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Abstract Aims Heart failure (HF) with reduced left ventricle ejection fraction (LVEF) is an entity with poor prognosis characterized by decompensations. Bioelectrical impedance analysis (BIA) is used to assess volume overload (VO) and may be useful to identify apparently stable HF outpatients at risk of decompensation. The aim of this study is to analyse whether VO assessed by BIA is associated with worsening heart failure (WHF) in stable outpatients with HF and reduced LVEF (HFrEF). Methods and results This is a prospective single‐centre observational study. Consecutive stable HF outpatients with LVEF below 40% underwent BIA, transthoracic echocardiography, blood sampling, and physical examination and were followed up for 3 months. VO was defined as the difference between the measured weight and the dry weight assessed by BIA. Demographic, clinical, anthropometric, echocardiographic, and analytical parameters were recorded. The primary endpoint was WHF, defined by visits to the emergency department for HF or hospitalization for HF. A total of 100 patients were included. The median VO was 0.5 L (interquartile range 0–1.6 L). Eleven patients met the primary endpoint. Univariate binary logistic regression analysis showed that left ventricle filling pressures assessed by E/e′, N‐terminal pro B‐type natriuretic peptide, inferior vena cava dilatation (≥21 mm), signs of congestion, and VO were associated with the primary endpoint. Binary logistic regression multivariate analysis showed that VO was the only independent predictor for the primary endpoint (adjusted OR 2.7; 95% CI 1.30–5.63, P = 0.008). Multivariate Cox regression analysis also showed an adjusted hazard ratio (HR) for VO of 2.03; 95% CI 1.37–3.02, P

Abstract The COVID-19 outbreak implied many changes in the daily life of most of the world’s population for a long time, prompting severe restrictions on sociality. The Behavioral Immune System (BIS) suggests that when facing pathogens, a psychological mechanism would be activated that, among other things, would generate an increase in prejudice and discrimination towards marginalized groups, including immigrants. This study aimed to test if people tend to enhance their rejection of minorities and foreign groups under the threat of contagious diseases, using the users’ attitudes towards migrants in Twitter data from Chile, for pre-pandemic and pandemic contexts. Our results appear to be mostly against the BIS hypothesis, with some faint exceptions, since threatened users increased their tweet production in the pandemic period, compared to empathetic users, but the latter grew in number and also increased the reach of their tweets between the two periods. We also found differences in the use of language between these types of users. Alternative explanations for these results may be context-dependent.

Abstract Background Community-acquired pneumonia (CAP) is associated with high morbidity and hospitalization rate. In infectious diseases, host genetics plays a critical role in susceptibility and immune response, and the immune pathways involved are highly dependent on the microorganism and its route of infection. Here we aimed to identify genetic risk loci for CAP using a case-control genome-wide association study (GWAS). Methods We performed a GWAS on 3,765 Spanish individuals, including 257 adult patients hospitalized with CAP and 3,508 population controls. Pneumococcal CAP was documented in 30% of patients; the remaining 70% were selected among patients with unidentified microbiological etiology. We tested 7,6 million imputed genotypes using logistic regressions. UK Biobank GWAS of bacterial pneumonia were used for results validation. Subsequently, we prioritized genes and likely causal variants based on Bayesian fine mapping and functional evidence. Imputation and association of classical HLA alleles and amino acids were also conducted. Results Six independent sentinel variants reached the genome-wide significance (p

The diverse physiography of the Portuguese land and marine territory, spanning from continental Europe to the Atlantic archipelagos, has made it an important repository of biodiversity throughout the Pleistocene glacial cycles, leading to a remarkable diversity of species and ecosystems. This rich biodiversity is under threat from anthropogenic drivers, such as climate change, invasive species, land use changes, overexploitation, or pathogen (re)emergence. The inventory, characterisation, and study of biodiversity at inter- and intra-specific levels using genomics is crucial to promote its preservation and recovery by informing biodiversity conservation policies, management measures, and research. The participation of researchers from Portuguese institutions in the European Reference Genome Atlas (ERGA) initiative and its pilot effort to generate reference genomes for European biodiversity has reinforced the establishment of Biogenome Portugal. This nascent institutional network will connect the national community of researchers in genomics. Here, we describe the Portuguese contribution to ERGA’s pilot effort, which will generate high-quality reference genomes of six species from Portugal that are endemic, iconic, and/or endangered and include plants, insects, and vertebrates (fish, birds, and mammals) from mainland Portugal or the Azores islands. In addition, we outline the objectives of Biogenome Portugal, which aims to (i) promote scientific collaboration, (ii) contribute to advanced training, (iii) stimulate the participation of institutions and researchers based in Portugal in international biodiversity genomics initiatives, and (iv) contribute to the transfer of knowledge to stakeholders and engaging the public to preserve biodiversity. This initiative will strengthen biodiversity genomics research in Portugal and fuel the genomic inventory of Portuguese eukaryotic species. Such efforts will be critical to the conservation of the country’s rich biodiversity and will contribute to ERGA’s goal of generating reference genomes for European species.

Abstract The characteristics of the host are crucial in the final outcome of COVID-19. Herein, the influence of genetic and clinical variants in COVID-19 severity was investigated in a total of 1350 patients. Twenty-one single nucleotide polymorphisms of genes involved in SARS-CoV-2 sensing as Toll-like-Receptor 7, antiviral immunity as the type I interferon signalling pathway (TYK2, STAT1, STAT4, OAS1, SOCS) and the vasoactive intestinal peptide and its receptors (VIP/VIPR1,2) were studied. To analyse the association between polymorphisms and severity, a model adjusted by age, sex and different comorbidities was generated by ordinal logistic regression. The genotypes rs8108236-AA (OR 0.12 [95% CI 0.02–0.53]; p = 0.007) and rs280519-AG (OR 0.74 [95% CI 0.56–0.99]; p = 0.03) in TYK2, and rs688136-CC (OR 0.7 [95% CI 0.5–0.99]; p = 0.046) in VIP, were associated with lower severity; in contrast, rs3853839-GG in TLR7 (OR 1.44 [95% CI 1.07–1.94]; p = 0.016), rs280500-AG (OR 1.33 [95% CI 0.97–1.82]; p = 0.078) in TYK2 and rs1131454-AA in OAS1 (OR 1.29 [95% CI 0.95–1.75]; p = 0.110) were associated with higher severity. Therefore, these variants could influence the risk of severe COVID-19.

The social recognition of cultural landscapes has increased in recent years. Culture must be accessible to all citizens, helping them to interpret the cultural landscape in the most respectful and autonomous way possible. Nevertheless, the link between accessibility and heritage requires a sensitive perception of the environment and individuals in their different situations. Usually, however, only partial solutions are offered, whereas a global, truly sustainable, and inclusive approach should be adopted. In this sense, information design can play an essential role in the enjoyment and knowledge of heritage landscapes. The aim of this article is to present some reflections on this topic, which have led a group of teachers and students from the Laboratory of Architectural, Cultural, and Heritage Landscape of the University of Valladolid (LAB/PAP) to develop experimental design proposals for the archaeological site of Tiermes, in Soria, Spain. The method applied is based on field research, case studies, project proposals, workshops, and user testing. The resulting proposals emerge from the previous research developed by the LAB/PAP. They will focus on information design to present this extraordinary site in an inclusive way. The final discussion will decide which of these proposals will be easier and more useful to implement.

Se presenta el caso de una paciente con neurofibromatosis-1, también conocida como enfermedad de von Recklinghausen, y neurofibromatosis hepática y en el que durante la evaluación por síndrome doloroso abdominal se realizó un estudio de imagen que definió el proceso ocupativo, extenso, con efecto compresivo sobre el parénquima hepático, y distorsión tanto de la vía biliar intrahepática como extrahepática. El desarrollo de extensos neurofibromas plexiformes es una presentación inusual de la condición y aún más con la afectación abdominal, como este caso, que es mucho menos frecuente.

Species diversity depends on the capacity of species to coexist, and when these share similar ecological requirements some degree of partitioning of the ecological niche is expected. Within the order Carnivora, direct and indirect interspecific interactions shape community structure and composition. Although strong negative interactions (e.g., interspecific killing) are expected between large carnivores and subordinate species, mesocarnivores that dominate most human disturbed landscapes can still strongly compete for resources given their similar body size and energy requirements. To identify the mechanisms of coexistence between mesocarnivore species in a Mediterranean landscape we assessed the ecological niche overlap between five species (Vulpes vulpes, Meles meles, Martes foina, Herpestes ichneumon, Genetta genetta), by simultaneously measuring the space, time, and trophic resource use. The multi-species occupancy model fit to camera-trapping data revealed spatial co-occurrence between most species’ pairs and an avoidance pattern between only stone marten and Eurasian badger (78 % probability of a negative effect). Using genetically identified scats, we assessed trophic niche breadth and overlap. Niche breadth was narrow for red fox, Eurasian badger, and stone marten, given these species consumed almost exclusively fruits and arthropods, and so trophic niche overlap was high. For the genet and the mongoose, the consumption of different food resources (e.g., mammals, birds, and reptiles) increased niche breadth and decreased the niche overlap with the other sympatric species. Finally, niche segregation was more significant along the temporal axis, since the mongoose has a diurnal activity pattern and the remaining carnivore species, although mostly nocturnal, had small asynchronies in the activity peaks which could decrease the chance of direct encounters. Therefore, our results suggest that similar habitat preferences and ecological requirements rather than interspecific competition shape the mesocarnivores’ resource use in this landscape. Nonetheless, fine-scale temporal segregation seems the main mechanism to facilitate coexistence, together with small differences in trophic resource use, especially for species with high spatial and temporal overlap.

Utilizando datos del proceso de admisión a la educación superior en 2020, este artículo analiza el comportamiento distributivo de los cupos especiales de una política de inclusión socioeducativa chilena. Se crearon distintos indicadores para perfilar tanto la demanda como la oferta programática que adhiere a esta iniciativa. Los resultados evidencian que la asignación de cupos especiales no es homogénea ni azarosa; conforme mayor es la elitización, perfil académico y atributos socioeconómicos de la matrícula de un programa, menor es su cantidad de vacantes para admisión especial. Asimismo, los cupos especiales aumentan en carreras con bajos niveles de demanda y que concentran estudiantes con bajo desempeño en pruebas de admisión. Las conclusiones discuten si la contribución que los programas de mayor prestigio hacen a la inclusión social es más simbólica que real, así como la configuración de una lógica de uso instrumental de la admisión especial en programas de baja demanda.

Abstract Glioblastoma (GB) is a devastating tumor of the central nervous system characterized by a poor prognosis. One of the best-established predictive biomarker in IDH-wildtype GB is O6-methylguanine-DNA methyltransferase (MGMT) methylation (mMGMT), which is associated with improved treatment response and survival. However, current efforts to monitor GB patients through mMGMT detection have proven unsuccessful. Small extracellular vesicles (sEVs) hold potential as a key element that could revolutionize clinical practice by offering new possibilities for liquid biopsy. This study aimed to determine the utility of sEV-based liquid biopsy as a predictive biomarker and disease monitoring tool in patients with IDH-wildtype GB. Our findings show consistent results with tissue-based analysis, achieving a remarkable sensitivity of 85.7% for detecting mMGMT in liquid biopsy, the highest reported to date. Moreover, we suggested that liquid biopsy assessment of sEV-DNA could be a powerful tool for monitoring disease progression in IDH-wildtype GB patients. This study highlights the critical significance of overcoming molecular underdetection, which can lead to missed treatment opportunities and misdiagnoses, possibly resulting in ineffective therapies. The outcomes of our research significantly contribute to the field of sEV-DNA-based liquid biopsy, providing valuable insights into tumor tissue heterogeneity and establishing it as a promising tool for detecting GB biomarkers. These results have substantial implications for advancing predictive and therapeutic approaches in the context of GB and warrant further exploration and validation in clinical settings.

Summary: Human genetic studies of critical COVID-19 pneumonia have revealed the essential role of type I interferon-dependent innate immunity to SARS-CoV-2 infection. Conversely, an association between the HLA-B∗15:01 allele and asymptomatic SARS-CoV-2 infection in unvaccinated individuals was recently reported, suggesting a contribution of pre-existing T cell-dependent adaptive immunity. We report a lack of association of classical HLA alleles, including HLA-B∗15:01, with pre-omicron asymptomatic SARS-CoV-2 infection in unvaccinated participants in a prospective population-based study in the United States (191 asymptomatic vs. 945 symptomatic COVID-19 cases). Moreover, we found no such association in the international COVID Human Genetic Effort cohort (206 asymptomatic vs. 574 mild or moderate COVID-19 cases and 1,625 severe or critical COVID-19 cases). Finally, in the Human Challenge Characterisation study, the three HLA-B∗15:01 individuals infected with SARS-CoV-2 developed symptoms. As with other acute primary infections studied, no classical HLA alleles favoring an asymptomatic course of SARS-CoV-2 infection were identified.

Anthropogenic and environmental processes present unique challenges for preserving cultural heritage in North Africa. Large parts of this region are characterised by unfavourable arid and semi-arid conditions and rapid changes to the landscapes caused by heightened regional development (e.g., urban expansion, road building, agricultural intensification, and socio-political conflicts). As a result, we are facing a fast-paced disappearance of heritage sites in regions that are still poorly understood. Following this, the utilisation of Earth observation data through aerial photographs and satellite imagery has emerged as an unmatched tool in the exploration of endangered archaeological heritage. Drawing on this context, this paper underscores the critical significance of incorporating digital research methods, such as remote sensing, GIS, or cartographic analysis, to ensure the evaluation and (digital) preservation of the historical sites along these vulnerable areas. Furthermore, our study seeks to provide new insights into data management and dissemination, fostering open research practices within North African archaeological research.

Light and color present complex interactions whose understanding is not always intuitive. Over the past forty years, numerous studies have aimed to identify preconceived notions and the various models employed in schools. Numerous teaching and learning strategies, along with didactic analyses, often fail to consider the multidimensional and interdisciplinary nature of these phenomena. This article presents a teaching experience aimed at training future primary education teachers. The theoretical context of this proposal, designed within the domains of physical and chemical didactics and plastic and visual expression, will be discussed. Instruments consistent with qualitative action research were used. Some results from the analysis of students’ narratives, both in laboratory notebooks and in sessions recorded audiovisually, will be presented.

Acute respiratory distress syndrome (ARDS) poses a significant and widespread public health challenge. Extensive research conducted in recent decades has considerably improved our understanding of the disease pathophysiology. Nevertheless, ARDS continues to rank among the leading causes of mortality in intensive care units and its management remains a formidable task, primarily due to its remarkable heterogeneity. As a consequence, the syndrome is underdiagnosed, prognostication has important gaps and selection of the appropriate therapeutic approach is laborious. In recent years, the noncoding transcriptome has emerged as a new area of attention for researchers interested in biomarker development. Numerous studies have confirmed the potential of long noncoding RNAs (lncRNAs), transcripts with little or no coding information, as noninvasive tools for diagnosis, prognosis and prediction of the therapeutic response across a broad spectrum of ailments, including respiratory conditions. This article aims to provide a comprehensive overview of lncRNAs with specific emphasis on their role as biomarkers. We review current knowledge on the circulating lncRNAs as potential markers that can be used to enhance decision making in ARDS management. Additionally, we address the primary limitations and outline the steps that will be essential for integration of the use of lncRNAs in clinical laboratories. Our ultimate objective is to provide a framework for the implementation of lncRNAs in the management of ARDS.

Introduction The nature of the relationship between inflammation, cardiovascular (CV) risk factors and atherosclerosis in axial spondyloarthritis (axSpA) remains largely unknown and sex differences in this regard are yet to be assessed.Methods Study including 611 men and 302 women from the Spanish multicentre AtheSpAin cohort to assess CV disease in axSpA. Data on CV disease risk factors were collected both at disease diagnosis and at enrolment, and data on disease activity, functional indices and carotid ultrasonography only at enrolment.Results After a median disease duration of 9 years, patients of both sexes who at disease diagnosis had elevated acute phase reactants (APRs), more frequently had hypertension and obesity. The same occurred with dyslipidaemia in men and with diabetes mellitus in women. At enrolment, CV risk factors were independently associated with APR and with activity and functional indices, with various sex differences. C reactive protein (CRP) values were inversely associated with HDL-cholesterol in men (β coefficient: −1.2 (95% CI: −0.3 to −0.07) mg/dL, p=0.001), while erythrocyte sedimentation rate values were positively associated with triglycerides in women (β coefficient: 0.6 (95% CI: 0.04 to 1) mg/dL, p=0.035). Furthermore, only women showed an independent relationship between insulin resistance parameters and APR or disease activity. Both men and women with high–very high CV risk according to the Systematic Assessment of Coronary Risk Evaluation 2 and CRP levels higher than 3 mg/L at diagnosis of the disease presented carotid plaques significantly more frequently than those with normal CRP levels at disease diagnosis.Conclusion Inflammation is associated with atherosclerosis and CV disease in axSpA. A gender-driven effect is observed in this relationship.

Introduction: Activated phosphoinositide 3-kinase (PI3K)δ syndrome (APDS) is an ultra-rare inborn error of immunity (IEI) combining immunodeficiency and immune dysregulation. This study determined what represents value in APDS in Spain from a multidisciplinary perspective applying multicriteria decision analysis (MCDA) methodology. Methods: A multidisciplinary committee of nine experts scored the evidence matrix. A specific framework for orphan drug evaluation in Spain and the weights assigned by a panel of 98 evaluators and decision-makers was used. Re-evaluation of scores was performed. Results: APDS is considered a very severe disease with important unmet needs, including misdiagnosis and diagnostic delay. Current management is limited to treatment of symptoms with off-label use of therapies supported by limited evidence. Therapeutic benefit is partial, resulting in limited disease control. Haematopoietic stem cell transplantation (HSCT), the only potential curative alternative, is restricted to a reduced patient population and without evidence of long-term efficacy or safety. All options present a limited safety profile. Data on patients’ quality of life are lacking. APDS is associated with high pharmacological, medical and indirect costs. Conclusions: APDS is considered a severe disease, with limited understanding by key stakeholders of how treatment success is assessed in clinical practice, the serious impact that has on patients and the associated high economic burden. This study brings to light how MCDA methodology could represent a useful tool to complement current clinical and decision-making methods used by APDS experts and evaluators.

Analiza el comportamiento de la matrícula y desempeño académico de hombres y mujeres en carreras con escasa presencia femenina. Tras crear un conjunto de índices de brechas de género y eficiencia interna, se realizó un análisis estadístico descriptivo y longitudinal de bases de datos de registro académico de la oferta programática de una universidad pública entre 2014 y 2023. Como resultado, las mujeres postulan menos a ingeniería, pero elegida esta opción evidencian un mejor desempeño académico. Aunque la matrícula femenina se ha expandido, en áreas como la ingeniería se evidencian rezagos y brechas. Son las mujeres quienes exhiben mayores índices de retención, permanencia, aprobación y titulación oportuna, además de presentar un rendimiento promedio significativamente superior. Se cuestiona el argumento de menores competencias matemáticas de las mujeres para explicar sus elecciones profesionales en ingeniería. Releva la importancia de intervenciones socioeducativas de cambio actitudinal que expandan sus elecciones a esta área

Objective To assess the predictive value of four cardiovascular (CV) risk algorithms for identifying high-risk psoriatic arthritis (PsA) patients.Methods Evaluation of patients with PsA enrolled in the Spanish prospective project CARdiovascular in RheuMAtology. Baseline data of 669 PsA patients with no history of CV events at the baseline visit, who were followed in rheumatology outpatient clinics at tertiary centres for 7.5 years, were retrospectively analysed to test the performance of the Systematic Coronary Risk Assessment (SCORE), the modified version (mSCORE) European Alliance of Rheumatology Associations (EULAR) 2015/2016, the SCORE2 algorithm (the updated and improved version of SCORE) and the QRESEARCH risk estimator version 3 (QRISK3).Results Over 4790 years of follow-up, there were 34 CV events, resulting in a linearised rate of 7.10 per 1000 person-years (95% CI 4.92 to 9.92). The four CV risk scales showed strong correlations and all showed significant associations with CV events (p

Not available.

Abstract Intergroup conflict has been a persistent aspect of human societies since the emergence of our species. Various researchers have proposed that competition between groups has acted as a key selective force throughout human evolutionary history. Such intergroup competition for limited resources exacerbated the expression of intergroup aggression and intragroup cooperation. Furthermore, it would have a sexual dimorphism, with men demonstrating increased sensitivity to conflict threats—in order to maximize reproductive opportunities—, while women generally reject from active engagement in intergroup conflict. In the present study, we conducted behavioral experiments under controlled laboratory conditions to measure cooperation and aggression from using virtual games, specifically the Public Good Games and the Point Subtraction Aggression Paradigm, in a sample of 541 participants. We created control and experimental intergroup competition scenarios, where aggression and cooperation were necessary to increase monetary rewards. Our results shows that men modulate aggression and cooperation in the presence of intergroup conflict. In addition, our data also reveals that women cooperate more than men and display heightened levels of cooperation and aggression when confronted with intergroup conflict. These findings prompt a reevaluation of current functional theoretical models concerning the role of women in intergroup conflict and suggest that the dynamics of human aggression and cooperation may be more nuanced than previously believed.

Abstract Small extracellular vesicles (sEVs) in the blood of cancer patients contain higher amounts of tumor markers than those identified as free-circulating. miRNAs have significant biomedical relevance due to their high stability and feasible detection. However, there is no reliable endogenous control available to measure sEVs-miRNA content, impairing the acquisition of standardized consistent measurements in cancer liquid biopsy. In this study, we identified three miRNAs from a panel of nine potential normalizers that emerged from a comprehensive analysis comparing the sEV-miRNA profile of six lung and ovarian human cancer cell lines in the absence of or under different conditions. Their relevance as normalizers was tested in 26 additional human cancer cell lines from nine different tumor types undergoing chemotherapy or radiotherapy treatment. The validation cohorts were comprised of 242 prospective plasma and ascitic fluid samples from three different human tumor types. Variability and normalization properties were tested in comparison to miR-16, the most used control to normalize free-circulating miRNAs in plasma. Our results indicate that miR-151a is consistently represented in small extracellular vesicles with minimal variability compared to miR-16, providing a novel normalizer to measure small extracellular vesicle miRNA content that will benefit liquid biopsy in cancer patients.

The Global Initiative for Childhood Cancer (GICC) aims to increase the cure rate for children with cancer globally by improving healthcare access and quality. The Pan American Health Organization (PAHO), St. Jude Children’s Research Hospital (St. Jude), and collaborators have joined efforts to improve outcomes of children with cancer in Latin America and the Caribbean (LAC) using the CureAll framework. In this article, we describe the process of developing regional resources aimed at accelerating the GICC implementation in LAC. In March 2021, PAHO formed regional working groups to develop core projects aligned with CureAll pillars and enablers. Seven working groups emerged from regional dialogues: early detection, nursing, psychosocial, nutrition, supportive care, treatment abandonment, and palliative care. PAHO arranged regular online meetings under the mentorship and support of St. Jude regional/transversal programs and international mentors. Between April and December 2021, 202 multidisciplinary experts attended 43 online meetings to promote the dialogue between stakeholders to improve childhood cancer outcomes. Fourteen technical outputs were produced: four regional snapshots, four technical documents, two virtual courses, one set of epidemiological country profiles, one educational content series for parents/caregivers, and two communication campaigns. The ongoing dialogue and commitment of PAHO, St. Jude, LAC working committees, and international collaborators are essential foundations to successfully accelerate GICC implementation. This is achievable through the development of materials of regional and global relevance. Further research and evaluation are needed to determine the impact of these strategies and resources on childhood cancer outcomes in LAC and other regions.

Background: This review addresses the emerging field of automated packing cells, which lies at the intersection of robotics and packing problems. Integrating these two fields is critical for optimizing logistics and e-commerce operations. The current literature focuses on packing problems or specific robotic applications without addressing their integration. Methods: To bridge this gap, we conducted a comprehensive review of 46 relevant studies, analyzing various dimensions, including the components of robotic packing cells, the types of packing problems, the solution approaches, and performance comparisons. Results: Our review reveals a significant trend towards addressing online packing problems, which reflects the dynamic nature of logistics operations where item information is often incomplete. We also identify several research gaps, such as the need for standardized terminologies, comprehensive methodologies, and the consideration of real-world constraints in robotic algorithms. Conclusions: This review uniquely integrates insights from robotics and packing problems, providing a structured framework for future research. It highlights the importance of considering practical robotic constraints. It proposes a research structure that enhances the reproducibility and comparability of results in real-world scenarios. By doing so, we aim to guide future research efforts and facilitate the development of more robust and practical automated packing systems.

This article presents a participatory research project developed in a school in Cantabria (Spain) that has sought to enhance the participation of the educational community to transform the school. The article focuses on the analysis of the contributions of the students (children from 3 to 12 years of age), key agents and promoters of change. Pedagogical documentation has been used as a tool to narrate the development of this research and to encourage subsequent reflection. The students have experienced what it means to participate, to listen, to be listened to, to feel recognised and to exert influence in their own lives. The results go beyond mere changes in the configuration and use of spaces. The project has made it possible to think of the school as a forum for citizen participation, favouring the experience of a democratic school, the development of otherness, the feeling of belonging and the experience of community.

High-level delafloxacin-resistant (H-L DLX-R) Staphylococcus aureus isolates (minimum inhibitory concentration ≥1 mg/L) associated with mutations affecting position 84 of ParC have emerged. We aimed to elucidate the role of these mutations as a mechanism of H-L DLX resistance in methicillin-resistant S. aureus (MRSA) isolates recovered from blood cultures. Susceptibility to DLX was determined in 75 MRSA isolates by E-test, and an rt-PCR was developed to detect mutations affecting position 84 of ParC to screen a further 185 MRSA isolates. The genomes of 48 isolates, including all DLX-R isolates or with alterations at position 84, and also a subset of DLX-susceptible isolates were analyzed. Among the 75 isolates studied, 77.34% were DLX-susceptible and only 4 H-L DLX-R isolates were found. Seven (3.8%) isolates with alterations at position 84 of ParC were detected by rt-PCR. Genomic analysis showed that 89.9% (8/9) of isolates with the substitution E84K/G in ParC, together with other mutations in gyrA and parC, were H-L DLX-R. However, the E84K substitution in ParC alone or with other alterations was found in two isolates without H-L DLX-R. Alterations at position 84 of ParC are rare but play a key role in H-L DLX resistance in MRSA but only when other alterations in GyrA are present.

(1) Background: The validation of new lines of therapy for the elderly is required due to the progressive ageing of the world population and scarce evidence in elderly patients with HF with reduced ejection fraction (HFrEF). The purpose of our study is to analyze the effect of SGLT2 inhibitors (SGLT2i) in this subgroup of patients. (2) Methods: A single-center, real-world observational study was performed. We consecutively enrolled all patients aged ≥ 75 years diagnosed with HFrEF and for treatment with SGLT2i, and considered the theoretical indications. (3) Results: A total of 364 patients were recruited, with a mean age of 84.1 years. At inclusion, the mean LVEF was 29.8%. Median follow-up was 33 months, and there were 122 deaths. A total of 55 patients were under SGLT2i treatment. A multivariate Cox logistic regression test for all-cause mortality was performed, and only SGLT2i (HR 0.39 [0.19–0.82]) and glomerular filtration rate (HR 0.98 [0.98–0.99]) proved to be protective factors. In parallel, we conducted a propensity-score-matched analysis, where a significant reduction in all-cause mortality was associated with the use of SGLT2i treatment (HR 0.39, [0.16–0.97]). (4) Conclusions: Treatment with SGLT2i in elderly patients with HFrEF was associated with a lower rate of all-cause mortality. Our data show that SGLT2i therapy could improve prognosis in the elderly with HFrEF in a real-world study.

This report describes the status of childhood cancer control initiatives in Latin America and the Caribbean (LAC). Progress between 2017 and 2023 is measured using the outcome indicators from the Pan American Health Organization (PAHO) childhood cancer logic model aligned with the World Health Organization Global Initiative for Childhood Cancer (GICC). This report also describes the advances, barriers, and facilitators for the implementation of the GICC at the Regional level. Methods used in this report encompassed a comprehensive approach, incorporating a literature review, interviews, surveys, and a Delphi study developed by the technical team of the PAHO Non-Communicable Diseases and Mental Health Department and by the GICC LAC working group. Since 2017, there has been a substantial increase in the number of countries that have included childhood cancer in their national regulations. Currently, 21 LAC countries are involved in the GICC implementation, activities, and dialogues. However, the objectives for 2030 will only be achieved if Member States overcome the barriers to accelerating the pace of initiative implementation. There is an urgent need to increase the efforts in childhood cancer control in LAC, especially regarding the prioritization of timely detection, essential diagnostics, access to cancer treatment, palliative care, and close follow-up of children and adolescents with cancer.

El presente artículo corresponde a una revisión sistemática, que pretende caracterizar el campo de investigación sobre el desarrollo de habilidades del pensamiento crítico y analizar las estrategias de aprendizaje utilizadas en el campo educativo de la formación universitaria. La búsqueda se realiza en las bases de datos WoS y Scopus. Con una muestra final de 64 artículos se realizan un análisis bibliométrico y uno de contenido, indagando en: Palabras clave más utilizadas, países de estudio, año de publicación, idioma, revistas científicas, áreas de formación profesional, metodologías de investigación, estrategias de aprendizaje utilizadas para promover las habilidades del pensamiento crítico y taxonomías de habilidades utilizadas en los estudios de la muestra correspondiente a 59 países y 6 trabajos no reportaron el país de estudio. Los principales resultados muestran que: Los países con mayor número de publicaciones son Estados Unidos e Indonesia; el inglés sigue predominando como idioma del conocimiento y las estrategias de aprendizajes más utilizadas son aquellas que dan protagonismo a los estudiantes en el proceso de aprendizaje tales como, el aprendizaje basado en problemas, proyectos, tecnología, casos y cooperativo, así como la combinación del aula invertida basada en proyectos para el aprendizaje en línea.

Objetivo: caracterizar la iniciación sexual y las conductas sexuales de riesgo que acompañan el ejercicio de la sexualidad entre jóvenes de 15 a 29 años en Chile. Metodología: con los resultados de la Décima Encuesta Nacional de Juventudes en Chile, mediante un análisis estadístico inferencial y la aplicación de modelos de regresión logística, se perfilan los principales descriptores de la iniciación sexual, con énfasis en la precocidad, formalidad y conducta preventiva. Resultados: según los datos, los y las jóvenes se inician sexualmente a edades tempranas, no obstante, privilegian la formalidad del vínculo y se observa una mayor presencia de conducta preventiva respecto a la última década. Conclusiones: se destaca la importancia de desarrollar intervenciones socioeducativas tendientes a modificar conductas sexuales de riesgo, interviniendo principalmente sobre el componente actitudinal.

Abstract Background The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU. Methods This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU from 19 hospitals. qPCR assays were performed in plasma samples collected within the first 48 h upon admission. A 16-miRNA panel was designed based on recently published data from our group. Results Nine miRNAs were validated as biomarkers of all-cause in-ICU mortality in the independent cohort of critically ill patients (FDR

Abstract Background The objectives of this study were to assess the discontinuation of biologic therapy in patients who achieve remission and identify predictors of discontinuation of biologics in patients with inflammatory arthritis in remission. Methods An observational retrospective study from the BIOBADASER registry comprising adult patients diagnosed with rheumatoid arthritis (RA), ankylosing spondylitis (AS), or psoriatic arthritis (PsA) and receiving 1 or 2 biological disease-modifying drugs (bDMARDs) between October 1999 and April 2021. Patients were followed yearly after initiation of therapy or until discontinuation of treatment. Reasons for discontinuation were collected. Patients who discontinued bDMARDs because of remission as defined by the attending clinician were studied. Predictors of discontinuation were explored using multivariable regression models. Results The study population comprised 3,366 patients taking 1 or 2 bDMARDs. Biologics were discontinued owing to remission by 80 patients (2.4%): 30 with RA (1.7%), 18 with AS (2.4%), and 32 with PsA (3.9%). The factors associated with a higher probability of discontinuation on remission were shorter disease duration (OR: 0.95; 95% CI: 0.91–0.99), no concomitant use of classic DMARDs (OR: 0.56; 95% CI: 0.34–0.92), and longer usage of the previous bDMARD (before the decision to discontinue biological therapy) (OR: 1.01; 95% CI: 1.01–1.02); in contrast, smoking status (OR: 2.48; 95% CI: 1.21–5.08) was associated with a lower probability. In patients with RA, positive ACPA was associated with a lower probability of discontinuation (OR: 0.11; 95% CI: 0.02–0.53). Conclusions Discontinuation of bDMARDs in patients who achieve remission is uncommon in routine clinical care. Smoking and positive ACPA in RA patients were associated with a lower probability of treatment discontinuation because of clinical remission.

Abstract Background Surgery and treatment for colorectal cancer (CRC) in the elderly patient increase the risk of developing post-operative complications, losing functional independence, and worsening health-related quality of life (HRQoL). There is a lack of high-quality randomized controlled trials evaluating the potential benefit of exercise as a countermeasure. The primary aim of this study is to evaluate the effectiveness of a home-based multicomponent exercise program for improving HRQoL and functional capacity in older adults undergoing CRC surgery and treatment. Methods This randomized, controlled, observer-blinded, single-center trial aims to randomize 250 patients (>74 years) to either an intervention or a control group (i.e., usual care). The intervention group will perform an individualized home-based multicomponent exercise program with weekly telephone supervision from diagnosis until three months post-surgery. The primary outcomes will be HRQoL (EORTC QLQ-C30; CR29; and ELD14) and functional capacity (Barthel Index and Short Physical Performance Battery), which will be assessed at diagnosis, at discharge, and one, three, and six months after surgery. Secondary outcomes will be frailty, physical fitness, physical activity, inspiratory muscle function, sarcopenia and cachexia, anxiety and depression, ambulation ability, surgical complications, and hospital length of stay, readmission and mortality. Discussion This study will examine the effects of an exercise program in older patients with CRC across a range of health-related outcomes. Expected findings are improvement in HRQoL and physical functioning. If proven effective, this simple exercise program may be applied in clinical practice to improve CRC care in older patients. Trial registration ClinicalTrials.gov ID: NCT05448846.

In this paper, it is presented the results of a descriptive exploratory study with which it is aimed to understand what previous conceptions future Infant and Primary Education teachers in Cantabria have regarding three central issues in the Global Citizenship Education approach (GCE). These are: a) what is «global citizenship» and what are the characteristics of a «global citizen», b) conceptions of poverty in a globalised world, and c) what role should education have in addressing these realities? The study was conducted over two academic years and 248 responses were analysed following the application of an open-ended questionnaire. Our objective is to understand the previous perceptions of these future teachers, to expand and challenge them, in the second phase, through the development of GCE projects in their university degrees. We understand GCE from the perspective of critical pedagogy and we are focused on developing a challenging university curriculum, which allows the discussion of topics linked to how globalisation affects our lives.

Building on the notion of an intangible resource, this research conceptualizes resilience as an intangible resource that can be ascribed to countries (governments and media) and explores its sources. After presenting the conceptual framework, the study uses cross-national comparable data from Eurobarometer to (a) determine whether a factor called “resilience to misinformation” can be composed of citizens’ attitudes and behaviors toward misinformation and be conceptualized and operationalized as an intangible asset, and (b) determine the extent to which other intangible assets regarding the media (legitimacy and trust) help predict resilience to misinformation. Based on statistical techniques, findings show that (a) it is possible to conceptualize “resilience to misinformation” as an intangible asset comprised of several items related to citizens’ awareness of misinformation, acknowledgment of the negative impact, and the development of skills to identify misinformation; (b) this intangible asset can be analyzed in relation to intangibles that derive from media performance, such as media legitimacy and trust in the media; and (c) media’s intangible assets seem to be more predictive of “resilience to misinformation” than sociodemographic variables. Based on the findings, this research proposes a conceptualization of “resilience to misinformation” as an intangible resource in the public sector. In addition, it highlights recommendations for the mainstream media on how to manage their intangible value while contributing to resilience to misinformation.

There are historical spaces that are very little known to the general population. for this reason, it is of great importance to ensure that these are known known throughout the world. For this, there are new informative techniques that allow you to visit places without the need to go to them. For this, the complete virtualization of space has been proposed, combining photogrammetry techniques with traditional survey techniques. That all of them together make up a complete model of the location its topography, layout, buildings, vegetation and the environment that surrounds it. With this, the architectural survey of the historic garden of Arguijuela de Arriba is propose), located in the province of Cáceres, (Spain) in an area of great importance due to its defensive nature during the time of the reconquest. With all this, it has been possible to combine different techniques to obtain a digital copy of the enclave, on which it has been possible to project an intervention that improves accessibility. and its conservation.

Various commercial fish species utilize different coastal habitats as nurseries in their juvenile stages, with surf zones being particularly crucial due to the protection and abundant food resources they offer. Among the species that rely on these areas are the spotted seabass (Dicentrarchus punctatus) and the European seabass (Dicentrarchus labrax). This study aimed to investigate the age and feeding habits of surf zone specimens of these species and explore their environmental adaptations. The average size for D. punctatus was 16.94 ± 4.05 cm, and for D. labrax, it was 23.23 ± 6.30 cm. The length–weight relationship for D. punctatus was TW = 0.013*TL2.885 (parameter a: 95% CI: 0.012–0.014; parameter b: 95% CI: 2.854–2.917), and for D. labrax, it was TW = 0.008*TL3.095 (parameter a: 95% CI: 0.006–0.009; parameter b: 95% CI: 3.040–3.151). In both D. punctatus (79.20%) and D. labrax (75.92%), the predominant age classes were 1+ and 2+. Significant variations in age class abundance were observed in D. punctatus based on the time of day, lunar phase, and season, while D. labrax showed variations only by season. A diet analysis revealed that both species primarily consume mysids and fish, with D. punctatus showing dietary variations related to the time of day, lunar phase, and season, and D. labrax showing variations with the time of day and season.

Honey is a natural sweetener made by bees that exhibits antimicrobial activity, mainly related to its H2O2 content. The aim of this work was to research the H2O2 concentration of 24 Spanish honeys from different botanical origins, studying their possible correlation with glucose oxidase (GOx), catalase (CAT), and anti-Staphylococcus aureus activities (minimal inhibition concentration (MIC), minimal bactericidal concentration (MBC), and percentage of inhibition at 5% (w/v) honey against Staphylococcus aureus), as well as possible correlations among all the analyzed parameters. The results showed that the H2O2 concentration did not depend on the botanical origin of the honeys. There were neither correlations between the H2O2 concentration and the activities of GOx and CAT, nor between GOx and antimicrobial activity. However, CAT and antimicrobial activities were positively correlated. Therefore, CAT could be successfully used as a possible marker of the antimicrobial activity of honeys against Staphylococcus aureus. Furthermore, a linear regression model has been fitted to explain the antimicrobial activity from CAT and GOx activity and H2O2 concentration. Although H2O2 is one of the compounds involved in honey’s antibacterial activity, this capacity also strongly depends on other honey components (such as low water activity, acidity, osmolarity, and phenolic compounds). The very high anti-Staphylococcus aureus activity exhibited by all samples could be interesting for commercial honey-based formulations also helping to promote local beekeeping.

AbstractNano- and micro-technologies can salvage drugs with very low solubility that were doomed to pre-clinical and clinical failure. A unique design approach to develop drug nanocrystals (NCs) loaded in extended release polymeric microparticles (MPs) for local treatments is presented here through the case of a potential osteoarthritis (OA) drug candidate for intra-articular (IA) administration. Optimizing a low-shear wet milling process allowed the production of NCs that can be subsequently freeze-dried (FD) and redispersed in a hydrophobic polymer-organic solvent solution to form spray-dried MPs. Results demonstrated a successful development of a ready-to-upscale formulation containing PLGA MPs with high drug NC encapsulation rates that showed a continuous and controlled drug release profile over four months. The screenings and procedures described allowed for identifying and overcoming common difficulties and challenges raised along the drug reduction to nano-size and spray-drying process. Above all, the technical knowledge acquired is intended for formulation scientists aiming to improve the therapeutic perspectives of poorly soluble drugs.

The field of pharmacogenetics (PGx) holds great promise in advancing personalized medicine by adapting treatments based on individual genetic profiles. Despite its benefits, there are still economic, ethical and institutional barriers that hinder its implementation in our healthcare environment. A retrospective analysis approach of anonymized data sourced from electronic health records was performed, encompassing a diverse patient population and evaluating key parameters such as prescribing patterns and test results, to assess the impact of pharmacogenetic testing. A head-to-head comparison with previously published activity results within the same pharmacogenetic laboratory was also conducted to contrast the progress made after 10 years. The analysis revealed significant utilization of pharmacogenetic testing in daily clinical practice, with 1,145 pharmacogenetic tests performed over a 1-year period and showing a 35% growth rate increase over time. Of the 17 different medical departments that sought PGx tests, the Oncology department accounted for the highest number, representing 58.47% of all genotyped patients. A total of 1,000 PGx tests were requested for individuals susceptible to receive a dose modification based on genotype, and 76 individuals received a genotype-guided dose adjustment. This study presents a comprehensive descriptive analysis of real-world data obtained from a public tertiary hospital laboratory specialized in pharmacogenetic testing, and presents data that strongly endorse the integration of pharmacogenetic testing into everyday clinical practice.

IntroductionRefractory/relapsed pediatric acute leukemia are still clinically challenging and new therapeutic strategies are needed. Interactions between Natural Killer Group 2D (NKG2D) receptor, expressed in cytotoxic immune cells, and its ligands (NKG2DL), which are upregulated in leukemic blasts, are important for anti-leukemia immunosurveillance. Nevertheless, leukemia cells may develop immunoescape strategies as NKG2DL shedding and/or downregulation.MethodsIn this report, we analyzed the anti-leukemia activity of NKG2D chimeric antigen receptor (CAR) redirected memory (CD45RA-) T cells in vitro and in a murine model of T-cell acute lymphoblastic leukemia (T-ALL). We also explored in vitro how soluble NKG2DL (sNKG2DL) affected NKG2D-CAR T cells’ cytotoxicity and the impact of NKG2D-CAR T cells on Jurkat cells gene expression and in vivo functionality.ResultsIn vitro, we found NKG2D-CAR T cells targeted leukemia cells and showed resistance to the immunosuppressive effects exerted by sNKG2DL. In vivo, NKG2D-CAR T cells controlled T cell leukemia burden and increased survival of the treated mice but failed to cure the animals. After CAR T cell treatment, Jurkat cells upregulated genes related to proliferation, survival and stemness, and in vivo, they exhibited functional properties of leukemia initiating cells.DiscussionThe data here presented suggest, that, in combination with other therapeutic approaches, NKG2D-CAR T cells could be a novel treatment for pediatric T-ALL.

The following study relates the qualities and uses of the GeoAcademy Project, a program designed with the aim of geolocating scientific articles automatically, such articles would be found in Scopus, Web of Science, or similar databases. An algorithm has been developed with the intention of capturing geographical coordinates or toponyms contained within the documents in order to perform reliable geolocation. In the methodology, we describe the stages of the project that have been necessary so as to build a sample database concerning the Sierra Nevada (Spain), as well as the development of the algorithm. The technical data regarding the employment of the algorithm on the sample documents and its levels of success are included in the results, as is an explanation of the platform containing web maps which can be utilised to show the texts which have been geolocated. In conclusion we outline the obstacles faced, potential bibliometric uses and the advantages it offers as a reference resource and source of information.

Objetivo: Describir las características epidemiológicas y clínicas de los pacientes con leucemia linfocítica aguda atendidos en el Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, que recibieron radioterapia externa, durante el periodo de enero de 2009 a diciembre de 2017. Métodos: Estudio observacional, descriptivo. Se revisaron retrospectivamente los expedientes clínicos de pacientes pediátricos (0-13 años) con leucemia linfocítica aguda, que recibieron radioterapia externa en el periodo mencionado. Se aplicó un análisis estadístico descriptivo de las variables cualitativas y cuantitativas. Resultados: Se analizó un total de 58 pacientes, de estos el 79,3% fueron hombres. La edad promedio fue de 7,3 años. El 84,2% fueron clasificados como L1, 84,2% con inmunofenotipo B común y el 56,9% eran grupo de alto riesgo al diagnóstico. La principal indicación de radioterapia fue recaída (67,7%). Aproximadamente la mitad se irradió a sistema nervioso central y la otra mitad a testículos. Los principales efectos adversos fueron cutáneos. Conclusiones: Los resultados obtenidos fueron comparables con los reportados en la literatura. La radioterapia es importante en el tratamiento de leucemias, especialmente en pacientes de recaída y de alto riesgo.

Este artículo explora y analiza la inseguridad ciudadana frente a la delincuencia en Chile, especialmente la vinculada con los llamados delitos de mayor connotación social (DMCS). El diseño metodológico fue de corriente cuantitativa y de tipo analítico-transeccional, utilizando técnicas descriptivas e inferenciales con datos de la Encuesta Nacional Urbana de Seguridad Ciudadana (ENUSC) del año 2019. Los principales hallazgos fueron que los DMCS tienen una marcada preponderancia en el temor ciudadano a la delincuencia; segundo, que en el interior de esta tipología las personas se ven muy expuestas a los DMCS contra la persona, especialmente los robos con violencia y por sorpresa y, tercero, que la inseguridad es un fenómeno transversal entre grupos de comparación. Las conclusiones destacan el carácter polimorfo de la inseguridad, un sentimiento que puede ser afectado por diversas fuentes y tiene sus propias dinámicas.

Reseñas de libros

Los niños presentan mayor morbimortalidad que los adultos en lista de espera a trasplante de órganos, teniendo además una gran dificultad para la obtención de donantes. La donación en asistolia controlada pediátrica (DACp) podría mejorar las opciones de trasplante de muchos pacientes. No obstante, dado que precisa modificar algunos aspectos de la asistencia médica antes de la muerte del donante, expertos bioeticistas y profesionales sanitarios han expresado reservas y dudas deontológicas no suficientemente debatidas. Este trabajo expone las cuestiones bioéticas con mayor relevancia en la práctica clínica y que deberían ser consideradas a fin de respetar los principios éticos de la donación.

El objetivo de este trabajo es proponer lineamientos para el desarrollo de habilidades de pensamiento crítico y las características del liderazgo docente a través de prácticas con perspectiva de género en la formación inicial docente. Para lograr este objetivo, realizamos una revisión documental basada en un diseño de investigación cualitativo, con la cual se lleva a cabo un análisis exhaustivo de artículos científicos y capítulos de libros reportados en la literatura especializada. Los hallazgos indican una vinculación conceptual de las variables aquí analizadas, por lo que es plausible la articulación entre los lineamientos para una inclusión exitosa y las características de los docentes líderes como mecanismo para promover habilidades de pensamiento crítico y la reducción del sesgo de género en las instituciones educativas. Se concluye que las seis directrices postuladas en este trabajo son alcanzables, están bien sustentadas por la literatura existente, requieren la participación activa de la comunidad académica y pueden servir como herramienta para abrir un debate crítico y transformador en los entornos educativos.

Este artículo explora los resultados de la Evaluación Docente en Chile durante la última década, especialmente los del portafolio docente y sus subdimensiones. Los resultados muestran que, durante los últimos años, ha incrementado el desempeño insatisfactorio en la evaluación docente, principalmente entre profesores de sexo masculino y que enseñan Historia. En cuanto al portafolio, es el instrumento con los resultados promedio más bajos cada año, especialmente, sus indicadores de énfasis curricular y uso del error para el aprendizaje. La regresión logística binaria indica que el perfil más favorable para un adecuado desempeño en este instrumento se vincula con el sexo femenino, la enseñanza media y el subsector de matemáticas. Las conclusiones discuten el rol y utilidad del portafolio en la Evaluación Docente y la política educativa.

IntroductionSARS-CoV-2 viral load has been related to COVID-19 severity. The main aim of this study was to evaluate the relationship between SARS-CoV-2 viremia and SNPs in genes previously studied by our group as predictors of COVID-19 severity.Materials and methodsRetrospective observational study including 340 patients hospitalized for COVID-19 in the University Hospital La Princesa between March 2020 and December 2021, with at least one viremia determination. Positive viremia was considered when viral load was above the quantifiable threshold (20 copies/ml). A total of 38 SNPs were genotyped. To study their association with viremia a multivariate logistic regression was performed.ResultsThe mean age of the studied population was 64.5 years (SD 16.6), 60.9% patients were male and 79.4% white non-Hispanic. Only 126 patients (37.1%) had at least one positive viremia. After adjustment by confounders, the presence of the minor alleles of rs2071746 (HMOX1; T/T genotype OR 9.9 p