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Sr. Editor: En el cierre de orejuela izquierda (COI), el acceso venoso es usualmente predecible. Presentamos 2 casos de enfermedad venosa detectada durante el COI y alternativas para su resolución. Ambos pacientes dieron su consentimiento para la publicación. En el caso 1, un varón de 88 años portador de marcapasos, con fibrilación auricular permanente, disfunción ventricular y fractura sacra no reintervenida, fue remitido para COI por hemorragias recidivantes. Previa punción venosa ecoguiada, se avanzó en el sistema transeptal experimentando una notable resistencia en la curvatura ilíaca, dificultad de torsión en la aurícula derecha y pérdida de empuje en la fosa oval (figura 1, vídeos 1-4 del material adicional). Se logró la punción transeptal mediante la parte rígida de una guía de angioplastia de 0,014 pulgadas, intercambiando por la parte flexible y avanzando la vaina hasta la vena pulmonar. Tras el intercambio por la vaina de 14 Fr y el pigtail sobre una guía de alto soporte, se apreció de nuevo una gran resistencia en la retracción y la rotación. No obstante, se logró posicionar en la orejuela y realizar angiografías. En la retirada del pigtail, la resistencia fue muy acusada u se evidenció torsión grave en continuidad con la cirugía lumbosacra previa. Ante...

To the Editor, In left atrial appendage closure (LAAC), venous access is often predictable. These are 2 cases of venous disease found during LAAC and the alternatives proposed for its resolution. Both patients gave their informed consent for publication purposes. In case #1, an 88-year-old man who was a pacemaker carrier, with permanent atrial fibrillation, ventricular dysfunction, and non-surgical sacral fracture was referred for LAAC due to recurrent hemorrhages. Through previous ultrasound-guided venous puncture a transseptal system was advanced that experienced significant resistance in the iliac curvature, difficult torsion at the right atrium, and loss of driving force in the fossa ovalis (figure 1, videos 1-4 of the supplementary data). Transseptal puncture was achieved through the rigid section of a 0.014 in angioplasty guidewire by exchanging the flexible section and advancing the sheath towards the pulmonary vein. Afterwards, it was exchanged for a 14-Fr sheath, and the pigtail catheter was mounted over the high-support guidewire. However, significant resistance during retraction and rotation maneuvers was reported. Nevertheless, it was successfully placed in the left atrial appendage and several angiographies were performed. During pigtail catheter withdrawal, resistance was very significant with evidence of severe torsion following the previous lumbosacral surgery. Since it was impossible to...

Alcohol-related liver disease (ALD) consists of a wide spectrum of clinical manifestations and pathological features, ranging from asymptomatic patients to decompensated cirrhosis and hepatocellular carcinoma. Patients with heavy alcohol intake and advanced fibrosis often develop a subacute form of liver failure called alcohol-induced hepatitis (AH). Globally, most patients with ALD are identified at late stages of the disease, limiting therapeutic interventions. Thus, there is a need for early detection of ALD patients, which is lacking in most countries. The identification of alcohol misuse is hampered by the existence of alcohol underreporting by many patients. There are useful biomarkers that can detect recent alcohol use. Moreover, there are several non-invasive techniques to assess the presence of advanced fibrosis among patients with alcohol misuse, which could identify patients at high risk of liver related events or early death. In this review, we discuss differences between early stages of ALD and AH as the cornerstone of advanced forms. A global overview of epidemiological, anthropometric, clinical, analytical, histological, and molecular differences is summarized in this article. We propose that campaigns aimed at identifying patients with subclinical forms can prevent the development of life-threatening forms.

The seismicity in the SE Iberian Peninsula is distributed parallel to the coast in a well-developed strike-slip fracture system known as the Eastern Betic Shear Zone (EBSZ). This work focuses on the characterization of the shallow subsurface structure of the Algezares-Casas Nuevas Fault, within the Carrascoy Fault System of the EBSZ. The Carrascoy Fault borders the Guadalentín Depression to the south, which is a densely populated area with extensive agricultural activity. Therefore, this faults system represents a seismic hazard with significant social and economic implications. We have constructed two velocity-depth models based on P-wave tomography and Multichannel Analysis of Surface Waves (MASW) acquired from seismic reflection data. The resulting velocity models have allowed us to interpret the first ~250m depth and have revealed: i) the thickness of the critical zone; ii) the geometry of the Algezares-Casas Nuevas Fault; iii) the depth of the Messinian/Tortonian contact and iv) the presence of blind thrusts and damage zones under the Guadalentín Depression. Our results have also helped us to estimate an apparent vertical slip rate of 0.66±0.06m/ky for the Algezares-Casas Nuevas Fault since 209.1±6.2ka. Our results provide a methodological and backflow protocol to study the shallow subsurface of active faults, complementing previous geological models based on paleoseismological trenches, and can be used to improve the seismic hazard assessment of tectonically active regions around the world.

Non-valvular atrial fibrillation (NVAF) is the most common cardiac arrhythmia in the general population, and its prevalence increases among patients with chronic kidney disease (CKD) undergoing hemodialysis. This population presents high risk of both hemorrhagic and thrombotic events, with little evidence regarding the use of oral anticoagulation treatment (OAT) and multiple complications arising from it; however, stroke prevention with percutaneous left atrial appendage closure (LAAC) is an alternative to be considered. We retrospectively describe the safety and efficacy of percutaneous LAAC in eight patients with NVAF and CKD on hemodialysis during a 12-month follow-up. The mean age was 78.8 years (range 64–86; SD ± 6.7), and seven patients were male. The mean CHA2DS2-VASC and HAS-BLED scores were high, 4.8 (SD ± 1.5) and 3.8 (SD ± 1.3), respectively. Seventy-five percent of the patients were referred for this intervention due to a history of major bleeding, with gastrointestinal bleeding being the most common type, while the remaining twenty-five percent of the patients were referred because of a high risk of bleeding. The percutaneous LAAC procedure was successfully completed in 100% of the patients, with complete exclusion of the appendage without complications or leaks exceeding 5 mm. There was one death not related to the procedure four days after the intervention. Among the other seven patients, no deaths, cardioembolic events or major bleeding were reported during the follow-up period. In our sample, percutaneous LAAC appears to be a safe and effective alternative to anticoagulation in patients with NVAF and CKD on hemodialysis.

Critical raw materials are essential for the development of our society. However, most shallow ores have already been exploited and only deep targets remain unexplored. This work aims to apply indirect geophysical techniques to the San Finx Sn-W deposit (A Coruña) in order to get further constrains of its deep structure and geometry. Accordingly, a magnetic and a gravity survey have been carried out in the area (SE of Noia, A Coruña), at the southern part of the Malpica-Tui Complex. The resulting absolute magnetic anomaly and the relative gravity anomaly have been studied analytically and through 2-2.75D forward modeling. Results indicate that, the sampling interval (~1 km) is too high to characterize the anomalies related to the Sn-W mineralization. Contrarily, they show the potential field imprint of the regional Variscan tectonics. To better assess the relationship between the regional Variscan tectonics and the mineralization, a higher resolution survey should be acquired to detect this deposit.

Measurement(s) population Technology Type(s) Count Factor Type(s) time scale • geographic location Sample Characteristic - Organism Aves Sample Characteristic - Location Europe Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.13240760

ABSTRACT Introduction and objectives: Coronary bifurcation lesions are a common scenario in our interventional practice and can be challenging for our routine clinical practice. Yet despite the existence of well-defined techniques, side-branch compromise is still the most important problem. Currently, the standard strategy recommended is a 1-stent technique: balloon angioplasty and provisional stenting. Published non-randomized data reveal that in up to 26% of the cases the indication for rotational atherectomy was to preserve the side-branch. A randomized comparison between rotational atherectomy and provisional stenting (RAPS) and standard strategy (SS) for the management of bifurcation lesions is needed at this point. Methods: We conducted a single center, prospective, randomized pilot study of consecutive patients from our center with bifurcation lesions. We compared the RAPS strategy to the SS. Lesions had to be located in the main vessel only. The bifurcation lesion angle was recorded. The primary endpoint was the need for side-branch therapy. Results: 148 patients were included: 74 patients (95 rotational atherectomy) were enrolled in the RAPS group and 74 patients in the SS group. The bifurcation lesion most frequently treated was that of the proximal left anterior descending coronary artery. The primary endpoint was lower in the RAPS group compared to the SS group (1.1 vs 31.2%; P < .001). Target vessel failure (TVF) was 13.1% and 24.8% (P = .04) in RAPS and SS, respectively. Both the primary endpoint and TVF were higher with bifurcation lesion angles < 70º compared to bifurcation lesion angles ≥ 70º (P = .03 and P = .02) in both groups. Conclusions: The need for side-branch therapy and TVF was lower when the RAPS strategy was used compared to the SS. Bifurcation lesion angles < 70º are associated with higher side-branch compromise and TVF rates. The SS was associated with a 4.92-fold higher risk of side-branch compromise compared to the RAPS strategy with bifurcation lesion angles < 70º. These data reinforce the idea of the overall clinical relevance of the RAPS strategy regarding the patency of the side-branch.

RESUMEN Introducción y objetivos: Durante el intervencionismo coronario percutáneo es frecuente observar lesiones coronarias que afectan a las bifurcaciones. El compromiso de la rama lateral es la principal complicación observada con las diversas técnicas descritas para su tratamiento. La estrategia convencional (EC) recomendada en la actualidad es la colocación de un stent condicional. Los datos publicados de estudios no aleatorizados muestran que hasta en el 26% de los casos la indicación de la aterectomía rotacional fue el tratamiento de lesiones en las bifurcaciones. Es necesario el desarrollo de un estudio aleatorizado que compare la estrategia de aterectomía rotacional y stent condicional (ARSCC) frente a la EC. Métodos: Estudio piloto aleatorizado, prospectivo, de un solo centro, en pacientes con enfermedad coronaria en una bifurcación. Se comparó la estrategia de ARSC con la EC. Se prestó especial atención al ángulo de la bifurcación. El objetivo primario evalúa la necesidad de tratamiento de la rama lateral con ambas técnicas. Resultados: Se incluyeron 148 pacientes: 74 (95 aterectomías rotacionales) en el grupo de ARSC y 74 en el grupo de EC. El objetivo primario fue menor con la ARSC que con la EC: 1,1% frente a 31,2% (p < 0,001). El objetivo de fallo del vaso tratado (FVT) fue del 13,1% en el grupo de ARSC y del 24,8% en el grupo de EC (p = 0,04). El objetivo primario y el FVT fueron mayores si la lesión era en una bifurcación < 70° en comparación con una bifurcación ≥ 70° en ambos grupos (p = 0,03 y p = 0,02). Conclusiones: La necesidad de tratamiento de la rama lateral y el FVT fueron menores con la estrategia de ARSC que con la EC. Un ángulo < 70° en la bifurcación aumenta el riesgo de compromiso de la rama lateral y las tasas de FVT. La EC se asoció a un incremento del riesgo de compromiso de la rama lateral de 4,92 veces cuando el ángulo de la bifurcación era < 70°. Estos datos sugieren que el abordaje de lesiones en una bifurcación mediante aterectomía rotacional podría tener un beneficio clínico global. Palabras clave: Lesión en bifurcación. Ángulo de la bifurcación. Aterectomía rotacional. Compromiso de rama lateral. Calcificación coronaria.

Background: The Watchman FLX is a device upgrade of the Watchman 2.5 that incorporates several design enhancements intended to simplify left atrial appendage occlusion (LAAO) and improve procedural outcomes. This study compares peri-procedural results of LAAO with Watchman FLX (Boston Scientific, Marlborough, Massachusetts) in centers with varying degrees of experience with the Watchman 2.5 and Watchman FLX. Methods: Prospective, multicenter, “real-world” registry including consecutive patients undergoing LAAO with the Watchman FLX at 26 Spanish sites (FLX-SPA registry). Implanting centers were classified according to the center’s prior experience with the Watchman 2.5. A further division of centers according to whether or not they had performed ≤ 10 or > 10Watchman FLX implants was prespecified at the beginning of the study. Procedural outcomes of institutions stratified according to their experience with the Watchman 2.5 and FLX devices were compared. Results: 359 patients [mean age 75.5 (SD8.1), CHA2DS2-VASc 4.4 (SD1.4), HAS-BLED 3.8(SD0.9)] were included. Global success rate was 98.6%, successful LAAO with the first selected device size was achieved in 95.5% patients and the device was implanted at first attempt in 78.6% cases. There were only 9(2.5%) major peri-procedural complications. No differences in efficacy or safety results according to the centeŕs previous experience with Watchman 2.5 and procedural volume with Watchman FLX existed. Conclusions: The Watchman FLX attains high procedural success rates with complete LAA sealing in unselected, real-world patients, along with a low incidence of peri-procedural complications, regardless of operatoŕs experience with its previous device iteration or the number of Watchman FLX devices implanted.

Introduction: Cluster randomized crossover trials are often faced with a dilemma when selecting an optimal model of consent, as the traditional model of obtaining informed consent from participant's before initiating any trial related activities may not be suitable. We describe our experience of engaging patient advisors to identify an optimal model of consent for the PREP-IT trials. This paper also examines surrogate measures of success for the selected model of consent. Methods: The PREP-IT program consists of two multi-center cluster randomized crossover trials that engaged patient advisors to determine an optimal model of consent. Patient advisors and stakeholders met regularly and reached consensus on decisions related to the trial design including the model for consent. Patient advisors provided valuable insight on how key decisions on trial design and conduct would be received by participants and the impact these decisions will have. Results: Patient advisors, together with stakeholders, reviewed the pros and cons and the requirements for the traditional model of consent, deferred consent, and waiver of consent. Collectively, they agreed upon a deferred consent model, in which patients may be approached for consent after their fracture surgery and prior to data collection. The consent rate in PREP-IT is 80.7%, and 0.67% of participants have withdrawn consent for participation. Discussion: Involvement of patient advisors in the development of an optimal model of consent has been successful. Engagement of patient advisors is recommended for other large trials where the traditional model of consent may not be optimal.

Soil instability is a major hazard facing the mining industry in its role of supplying the indispensable mineral resources that our societal challenges require. Aiming to demonstrate the monitoring potential of radar satellites in the mining sector, we analyze the deformation field in the Riotinto mine, Spain. We propose a new method for combining ascending and descending results into a common dataset that provides better resolution. We project the LOS measurements resulting from both geometries to a common reference system without applying any type of geometric restriction. As a projection system, we use the vertical direction in flat areas and the slope in steep topographies. We then identify and remove outliers and artifacts from the joint dataset to finally obtain a deformation map that combines the two acquisition perspectives. The results in the Atalaya pit are consistent with GNSS measurements. The movements observed in the rock dumps were unknown before this study. We demonstrate the great potential of the Sentinel-1 satellite as a complementary tool for monitoring systems in mining environments and we call for its use to be standardized to guarantee a safe and sustainable supply of mineral resources necessary for a just technological transition.

Introduction: Pragmatic trials in comparative effectiveness research assess the effects of different treatment, therapeutic, or healthcare options in clinical practice. They are characterized by broad eligibility criteria and large sample sizes, which can lead to an unmanageable number of participants, increasing the risk of bias and affecting the integrity of the trial. We describe the development of a sampling strategy tool and its use in the PREPARE trial to circumvent the challenge of unmanageable work flow. Methods: Given the broad eligibility criteria and high fracture volume at participating clinical sites in the PREPARE trial, a pragmatic sampling strategy was needed. Using data from PREPARE, descriptive statistics were used to describe the use of the sampling strategy across clinical sites. A Chi-square test was performed to explore whether use of the sampling strategy was associated with a reduction in the number of missed eligible patients. Results: 7 of 20 clinical sites (35%) elected to adopt a sampling strategy. There were 1539 patients excluded due to the use of the sampling strategy, which represents 30% of all excluded patients and 20% of all patients screened for participation. Use of the sampling strategy was associated with lower odds of missed eligible patients (297/4545 (6.5%) versus 341/3200 (10.7%) p

The critical zone (CZ) represents the most-shallow subsurface, where the bio-, hydro-, and geospheres interact with anthropogenic activity. To characterize the thickness and lateral variations of the CZ, here we focus on the Eastern Betic Shear Zone (EBSZ), one of the most tectonically active regions in the Iberian Peninsula. Within the EBSZ, the Guadalentín Depression is a highly populated area with intensive agricultural activity, where the characterization of the CZ would provide valuable assets for land use management and seismic hazard assessments. To achieve this, we have conducted an interdisciplinary geophysical study along the eastern border of the Guadalentín Depression to characterize the CZ and the architecture of the shallow subsurface. The datasets used include Electrical Resistivity Tomography (ERT), first-arrival travel time seismic tomography, and multichannel analysis of surface waves (MASW). The geophysical datasets combined help to constrain the high-resolution structure of the subsurface and image active fault systems along four transects. The resulting geophysical models have allowed us to interpret the first ~150 m of the subsurface and has revealed: (i) the variable thickness of the CZ; (ii) the CZ relationship between the fault zone and topographic slope; and (iii) the differences in CZ thickness associated with the geological units. Our results provide a method for studying the shallow subsurface of active faults, complementing previous geological models based on paleo-seismological trenches, and can be used to improve the CZ assessment of tectonically active regions.

Background: Data on the occurrence of acute kidney injury (AKI) in patients undergoing cardiac resynchronization therapy (CRT) implantation is limited and no previous studies investigated its impact in an elderly population. CRT implantation requires a relatively low quantity of contrast medium. Previous studies, however, focused primarily on contrast medium as etiological factor for AKI, reporting a high incidence (8–14%). The high incidence of AKI in absence of use of substantial amounts of contrast volume, suggests the existence of other factors that contribute to AKI. Objectives: To determine the predictive value of patient and procedure-related risk factors for the occurrence of AKI post CRT, as well as the AKIs impact on length of in-hospital stay (LOS) and 1-year mortality. Methods: Retrospective observational study, including consecutive patients that underwent CRT implantation in a single center. Results: 60 patients with a mean age of 77 ± 8.4 years were included in the study and Twelve (20%) developed AKI. Prior renal insufficiency (p = 0.03; OR = 15.4), larger procedure time (p = 0.02; OR = 1.03), intra-operative hypotension (p

This study aims to assess the feasibility of delineating and identifying mineral ores from hyperspectral images of tin–tungsten mine excavation faces using machine learning classification. We compiled a set of hand samples of minerals of interest from a tin–tungsten mine and analyzed two types of hyperspectral images: (1) images acquired with a laboratory set-up under close-to-optimal conditions, and (2) a scan of a simulated mine face using a field set-up, under conditions closer to those in the gallery. We have analyzed the following minerals: cassiterite (tin ore), wolframite (tungsten ore), chalcopyrite, malachite, muscovite, and quartz. Classification (Linear Discriminant Analysis, Singular Vector Machines and Random Forest) of laboratory spectra had a very high overall accuracy rate (98%), slightly lower if the 450–950 nm and 950–1650 nm ranges are considered independently, and much lower (74.5%) for simulated conventional RGB imagery. Classification accuracy for the simulation was lower than in the laboratory but still high (85%), likely a consequence of the lower spatial resolution. All three classification methods performed similarly in this case, with Random Forest producing results of slightly higher accuracy. The user’s accuracy for wolframite was 85%, but cassiterite was often confused with wolframite (user’s accuracy: 70%). A lumped ore category achieved 94.9% user’s accuracy. Our study confirms the suitability of hyperspectral imaging to record the spatial distribution of ore mineralization in progressing tungsten–tin mine faces.

Introduction: While preoperative urinary tract infection (UTI) has the potential to cause bacteremia and postsurgical acute prosthetic joint infections (APJIs), the influence of asymptomatic bacteriuria (AB) in these infections remains unclear. So the majority of guidelines not recommend the treatment of AB prior to the surgery. However, as patients with dementia usually cannot explain the symptoms of dysuria, the differential diagnosis between AB and UTI may be very difficult in this group of patients. The principal aim of the study was to compare the rate of positive urine culture at admission in patients with femoral neck fracture with and without dementia and secondarily try to assess the connection of positive urinoculture and postoperative acute gram-negative PJI. Methods: All patients with a femoral neck fracture underwent a urine culture on hospital admission and were prospectively recorded. Variables such as sex, age, institutionalization, dementia and other comorbidities, PJI rate, and in-hospital death were collected. The results of cultures were retrospectively revised. Patients who received postoperative antibiotics or had been diagnosed with UTI during hospital stay were excluded. Statistical comparisons between patients with and without dementia were performed using SPSS software version 17. Results: A total of 148 patients were included (52 with dementia). The rate of positive urine culture was 32% (n = 16) in patients with dementia and 11.5% in patients without dementia ( P = .003). Of these 16 patients with dementia and positive urine culture, 2 (12.5%) developed an acute gram-negative PJI, whereas there were no cases in the group without dementia ( P = .011). Discussion: The only difference between UTI and AB is the expression of symptoms by the patient. However, as patients with dementia have difficulties to explain UTI symptoms, some UTI may be underdiagnosed. Conclusion: Patients with dementia have a statistically higher rate of presurgical positive urine culture compared with patients without dementia.

The deployment of Intelligent Vehicles in urban environments requires reliable estimation of positioning for urban navigation. The inherent complexity of this kind of environments fosters the development of novel systems which should provide reliable and precise solutions to the vehicle. This article details an advanced GNSS/IMU fusion system based on a context-aided Unscented Kalman filter for navigation in urban conditions. The constrained non-linear filter is here conditioned by a contextual knowledge module which reasons about sensor quality and driving context in order to adapt it to the situation, while at the same time it carries out a continuous estimation and correction of INS drift errors. An exhaustive analysis has been carried out with available data in order to characterize the behavior of available sensors and take it into account in the developed solution. The performance is then analyzed with an extensive dataset containing representative situations. The proposed solution suits the use of fusion algorithms for deploying Intelligent Transport Systems in urban environments.

Abstract Time-integrated radiography using MeV Bremsstrahlung X-ray sources is the norm for imaging during system-level testing of components and structures under dynamic condition. One source of error in the analysis of the time-integrated radiography data sets stems from motion blur which smears out sharp interfaces to a greater degree with longer exposure times, which become necessary to provide sufficient signal-to-noise with low X-ray penetration of objects of interest. To quantify motion blur, a 1D shock wave through PMMA was investigated experimentally at The Dynamic Compression Sector at The Advanced Photon Source (DCS@APS) with tapered broadband and 25.46 ± 1.06 keV narrowband X-rays. Four cameras with different exposure times were used for each experiment to compare the effect that exposure time has on motion blur. In addition, our methodology to accurately simulate motion blur in terms of transmission and shape is presented and compared to our experimental results and quantified. There is a high level of agreement between the experimental and simulation results across the range of data sets investigated in this study with a percent difference range of 0.29–1.31% for the four shots. The methodology of this work serves as a steppingstone towards a physically validated model that could be used in conjunction with experimental results to deconvolve physical parameters, densities, and interfaces of interest in a way that would not be possible with experimental results alone.

Abstract Background Patients with COVID-19 may experience a persistent increase in the blood urea nitrogen over creatinine ratio (PI-BUN/Cr). Its elevation could reflect multiple underlying pathophysiological processes beyond prerenal injury but also warrants nuanced interpretation due to its complex interplay with various factors, underscoring the importance of investigating its effects on mortality and acute kidney injury in this population. Methods We analized a retrospective and longitudinal cohort of patients admitted to a single center in Mexico City for patients with severe COVID-19. Between March 5, 2020 and August 25, 2021, we included patients with confirmed positive diagnosis for SARS-CoV-2, age > 18 years, disease severity was defined by clinical data of respiratory distress syndrome and a ratio of partial oxygen pressure to inspired oxygen fraction 30 in more than 60% of measurements in the hospital. The outcomes included: risk factors to mortality and AKI in-hospital. Results The cohort included 3,007 patients with a median age of 54.6 ± 14.5 years. 35% of patients died; 44.6% developed PI-BUN/Cr ratio and 71.4% AKI. Mortality was associated with older age > 60 years [Hazard ratio (HR)] = 1.45, 95% CI: 1.28–1.65; p

Abstract Understanding of newborn immune ontogeny in the first week of life will enable age-appropriate strategies for safeguarding vulnerable newborns against infectious diseases. Here we conducted an observational study exploring the immunological profile of infants longitudinally throughout their first week of life. Our Expanded Program on Immunization - Human Immunology Project Consortium (EPIC-HIPC) studies the epigenetic regulation of systemic immunity using small volumes of peripheral blood samples collected from West African neonates on days of life (DOL) 0, 1, 3, and 7. Genome-wide DNA methylation and single nucleotide polymorphism markers are examined alongside matched transcriptomic and flow cytometric data. Integrative analysis reveals that a core network of transcription factors mediates dynamic shifts in neutrophil-to-lymphocyte ratios (NLR), which are underpinned by cell-type specific methylation patterns in the two cell types. Genetic variants are associated with lower NLRs at birth, and healthy newborns with lower NLRs at birth are more likely to subsequently develop sepsis. These findings provide valuable insights into the early-life determinants of immune system development.

Abstract The burgeoning realm of Machine Type Communications (MTC) has ushered in a paradigm shift in wireless communication, necessitating innovative strategies to efficiently manage diverse application requirements. This paper presents a pioneering Dynamic Priority-based Bandwidth Allocation (DPBA) scheme tailored specifically for MTC scenarios, encompassing both MTC and Human Type Communications (HTC) coexistence. DPBA employs an adaptive framework addressing dynamic MTC traffic, optimizing resource use while meeting latency constraints and sporadic data patterns. By dynamically prioritizing MTC applications based on requirements, the scheme allocates bandwidth for reliable data delivery. DPBA extends to MTC and HTC coexistence, managing diverse quality demands. This underlines its versatility and capacity to serve distinct needs in a shared spectrum. To substantiate its performance, the DPBA scheme is rigorously evaluated against a spectrum of related allocation methods like Proportional Fairness (PF), Static Priority Scheduling (SPS), and the Machine Learning-based Scheme (MLS), DPBA excels in simulations, minimizing packet loss, latency, enhancing throughput and ensuring fairness, surpassing benchmarks. This research underscores the critical importance of tailored bandwidth allocation strategies in advancing MTC and HTC coexistent environments. With its adaptability, efficiency, and remarkable performance, the DPBA scheme emerges as a cornerstone in the trajectory of wireless communication networks, catering to the distinct requirements of both MTC and HTC applications.

Abstract Background Depression is a chronic psychiatric disease of multifactorial etiology, and its pathophysiology is not fully understood. Stress and other chronic inflammatory pathologies are shared risk factors for psychiatric diseases, and comorbidities are features of major depression. Epidemiological evidence suggests that periodontitis, as a source of low-grade chronic systemic inflammation, may be associated with depression, but the underlying mechanisms are not well understood. Methods Periodontitis (P) was induced in Wistar: Han rats through oral gavage with the pathogenic bacteria Porphyromonas gingivalis and Fusobacterium nucleatum for 12 weeks, followed by 3 weeks of chronic mild stress (CMS) to induce depressive-like behavior. The following four groups were established (n = 12 rats/group): periodontitis and CMS (P + CMS+), periodontitis without CMS, CMS without periodontitis, and control. The morphology and inflammatory phenotype of microglia in the frontal cortex (FC) were studied using immunofluorescence and bioinformatics tools. The endocannabinoid (EC) signaling and proteins related to synaptic plasticity were analyzed in FC samples using biochemical and immunohistochemical techniques. Results Ultrastructural and fractal analyses of FC revealed a significant increase in the complexity and heterogeneity of Iba1 + parenchymal microglia in the combined experimental model (P + CMS+) and increased expression of the proinflammatory marker inducible nitric oxide synthase (iNOS), while there were no changes in the expression of cannabinoid receptor 2 (CB2). In the FC protein extracts of the P + CMS + animals, there was a decrease in the levels of the EC metabolic enzymes N-acyl phosphatidylethanolamine-specific phospholipase D (NAPE-PLD), diacylglycerol lipase (DAGL), and monoacylglycerol lipase (MAGL) compared to those in the controls, which extended to protein expression in neurons and in FC extracts of cannabinoid receptor 1 (CB1) and to the intracellular signaling molecules phosphatidylinositol-3-kinase (PI3K), protein kinase B (Akt) and extracellular signal-regulated kinase 1/2 (ERK1/2). The protein levels of brain-derived neurotrophic factor (BDNF) and synaptophysin were also lower in P + CMS + animals than in controls. Conclusions The combined effects on microglial morphology and inflammatory phenotype, the EC signaling, and proteins related to synaptic plasticity in P + CMS + animals may represent relevant mechanisms explaining the association between periodontitis and depression. These findings highlight potential therapeutic targets that warrant further investigation. Graphical Abstract

Abstract Transcutaneous vagus nerve stimulation (tVNS) is a promising technique for enhancing cognitive performance and skill acquisition. Yet, its efficacy for enhancing learning rate and long-term retention in an ecologically valid learning environment has not been demonstrated. We conducted two double-blind sham-controlled experiments examining the efficacy of auricular tVNS (taVNS: Experiment (1) and cervical tVNS (tcVNS: Experiment (2), on a 5 day second-language vocabulary acquisition protocol among highly selected career linguists at the US Department of Defense’s premier language school. tcVNS produced accelerated recall performance during training (Day 2–4), benefits of which were maintained across a 24 h retention interval with no stimulation at the final test. Consistent with prior work, tcVNS also produced fatigue-mitigating and focus-promoting effects as measured by the Air Force Research Laboratory Mood Questionnaire. Based on the current and the previous findings supporting tVNS’ efficacy on performance, training enhancement, and fatigue mitigation, we believe tcVNS to be an effective learning acceleration tool that can be utilized at language-teaching and other institutions focused on intensive training of cognitive skills.

Background/Aim: The number of convictions related to crimes against road safety continues to increase, with more than half being caused by driving under the influence (DUI) of alcohol or drugs. In Spain, offenders for crimes against road safety have been widely sentenced to community service orders. Additionally, the penitentiary institution has implemented two intervention programmes, TASEVAL (awareness and re-education) and PROSEVAL (re-education and psychotherapeutic). A field study was designed to estimate the effectiveness of the TASEVAL and PROSEVAL intervention programmes in the reduction of the recidivism rate and drug and alcohol use. Method: A total of 57,532 offenders for crimes against road safety (37,556 sentenced to a community service order of up to 60 days’ duration and 19,976 to a community service order of up to 60 days’ duration and the TASEVAL intervention programme) were followed up in relation to recidivism. And a total of 5,765 (5,117 sentenced to a community service order of over 60 days’ duration and 648 to a community service order of over 60 days’ duration and the PROSEVAL intervention programme) were also followed up in relation to recidivism. 29 attendees on the TASEVAL intervention programme and 32 attendees on the PROSEVAL intervention programme were assessed pre- and post-intervention in unhealthy alcohol use and problematic drug use. Results: The results showed a significant association between the participation in the TASEVAL and PROSEVAL intervention programmes and non-recidivism. Succinctly, compared to community service orders, participation in these programmes increases the non-recidivist rate for the TASEVAL and PROSEVAL intervention programmes by 14.6% and 58.4% respectively. Regarding substance and alcohol use, the TASEVAL programme showed a significant reduction in alcohol and drug use after the implementation of the programme. However, the PROSEVAL programme did not reveal a significant effect on alcohol and drug use (no therapeutic effect). Conclusions: The present study supports the effectiveness of specific intervention programmes for road traffic offenders in the reduction of recidivism. Additionally, these intervention programmes (though not all of them) may have a mitigating effect on the alcohol and drug use mediators of recidivism.

Abstract Background Infants with frequent viral and bacterial respiratory infections exhibit compromised immunity to routine immunizations. They are also more likely to develop chronic respiratory diseases in later childhood. This study investigated the feasibility of epigenetic profiling to reveal endotype-specific molecular pathways with potential for early identification and immuno-modulation. Peripheral blood mononuclear cells from respiratory infection allergy/asthma-prone (IAP) infants and non-infection allergy/asthma prone (NIAP) were retrospectively selected for genome-wide DNA methylation and single nucleotide polymorphism analysis. The IAP infants were enriched for the low vaccine responsiveness (LVR) phenotype (Fisher's exact p-value = 0.02). Results An endotype signature of 813 differentially methylated regions (DMRs) comprising 238 lead CpG associations (FDR

The cement industry contributes around 7% of global anthropogenic carbon dioxide emissions, mainly from the combustion of fuels and limestone decomposition during clinker production. Using alternative fuels derived from wastes is a key strategy to reduce these emissions. However, alternative fuels vary in composition and heating value, so selecting appropriate ones is crucial to maintain clinker quality and manufacturing processes while minimizing environmental impact. This study evaluated various biomass and industrial wastes as potential alternative fuels, characterizing them based on proximate analysis, elemental and oxide composition, lower heating value, and bulk density. Sawdust, pecan nutshell, industrial hose waste, and plastic waste emerged as viable options as they met the suggested thresholds for heating value, chloride, moisture, and ash content. Industrial hose waste and plastic waste were most favorable with the highest heating values while meeting all the criteria. Conversely, wind blade waste, tire-derived fuel, and automotive shredder residue did not meet all the recommended criteria. Therefore, blending them with alternative and fossil fuels is necessary to preserve clinker quality and facilitate combustion. The findings of this research will serve as the basis for developing a computational model to optimize the blending of alternative fuels with fossil fuels for cement production.

Abstract Detecting early signals of an outbreak in a viral process is challenging due to its exponential nature, yet crucial given the benefits to public health it can provide. If available, the network structure where infection happens can provide rich information about the very early stages of viral outbreaks. For example, more central nodes have been used as social network sensors in biological or informational diffusion processes to detect early contagious outbreaks. We aim to combine both approaches to detect early signals of a biological viral process (influenza-like illness, ILI), using its informational epidemic coverage in public social media. We use a large social media dataset covering three years in a country. We demonstrate that it is possible to use highly central users on social media, more precisely high out-degree users from Twitter, as sensors to detect the early signals of ILI outbreaks in the physical world without monitoring the whole population. We also investigate other behavioral and content features that distinguish those early sensors in social media beyond centrality. While high centrality on Twitter is the most distinctive feature of sensors, they are more likely to talk about local news, language, politics, or government than the rest of the users. Our new approach could detect a better and smaller set of social sensors for epidemic outbreaks and is more operationally efficient and privacy respectful than previous ones, not requiring the collection of vast amounts of data.