantum yield (PLQY). The lack of control over the atomic scale organization of such complex materials is one of the main barriers limiting their optical performance. Here, the growth of either homogeneous (α-NaYF4) or heterogeneous (CaF2) shell domains on optically-active α-NaYF4:Yb:Er (with and without Ce3+ co-doping) core nanocrystals is reported. The atomic scale organization can be controlled by preventing cation intermixing only in heterogeneous core-shell nanocrystals with a dramatic impact on the PLQY. The latter reached 50% at 60 mW/cm2; one of the highest reported PLQY values for sub-15 nm nanocrystals. The most efficient nanocrystals were utilized for in vivo imaging above 1450 nm.

As Bacias de Detenção de Águas Pluviais (BD) são obrigatórias para novos empreendimentos imobiliários na área urbana do Município de Araraquara-SP. O presente estudo identificou e analisou, comparativamente, os métodos de dimensionamento e parâmetros de projeto que vêm sendo adotados e aceitos pelo órgão público municipal. Foram identificados: Método 1 - Método Racional; Método 2 - Método Simplificado e o Método 3 - Hidrograma do Método Racional Modificado. A comparação entre eles demonstrou diferenças significativas nos volumes de detenção. O Método 1 superou o Método 3 na ordem de 20% a 75%, e o Método 2 na ordem de 189% a 413%. O Método 3 apresentou volumes de 312% a 764% maiores que o Método 2. Esses resultados indicaram volumes subestimados do Método 2 quando comparados com os demais métodos. Vale destacar que mesmo mantendo iguais os parâmetros de tempo, intensidade e de área, as diferenças foram significativas, embora menores que as anteriores. Concluiu-se, portanto, a necessidade de definir um método único e padronizado para o dimensionamento das BD em Araraquara, bem como de estudos específicos para o desenvolvimento de um método de fácil aplicação e condizente com as características locais.

El presente artículo de investigación toma como punto de partida la Declaración de Sharm el-Sheikh, que pretende una integración de la diversidad biológica, con todos los sectores que se implican por lograr una armonía con la naturaleza. A nivel metodológico, ha sido elaborado sobre la base del método analítico, utilizando la herramienta de revisión documental y la hermenéutica jurídica. En particular, este estudio analiza diferentes aspectos que se problematizan en torno a la pregunta ¿Invertir en la diversidad biológica para la gente y el Planeta? Además de resaltar la relación naturaleza – cultura que las Naciones Unidas ha manifestado, abriendo camino para reflexionar acerca de la paz ambiental como alternativa conciliadora entre hombre y naturaleza, desde el pensamiento complejo y una perspectiva Latinoamericana, concretamente a partir del Buen Vivir / Vivir Bien Andino y la sentencia T-622/2016 de la Corte Constitucional de Colombia, que integra la conocida Jurisprudencia de la Tierra. Finalmente, se presentan algunas reflexiones que abrirán nuevas posibilidades de debate académico en la configuración de la paz ambiental; en lo político con tomadores de decisiones y en lo jurídico; la elaboración de nuevos marcos legislativos y decisiones judiciales, que seguramente repercutirán en beneficio de la Comunidad de la Vida.

With governance increasingly regarded as co-governance, states’ capacity to steer, correct, and discipline a wide range of self-governing actors becomes crucial for states’ effectiveness, efficiency, and democracy. This article investigates that capacity and the relationship between formal institutions and customary self-governance in areas of limited statehood. In South Sudan, the field of land governance can be regarded as an area of limited statehood. As land relations are closely connected to clan structures and intra-familial relationships, customary norms and institutions enjoy great legitimacy and are an important locus of local land governance and dispute resolution. The South Sudanese government has promulgated legal provisions for equal rights to property and inheritance that clash head-on with customary notions of gender roles in the family and the preservation of family land. By focusing on the case of women’s land rights in South Sudan, combining literature study with data from exploratory fieldwork in two South Sudanese towns, this article aims to reflect on the cohabitation of customary and formal norms and values and the role formal legal and administrative systems, in areas of limited statehood, can and do play in boundary setting for customary self-governance.

ABSTRACT: Objectives: To determine genomic characteristics and molecular epidemiology of carbapenem non-susceptible Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa from medical centres of Mexico using whole genome sequencing data analysed with the EPISEQⓇ CS application and other bioinformatic platforms. Methods: Clinical isolates collected from 28 centres in Mexico included carbapenem-non-susceptible K. pneumoniae (n = 22), E. coli (n = 24), A. baumannii (n = 16), and P. aeruginosa (n = 13). Isolates were subjected to whole genome sequencing using the Illumina (MiSeq) platform. FASTQ files were uploaded to the EPISEQⓇ CS application for analysis. Additionally, the tools Kleborate v2.0.4 and Pathogenwatch were used as comparators for Klebsiella genomes, and the bacterial whole genome sequence typing database was used for E. coli and A. baumannii. Results: For K. pneumoniae, both bioinformatic approaches detected multiple genes encoding aminoglycoside, quinolone, and phenicol resistance, and the presence of blaNDM-1 explained carbapenem non-susceptibility in 18 strains and blaKPC-3 in four strains. Regarding E. coli, both EPISEQⓇ CS and bacterial whole genome sequence typing database analyses detected multiple virulence and resistance genes: 20 of 24 (83.3%) strains carried blaNDM, 3 of 24 (12.4%) carried blaOXA-232, and 1 carried blaOXA-181. Genes that confer resistance to aminoglycosides, tetracyclines, sulfonamides, phenicols, trimethoprim, and macrolides were also detected by both platforms. Regarding A. baumannii, the most frequent carbapenemase-encoding gene detected by both platforms was blaOXA-72, followed by blaOXA-66. Both approaches detected similar genes for aminoglycosides, carbapenems, tetracyclines, phenicols, and sulfonamides. Regarding P. aeruginosa, blaVIM, blaIMP, and blaGES were the more frequently detected. Multiple virulence genes were detected in all strains. Conclusion: Compared to the other available platforms, EPISEQⓇ CS enabled a comprehensive resistance and virulence analysis, providing a reliable method for bacterial strain typing and characterization of the virulome and resistome.

The first electrogeneration of O-centered radicals from N-alkoxyphthalimides via rapid alternating polarity (RAP) electrolysis, using previous experimental conditions of photoredox catalysis (PRC) is reported. The electrochemical methodology emulates satisfactorily the redox cycle behavior accepted to explain the PRC technique. Notably, the contribution of oxidized Hantzsch ester produced during the anodic reaction is emphasized, which behaves as an efficient proton donor to facilitate N–O cleavage and to extinguish the radical sequence efficiently. The reaction is conducted in a practical way using an undivided cell fitted with glassy carbon electrodes, allowing the same reactions to occur on both electrodes during the overall transformation reaching a 77% yield of the corresponding alcohol. This yield is higher than the electrochemical protocol using direct current electrolysis, confirming that the use of RAP electrolysis favors the proximity where the reactive intermediates are produced, facilitating their reaction to promote the desired reaction pathway.

Introducción. La gastrectomía y disección ganglionar es el estándar de manejo para los pacientes con cáncer gástrico. Factores como la identificación de ganglios por el patólogo, pueden tener un impacto negativo en la estadificación y el tratamiento. El objetivo de este estudio fue comparar el recuento ganglionar de un espécimen quirúrgico después de una gastrectomía completa (grupo A) y de un espécimen con un fraccionamiento por grupos ganglionares (grupo B). Métodos. Estudio de una base de datos retrospectiva de pacientes sometidos a gastrectomía D2 en el Servicio de Cirugía gastrointestinal de la Liga Contra el Cáncer seccional Risaralda, Pereira, Colombia. Se comparó el recuento ganglionar en especímenes quirúrgicos con y sin división ganglionar por regiones anatómicas previo a su envío a patología. Resultados. De los 94 pacientes intervenidos, 65 pertenecían al grupo A y 29 pacientes al grupo B. El promedio de ganglios fue de 24,4±8,6 y 32,4±14,4 respectivamente (p=0,004). El porcentaje de pacientes con más de 15 y de 25 ganglios fue menor en el grupo A que en el grupo B (27 vs 57, p=0,432 y 19 vs 24, p=0,014). El promedio de pacientes con una relación ganglionar menor 0,2 fue mayor en el grupo B (72,4 % vs 55,4 %, p=0,119). Conclusiones. Los resultados de nuestro estudio mostraron que una división por grupos ganglionares previo a la valoración del espécimen por el servicio de patología incrementa el recuento ganglionar y permite establecer de manera certera el pronóstico de los pacientes, teniendo un impacto positivo en su estadificación, para evitar el sobretratamiento.

A method to access carbonyl compounds using reductive conditions was evaluated via electrochemical reduction of their corresponding N-benzyloxyphthalimide derivatives (NBOPIs). The mechanism of this originally reported electrochemical reaction was proposed based on DFT calculation and is experimentally confirmed herein, contrasting simulated and experimental cyclic voltammetry data. The reaction scope studied in a preparative scale and using redox sensitive functional groups showed good selectivity and tolerance toward oxidation under the reaction conditions with a moderate to good yield (50–71%). Nevertheless, some restrictions with reducible functional groups, like benzyl-brominated and nitro-aromatic derivatives, were observed. The present approach can be considered a self-sustainable electrochemical catalysis for the synthesis of aromatic carbonylic compounds passing through anion radical intermediates produced by a cathodic reaction.

Abstract This study aimed to evaluate trends in the prevalence of dental caries in preschool children and associated factors considering different time variations. This is a time series study performed using data from three cross-sectional studies with pre-school children from southern Brazil in 2008, 2013 and 2019. This children group was born between the years of 2003 to 2018. Dental caries was evaluated by decayed, missing and filled deciduous teeth (dmft index). Demographic, socioeconomic, behavioural and psychosocial variables were also collected. Chi-square test for trends and a hierarchical age-period-cohort (HAPC) analysis using multilevel Poisson regression model for testing the associations between predictor variables and dental caries experience were used. A total of 1,644 pre-school children participated in all surveys. There was a significant difference in caries experience considering all APC effects. The prevalence of dental caries was 25.0% in 2008, 16.3% in 2013, and 19.4% in 2019 (p < 0.01) and no statistical difference was observed. An age effect showed that older children were more likely to experience dental caries. Considering the cohort effect, there is a significant difference between the generations, mainly between 2003 and 2018. Household income, use of dental services, and parent’s perception of child oral health were associated with dental caries experience no matter the time variation. Despite recent declines in dental caries prevalence among preschool children, caries levels increased with age and social inequalities persisted through the years, indicating a need of reviewing the policies to reduce the burden of this oral disease.

Traumatic Brain Injuries (TBIs), including mild TBI (mTBI) and concussions, affect an estimated 69 million individuals annually with significant cognitive, physical, and psychosocial consequences. The Sport Concussion Assessment Tool 5th Edition (SCAT5) is pivotal for diagnosing these conditions but possesses inherent subjectivity. Conversely, eye-tracking systems provide objective data, capturing subtle disruptions in ocular and cognitive functions often missed by traditional measures. Yet, the concurrent use of these promising tools for neurotrauma diagnostics is relatively unexplored. This paper proposes integrating eye-tracking with SCAT5 to enhance mTBI and concussion diagnostics. We introduce a model that synergistically combines the strengths of both techniques into an ‘ocular score’, adding objectivity to SCAT5. This union promises improved clinical decision-making, impacting return-to-play, fitness-to-drive, and return-to-work judgments, providing a novel landscape in the neurotrauma scenario. However, our theoretical framework requires empirical validation. We advocate for future large-scale collaborative research databases, and exploration of eye-tracking-based diagnostic markers. Our methodology highlights the potential of this integrated approach to redefine neurotrauma management and diagnostics, addressing a critical global health concern with proven utility in high-risk settings like sports and the military.

Objetivou-se comparar o uso de dietas convencional, sem volumoso à base de milho íntegro ou milho íntegro hidratado em novilhos Angus x Nelore não-castrados confinados, tendo como variáveis analisadas o comportamento ingestivo, desempenho, parâmetros sanguíneos e características de carcaça. Foram utilizados 24 bovinos com média de 18 meses e com peso médio de 362,6 ± 22,3 kg, distribuídos em três tratamentos e mantidos em confinamento até o abate. Os animais foram alimentados ad libitum duas vezes ao dia de acordo com a respectiva dieta de cada tratamento e a duração do período experimental foi de 77 dias. Os animais do tratamento convencional apresentaram maior consumo médio de matéria seca (18,2 vs 10,1 vs 8,9 kg/dia para convencional, milho íntegro e milho íntegro hidratado, respectivamente). Não houve diferença estatística (P>0,05) para o ganho de peso diário e por período, rendimento de carcaças e cortes primários, pH e cobertura de gordura. As dietas sem volumoso alteraram o comportamento ingestivo, com redução do tempo de alimentação (3,59 vs 1,67 vs 1,60 h/dia) e ruminação (7,17 vs 1,37 vs 1,66 h/dia) e aumento do tempo de ócio (13,32 vs 21,03 vs 20,82h/dia) para os tratamentos convencional, grão de milho íntegro e grão de milho íntegro hidratado, respectivamente. Houve efeito significativo (P

El objetivo del presente trabajo fue analizar la influencia de la regla del punto de oro en parámetros de juego en pádel profesional. Se analizaron mediante observación sistemática un total de 91 sets (47 femeninos y 44 masculinos) de las temporadas 2019 y 2020 del circuito profesional World Padel Tour. Los resultados obtenidos mostraron una mayor duración del set (p=.009), tiempo de descanso (p=.039), bolas de breaks (p=.005) y breaks (p=.018) en pádel femenino. Además, se observaron diferencias significativas en el tiempo de pausa en función del set (p=.009), siendo el tercer set en el que los jugadores realizan un mayor tiempo de pausa. La incorporación de la regla del punto de oro produjo un incremento en el número de juegos por set (p=.040).Por último, se encontraron diferencias significativas en el número de bolas de break (p=. 013) en función de la ronda de juego. Concretamente se produce un mayor número de bolas de break en la final respecto a la ronda de cuartos de final (p

One of the biggest challenges in the field of material science lies in understanding the structure and behavior of crystalline materials and nanostructures [...]

Background: First-line treatments for methicillin-susceptible S. aureus (MSSA) bacteraemia are nafcillin, oxacillin, or cefazolin. Regional shortages of these antibiotics force clinicians to use other options like dicloxacillin and cephalotin. This study aims to describe and compare the safety and efficacy of cephalotin and dicloxacillin for the treatment of MSSA bacteraemia. Methods: This retrospective study was conducted in a referral centre in Mexico City. We identified MSSA isolates in blood cultures from 1 January 2012 to 31 December 2022. Patients ≥ 18 years of age, with a first episode of MSSA bacteraemia, who received cephalotin or dicloxacillin as the definitive antibiotic treatment, were included. The primary outcome was in-hospital all-cause mortality. Results: We included 202 patients, of which 48% (97/202) received cephalotin as the definitive therapy and 52% (105/202) received dicloxacillin. In-hospital all-cause mortality was 20.7% (42/202). There were no differences in all-cause in-hospital mortality between patients receiving cephalotin or dicloxacillin (20% vs. 21%, p = 0.43), nor in 30-day all-cause mortality (14% vs. 18%, p = 0.57) or 90-day all-cause mortality (24% vs. 22%, p = 0.82). No severe adverse reactions were associated with either antibiotic. Conclusions: Cephalotin and dicloxacillin were equally effective for treating MSSA bacteraemia, and both showed an adequate safety profile.

Abstract This study aimed to explore the pathways that can influence cigarette smoking among adolescents. This population-based cohort followed a random sample of 12-year-old adolescents from southern Brazil for 6 years. Regular cigarette smoking was assessed through a self-reported question, previously used in the Brazilian National Survey of Scholar Health. We also gathered data on bullying, dental caries at baseline, incidence of caries, sex, friend network, and Sense of Coherence (SOC). Socioeconomic and demographic characteristics were also collected. Structural equation modeling was used to evaluate the pathways. Of the 1,134 adolescents examined at baseline, 768 were re-evaluated (67.7% retention rate). The prevalence of smoking was 37.6%. This prevalence was directly affected by low SOC (SC: -0.14, p < 0.01), low household income (SC: -0.12, p < 0.01), and male sex (SC: 0.15, p < 0.01). Presence of dental caries at baseline indirectly influenced the occurrence of dental bullying at follow-up via the incidence of dental caries (SC: 0.01, p < 0.05). Dental bullying indirectly influenced cigarettes consumption via SOC (SC: 0.62, p < 0.05). Friend network also indirectly influenced the consumption of cigarettes via SOC (SC: 0.32, p < 0.05). Psychosocial factors influence adolescent cigarette consumption through its higher direct and indirect effects (via bullying). In addition, behavioral, sociodemographic, and clinical factors also influence the occurrence of smoking.

Abstract Bamboo fiber is one of the strongest natural fibers with high strength‐to‐weight and stiffness‐to‐weight ratios and can be used economically for manufacturing fiber‐reinforced composites. In this paper, bamboo fabric‐reinforced epoxy composite is manufactured and its tribological properties for load‐bearing applications are investigated. Sliding wear tests are conducted using a linear reciprocating tribometer and the effect of dry and lubricated contact conditions, applied load, sliding speed, temperature, and woven fabric direction on the coefficient of friction and wear rate are investigated. A scanning electron microscope is used to define the wear mechanisms at room and elevated temperatures. It is observed that the fabric orientation influences the mechanical and tribological performances of the composite material. Wear rate increases at higher loads and working temperatures; however, the effect of sliding speed is not remarkable, especially under lubricated contact conditions. The results present in this paper can be used for designing bamboo‐reinforced epoxy composites for load‐bearing applications, under different working conditions.

In this paper, we examine the metaphilosophical relevance of the phenomenon of sleep, suggesting that it has the potential to not only enrich the analysis of limit cases but also to test some of the ideas concerning the possibility of naturalizing phenomenology and its limits. Insofar as sleeping allows for both a first personal and a third personal description and challenges the usual primacy of the first-person point of view, exploring sleeping under the prism of its import for the phenomenological method allows to illuminate the relationships between a first personal transcendental phenomenology and a third personal naturalized one. We do this by examining Husserl’s treatment of sleep as a limit-case, and the problem of accounting for deep sleep from a first-personal perspective. Drawing from a Heidegger-inspired account of sleep, we argue that sleep demands for a type of approach that can be fairly described as ontological, and which reveals a new understanding of subjectivity as a dynamic unity of different modes of being. Although this approach challenges a first-personal based approach, it does not, however support the naturalization of phenomenology or undermine the project of a transcendental philosophy of experience.

Cold-formed steels (CFS) or light gauge steels (LGS) are steel sections created through processes without heat application, such as roll forming or press-braking. In the past few decades, the utilization of CFS as a structural material has expanded due to its advantages over the other materials used in the construction industry, consequently increasing the number of studies conducted by many researchers. CFS studies have focused on many research areas, including designing, and analyzing members and systems, connections, sustainability, residual stresses, and post-fire data. As a result, several authors have also conducted a literature review involving these areas. However, a literature review for more recent studies involving elevated temperature exposure of CFS has not been conducted. This paper seeks to compile and review the recent publications regarding CFS behavior and performance at high temperatures events. Sixty-nine (69) journal articles published from 2017 to 2023 were retrieved from the Scopus database and systematically reviewed through text mining with the aid of VOS Viewer. Prior studies utilizing finite element analysis and experimental methods to investigate the performance at elevated temperature events of varying CFS sections, systems, and steel grades have been summarized. In addition, this paper also briefly discussed the findings of the recent research works involving member connections of CFS. Key points from the literature review have been emphasized such as the outcome of experimental and numerical validation of existing design rules from different codes such as American Iron and Steel Institute (AISI), Eurocodes, and Australian codes which could vary depending on the CFS section and steel grades. Important points of previous studies regarding the CFS walls, insulations, and screwed connections have also been noted in this paper. Based on the review, research gaps in the prior studies involving elevated temperature exposure of CFS have been identified, such as lack of CFS investigation under fatigue and cyclic loading. These were then recommended as future direction and concentration of CFS at elevated temperatures research works.

El turismo es una de las actividades económicas más importantes de la región de Cusco. Sin embargo, se concentra sólo en algunos destinos con experiencias de poco valor agregado. El presente artículo introduce los conceptos de coevolución e innovación inclusiva para entender la complejidad de promover innovación en turismo en contextos de exclusión social. Se presenta el estudio de caso del Valle de Huyro en Cusco, Perú, basado en el diseño metodológico de investigación-acción con el objetivo de comprender las problemáticas específicas en el sector, y con ello co-diseñar e implementar con los actores locales propuestas innovadoras. Los resultados de la investigación brindan evidencia sobre cómo las innovaciones en agroturismo en el Valle de Huyro son una confluencia de nuevos productos tangibles, conocimientos y arreglos institucionales. El entendimiento de esta interdependencia y adaptación continua entre las dimensiones social, técnica e institucional de la innovación tiene implicancias para el desarrollo de políticas y programas de turismo a partir del valor de los recursos naturales y culturales, conocimientos y capacidades organizativas de la localidad.

Abstract Background Previous research suggests that unhealthy community food environments around schools contribute to unhealthy eating habits and negative health outcomes among the youth. However, little is known about how socioeconomic inequalities in those community food environments are associated with food deserts and food swamps across schools’ neighborhoods. Methods An ecological study was carried out in all 3,159 public and private schools in Rio de Janeiro, Brazil. Three measures of socioeconomic inequality were evaluated: per capita income, segregation index and deprivation index. The community school food environment was analyzed by metrics of food swamps and food deserts. Results Food deserts and food swamps were simultaneously more prevalent in neighborhoods of the lowest income, high deprivation, and high segregation. Spatial socioeconomic disparities at the neighborhoods of schools were associated with food deserts and food swamps in Rio de Janeiro. Conclusions Our results point to a spatial socioeconomic inequality of establishments that sell food around schools in a Brazilian metropolis, indicating that the areas of greatest deprivation of food services are also the areas with the worst socioeconomic characteristics.

Dexamethasone implementation for COVID-19 management represented a milestone but data regarding its impact and safety have not been consistently reproduced. We aimed to evaluate in-hospital mortality before and after the implementation of corticosteroid treatment (CS-T) for severe and critical COVID-19. We conducted a cohort study that included patients admitted with severe and critical COVID-19. The primary outcome was death during hospitalization. Secondary outcomes included the length of stay (LOS), need for invasive mechanical ventilation (IMV), time to IMV initiation, IMV duration, and development of hospital-acquired infections (HAIs). Bivariate, multivariate, and propensity-score matching analysis were performed. Among 1540 patients, 688 (45%) received CS-T. Death was less frequent in the CS-T group (18 vs 31%, p

En la actualidad, la investigación en grandes simios ha dejado de realizarse en prácticamente todo el mundo. En este contexto, cabe preguntarse si es que ha llegado el tiempo de prohibir o restringir severamente la investigación con toda clase de primates no humanos. Una manera de abordar esta pregunta es evaluando si es que las razones que fueron esgrimidas—con éxito—en favor de restringir la investigación con grandes simios, pueden ser extendidas al caso de los demás primates no humanos. Teniendo como base una reciente revisión del debate sobre la restricción de la investigación con grandes simios (Aguilera, Perez Gomez, y DeGrazia, 2021), el presente artículo lleva a cabo esta tarea, analizando dominios de razones relacionados con el estatus moral, la ciencia, el bienestar animal, las actitudes de los expertos y el público, la conservación y el retiro de los primates, los costos financieros, y la atribución de respeto y derechos a los primates no humanos. De esta manera, se pretende iluminar el debate en torno a la restricción de la investigación con toda clase de primates no humanos, aportando herramientas estratégicas, persuasivas y filosóficas para quienes deseen avanzar en esta dirección.

Abstract Mitokines (Humanin (HN), GDF15 and FGF21) are produced as a result of mitochondrial dysfunction and may have major roles in chronic inflammation, malnutrition and exercise capacity in people with COPD. Except for GDF15, studies on this subject are lacking. A total of 165 patients with stable COPD and 49 smokers without COPD were enrolled. We assessed their serum mitokine levels and clinical characteristics at baseline. We recorded moderate and severe exacerbation for the next 12 months. Baseline serum HN (p = 0.037) and GDF-15 (p = 0.013) levels were higher in the COPD group. High HN levels were independently associated with a high risk of exacerbation (HRE) (OR 2.798, 95% CI 1.266–6.187, p = 0.011), malnutrition (OR 6.645, 95% CI 1.859–23.749, p = 0.004), and 6MWD (OR 0.995, 95% CI 0.991–0.999, p = 0.008), and future moderate (HR 1.826, 95% CI 1.181–2.822, p = 0.007) and severe exacerbations (HR 3.445, 95% CI 1.357–8.740, p = 0.009). High GDF15 levels were associated with HRE (OR 3.028, 95% CI 1.134–8.083, p = 0.027), 6MWD (OR 0.995, 95% CI 0.990–0.999, p = 0.017) and predicted desaturation in 6MWT (OR 3.999, 95% CI 1.487–10.757, p = 0.006). High FGF21 levels were associated with HRE (OR 2.144, 95% CI 1.000–4.600, p = 0.05), and predicted future severe exacerbation (HR 4.217, 95% CI 1.459–12.193, p = 0.008). The mitokine levels were higher in patients with COPD than smokers without COPD, and were associated with important clinical outcomes such as exercise capacity and COPD exacerbation. Among the mitokines, HN showed the strongest association with COPD and may serve as a future risk biomarker in this disease. Trial registation NCT04449419.