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Abstract Background Efforts toward tuberculosis management and control are challenged by the emergence of Mycobacterium tuberculosis (MTB) resistance to existing anti-TB drugs. This study aimed to explore the potential of machine learning algorithms in predicting drug resistance of four anti-TB drugs (rifampicin, isoniazid, streptomycin, and ethambutol) in MTB using whole-genome sequence and clinical data from Uganda. We also assessed the model’s generalizability on another dataset from South Africa. Results We trained ten machine learning algorithms on a dataset comprising of 182 MTB isolates with clinical data variables (age, sex, HIV status) and SNP mutations across the entire genome as predictor variables and phenotypic drug-susceptibility data for the four drugs as the outcome variable. Model performance varied across the four anti-TB drugs after a five-fold cross validation. The best model was selected considering the highest Mathews Correlation Coefficient (MCC) and Area Under the Receiver Operating Characteristic Curve (AUC) score as key metrics. The Logistic regression excelled in predicting rifampicin resistance (MCC: 0.83 (95% confidence intervals (CI) 0.73–0.86) and AUC: 0.96 (95% CI 0.95–0.98) and streptomycin (MCC: 0.44 (95% CI 0.27–0.58) and AUC: 0.80 (95% CI 0.74–0.82), Extreme Gradient Boosting (XGBoost) for ethambutol (MCC: 0.65 (95% CI 0.54–0.74) and AUC: 0.90 (95% CI 0.83–0.96) and Gradient Boosting (GBC) for isoniazid (MCC: 0.69 (95% CI 0.61–0.78) and AUC: 0.91 (95% CI 0.88–0.96). The best performing model per drug was only trained on the SNP dataset after excluding the clinical data variables because intergrating them with SNP mutations showed a marginal improvement in the model’s performance. Despite the high MCC (0.18 to 0.72) and AUC (0.66 to 0.95) scores for all the best models with the Uganda test dataset, LR model for rifampicin and streptomycin didn’t generalize with the South Africa dataset compared to the GBC and XGBoost models. Compared to TB profiler, LR for RIF was very sensitive and the GBC for INH and XGBoost for EMB were very specific on the Uganda dataset. TB profiler outperformed all the best models on the South Africa dataset. We identified key mutations associated with drug resistance for these antibiotics. HIV status was also identified among the top significant features in predicting drug resistance. Conclusion Leveraging machine learning applications in predicting antimicrobial resistance represents a promising avenue in addressing the global health challenge posed by antimicrobial resistance. This work demonstrates that integration of diverse data types such as genomic and clinical data could improve resistance predictions while using machine learning algorithms, support robust surveillance systems and also inform targeted interventions to curb the rising threat of antimicrobial resistance.

Our work provides a checklist of freshwater decapods (Brachyura and Caridea) from the Parnaíba river basin, Brazil, based on field collections carried out between 2018 and 2020. Eight species were collected at 30 sampling sites in the main river channels, streams, and ponds throughout the upper, middle, and lower regions of the Parnaíba river basin. The species of shrimp reported herein are Atya gabonensis (Gibiel, 1875) (Atyidae), Macrobrachium amazonicum (Heller, 1862), Macrobrachium brasiliense (Heller, 1862), Macrobrachium jelskii (Miers, 1778), and Macrobrachium olfersii (Wiegmann, 1836) (Palaemonidae), while crab species reported are Goyazana castelnaui (H. Milne-Edwards, 1853), Sylviocarcinus pictus (H. Milne-Edwards, 1853) (Trichodactylidae), and Kingsleya parnaiba Pralon, Pinheiro & Santana, 2020 (Pseudothelphusidae). The record of Macrobrachium brasiliense is the first for the Parnaíba river basin. The knowledge of the diversity of freshwater decapod fauna can contribute to the conservation of species and their habitats.

Abstract Climate change pose significant challenges to modern agriculture management systems, threatening food production and security. Therefore, tackling its effects has never been so imperative to attain sustainable food access and nutrition worldwide. In the case of viticulture, besides jeopardizing grape production, climate change has severe impact in quality, which has becoming more challenging to manage, due to the increasingly frequent fungal contamination, with consequences for relevant quality parameters such as the aromatic profiles of grapes and wines and their phenolic compounds. This has been leading to a reconfiguration of the wine industry geostrategic landscape and economy dynamics, particularly in Southern Europe. To address these and other emerging challenges, in-field deployable proximity-based precision technologies have been enabling real-time monitoring of crops ecosystems, including climate, soil and plants, by performing relevant data gathering and storage, paving the way for advanced decision support under the Internet of Things (IoT) paradigm. This paper explores the integration of agronomic and technological knowledge, emphasizing the proper selection of IoT-capable sensors for viticulture, while considering more general ones from agriculture to fill gaps when specialized options are unavailable. Moreover, advisable practices for sensor installation are provided, according to respective types, data acquisition capabilities and applicability.

Abstract Background Clinical management of patients with chronic cardiometabolic disease is complicated by polypharmacy. Consequently, when patients clinically deteriorate, physicians are challenged to distinguish both medication nonadherence and drug-drug interactions (DDI) from chronic disease progression. Methods In this randomized controlled trial, we enrolled U.S. board-certified Primary Care Physicians (PCPs) serving patients with cardiometabolic disease. PCPs were randomized and managed their patients with (intervention), or without (control), a novel chronic disease management test (CDMT) that can detect medication nonadherence and DDIs. Patients’ medical records were abstracted at baseline and 3-month follow-up. Primary outcomes were the CDMT’s impact on both the PCPs’ detection of medication nonadherence and DDI, and the frequency of performing medication nonadherence- and DDI-related clinical actions. Secondary outcomes examined the types of clinical actions performed. Primary and secondary outcomes were analyzed by logistic regression using single variable and clustered multivariable modeling to adjust for similarities in patient characteristics, by PCP practice. Results Sixteen intervention and 20 control PCPs shared de-identified records for 126 and 207 patients, respectively. There were no significant demographic differences between the two study arms, among PCPs or patients. At baseline, there was no significant difference between the intervention and control PCPs in the percentage of clinical actions performed for medication nonadherence (P = 0.98) and DDI (P = 0.41). At 3-month follow-up (after CDMT), 69.1% of intervention compared to 20.3% of control patients with medication nonadherence had a related clinical action performed (P

Abstract Neural entrainment has become a popular technique to non-invasively manipulate brain rhythms via external, periodic stimulation. However, there is still debate regarding its underlying mechanisms and effects on brain activity. Here, we used EEG recordings during a visual entrainment paradigm to assess characteristic changes in the spectral content of EEG signals due to entrainment. Our results demonstrate that entrainment not only increases synchrony between neural oscillations and the entraining stimulus but also elicits previously unreported spectral tuning effects and long-lasting after-effects. These findings offer compelling evidence for the presence of dedicated, flexible, and adaptive mechanisms for neural entrainment, which may have key roles in adjusting the sensitivity and dynamic range of brain oscillators in response to environmental temporal structures.

Abstract Nanostructured materials with antibacterial activity face the same threat as conventional antibiotics - bacterial resistance, which reduces their effectiveness. However, unlike antibiotics, research into the emergence and mechanisms of bacterial resistance to antibacterial nanomaterials is still in its early stages. Here we show how Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli bacteria develop resistance to silver nanoparticles, resulting in an increase in the minimum inhibitory concentration from 1.69 mg/L for S. aureus and 3.38 mg/L for E. coli to 54 mg/L with repeated exposure over 12 and 6 cultivation steps, respectively. The mechanism of resistance is the same for both types of bacteria and involves the aggregation of silver nanoparticles leading to the formation of black precipitates. However, the way in which Gram-positive and Gram-negative bacteria induce aggregation of silver nanoparticles is completely different. Chemical analysis of the surface of the silver precipitates shows that aggregation is triggered by flagellin production in E. coli and by bacterial biofilm formation in S. aureus. However, resistance in both types of bacteria can be overcome by using pomegranate rind extract, which inhibits both flagellin and biofilm production, or by stabilizing the silver nanoparticles by covalently binding them to a composite material containing graphene sheets, which protects the silver nanoparticles from aggregation induced by the bacterial biofilm produced by S. aureus. This research improves the understanding of bacterial resistance mechanisms to nanostructured materials, which differ from resistance mechanisms to conventional antibiotics, and provides potential strategies to combat bacterial resistance and develop more effective antimicrobial treatments.

Abstract Wolverine distribution contracted along the southern periphery of its range in North America during the 19th and 20th centuries due primarily to human influences. This history, along with low densities, sensitivity to climate change, and concerns about connectivity among fragmented habitats spurred the recent US federal listing of threatened status and special concern status in Canada. To help inform large scale landscape connectivity, we collected 882 genetic samples genotyped at 19 microsatellite loci. We employed multiple statistical models to assess the landscape factors (terrain complexity, human disturbance, forest configuration, and climate) associated with wolverine genetic connectivity across 2.2 million km2 of southwestern Canada and the northwestern contiguous United States. Genetic similarity (positive spatial autocorrelation) of wolverines was detected up to 555 km and a high-to-low gradient of genetic diversity occurred from north-to-south. Landscape genetics analyses confirmed that wolverine genetic connectivity has been negatively influenced by human disturbance at broad scales and positively influenced by forest cover and snow persistence at fine- and broad–scales, respectively. This information applied across large landscapes can be used to guide management actions with the goal of maintaining or restoring population connectivity.

El estudio tenía por objetivos (a) determinar la exigencia condicional de carga externa en función de los periodos de intensidad submáxima (PISubM) durante el microciclo competitivo, (b) comparar el número y la duración de los eventos PISubM exigidos en las diferentes sesiones realizadas en el microciclo competitivo y, además, (c) comparar esta exigencia en función del PISubM en función de la posición específica ocupada por los futbolistas durante el microciclo competitivo. Se analizó un total de 77 sesiones de entrenamiento durante 15 microciclos competitivos y 15 partidos oficiales de liga durante la temporada 2019-20 (Liga Premier de Azerbaiyán) en las cuales se obtuvo un total de 1,037 registros individuales de 22 jugadores. Los datos se recogieron mediante dispositivos GPS. Para determinar el porcentaje del número de eventos PISubM diarios respecto a los encontrados en la competición, estos eventos también se relativizaron en función del perfil individual mostrado por jugador en competición. Los principales resultados del estudio fueron la existencia de diferencias significativas (p ≤ .05) en cada una de las variables entre los días de entrenamiento/competición y las posiciones en función del PISubM. Algunos indicadores, como la distancia a velocidad superior a 19.8 km/h (CAV), la distancia a velocidad superior a 25.2 km/h (Esprint), la densidad de aceleración (DensAc) y la distancia a alta intensidad metabólica superior a 25.5 W/kg (DCMA), acumularon valores de más del 50 % del número de eventos de PISubM en ciertos días del microciclo. Sin embargo, otros indicadores mostraron intervalos mucho más bajos (menos del 15 %) respecto a la competición en cuanto al número de pruebas y el tiempo por encima del umbral establecido en las variables “metros por minuto” (Mmin) y “potencia metabólica media” (PotMet). Estos nuevos resultados sugieren la conveniencia de plantear nuevas alternativas para el control de la carga en los deportes de equipo.

Abstract Two cystic fibrosis (CF) rat models, one carrying the common Phe508del mutation and the other a nonsense cystic fibrosis transmembrane conductance regulator (CFTR) mutation (knockout) were previously characterised. Although relevant CFTR mRNA reductions were present in the lung, no overt CF lung disease was observed. This study used flexiVent lung mechanic assessment and regional ventilation assessment via X-ray velocimetry (XV) functional imaging to assess the lung phenotype in both models. To determine the sensitivity of XV regional ventilation imaging, the effect of a localised physical obstruction (delivery of agar beads to part of the lungs) on lung ventilation was examined. At baseline, Phe508del and knockout CF rats had a lower inspiratory capacity, total respiratory system compliance, and static compliance than wildtype rats. Following agar bead delivery all XV ventilation parameters were altered, with substantial increases in poorly ventilated regions and ventilation heterogeneity. XV ventilation maps accurately identified locations of bead-induced airflow changes. Despite unremarkable lung histopathology, this study indicated that CF rats display altered respiratory mechanics, with CF rats needing to exert additional effort to expand and deflate their lungs due to increased stiffness. This study demonstrated the utility of XV imaging providing spatial lung ventilation information.

Abstract Background Parental psychological distress is a well-known risk factor for developmental psychopathology, with longer term parental distress associated with worse youth mental health. Neurotoxicant exposure during pregnancy is a risk factor for both poor maternal and youth mental health. The impact of one class of pollutant, polycyclic aromatic hydrocarbons (PAH), on long-term trajectories of maternal distress and youth self-reported mental health symptoms in adolescence has been understudied. Methods PAH exposure was measured by DNA adducts in maternal blood sampled during the third trimester of pregnancy. Maternal distress, operationalized as maternal demoralization, was measured at 11 timepoints (prenatal to child age 16). Adolescent mental health symptoms were measured at age 13–15. Follow up analyses examined a subset of measures available at age 15–20 years. Structural equation modeling examined associations between PAH exposure during pregnancy and latent growth metrics of maternal distress, and between maternal distress (intercept and slope) and youth mental health symptoms in a prospective longitudinal birth cohort (N = 564 dyads). Results Higher prenatal PAH exposure was associated with higher concurrent maternal distress. Prenatal maternal distress was associated with adolescent’s self-reported anxiety, depression, and externalizing problems. On average, maternal distress declined over time; a slower decline in mother’s distress across the course of the child’s life was associated with greater self-reported anxiety and externalizing problems in youth. Conclusions Our findings are consistent with an intergenerational framework of environmental effects on mental health: PAH exposure during pregnancy affects maternal mental health, which in turn influences mental health outcomes for youth well into adolescence. Future research is necessary to elucidate the possible social and biological mechanisms (e.g., parenting, epigenetics) underlying the intergenerational transmission of the negative effects of pollution on mental health in caregiver-child dyads.

Congenital pulmonary airway malformations (CPAMs) are cystic lung lesions often detected prenatally. Resection is often recommended for potential recurrent infections and malignancy. This report describes a case of a 14-year-old female patient who presented with abdominal pain. A computed tomographic scan of the abdomen revealed a cystic lesion at the base of her right lung. Consequently, a computed tomographic arteriogram of the chest demonstrated a right lower lobe lesion concerning for type I CPAM. After thoracoscopic segmentectomy, histopathologic examination revealed papillary adenocarcinoma with a KRAS mutation. Residual CPAM prompted a lobectomy, emphasizing the importance of surgical intervention for cystic lesions.

The NASA’s Artemis project intends to bring humans back to the Moon in the next decade. A key element of the project will be the Lunar Gateway, a space station placed in a peculiar, near rectilinear Halo orbit in the vicinity of a collinear libration point in the Earth–Moon system. This study focuses on the high-fidelity description of the relative orbit dynamics of a chaser spacecraft with respect to the Gateway, as well as on the design of a proper orbit control strategy for rendezvous maneuvers. A novel formulation of the Battin–Giorgi approach is introduced, in which the reference orbit is that traveled by the Gateway, i.e., it is a highly non-Keplerian, perturbed orbit. The modified Battin–Giorgi approach allows for the description of a relative orbit motion with no restrictive assumption, while including all the relevant orbit perturbations on both the chaser and the Gateway. Moreover, nonlinear hybrid predictive control is introduced as a feedback guidance strategy. This new technique is shown to outperform the classical, well-established feedback linearization in terms of success rate and accuracy on the final conditions. Moreover, a Monte Carlo analysis confirms that hybrid predictive control is also effective in the presence of the temporary unavailability of propulsion or thrust misalignment.

Abstract Background Staphylococcus aureus (S. aureus) often colonizes the human skin, upper respiratory and genital tracts. In the female genital tract, it can be passed on to the newborn during vaginal delivery leading to either ordinary colonization, or neonatal infections notably umbilical stump sepsis, scalded skin syndrome, arthritis, or bacteraemia/sepsis. These infections are mediated by staphylococcal virulence factors such as (i) Staphylococcal Enterotoxins A, B, C, D, and E encoded by the sea, seb, sec, sed, see genes, (ii) Exfoliative Toxins A and B encoded by the eta and etb genes, (iii) Toxic Shock Syndrome Toxin 1 (TSST-1) encoded by the tst gene, (iv) Panton-Valentine Leukocidin (PVL) encoded by the pvl gene, and (v) Hemolysins alpha and delta encoded by the hla and hld genes, respectively. We determined the prevalence of S. aureus possessing one or more virulence factor genes and of methicillin resistant Staphylococcus aureus (MRSA) in this population. Methods This was a cross-sectional study, which used 85 S. aureus isolates from the Chlorohexidine (CHX) clinical trial study in Uganda. The isolates had been obtained by culturing vaginal swabs (VS) from 1472 women in labour, frozen at minus 80oC, then thawed, sub-cultured, and tested for the selected virulence genes sea, seb, sec, sed, see eta, etb, tst, pvl, hla and hld, and for the methicillin resistance determining gene (mecA). Data were analyzed using SPSS version 20. Results Of the 85 S. aureus isolates 13 (15.3%) were positive for one or more virulence factor genes, as follows: pvl 9/85 (10.6%), hld 5/85 (5.9%), sea 1/85 (1.2%) and seb genes 1/85 (1.2%). The other virulence genes (sec, sed, see, eta, etb, hla and tst) were not detected in any of the isolates. MRSA was detected in 55.3% (47/85) of the isolates, but only two of these carried the pvl virulence gene. Conclusion This study demonstrated that 15% of the S. aureus colonizing the female lower genital tract of mothers in labour in central Uganda carried one or more virulence genes, mostly pvl, indicating potential for newborn infection with S. aureus acquired in the maternal birth canal. More than half of the isolates were MRSA.

Abstract Current treatment outcome of patients with glioblastoma (GBM) remains poor. Following standard therapy, recurrence is universal with limited survival. Tumors from 173 GBM patients are analysed for somatic mutations to generate a personalized peptide vaccine targeting tumor-specific neoantigens. All patients were treated within the scope of an individual healing attempt. Among all vaccinated patients, including 70 treated prior to progression (primary) and 103 treated after progression (recurrent), the median overall survival from first diagnosis is 31.9 months (95% CI: 25.0–36.5). Adverse events are infrequent and are predominantly grade 1 or 2. A vaccine-induced immune response to at least one of the vaccinated peptides is detected in blood samples of 87 of 97 (90%) monitored patients. Vaccine-specific T-cell responses are durable in most patients. Significantly prolonged survival is observed for patients with multiple vaccine-induced T-cell responses (53 months) compared to those with no/low induced responses (27 months; P = 0.03). Altogether, our results highlight that the application of personalized neoantigen-targeting peptide vaccine is feasible and represents a promising potential treatment option for GBM patients.

Obstructive sleep apnea (OSA) is a common sleep disordered breathing in stroke patients. This case report aimed to show the presence of OSA in stroke can contribute to the increasing chance of mortality and morbidity. We presented a case of first-time stroke in a 64-year-old female with a history of pre-stroke OSA. She underwent intravenous thrombolysis as main therapy within the time limit under 4.5 hours since the stroke onset. She had prolonged hospital stay due to complications from OSA, even though she only had a small ischemic core (9 mL) in follow-up radiological imaging and was discharged with a greater National Institutes of Health Stroke Scale (NIHSS) score than admission (5 to 10). OSA can be one of warning signs for poor prognosis in stroke patients. Understanding the presence of OSA not only can be beneficial toward choosing the next steps of therapy, but also important for the rehabilitation and recovery period of stroke patients.

Devising a financial trading strategy that allows for long-term gains is a very common problem in finance. This paper aims to formulate a mathematically rigorous framework for the problem and compare and contrast the results obtained. The main approach considered is based on Dynamic Bayesian Networks (DBNs). Within the DBN setting, a long-term as well as a short-term trading strategy are considered and applied on twelve equities obtained from developed and developing markets. It is concluded that both the long-term and the medium-term strategies proposed in this paper outperform the benchmark buy-and-hold (B&H) trading strategy. Despite the clear advantages of the former trading strategies, the limitations of this model are discussed along with possible improvements.

Abstract On February 17, 1996, an earthquake ( $${M}_{\text{w}}=$$ M w = 8.2) occurred northeast of Biak Island, Indonesia, and generated a tsunami. Interestingly, the tsunami runup on the southwest side of Biak Island, which did not face the epicenter, was higher than that on the side of the island facing the epicenter. It was earlier suggested that the earthquake triggered submarine landslides. However, this hypothesis remains unexplored and unconfirmed. In this study, tsunami arrival times obtained from eyewitness accounts were used to perform backward tsunami travel time modeling. Based on the backward tsunami travel time results and multibeam bathymetry, five submarine landslide candidates were identified: three located to the southwest of Biak Island and two to the south of the island. Our analysis indicates that tsunamis from a large submarine landslide off the southwest coast of Biak Island (SL 2) and a small submarine landslide off the south side of Biak Island (SL 4) contributed to the 1996 Biak tsunami event and came earlier than the main tsunami from the earthquake fault. Tsunami sources were earlier modeled only by fault parameters without considering submarine landslide sources. As a result, the models could not explain the observed runup and eyewitness tsunami arrival times for the southwest and south of Biak Island. To address this problem, we propose an approach that combines a submarine landslide model with a modified version of a previously proposed fault model. Our combined model explains the observed runup and eyewitness tsunami arrival times well (Aida’s index values of the model are K = 1.00 and $$\kappa$$ κ = 1.44). Graphical abstract

Today’s data-driven world requires earth and environmental scientists to have skills at the intersection of domain and data science. These skills are imperative to harness information contained in a growing volume of complex data to solve the world’s most pressing environmental challenges. Despite the importance of these skills, Earth and Environmental Data Science (EDS) training is not equally accessible, contributing to a lack of diversity in the field. This creates a critical need for EDS training opportunities designed specifically for underrepresented groups. In response, we developed the Earth Data Science Corps (EDSC) which couples a paid internship for undergraduate students with faculty training to build capacity to teach and learn EDS using Python at smaller Minority Serving Institutions. EDSC faculty participants are further empowered to teach these skills at their home institutions which scales the program beyond the training lead by our team. Using a Rasch modeling approach, we found that participating in the EDSC program had a significant impact on undergraduate learners’ comfort and confidence with technical and nontechnical data science skills, as well as their science identity and sense of belonging in science, two critical aspects of recruiting and retaining members of underrepresented groups in STEM. Supplementary materials for this article are available online.

Abstract Robustness is the reproducible development of a phenotype despite stochastic noise. It often involves tradeoffs with other performance metrics, but the mechanisms underlying such tradeoffs were largely unknown. An Arabidopsis flower robustly develops four sepals from four precisely positioned auxin maxima. The development related myb-like 1 (drmy1) mutant generates noise in auxin signaling that disrupts robustness in sepal initiation. Here, we find that increased expression of CUP-SHAPED COTYLEDON1 (CUC1), a boundary specification transcription factor, in drmy1 underlies this loss of robustness. CUC1 surrounds and amplifies stochastic auxin noise in drmy1 to form variably positioned auxin maxima and sepal primordia. Removing CUC1 from drmy1 provides time for noisy auxin signaling to resolve into four precisely positioned auxin maxima, restoring robust sepal initiation. However, removing CUC1 decreases the intensity of auxin maxima and slows down sepal initiation. Thus, CUC1 increases morphogenesis speed but impairs robustness against auxin noise. Further, using a computational model, we find that the observed phenotype can be explained by the effect of CUC1 in repolarizing PIN FORMED1 (PIN1), a polar auxin transporter. Lastly, our model predicts that reducing global growth rate improves developmental robustness, which we validate experimentally. Thus, our study illustrates a tradeoff between speed and robustness during development.

AIM: To determine and compare clinico-sociodemographic profiles of primary open angle glaucoma(POAG)with non-glaucoma eye patients in Gwagwalada, Nigeria.METHODS:A cross-sectional comparative study. A total of 235 adult patients including 96 with POAG and 139 non-glaucoma were included. General characteristics such as age, gender, education, vocation, ethnicity, family history of glaucoma, ocular itching, diabetes mellitus, and hypertension were recorded. Ocular examinations included visual acuity, central visual field, cup disc ratio, anterior chamber angle assessment, and intraocular pressure.RESULTS:Mean age was 49.88+13.75 years and 114(48.5%)were males. Patients with POAG comprised 42 ethnics with Igbo(24/96, 25.0%)and Yoruba(20/96, 20.8%)being most common. Most POAG(74/96, 77.1%)were in the age range 40-69. The POAG(73/96, 76.0%)had varied visual impairment. The POAG versus non-glaucoma as follows: positive family history of glaucoma(34/96, 35.4%)vs (25/139, 18.0%; P=0.012); history of diabetes mellitus(8/96, 8.3%)vs(6/139, 4.3%); hypertension(24/96, 25.0%)vs(28/139, 20.1%); combined diabetes mellitus and hypertension(1/96, 1.0%)vs(4/139, 2.9%; P=0.268); antidiabetic drugs(5/96, 5.2%)vs(7/139, 5.0%); antihypertensives drugs(24/96, 25.0%)vs(23/139, 16.5%); combined antidiabetic and antihypertensive drugs(4/96, 4.2%)vs(5/139, 3.6%; P=0.328); ocular itching(18/96, 18.7%)vs(37/139, 26.6%; P=0.328); visual impairment [right eye(RE):51/96, 53.1%; left eye(LE):60/96, 62.5%] vs(RE:40/139, 28.7%; LE:37/139, 26.6%; P=0.000); vertical cup disc ratio>0.4(RE: 96/96, 100.0%; LE:96/96, 100.0%)vs(RE:131/139, 94.2%; LE:124/139, 89.2%)(RE: P=0.307; LE: P=0.006); intraocular pressure >22 mmHg(RE: 17/96, 17.7%; LE: 22/96, 22.9%)vs(RE: 2/139, 1.4%; LE: 2/139, 1.4%; P=0.006). Most POAG(60/96, 62.5%)were on antiglaucoma drugs and(23/96, 24.0%)were yet to commence medication(P=0.000). Many POAG(32/96, 33.3%)were on combination antiglaucoma drugs of beta blockers, prostaglandin inhibitors and carbonic anhydrase inhibitors.CONCLUSION:Glaucoma has distinguishing clinico-sociodemographic features from other eye conditions. Many participants affirmed family history of glaucoma, and most glaucoma participants were on antiglaucoma treatment. The visual impairment including blindness was significantly associated with glaucoma. The study affirmed open angle glaucoma was associated with high cup-disc ratio and high intra ocular pressure.

BackgroundRelapsing multiple sclerosis (RMS) is a chronic, inflammatory disease of the central nervous system. Ublituximab, an anti-CD20 monoclonal antibody (mAb), is indicated for the treatment of RMS. We performed a systematic literature review (SLR) to identify randomized trials reporting the clinical efficacy and tolerability of ublituximab or comparator disease-modifying therapies (DMTs) for treatment of RMS, and assessed their comparative effects using network meta-analysis (NMA).MethodsThe SLR involved a comprehensive search across various medical databases to identify relevant studies. Included studies were randomized controlled trials (RCTs) of an adult RMS population, focusing on treatment with at least one of ublituximab, alemtuzumab, natalizumab, ocrelizumab, or ofatumumab. For outcomes included in the NMA (annualized relapse rate (ARR), confirmed disability progression (CDP), and treatment discontinuation rate), rate ratios (RR) or hazard ratios (HR), along with their 95% confidence intervals (CIs), were calculated. We performed NMA using a contrast-based random-effects model within a frequentist framework for all outcomes. Ranking probabilities among comparators, and intervention rankings for the NMA, were estimated using surface under the cumulative ranking curve (SUCRA).ResultsWe included 15 RCTs in the review. For the ARR outcome, there was no statistically significant difference between ublituximab and the other included mAbs [ofatumumab (RR 1.02 (95% CI 0.64–1.62)), natalizumab (RR 0.99 (0.59–1.65)), alemtuzumab (RR 0.86 (0.51–1.46)), and ocrelizumab (RR 0.75 (0.44–1.28))]. For CDP at 6 months, our results showed no statistically significant difference between ublituximab and the comparator mAbs [ofatumumab (HR 0.97 (0.49–1.92)), natalizumab (HR 1.13 (0.53–2.40)), alemtuzumab (HR 1.25 (0.56–2.81)), and ocrelizumab (HR 1.29 (0.57–2.90))]. For CDP at 3 and 6 months, there was no statistically significant difference between ublituximab and placebo. The all-cause treatment discontinuation rate analysis showed no significant difference between ublituximab and other mAbs, except for alemtuzumab.ConclusionsResults of this SLR-informed NMA showed that there is no statistically significant difference between ublituximab and the other mAbs in terms of clinical efficacy. Additionally, the findings show that there is no statistically significant difference in discontinuation rates with the exception of the comparison with alemtuzumab, which may be attributed to its unique dosing schedule.

In 2023, the Australian Government issued ∼250,000 soil carbon credits following a measurement period characterised by high rainfall (Decile 10). The inferred soil organic carbon (SOC) sequestration rates during this period, ranging from ∼2 to 8 t C ha−¹ yr−¹, significantly exceed rates reported in Australian scientific studies (∼0.1 to 1.2 t C ha−¹ yr−¹). Our analysis, incorporating SOC and biomass measurements alongside remote sensing of NDVI, reveals that these SOC gains were largely attributable to above-average rainfall rather than project interventions. Moreover, these gains were not sustained when rainfall returned to average levels, raising concerns about the durability of credited sequestration and its additionality beyond natural climatic variability. Our findings demonstrate that current safeguards within the Soil Carbon Method—such as withholding 25% of credits during the first measurement period—are likely insufficient to account for climatic variability. To strengthen the integrity of the carbon crediting system, we recommend extending the minimum measurement period for credit issuance to at least five years. Additionally, governments should establish science-based ‘reasonable bounds’ for expected long-term SOC gains from management practices to sense-check reported outcomes. These measures will ensure that credited SOC sequestration is more closely tied to management-driven outcomes rather than short-term climate-driven fluctuations.

The 2 November 2023 Cyberbiosecurity Summit at Georgia Tech Research Institute’s (GTRI) headquarters in Atlanta united cybersecurity and biotechnology stakeholders to address safeguarding of bio-based industries. Goals included identifying cyberbiosecurity vulnerabilities and establishing prevention best practices for emerging biotech hardware, software, data and bio-based systems. The Summit highlighted risks and explored mitigation strategies for a safer bioeconomy. Key takeaways include: (1) as genome databases proliferate globally, it becomes more likely that these databases will become targets for cyberbiosecurity attacks; (2) the biotech community should not view cybersecurity as an impediment to research, but rather as a national security and global health imperative for proactive investment and workforce training; (3) the bioeconomy depends on a vulnerable supply chain for software; and (4) mapping of a biological attack surface, inspired by traditional cybersecurity assessments, would facilitate identification of vulnerabilities of cyber-bio-physical systems and the development of protective measures for the bioeconomy.

This article summarizes the thermal state of Mexican permafrost and its relationship to snow, ice, and geothermal environments. Ice-rich permafrost is observed near the summits of Citlaltépetl (Pico de Orizaba) and Iztaccíhuatl volcanoes. The lower limit of mountain permafrost is about 5,200 to 5,300 m.a.s.l. much higher than originally thought. Some of the sporadic permafrost may still exist on the Little Ice Age rock glaciers, but most of the buried glacial ice between 4,500 and 5,000 m.a.s.l. is slowly decaying and not thermally stable as permafrost. During the summer months, the Inter-Tropical Convergence Zone approaches the Mexican highlands and provides moist conditions sufficient for snow cover at high elevations. Maximum active layer thickness occurred during the snow-free seasons, typically April to July in Citlaltépetl and Iztaccíhuatl, perhaps Popocatépetl, but not Nevado de Toluca, where the summit is below the snowline most of the time today. The diurnal temperature amplitude results in freeze–thaw cycles only near the surface to 15 cm. The importance of the snow cover is that it provides great protection for incoming solar energy penetration, helping to preserve buried glacial ice and permafrost.

In 2021 and 2022, the national and cross-sector project CAPRIV funded by the French Ministry of Agriculture, made it possible to assess the influence of application techniques associated or not with a hedge or an anti-drift net on spray drift and bystander exposure. The acronym CAPRIV stands for ''Concilier l'application des PPP et la protection des riverains'' (Reconciling the use of PPPs and the protection of residents), within the orchard, viticulture, and field crops sectors. This specific data article focuses on viticulture. In viticulture, over the two years, 10 different spray application techniques were tested. For 3 of them the influence of a hedge on drift mitigation was also evaluated. All the trials were conducted on the “EoleDrift” test bench, with an artificial vegetation and an artificial wind. Spray drift has been measured according to a common protocol harmonised between cropping sectors within the project using three different types of passive drift collectors that were set up downwind of the treated field. Petri dishes collected sedimentary drift, PVC wires collected airborne drift and cotton T-shirts placed on manikins were used to assess potential dermal exposure of bystanders. The plant protection mix was simulated by a dilution of a fluorescent dye in water. The collected mass of dye was measured using a classical technique with dilution and concentration evaluation. Two fluorescent dyes were successively used, Brillant Sulfaflavine and Sulforhodamine B. A total amount of 4770 collectors were analysed individually. The data set provides a drift index for each collector expressed as the quantity of dye recovered per unit area of collector on the quantity of dye applied per unit area on the sprayed field multiplied by 100.

Harvested forage is the main raw feed for ruminant animals in Sweden, and is commonly cultivated in mixed stands of legume and grass species. The fraction of legume on a dry matter basis, known as botanical composition (BC) is a very important indicator of forage quality. In this study, hyperspectral imaging and near-infrared spectrometer (NIRS) based methods were used to estimate BC, to overcome the shortcomings of hand separation, which is time and resource consuming. Timothy and red clover mix samples were collected from different harvests in 2017–2019 from multiple sites in Northern Sweden and hand separated. The samples were synthetically mixed to 11 different BC levels, i.e., 0–100 % clover content. Two different instruments (Specim shortwave infrared (SWIR) hyperspectral imaging system and Foss 6500 spectrometer) were used to collect spectral data of samples milled to two levels of coarseness. Three different regression analyses: partial least squares regression (PLSR), support vector regression (SVR) and random forest regression (RFR), were used to build BC estimation models. The effects of the milling particle sizes and the different instruments on the performances of the models were compared. The data from second harvest in 2019 were used for independent validation as evaluation, and the rest of data were randomly split for model calibration (75 %) and validation (25 %). The models were iteratively run 1000 times with different splits, to check the effect from the splitting of calibration and validation datasets. Among different regression analyses, PLSR performed best, with mean Nash-Sutcliffe efficiency (NSE) for model evaluation from 0.76 to 0.87, varying for different instruments and milling sizes. Finer milling made the model accuracies slightly higher. This study developed quick and robust methods to determine the BC of timothy grass and red clover mixtures, which can provide useful information for farmers or researchers.

While recommender systems (RS) used in e-commerce have improved significantly providing customers with a personalised shopping experience, scholars have constantly raised concerns over the risks associated with e-commerce RS. However, a lack of methodological synthesis of risk-generating events associated with e-commerce recommender systems has curtailed systematic investigation of the risks of e-commerce RS. This paper presents a scoping review aimed at addressing this gap by synthesising different risk-generating events involved with the use of e-commerce RS as reported in the literature that could affect the welfare of customers who use those systems. Accordingly, peer-reviewed research studies published from 2003-2023 were extracted from the SCOPUS database and EBSCOhost platform for review. Sixty-two publications with evidence on risk-generating events of e-commerce RS were considered for the review. Twenty risk-generating events were identified through the review. These events were mapped with the corresponding risks based on existing frameworks on risks of e-commerce. We were able to identify several risk-generating events that had not previously been considered in conceptualising the risks of e-commerce RS. Further, we identified the plurality of the outcomes of risk-generating events which could provide guidance for the evaluation of e-commerce recommender systems from a multistakeholder perspective.

Doping is considered a critical deviant behavior in competitive sports, and particularly in cycling, even though the phenomenon remains limited in sports in general. Previous qualitative studies have contributed to identify situations of vulnerability to doping in athletes. However, much of the research tends to focus on singular dimensions of vulnerability, such as physical or psychological aspects. The present study aimed to extend existing knowledge by concurrently exploring and attempting to categorize different types of situations of vulnerability that predispose elite cyclists to engage in doping. Ten high-level French-speaking doped cyclists were recruited (Mage = 49; SD = 14.63, two women). Semi-structured interviews were conducted. Both deductive and inductive thematic analyses were performed. Our results highlighted four types of vulnerability situations: (a) psychological (e.g., negative affects, maladaptive motivation, depression), (b) physical (e.g., exhaustion, impairments, injuries), (c) relational (e.g., organized doping, control, psychological or sexual harassment, social approval of doping), and (d) contextual (e.g., cycling culture, weather conditions, competitive stakes). By providing a clearer categorization of the situations of vulnerability that converge toward doping in sport, this comprehensive study allows for a holistic understanding of the various vulnerabilities. It paves the way for future research on related vulnerabilities and dispositional factors. Practically, it should also improve doping screening and prevention, and provide more favorable conditions for athletes.

O artigo examina três práticas psicanalíticas – a casuística, a escuta e a rememoração – que podem ter efeitos anticoloniais e desafiar o universalismo europeu. Enquanto a casuística permite considerar uma particularidade cultural irredutível às pretensões universalistas do Ocidente, a escuta atribui um lugar de sujeito para aqueles que eram vistos tradicionalmente como objetos do saber europeu e a rememoração pode abrir um espaço para o presente do passado pré-colonial, subvertendo assim a temporalidade colonial com o seu presentismo a-histórico. A conclusão traça uma distinção entre a prática psicanalítica com seu potencial anticolonial e a metapsicologia freudiana que corresponde irremediavelmente a concepções europeias da subjetividade, propondo-se a estudar outras concepções, como as indígenas da América.

The pulmonary microbiome has emerged as a significant factor in respiratory health and diseases. Despite the sterile conditions maintained during ex vivo lung perfusion (EVLP), the use of antibiotics in the perfuse liquid can lead to dynamic changes in the lung microbiome. Here, we present the design of a study that aims to investigate the hypothesis that EVLP alters the lung microbiome and induces tissue inflammation. This pilot, prospective, controlled study will be conducted in two Spanish donor centers and will include seven organ donors after brain death or after controlled cardiac death. After standardized retrieval, the left lung will be preserved in cold storage and the right lung will be perfused with EVLP. Samples from bronchoalveolar lavage, perfusion and preservation solutions, and lung biopsies will be collected from both lungs and changes in lung microbiome and inflammatory response will be compared.

La Red de Maestras y Maestros STEM + Transforma se constituyó en un escenario para el empoderamiento pedagógico de los docentes participantes. Con el objetivo de impulsar acciones colectivas que fortalecieran la construcción de conocimientos en procesos de enseñanza y aprendizaje desde el enfoque STEM, durante el periodo 2021-2023, esta iniciativa consolidó una comunidad docente que contribuyeran a la transformación pedagógica en Bogotá. Metodológicamente se fundamentó en los principios de gestión del conocimiento propuestos por Minakata. Esta metodología generó diversas iniciativas destinadas a fundamentar y potenciar aspectos clave del colectivo, desde procesos de gobernanza hasta estrategias pedagógicas y de divulgación. De acuerdo con lo anterior, la dinamización de la Red condujo a la creación de un modelo de gobernanza que facilitó la organización interna del colectivo y promovió la construcción de estrategias desde sus seis nodos de estudio. Dichas estrategias estuvieron centradas en generar la autogestión del colectivo e impactar las aulas distritales, vinculando la educación STEM con los contextos educativos y con los Objetivos de Desarrollo Sostenible (ODS) como Salud y Bienestar, Educación de Calidad, Igualdad de Género, Trabajo Decente y Crecimiento Económico, Ciudades y Comunidades Sostenibles, y Acción por el Clima. Este proceso marcó el inicio de un colectivo dedicado al fortalecimiento de ambientes de aprendizaje desde el enfoque educativo STEM, resaltando la importancia de la colaboración entre docentes para generar innovaciones pedagógicas y avances educativos que respondan de manera dinámica y acorde con los desafíos y oportunidades del siglo XXI.

Summary: Background: Prognostic factors for ambulatory oncology patients have been described, including Eastern Cooperative Oncology Group (ECOG), tumor stage and malnutrition. However, there is no firm evidence on which variables best predict mortality in hospitalized patients receiving active systemic treatment. Our main goal was to develop a predictive model for 90-day mortality upon admission. Methods: Between 2020 and 2022, we prospectively collected data from three sites for cancer patients with hospitalizations. Those with metastatic disease receiving systemic therapy in the 6 months before unplanned admission were eligible to this study. The least absolute shrinkage and selection operator (LASSO) method was used to select the most relevant factors to predict 90-day mortality at admission. A multivariable logistic regression was fitted to create the PROgnostic Score for Hospitalized Cancer Patients (PROMISE) score. The score was developed in a single-center training cohort and externally validated. Findings: Of 1658 hospitalized patients, 1009 met eligibility criteria. Baseline demographics, patient and disease characteristics were similar across cohorts. Lung cancer was the most common tumor type in both cohorts. Factors associated with higher 90-day mortality included worse ECOG, stable/progressive disease, low levels of albumin, increased absolute neutrophil count, and high lactate dehydrogenase. The c-index after bootstrap correction was 0.79 (95% CI, 0.75–0.82) and 0.74 (95% CI, 0.68–0.80) in the training and validation cohorts, respectively. A web tool (https://promise.vhio.net/) was developed to facilitate the clinical deployment of the model. Interpretation: The PROMISE tool demonstrated high performance for identifying metastatic cancer patients who are alive 90 days after an unplanned hospitalization. This will facilitate healthcare providers with rational clinical decisions and care planning after discharge. Funding: Merck S.L.U., Spain.

With the emergence of high-precision radiotherapy technologies such as stereotactic ablative radiotherapy (SABR), MR guided brachytherapy, image guided intensity modulated photon and proton radiotherapy and most recently daily adaptive radiotherapy, reirradiation is increasingly recognized as a viable treatment option for many patients. This includes those with recurrent, metastatic or new malignancies post initial radiotherapy. The primary challenge in reirradiation lies in balancing tumor control against the risk of severe toxicity from cumulative radiation doses to previously irradiated normal tissue.Although technology for precise delivery has advanced at a fast pace, clinical practice of reirradiation still mostly relies on individual expertise, as prospective evidence is scarce, the level of reporting in clinical studies is not standardized and of low quality − especially with respect to cumulative doses received by organs at risk.A recent ESTRO/EORTC initiative proposed a standardized definition of reirradiation and formulated general requirements for minimal reporting in clinical studies [1].As a consequence we found it timely to convene for an international and interdisciplinary meeting with experts in the field to summarize the current evidence, identify knowledge gaps and explore which best practices can be derived for safe reirradiation. The meeting was held on 15.06.2023 in Zurich and was endorsed by the scientific societies SASRO, DEGRO and ESTRO. Here, we report on available evidence and research priorities in the field of reirradiation, as discussed during the meeting.

BackgroundNodes are the second site for prostate cancer recurrence. Whole-pelvic radiotherapy (WPRT) has shown superiority over nodal stereotactic body radiotherapy (SBRT) in two retrospective cohorts. We aimed to compare both modalities and assess factors associated with treatment outcomes.Materials and methodsThis retrospective multicentric cohort study included patients from five institutions spanning from 2010 to 2022. Patients had a history of prostatic adenocarcinoma classified as N0 M0 at diagnosis with a first nodal-only pelvic castration-sensitive recurrence. Failure-free survival (FFS) was defined as the time from the end of RT to the first failure event–biochemical or imaging recurrence, or death.ResultsA total of 147 patients (pts) were analyzed, mainly treated for a recurrence after initial prostatectomy (87%), with 64 (43.5%) undergoing SBRT and 83 (56.5%) undergoing WPRT. SBRT was chosen mainly for dosimetric constraints (67%) and was associated with a lower rate of concomitant androgen deprivation therapy (ADT) prescription. With a median follow-up of 68 months [inter-quartile range (IQR) = 51], FFS was significantly lower in the SBRT group (p < 0.0001). In multivariable analysis, WPRT and ADT were associated with a longer FFS. Factors associated with a longer FFS after SBRT included associated ADT, lower prostate-specific antigen (PSA) levels, a PSA doubling time >6 months, and a Gleason score

This report demonstrates the development of carbon fibers (CFs) decorated with TiO2 nanoparticles (NPs) as an efficient photocatalyst for the photocatalytic degradation of methylene blue (MB) as a model dye. Carbon fibers were produced by carbonization of polyacrylonitrile fibers, previously produced by centrifugal spinning. Subsequently, the CFs were decorated with TiO2 NPs (CFs@TiO2) by tailored soaking protocol using aqueous TiCl4 solution with different concentrations (0.025, 0.05, 0.1, and 0.2 M). SEM analyses revealed that soaking in TiCl4 produced a smooth, conformal, continuous TiO2 nanoparticulate coating with thickness increasing from 40.4 ± 21.2 to 257.9 ± 63.9 nm with increasing TiCl4 concentration. X-ray diffraction and Raman spectroscopy confirmed the anatase nature of TiO2. Photocatalytic decomposition rates of MB were assessed under UV light illumination for all CFs@TiO2 samples, and it was revealed that the lowest amount of TiO2 NP on C yielded the highest rates. The synergistic interaction between CFs and TiO2 NPs with a uniform morphology and a well-crystalline anatase structure, present in an optimal amount of fiber bodies, is the key reason for the remarkable photocatalytic performance. This work shows that C fibers decorated with an optimal amount of TiO2 NPs have a great potential as an effective photocatalytic material.

Background Genetic testing is a cornerstone in the assessment of many cardiac diseases. However, variants are frequently classified as variants of unknown significance, limiting the utility of testing. Recently, the DeepMind group (Google) developed AlphaMissense, a unique artificial intelligence–based model, based on language model principles, for the prediction of missense variant pathogenicity. We aimed to report on the performance of AlphaMissense, accessed by VarCardio, an open web‐based variant annotation engine, in a real‐world cardiovascular genetics center. Methods and Results All genetic variants from an inherited arrhythmia program were examined using AlphaMissense via VarCard.io and compared with the ClinVar variant classification system, as well as another variant classification platform (Franklin by Genoox). The mutation reclassification rate and genotype–phenotype concordance were examined for all variants in the study. We included 266 patients with heritable cardiac diseases, harboring 339 missense variants. Of those, 230 (67.8%) were classified by ClinVar as either variants of unknown significance or nonclassified. Using VarCard.io, 198 variants of unknown significance (86.1%, 95% CI, 80.9–90.3) were reclassified to either likely pathogenic or likely benign. The reclassification rate was significantly higher for VarCard.io than for Franklin (86.1% versus 34.8%, P

BackgroundEfforts to eradicate tuberculosis (TB) are threatened by diabetes mellitus (DM), which confers a 3-fold increase in the risk of TB disease. The changes in the memory phenotypes and functional profiles of Mycobacterium tuberculosis (Mtb)-specific T cells in latent TB infection (LTBI)-DM participants remain poorly characterised. We, therefore, assessed the effect of DM on T-cell phenotype and function in LTBI and DM clinical groups.MethodsWe compared the memory phenotypes and function profiles of Mtb-specific CD4+ and CD8+ T cells among participants with LTBI-DM (n=21), LTBI-only (n=17) and DM-only (n=16). Peripheral blood mononuclear cells (PBMCs) were stimulated with early secretory antigenic 6 kDa (ESAT-6) and culture filtrate protein 10 (CFP-10) peptide pools or phytohemagglutinin (PHA). The memory phenotypes (CCR7/CD45RA), and functional profiles (HLA-DR, PD-1, CD107a, IFN-γ, IL-2, TNF, IL-13, IL-17A) of Mtb-specific CD4+ and CD8+ T cells were characterised by flow cytometry.ResultsNaïve CD4+ T cells were significantly decreased in the LTBI-DM compared to the LTBI-only participants [0.47 (0.34-0.69) vs 0.91 (0.59-1.05); (p

The past several decades have seen rapid advances in diagnosis and treatment of cardiovascular diseases and stroke, enabled by technological breakthroughs in imaging, genomics, and physiological monitoring, coupled with therapeutic interventions. We now face the challenge of how to (1) rapidly process large, complex multimodal and multiscale medical measurements; (2) map all available data streams to the trajectories of disease states over the patient's lifetime; and (3) apply this information for optimal clinical interventions and outcomes. Here we review new advances that may address these challenges using digital twin technology to fulfill the promise of personalized cardiovascular medical practice. Rooted in engineering mechanics and manufacturing, the digital twin is a virtual representation engineered to model and simulate its physical counterpart. Recent breakthroughs in scientific computation, artificial intelligence, and sensor technology have enabled rapid bidirectional interactions between the virtual‐physical counterparts with measurements of the physical twin that inform and improve its virtual twin, which in turn provide updated virtual projections of disease trajectories and anticipated clinical outcomes. Verification, validation, and uncertainty quantification builds confidence and trust by clinicians and patients in the digital twin and establishes boundaries for the use of simulations in cardiovascular medicine. Mechanistic physiological models form the fundamental building blocks of the personalized digital twin that continuously forecast optimal management of cardiovascular health using individualized data streams. We present exemplars from the existing body of literature pertaining to mechanistic model development for cardiovascular dynamics and summarize existing technical challenges and opportunities pertaining to the foundation of a digital twin.

El proceso constructivo es fundamental en la construcción de obras civiles, la visión y planificación debe estar definida de manera correcta antes de realizar una obra estructural en campo, mucho más si son obras que requieren de un proceso más detallado como lo son las obras de tipo esencial. En el presente artículo se realizó un análisis estructural del proceso constructivo que conlleva una estructura de carácter esencial, la misma tiene como características: 6 niveles, luces de 9 m y una altura de entrepiso de 4,50 m, de acuerdo con éstas se realizó una modelación del proceso constructivo aplicando un procedimiento de cimbrado, clareado y descimbrado. Con la ayuda de paquetes computacionales como el ETABS, se ha realizado modelaciones para el análisis de la estructura frente a los elementos auxiliares que existen en ella en este caso los puntales, dando como resultado el comportamiento de la estructura de acuerdo con los pasos de carga utilizados en el programa, así, obteniendo que las cargas del Modelo 2 son de 3-6 veces mayores que el Modelo 1. Así como el valor más crítico de 135,51 kN obtenido en el paso de carga N°2 del Modelo 2

Abstract Suicide is a leading cause of death among adolescents, and recent suicide theories have sought to clarify the factors that facilitate the transition from suicide ideation to action. Specifically, the Interpersonal Theory of Suicide (IPTS), Integrated Motivational-Volitional Model (IMV), and Three Step Theory (3ST) have highlighted risk factors central to the formation of suicidal ideation and suicidal behaviors, which is necessary for suicide death. However, these models were initially developed and tested among adults, and given core socioemotional and neurodevelopmental differences in adolescents, the applicability of these models remains unclear. Directly addressing this gap in knowledge, this systematic review aimed to (1) describe the evidence of leading ideation-to-action theories (i.e., IPTS, IMV, 3ST) as they relate to suicide risk among adolescents, (2) integrate ideation-to-action theories within prevailing biological frameworks of adolescent suicide, and (3) provide recommendations for future adolescent suicide research. Overall, few studies provided a complete test of models in adolescent samples, and empirical research testing components of these theories provided mixed support. Future research would benefit from integrating neurodevelopmental and developmentally sensitive psychosocial frameworks to increase the applicability of ideation-to-action theories to adolescents. Further, utilizing real-time monitoring approaches may serve to further clarify the temporal association among risk factors and suicide.

The objective of this study was to assess the osteoarthritis (OA) disease severity in 47 temporomandibular joints (TMJs) using a validated scale for gross signs of OA while noting the specific sites for profound disease on the donor condyle and fossa. A disease severity score of Grade 0–4, representing absent to severe disease, was awarded to each specimen’s condyle and fossa by two blinded investigators who have demonstrated interrater reliability. The mandibular fossa was more pathological compared to the mandibular condyle (* p = 0.001). When the deepest focal lesions were qualitatively assessed, it was demonstrated that the mandibular fossa was more severely degenerated than the articular eminence in 58% of donors. In this subpopulation, 74% of the severe mandibular fossa pathology was seen on the deep articular surface. When the articular eminence was the most severely degenerated region of the fossa, it was equivalently likely to see severe focal lesions on the lateral eminence (35%) or equally distributed across the entire eminence (35%). The greatest disease severity was discovered in sites of overloading, which may be associated with paranormal mandibular movements and potentially bruxism. Patients with bruxism produce significant translational movements (grinding) in the upper joint compartment and heavy vertical loading (clenching). Theoretically, this amplifies pressure and inflammation on the lateral articular surfaces and in the deep fossa.

Abstract Background . Splash pads for recreational purposes are widespread. Using these pads can pose a health risk if they lack installation regulation and water quality supervision. Our aim was to describe a waterborne disease outbreak caused by Clostridium perfringens and Cryptosporidium spp. in a Barcelona district and the measures taken for its control. Methods . On August 2018, 71 cases of acute gastroenteritis were detected, affecting people who used a splash pad or were in contact with a user. Microbiological and environmental investigations were carried out. A descriptive analysis of the sample and Poisson regression models adjusted for age and sex were performed, obtaining frequencies, median values, and adjusted prevalence ratios with their 95% confidence intervals. Results The median age of the cases was 6.7 years, 27 (38%) required medical care, and three (4.2%) were hospitalized. The greater the number of times a person entered the area, the greater the number of symptoms and their severity. Nineteen (76%) of the 25 stool samples collected from cases showed the presence of one or both pathogens. Environmental investigations showed deficiencies in the facilities and identified the presence of both species in the splash pad. Health education and hygiene measures were carried out, and 14 days after the closure of the facilities, no more cases related to the pad were recorded. Conclusions . Specific regulations are needed on the use of splash pads for recreational purposes. Until these regulations are in place, these types of facility should comply with the regulations that apply to swimming pools and spas, including those related to the design of the tanks, water recirculation systems, and adequate disinfection systems.

Objectives: Our objective was to assess the rate of complications and gastrointestinal adverse effects of rectal spacer insertion for salvage post prostatectomy radiation therapy. Methods: A retrospective observational study was performed. Between September 2018 and March 2022, 64 post-radical prostatectomy patients who were planned for salvage radiation therapy received a rectal spacer. The selected patients were those who had nerve-sparing prostatectomy with intrafascial or interfascial dissections (where Denonvillier’s fascia is retained). Radiation dose to the rectal wall and gastrointestinal symptoms were assessed. Symptoms were graded using the National Cancer Center Institute Common Terminology Criteria for Adverse Events v4.0 grading scheme. A total of 39 patients had pre-spacer planning computer tomography (CT) scans, and the rectal dose before and after the spacer insertion was calculated. Comparisons were made using the Student’s t-test, with a p-value < 0.05 representing statistical significance. Finally, clinicians were surveyed to rate the ease of the procedure using a 5-point Likert scale of 1 to 5 (1: very difficult, 2: difficult, 3: moderate, 4: easy, 5: very easy). Results: A total of 64 patients successfully underwent rectal spacer insertion. The mean age was 64.4 years (standard deviation: 5.7 years). After a median of 14 months’ (range 6 to 35) follow up, acute grade 1 and above gastrointestinal (GI) toxicities were seen in 28% of patients (grade 2 in 1.5%), and late grade 1 and above GI toxicities were seen in 12% of patients (grade 2 in 1.5%). Amongst the 39 patients with pre-spacer planning CT images, the volume of the rectum receiving 60%, 70%, 80%, 90%, and 100% of the prescribed radiation dose was reduced by 25.9%, 34.2%, 35.4%, 43.7%, and 61.7%, respectively. All dose reductions were statistically significant. The procedure was rated as “easy” or “very easy” to perform in 56% of cases. Conclusions: The insertion of a rectal spacer in selected patients undergoing PPRT is feasible and safe and significantly improves rectal wall radiation dosimetry in salvage post prostatectomy radiation therapy. It was accomplished in >95% of patients, increasing vesico-rectal separation from ‘immediate vicinity’ to 11 mm without any post-operative complications in experienced hands. In addition, it achieved significant reduction in rectal radiation doses, leading to low rates of acute and late grade 2 toxicity.

Abstract Background Most patients suffering from Leber hereditary optic neuropathy carry one of the three classic pathologic mutations, but not all individuals with these genetic alterations develop the disease. There are different risk factors that modify the penetrance of these mutations. The remaining patients carry one of a set of very rare genetic variants and, it appears that, some of the risk factors that modify the penetrance of the classical pathologic mutations may also affect the phenotype of these other rare mutations. Results We describe a large family including 95 maternally related individuals, showing 30 patients with Leber hereditary optic neuropathy. The mutation responsible for the phenotype is a novel transition, m.3734A > G, in the mitochondrial gene encoding the ND1 subunit of respiratory complex I. Molecular-genetic, biochemical and cellular studies corroborate the pathogenicity of this genetic change. Conclusions With the study of this family, we confirm that, also for this very rare mutation, sex and age are important factors modifying penetrance. Moreover, this pedigree offers an excellent opportunity to search for other genetic or environmental factors that additionally contribute to modify penetrance.

Abstract The Earth’s energy imbalance is the net radiative flux at the top-of-atmosphere. Climate model simulations suggest that the observed positive imbalance trend in the previous two decades is inconsistent with internal variability alone and caused by anthropogenic forcing and the resulting climate system response. Here, we investigate anthropogenic contributions to the imbalance trend using climate models forced with observed sea-surface temperatures. We find that the effective radiative forcing due to anthropogenic aerosol emission reductions has led to a 0.2 ± 0.1 W m−2 decade−1 strengthening of the 2001–2019 imbalance trend. The multi-model ensemble reproduces the observed imbalance trend of 0.47 ± 0.17 W m−2 decade−1 but with 10-40% underestimation. With most future scenarios showing further rapid reductions of aerosol emissions due to air quality legislation, such emission reductions may continue to strengthen Earth’s energy imbalance, on top of the greenhouse gas contribution. Consequently, we may expect an accelerated surface temperature warming in this decade.

Abstract Background & aims Some studies have reported links between 25-hydroxyvitamin D levels and the presence of obesity and some genetic variants. The aim of our design was to evaluate the effects of rs2282679 genetic variant of CG gene on 25-hydroxyvitamin D levels, weight loss and metabolic parameters after a robotic sleeve gastrectomy in premenopausal females with obesity. Methods 76 participants were enrolled. 25-hydroxyvitamin D levels, biochemical evaluation and anthropometric parameters were registered before surgery and after 3, 6 and 12 months follow up. Genotype of rs2282679 CG gene was evaluated. Results The improvements in anthropometric parameters, blood pressure and lipid profile were similar in both genotypes (TT vs TG + GG). Basal insulin levels and HOMA-IR were greater in G allele carriers than non-carriers (Delta: 6.7 ± 1.2 mUI/L; p = 0.01) and (Delta: 1.3 ± 0.1 units; p = 0.02). 25-hydroxyvitamin D levels were lower in G allele carriers than non-carriers (Delta: 8.1 ± 1.1 ng/dl; p = 0.03). The levels of insulin and HOMA-IR remained greater in G allele carriers than non-carriers throughout all the visits. The levels of 25-hydroxyvitamin D remained lower in G allele carriers than non-G allele. The average level of 25-hydroxyvitamin D at 12 months in non-G allele carriers were above 30 ng/dl (36.0 ± 3.1 ng/dl) and the level in G allele carriers were below (24.9 ± 4.9 ng/dl). Conclusions rs 2282679 (GC) was related with low 25 hydroxyvitamin D levels and insulin resistance. In addition, the presence of G allele produced a decrease in the improvement of 25-hydroxyvitamin D levels and insulin resistance after weight loss during 12 months.

Introduction: Articular cartilage injuries of the knee are a complex and challenging clinical pathology. Objectives: The purpose of this study was to establish consensus statements via a Delphi process on the management of failed knee cartilage surgery. Methods: A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eleven questions were generated on the management of failed knee cartilage surgery, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement. Results: Of the 11 total questions and consensus statements on the management of failed knee cartilage surgery developed from 3 rounds of voting, 0 achieved unanimous consensus, 10 achieved strong consensus, and 1 achieved consensus. Conclusions: The statements that achieved strong consensus related to revision cartilage indications, contraindications, lesion size, prior procedures, unipolar/bipolar lesions, and salvage procedures. The statement that did not achieve strong consensus was related to the management of a failed osteochondral autograft/allograft.

Resumen Son ya numerosos los heurísticos que han servido al estudio sociogenético de la realidad escolar y de las materias enseñadas. Para sistematizar el potencial conjunto de los mismos se hace necesario realizar un balance y repensar, a partir de sus aportaciones, un marco teórico-metodológico que permita avanzar en el desarrollo del campo de estudio, contemplando la complejidad de relaciones que se dan en la existencia y devenir de las asignaturas escolares y relacionándola con la posibilidad de cambio educativo. El presente artículo ha revisado, pues, los estudios fundacionales y reflexiones posteriores en torno a algunos de estos heurísticos, señalando su naturaleza, debilidades, potencialidades y posibilidades de interrelación.