Search

Elisabetta Iacopi,1 Nicola Riitano,1,2 Valentina Dini,2 Rossana Berta,3 Letizia Pieruzzi,1 Agata Janowska,2 Marco Anselmino,3 Alberto Piaggesi,1 Marco Romanelli2 1Diabetic Foot Section, Pisa University Hospital, Pisa, Italy; 2Dermatology Department, Pisa University Hospital, Pisa, Italy; 3Bariatric Surgery Unit, Pisa University Hospital, Pisa, ItalyCorrespondence: Marco RomanelliDermatology Unit, Via Roma, 67, Pisa 56126, ItalyTel +39 050 992436Fax +39 050 551124Email m.romanelli@med.unipi.itAim: To evaluate the distinct contribution of obesity and diabetes (DM) to the skin modification in metabolic diseases.Methods: We analysed all patients admitted for bariatric surgery in our hospital with BMI between 38 and 47 kg/m2, with (Group 1) or without (Group 2) DM and compared them with a group of nonobese diabetic patients (Group 3) and healthy volunteers (Group 4). The following features were evaluated: hardness, temperature, hydration and thickness alongside with anthropometric measures of foot and leg.Results: For the general characteristics, patients differed in age and body mass index. As predictable all circumferences (dorsal foot, sovramalleolar and under the knee) were significantly higher in obese with no differences depending on DM (all parameters: p< 0.01 in Group 1 and Group 2 vs Group 3 and Group 4). Skin temperature was significantly higher in all obese, irrespectively from the presence of DM (1st metatarsal head: p=0.02 Group 1 and Group 2 vs Group 3 and Group 4; 5th metatarsal head: p< 0.01 in Group 1 and Group 2 vs Group 3 and Group 4). Skin hydration score showed increased anhydrosis in both diabetics and severe obesity (p< 0.01 in Group 1 and Group 3 vs Group 2 and Group 4). Increase in thickness of skin and subcutaneous tissues was observed (at heel: p< 0.01 in Group 1 and Group 2 vs Group 3 and Group 4 and under the scaphoid p=0.03 Group 1 and Group 2 vs Group 3 and Group 4) and plantar fascia (in both regions p=0.02 Group 1 and Group 2 vs Group 3 and Group 4) in all obese patients, with or without DM.Conclusion: Severe obesity significantly affects both shape and structure of the foot, possibly exposing these patients to a higher risk of biomechanical stress. On such a background DM, modifying skin hydration and protective mechanisms exerts a synergistic role further increasing the risk of trauma and ulcers.Keywords: diabetes, obesity, skin disease

OBJECTIVE: To evaluate the degree of absolute change, relative stability and state dependence of trait perfectionism in sleep disturbances in a sample of university students. METHOD: Participants completed the Multidimensional Perfectionism Scale and two items concerning sleep difficulties. The mean age at T0 (baseline) was 19.59 years (SD = 1.61, range = 17-25) and 62.5% of the sample were female. RESULTS: Absolute changes in self-oriented and socially-prescribed perfectionism were found. Relative stability was found for all perfectionism dimensions. Prior and concurrent sleep disturbances explained a significant amount of variance in perfectionism. Controlling for the effects of sleep measures, prior self-oriented perfectionism and other-oriented perfectionism were the only significant predictors of subsequent self-oriented perfectionism and other-oriented perfectionism, at T1 and T2. Difficulties falling asleep at T1 and socially-prescribed perfectionism at T0 were significant predictors of socially-prescribed perfectionism at T1. CONCLUSION: Despite significant changes in perfectionism mean scores over the follow-up, the correlation analyses demonstrated that participants remained quite stable in regard to their relative levels of perfectionism. As concurrent difficulties initiating sleep also predicted concurrent socially-prescribed perfectionism, this seems to be one dimension of perfectionism with trait-state characteristics.OBJETIVOS: Avaliar o grau de mudança absoluta, de estabilidade relativa e dependência do estado do perfeccionismo nas perturbações de sono numa amostra de estudantes universitários. MÉTODO: Os sujeitos completaram a Escala Multidimensional do Perfeccionismo e dois itens sobre dificuldades em dormir. Os dados foram recolhidos em três momentos de avaliação, separados por um intervalo de um ano acadêmico. A idade média dos sujeitos no T0 era de 19,59 anos (DP = 1,61, variação = 17-25); 62,5% eram mulheres. RESULTADOS: Foram encontradas ao longo do follow-up mudanças absolutas para o perfeccionismo auto-orientado e para o perfeccionismo socialmente prescrito. Foi encontrada estabilidade relativa para todas as dimensões do perfeccionismo. As dificuldades de sono prévias e concorrentes explicaram significativamente a variância do perfeccionismo. Controlando o efeito das dificuldades em dormir, o perfeccionismo auto-orientado e o perfeccionismo orientado para o outro prévios foram os únicos preditores significativos de perfeccionismo auto-orientado e perfeccionismo orientado para o outro (T1 e T2). As dificuldades em iniciar o sono no T1 e o perfeccionismo socialmente prescrito prévio (T0) revelaram-se preditores significativos de perfeccionismo socialmente prescrito no T1. CONCLUSÃO: Apesar das mudanças significativas nas pontuações médias de perfeccionismo ao longo do follow-up, as análises de correlação demonstraram que os participantes permaneceram relativamente estáveis nos seus níveis de perfeccionismo. Uma vez que as dificuldades em iniciar o sono concorrentes se revelaram um preditor significativo de perfeccionismo socialmente prescrito, esta é a dimensão do perfeccionismo que possui características traço-estado.

La 53ª sesión de la Comisión de Derechos Humanos, incluía en su preámbulo el derecho a un nivel de vida adecuado, incluyendo la alimentación. Desde hace años existe una gran preocupación por los organismos internacionales en relación con la producción de alimentos, por la gravedad y extensión del problema y su impacto económico. La accesibilidad de los alimentos está determinada por la existencia de los mismos y las posibilidades de adquisición. Algunos malos resultados perinatales son producto de una dieta insuficiente y desequilibrada, que puede corregirse utilizando la educación nutricional y la promoción social, analizando los hábitos alimentarios, los alimentos disponibles y su accesibilidad. Los esfuerzos para la solución de este problema están relacionados con la seguridad alimentaria y la presión social que se ejerza para lograr la posibilidad de un desarrollo armónico a escala mundial.

Estudo do LCR de recém-nascidos a termo e de parto normal, sem intercorrências perinatais, para verificar o quanto a xantocromia é devida à bilirrubinorraquia. Foi verificado que a bilirrubinorraquia é constante na primeira semana de vida e que sua concentração: não guarda relação com a concentração proteica total do LCR e/ou com os níveis de bilirrubina no soro; não sofre influência do número de hemácias e/ou de leucócitos presente na amostra. Os valores encontrados no LCR quanto ao número de leucócitos e de hemácias e às concentrações de proteínas totais e de bilirrubina são analisados na caracterização do LCR do recém-nascido normal na primeira semana de vida.The study was made in order to verify if the bilirubin content of the cerebrospinal fluid (CSF) is constant during the first week of life, and their relations to: the concentrations of total proteins in the CSF and bilirubin in the blood serum; the red blood cells and leucocytes present in the CSF sample. The study was made in 79 normal newborns without perinatal problems or obstetrical abnormalities. The gestational ages were stablished through maternal anamnesis and the clinical evaluation of the newborn was made according to the patterns established by Usher & col., Lubchenko & col. and Lubchenko. All the pregnancies were over 37 weeks. The vital conditions of the newborn immediately after the delivery were calculated according to the patterns proposed by Apgar and Apgar & James. The first complete clinical examination was made in the first twelve hours of life. The cranial sizes were situated within the limits accepted as normal. The deliveries were head-first (only two were breech presentation). The cry was immediate after birth, the breathing well established in the first minute of life and the cut of the umbelical cord was made after the first respiratory movement. The deliveries were made in delivery rooms or surgical rooms always assisted by an obstetrician and a pediatrician. The collecting of venous blood to determine the serum concentration of bilirubin was made soon after lumbar punction for collecting CSF. Samples were collected in the second day of life in all the 79 newborns studied; in 40 of them, new samples were collected in the 7th day of life. CSF samples were analyzed as to: total white cells count; total red blood cells count; total protein concentration; bilirubin and haemoglobin concentrations according to the Kronholm & Lintrup nomogram. General data pertinent to weight, height and cranial size of the newborn children studied were the following: weight: 3.213.1 ± 286.9 g; height: 49.24 ± 1.12 cm; cranial size: 35.29 ± 0.89 cm. Most CSF supernadant were either xanthochromic or slightly xanthochromic. The following values were found for cells, proteins and pigments in the CSF: 1. Total white cell count at the second day of life: mean of 4.44 cells/cu.mm., standard deviation 3.83; in the seventh day the average of cells was 4.40 cu.mm. and standard deviation 3.33; no significant difference was found between these two values. 2. Red blood cell count in the second day of life: mean 155.76 red blood cells/cu.mm. with standard deviation of 223.48; in the seventh day the mean was 74.10 red blood cells/cu.mm. and standard deviation was 123.72. The average number of CSF red blood cells at the second day of life was found to be larger than the mean value at the seventh day. 3. Total protein concentration: the average of total protein (mgm/100 ml) was 71.44 with standard deviation of 24.15 in the second day of life; at the seventh day the average was 69.27 with standard deviation of 22.21. There were no significant statistical differences between these values. 4. No haemoglobin was found but bilirubin was always present. The average of bilirubin at the second day of life was 1.96 micromol/liter with standard deviation of 0.17; in the seventh day of life the average was 1.89 micromol/liter with standard deviation of 0.20. The difference between the second and seventh days of life, although statistically significant, is inconspicuous for clinical and diagnostic purposes. No significant correlation was found between the bilirubin concentration in the CSF, and the respective white cells, erythrocytes or protein concentration. No significant correlation was found between protein and bilirubin in normal newborn's CSF. No significant correlation was found between bilirubin concentration in the serum and that of the CSF.

TV is a medium with high penetration rates and has been suited to deliver informal education in several aspects since years. Thus, interactive TV may play a significant role in the current Life-Long Learning challenges, provided that meaningful applications are implemented. In this research work, we have explored the added value of interactivity in digital TV, with a particular focus on Serious Games (SGs), given their growing relevance in technology-enhanced learning. We have followed an evolutionary rather than revolutionary approach, in particular given the still traditional use of TV by a large audience. The approach preserves a media-driven strategy and the role of the author/director in proposing contents (storytelling), as in the TV tradition. We argue that interactive SGs may help the viewer to better contextualize/understand the video stream and go more in depth about the touched items at the end of the stream. This also enables new iTV applications, in particular to support weaker users (i.e. users that could not view the video without a help). This paper presents the results from user tests based on an interactive enhancement of a clip from the Disney's Snow White movie, that challenged the authors in addressing a dynamic, high-value document. Qualitative and quantitative results show the potential of the system for informal education. The tests also stress the importance of good solutions (e.g., development languages, display modalities, metaphors) for synchronizing video and overlaid interactive elements. To the best of our knowledge, this research work is the first one discussing user test results about the usefulness of a class of iTV SG applications that can be instantiated serially in several different contexts.

IntroductionThis study aims to investigate the relationship between deprivation, as measured by a socioeconomic deprivation index (SDI) score for census tract urban areas, and COVID-19 infections and vaccine uptake among children and adolescents before and after the vaccination rollout in Catalonia, Spain.MethodsWe conducted a population-based cohort study using primary care records. Individuals were followed 3 months before the start of the vaccination campaign in Spain and 3 months after. Children (5–11 years) and adolescents (12–15 years) with at least 1 year of prior history observation available and without missing deprivation data. For each outcome, we estimated cumulative incidence and crude Cox proportional-hazard models by SDI quintiles, and hazard ratios (HRs) of COVID-19 infection and vaccine uptake relative to the least deprived quintile, Q1.ResultsBefore COVID-19 vaccination rollout, 290,625 children and 179,685 adolescents were analyzed. Increased HR of deprivation was associated with a higher risk of COVID-19 infection in both children [Q5: 1.55 (95% CI, 1.47–1.63)] and adolescents [Q5: 1.36 (95% CI, 1.29–1.43)]. After the rollout, this pattern changed among children, with lower risk of infection in more deprived areas [Q5: 0.62 (95% CI, 0.61–0.64)]. Vaccine uptake was higher among adolescents than children, but in both age groups, non-vaccination was more common among those living in more deprived areas (39.3% and 74.6% in Q1 vs. 26.5% and 66.9% in Q5 among children and adolescents, respectively).ConclusionsChildren and adolescents living in deprived areas were at higher risk of COVID-19 non-vaccination. Socioeconomic disparities in COVID-19 infection were also evident before vaccine rollout, with a higher infection risk in deprived areas across age groups. Our findings suggest that changes in the association between deprivation and infections among children after the vaccine rollout were likely due to testing disparities.

Background & Aims: Patients with acutely decompensated (AD) cirrhosis are immunocompromised and particularly susceptible to infections. This study investigated the immunomodulatory actions of albumin by which this protein may lower the incidence of infections. Methods: Blood immunophenotyping was performed in 11 patients with AD cirrhosis and 10 healthy volunteers (HV). Bulk and single-cell RNA sequencing (scRNA-seq) and flow cytometry were performed in peripheral blood mononuclear cells (PBMCs) from 20 patients with AD cirrhosis and 34 HV exposed to albumin. Albumin’s effects on degranulation, phagocytosis, chemotaxis, and swarming of neutrophils from six patients with AD cirrhosis and nine HV were assessed by measuring myeloperoxidase enzymatic activity, the engulfment of fluorescent-labeled Escherichia coli and zymosan, and interactions of neutrophils with Candida albicans at single-cell resolution in microfluidic chambers, respectively. Whole blood RNA sequencing (RNA-seq) analyses were performed in 49 patients admitted for severe AD cirrhosis, of whom 30 received albumin during hospitalization. Results: Compared with HV, patients with AD cirrhosis showed severe lymphopenia and defective neutrophil antimicrobial function. Bulk and scRNA-seq analyses revealed significantly (false discovery rate [FDR]

Abstract Patients with cancer were excluded from pivotal randomized clinical trials of COVID-19 vaccine products, and available observational evidence on vaccine effectiveness (VE) focused mostly on mild, and not severe COVID-19, which is the ultimate goal of vaccination for high-risk groups. Here, using primary care electronic health records from Catalonia, Spain (SIDIAP), we built two large cohorts of vaccinated and matched control cancer patients with a primary vaccination scheme (n = 184,744) and a booster (n = 108,534). Most patients received a mRNA-based product in primary (76.2%) and booster vaccination (99.9%). Patients had 51.8% (95% CI 40.3%−61.1%) and 58.4% (95% CI 29.3%−75.5%) protection against COVID-19 hospitalization and COVID-19 death respectively after full vaccination (two-doses) and 77.9% (95% CI 69.2%−84.2%) and 80.2% (95% CI 63.0%−89.4%) after booster. Compared to primary vaccination, the booster dose provided higher peak protection during follow-up. Calibration of VE estimates with negative outcomes, and sensitivity analyses with slight different population and COVID-19 outcomes definitions provided similar results. Our results confirm the role of primary and booster COVID-19 vaccination in preventing COVID-19 severe events in patients with cancer and highlight the need for the additional dose in this population.

Coated superconducting radio-frequency (SRF) cavities are planned to be implemented in the Future Circular Collider (FCC) at the European Organization for Nuclear Research (CERN). The interest in industrialized and high-performance processes for fabrication of the corresponding copper substrates has thus risen. Tubular hydroforming is a well-known industrial process, but has not been thoroughly applied for ultra-pure oxygen-free electronic copper (Cu-OFE) thick products. To provide a feasibility analysis for the optimized fabrication process of copper substrate seamless cavities, a Forming Limit Diagram (FLD) of the material of interest was studied. In this paper, the methodology, test results and initial benchmark of the material model is presented, for 4 mm and 2 mm thick sheets.

In monotocous mammals, most individuals experience the birth of a younger sibling. This period may induce losses in maternal care and can be physiologically, energetically and emotionally challenging for the older sibling, yet has rarely been studied in wild primates. We used behavioural data collected from a natural population of mandrills to investigate changes in maternal care and mother–juvenile relationship throughout the transition to siblinghood (TTS), by comparing juveniles who recently experienced the birth of a younger sibling, to juveniles who did not. We found that the TTS was associated with an abrupt cessation of the weaning process for the juvenile, and to a decrease in maternal affiliation. Juveniles’ reactions were sex-specific, as males associated less with their mother, while females tended to groom their mother more often after the birth of their sibling. Despite the substantial loss of maternal care, juveniles did not show an increase in conflict or anxiety-related behaviours. This study contributes to explain why short interbirth intervals often pose a risk to juveniles’ survival in monotocous primates. Our results contrast existing studies and further highlight the importance of examining the TTS in species and populations with various life histories and ecologies.

Resumen: Objetivo: Evaluar una guía de codificación de determinantes sociales de la salud en las consultas de atención primaria como herramienta eficaz en el flujo de trabajo diario del profesional. Diseño: Estudio mixto secuencial explicativo. Formado por una parte cuantitativa (experimental) y una parte cualitativa (descriptivo-evaluativo). Emplazamiento: Todos los equipos de gerencia de atención primaria y a la Comunidad de Catalunya Central (32 equipos). Participantes y contexto: Todos los profesionales de enfermería, trabajo social y medicina que trabajan en los 32 equipos de atención primaria del Instituto Catalán de la Salud en la Catalunya Central durante febrero a julio del 2023. Métodos: Se desarrolló una guía de codificación de determinantes sociales de la salud. Esta guía fue creada de forma multidisciplinaria y multicéntrico. Muestreo intencional. En la parte cuantitativa se contabilizó el número de diagnósticos que habían registrado el grupo experimental vs. el grupo control, cualitativamente se realizó un análisis temático partiendo de una perspectiva socioconstructivista. Resultados: Los resultados fueron significativos y satisfactorios. Con una metodología cuantitativa se valoró la efectividad del uso de la guía. Se observó un aumento significativo de uso de los determinantes sociales en el grupo intervención vs. el grupo control, con un porcentaje de uso postintervención de 19,53% en el grupo control y de 32,26% en el grupo intervención (p

ObjectivesTo describe mesenchymal stromal cells (MSCs) in the treatment of hematopoietic stem cell transplantation (HSCT) complications and to assess its safety and efficacy.MethodsSingle-center retrospective study (2016–2023). Patients under 20 years who received MSCs for the treatment of HSCT-related complications were included.ResultsThirty patients (53.7% boys), median age at transplant 11 years (range 2–19) were included. MSCs indications were: graft-vs.-host disease (GVHD) in 18 patients (60%), of them 13 had acute GVHD (43.3%) and 5 chronic GVHD (16.7%); Grade 3–4 hemorrhagic cystitis (HC) in 4 (13.3%); poor graft function (PGF) in 6 (20%), 5 of them receiving MSCs with a CD34 stem cell-boost coinfusion; graft failure (GF) in 2 (6.7%), to enhance engraftment after a subsequent HSCT. Infusion-related-adverse-events were not reported. Overall response (OR) was 83% (25/30); 44% of responders (11/25) showed complete response (CR). OR for GVHD, HC, PGF and GF was 83.3%, 100%, 66.7% and 100% respectively. Response rate was 40% (95% CI: 20–55) and 79% (95% CI: 57–89) at 15 and 30 days. With a median follow-up of 21 months (IQR11–52.5), overall survival (OS) was 86% (95% CI: 74–100) and 79% (95% CI: 65–95) at 6 and 12 months post-MSCs infusion.ConclusionIn our study, the most frequent indication of MSCs was refractory aGVHD (43.3%). Response rates were high (OR 83%) and safety profile was good.

The use of anaerobic fermentation to produce volatile fatty acids (VFAs) is an environmentally sustainable alternative for cheese whey (CW) valorization. This study evaluates the effect of pH control on the conversion of organic matter to VFAs from CW and assesses VFA recovery using a novel approach based on gas-permeable membranes. VFA bioconversion and composition were studied with initial and sequential control of pH, both in acidic and alkaline conditions. Bioconversion efficiencies for assays with initial pH control were 36% and 45% for acidic and alkaline conditions, respectively. Sequential control of pH resulted in an increase in bioconversion to 54% under acidic conditions. Under acidic conditions, a variety of VFA was produced (mainly butyric, acetic, and propionic acids), while under alkaline conditions the majority was acetic acid. VFA recovery using a novel system of tubular gas-permeable membranes accounted for 15% and 100% of the total VFA from effluent 1 (butyric, acetic, and propionic acids) and effluent 2 (mainly acetic acid), respectively.

Background: Cancer is one of the leading causes of morbidity and mortality in the world. Its growing incidence and prevalence, as well as the advances in diagnostic and treatment tools, motivate an open debate about the economic burden it may place on health systems and have raised concerns about access to this technological innovation. There is a lack of information on the detailed costs of pharmacological treatment of cancer in our health setting. In this context, it is necessary to know the use of drugs in cancer treatment in conditions of real clinical practice. A real-word, evidence-based retrospective cohort study was conducted at Vall d’Hebron University Hospital (VHUH), the largest hospital complex in Catalonia, Spain, in order to determine the use of drugs and the associated cost in real clinical practice for the treatment of solid tumors in adult patients attended at this institution over 10 years (2010–2019). Methods: This was a single-center retrospective cohort study of adult cancer patients attended in clinical practice at the Medical Oncology Department of VHUH between 1 January 2010 and 31 December 2019. Data of prescription, preparation, and cost of antineoplastic treatments were analyzed by pharmacological class (cytotoxic drugs, immunotherapy, targeted therapy, radiopharmaceuticals, and others), by antineoplastic agent, and by type of tumor. The number of patients and the pharmaceutical expenditure corresponding to all these subgroups were recorded. The cost per patient in each tumor location was also calculated. Results: The study population included 13,209 patients with an overall pharmaceutical antineoplastic expenditure of EUR 120,396,097, increasing from 7.67% in relation to the total HUVH pharmaceutical expenditure in 2010 to 12.82% in 2019. By pharmacological class, the specific weight of the cost of targeted therapy is relevant (75.22% of pharmaceutical antineoplastic expenditure, 21.3% of patients) compared to the group of conventional cytotoxics (17.25% of pharmaceutical antineoplastic expenditure, 76.37% of patients), while immunotherapy has represented the largest relative increase, from 5% in 2014 to 12% in 2019. Eight targeted therapy drugs represented 50% of the costs of the targeted therapy drug class (palbociclib, trastuzumab, pertuzumab, bevacizumab, nivolumab, cetuximab, pembrolizumab, and trastuzumab emtansine). Eleven tumor sites accounted for 90% of the expenditure in 71% of all patients. Breast cancer had the highest expenditure during the study period (EUR 34,332,210) and at each individual year. Melanoma showed the highest increase, with 9.7% of total pharmaceutical antineoplastic expenditure in 2019 (2% of patients), representing a paradigm of the rising costs of cancer treatment due to the incorporation of new high-cost therapies. The average annual cost per patient was highly variable depending on the pathology. There was a growing increase in costs per patient in most tumor locations, particularly in patients with melanoma (from EUR 1922 in 2010 to EUR 37,020 in 2019), prostate cancer (from EUR 2992 in 2010 to EUR 14,118 in 2019), and non-small cell lung cancer (from EUR 3545 in 2010 to EUR 8371 in 2019). The relevance of the difference in monthly cost per patient that has been identified for the different intrinsic subtypes in breast cancer patients during 2019 (HER2+ EUR 2661/month, Luminal EUR 881/month, Triple negative EUR 386/month) makes us consider suggesting differentiated reimbursement rates for certain clinical conditions. Finally, support treatment with antiemetic drugs, erythropoietin stimulating agents, granulocyte-colony stimulating factor (G-CSF), and bone resorption inhibitors has involved a cost of EUR 5,751,910, which represents 4.6% of the overall pharmacological cost of cancer treatment. Conclusion: This study provides detailed insights on the oncological pharmaceutical expenditure for the treatment for solid tumors in the VHUH, based on real cost information from our hospital practice and for all antineoplastic therapies and types of solid tumors. This type of information on all the different types of cancer can be useful to better understand the economic burden of the disease and can be decisive for allocating public resources and funds for research, especially in those areas where information is scarce and therefore where further studies are needed. The contribution to knowledge of the cost of oncology therapy is of great value due to its realism and scope.

IntroductionThe COVID-19 pandemic had collateral effects on many health systems. Cancer screening and diagnostic tests were postponed, resulting in delays in diagnosis and treatment. This study assessed the impact of the pandemic on screening, diagnostics and incidence of breast, colorectal, lung, and prostate cancer; and whether rates returned to pre-pandemic levels by December, 2021.MethodsThis is a cohort study of electronic health records from the United Kingdom (UK) primary care Clinical Practice Research Datalink (CPRD) GOLD database. The study included individuals registered with CPRD GOLD between January, 2017 and December, 2021, with at least 365 days of clinical history. The study focused on screening, diagnostic tests, referrals and diagnoses of first-ever breast, colorectal, lung, and prostate cancer. Incidence rates (IR) were stratified by age, sex, and region, and incidence rate ratios (IRR) were calculated to compare rates during and after lockdown with rates before lockdown. Forecasted rates were estimated using negative binomial regression models.ResultsAmong 5,191,650 eligible participants, the first lockdown resulted in reduced screening and diagnostic tests for all cancers, which remained dramatically reduced across the whole observation period for almost all tests investigated. There were significant IRR reductions in breast (0.69 [95% CI: 0.63-0.74]), colorectal (0.74 [95% CI: 0.67-0.81]), and prostate (0.71 [95% CI: 0.66-0.78]) cancer diagnoses. IRR reductions for lung cancer were non-significant (0.92 [95% CI: 0.84-1.01]). Extrapolating to the entire UK population, an estimated 18,000 breast, 13,000 colorectal, 10,000 lung, and 21,000 prostate cancer diagnoses were missed from March, 2020 to December, 2021.DiscussionThe UK COVID-19 lockdown had a substantial impact on cancer screening, diagnostic tests, referrals, and diagnoses. Incidence rates remained significantly lower than pre-pandemic levels for breast and prostate cancers and associated tests by December, 2021. Delays in diagnosis are likely to have adverse consequences on cancer stage, treatment initiation, mortality rates, and years of life lost. Urgent strategies are needed to identify undiagnosed cases and address the long-term implications of delayed diagnoses.

Knowledge of the energy and macronutrient content of complex foods is essential for the food industry and to implement population-based dietary guidelines. However, conventional methodologies are time-consuming, require the use of chemical products and the sample cannot be recovered. We hypothesize that the nutritional value of heterogeneous food products can be readily measured instead by using hyperspectral imaging systems (NIR and VIS-NIR) combined with mathematical models previously fitted with spectral profiles.118 samples from different food products were collected for building the predictive models using their hyperspectral imaging data as predictors and their nutritional values as dependent variables. Ten different models were screened (Multivariate Linear regression, Lasso regression, Rigde regression, Elastic Net regression, K-Neighbors regression, Decision trees regression, Partial Least Square, Support Vector Machines, Gradient Boosting regression and Random Forest regression). The best results were obtained with Ridge regression for all parameters. The best performance was for estimating the protein content with a RMSE of 1.02 and a R2 equal to 0.88 in a test set, following by moisture (RMSE of 2.21 and R2 equal to 0.85), energy value (RMSE of 21.84 and R2 equal to 0.76) and total fat (RMSE of 2.17 and R2 equal to 0.72). The performance with carbohydrates (RMSE of 2.12 and R2 equal to 0.61) and ashes (RMSE of 0.25 and R2 equal to 0.38) was worse. This study shows that it is possible to predict the energy and nutrient values of processed complex foods, using hyperspectral imaging systems combined with supervised machine learning methods.

ObjectiveBilirubin and triglycerides can regulate insulin secretion and glucose uptake. The aim of our study is to analyze associations between total bilirubin (TB) and the bilirubin-to-triglycerides ratio (BTR) with metabolic markers in healthy prepubertal children.MethodsSubjects were 246 healthy children (mean age 8), of whom 142 (58%) were reevaluated 4 years later (mean age 12). The subjects were stratified according to age into three groups (9.6 years; n=82 each) at baseline and into two groups (

Summary: Group 3 innate lymphoid cells (ILC3s) are vital for defending tissue barriers from invading pathogens. Hypoxia influences the production of intestinal ILC3-derived cytokines by activating HIF. Yet, the mechanisms governing HIF-1α in ILC3s and other innate RORγt+ cells during in vivo infections are poorly understood. In our study, transgenic mice with specific Hif-1a gene inactivation in innate RORγt+ cells (RAG1KO HIF-1α▵Rorc) exhibit more severe colitis following Citrobacter rodentium infection, primarily due to the inability to upregulate IL-22. We find that HIF-1α▵Rorc mice have impaired IL-22 production in ILC3s, while non-ILC3 innate RORγt+ cells, also capable of producing IL-22, remain unaffected. Furthermore, we show that IL-18, induced by Toll-like receptor 2, selectively triggers IL-22 in ILC3s by transcriptionally upregulating HIF-1α, revealing an oxygen-independent regulatory pathway. Our results highlight that, during late-stage C. rodentium infection, IL-18 induction in the colon promotes IL-22 through HIF-1α in ILC3s, which is crucial for protection against this pathogen.

Population-based studies can provide information on the safety of COVID-19 vaccines. Here the authors report the rates of thrombosis and thrombocytopenia after vaccination against and infection with SARS-CoV-2 in Catalonia, Spain and compare them with the background (expected) rates in the general population.

Evidence on the impact of the COVID-19 vaccine rollout on socioeconomic COVID-19–related inequalities is scarce. We analyzed associations between socioeconomic deprivation index (SDI) and COVID-19 vaccination, infection, and hospitalization before and after vaccine rollout in Catalonia, Spain. We conducted a population-based cohort study during September 2020–June 2021 that comprised 2,297,146 adults >40 years of age. We estimated odds ratio of nonvaccination and hazard ratios (HRs) of infection and hospitalization by SDI quintile relative to the least deprived quintile, Q1. Six months after rollout, vaccination coverage differed by SDI quintile in working-age (40–64 years) persons: 81% for Q1, 71% for Q5. Before rollout, we found a pattern of increased HR of infection and hospitalization with deprivation among working-age and retirement-age (>65 years) persons. After rollout, infection inequalities decreased in both age groups, whereas hospitalization inequalities decreased among retirement-age persons. Our findings suggest that mass vaccination reduced socioeconomic COVID-19–related inequalities.

Summary: Background: While a low CD4/CD8 ratio during HIV treatment correlates with immunosenescence, its value in identifying patients at an increased risk for clinical events remains unclear. Methods: We analyzed data from the CoRIS cohort to determine whether CD4 count, CD8 count, and CD4/CD8 ratio at year two of antiretroviral therapy (ART) could predict the risk of serious non-AIDS events (SNAEs) during the next five years. These included major adverse cardiovascular events, non-AIDS-defining malignancies, and non-accidental deaths. We used pooled logistic regression with inverse probability weighting to estimate the survival curves and cumulative risk of clinical events. Findings: The study included 4625 participants, 83% male, of whom 200 (4.3%) experienced an SNAE during the follow-up period. A CD4/CD8 ratio

Abstract: Exposure to ambient air pollution increases mortality and morbidity, leading disabilities, and premature deaths. Air pollution has been identified as a leading cause of global disease burden, especially in low- and middle-income countries in 2015 (Global Burden of Diseases, Injuries and Risk Factors Study, 2015). This study explores the relation between mortality rates and particulate matter (PM) concentrations in the 50 Spanish regions for the period 2002-2017. Moreover, we estimated the premature deaths due to PM in Spain according to welfare and production losses in 2017. Random-effects models were developed to evaluate the relation between mortality rates and PM concentrations. The economic cost of premature deaths was assessed using the Willingness to Pay approach to quantify welfare losses and the Human Capital method to estimate production losses. PM10 concentrations are positively related to mortality due to respiratory diseases and stroke. Based on 10,342 premature deaths in 2017, losses in welfare amount to EUR 36,227 million (3.1% of Spanish GDP). The economic value of current and future production losses reached EUR 229 million (0.02% of GDP). From a social perspective, air pollution is a public health concern that greatly impacts health and quality of life. Results highlight the need to implement or strengthen regulatory, fiscal, and health public policies to substantially benefit the population’s health by reducing their exposure to air pollution.