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Abstract Spintronic sensors are uniquely positioned to deliver the next generation of high-performance magnetic field measurement tools with re-configurable key features. In this perspective article, we focus on giant and tunnel magnetoresistance sensors that exploit changes in the electrical resistance of thin films in response to an external magnetic field. We discuss strategies to address ongoing open challenges to improve operation limits. The goal is to meet current technological needs and thus expand the scope of existing applications. We also propose innovative approaches to design sensors with adaptable characteristics and embedded multifunctionality, aiming to create opportunities for future magnetic sensing applications. These solutions leverage the versatility of spintronic sensors, from the thin-film multilayers that form their building blocks, to device fabrication methods and potential integration with other technologies. The outlook of novel applications spans multiple areas, including electric vehicles, robotics, remote detection, or biomedicine.

Abstract Despite recognized need and reasonable demand, health systems and rehabilitation communities keep working in silos, independently with minimal recognition to the issues of those who require rehabilitation services. Consolidated effort by health systems and rehabilitation parties, recognizing the value, power and promise of each other, is a need of the hour to address this growing issue of public health importance. In this paper, the importance and the need for integration of rehabilitation into health system is emphasized. The efforts being made to integrate rehabilitation into health systems and the potential challenges in integration of these efforts were discussed. Finally, the strategies and benefits of integrating rehabilitation in health systems worldwide is proposed. Health policy and systems research (HPSR) brings a number of assets that may assist in addressing the obstacles discussed above to universal coverage of rehabilitation. It seeks to understand and improve how societies organize themselves to achieve collective health goals; considers links between health systems and social determinants of health; and how different actors interact in policy and implementation processes. This multidisciplinary lens is essential for evidence and learning that might overcome the obstacles to the provision of rehabilitation services, including integration into health systems. Health systems around the world can no longer afford to ignore rehabilitation needs of their populations and the World Health Assembly (WHA) resolution marked a global call to this effect. Therefore, national governments and global health community must invest in setting a priority research agenda and promote the integration of rehabilitation into health systems. The context-specific, need-based and policy-relevant knowledge about this must be made available globally, especially in low- and middle-income countries. This could help integrate and implement rehabilitation in health systems of countries worldwide and also help achieve the targets of Rehabilitation 2030, universal health coverage and Sustainable Development Goals.

Abstract Amplification of the MDM2 and CDK4 genes on chromosome 12 is commonly associated with low-grade osteosarcomas. In this study, we conducted high-resolution genomic and transcriptomic analyses on 33 samples from 25 osteosarcomas, encompassing both high- and low-grade cases with MDM2 and/or CDK4 amplification. We discerned four major subgroups, ranging from nearly intact genomes to heavily rearranged ones, each harbouring CDK4 and MDM2 amplification or CDK4 amplification with TP53 structural alterations. While amplicons involving MDM2 exhibited signs of an initial chromothripsis event, no evidence of chromothripsis was found in TP53-rearranged cases. Instead, the initial disruption of the TP53 locus led to co-amplification of the CDK4 locus. Additionally, we observed recurring promoter swapping events involving the regulatory regions of the FRS2, PLEKHA5, and TP53 genes. These events resulted in ectopic expression of partner genes, with the ELF1 gene being upregulated by the FRS2 and TP53 promoter regions in two distinct cases.

Introduction. Abdominal and neural angiostrongyliasis caused by Angiostrongylus costaricensis and A. cantonensis, respectively, are zoonotic diseases involving snails as intermediate hosts. Colombia has already reported human cases, and the increasing distribution of Lissachatina fulica and Cornu aspersum raises public health concerns due to the potential risk of disease transmission in areas where parasites and hosts coexist. Objective. To identify the presence of Angiostrongylus spp. in snail species L. fulica and C. aspersum in Antioquia, Colombia. Materials and methods. This prospective cross-sectional study had a population of 5,855 L. fulica and C. aspersum snails captured in the ten towns of the Valle de Aburrá (Antioquia, Colombia), 169 samples were collected in 28 sampling points. Lung tissues of the collected snails were dissected and analyzed to detect Angiostrongylus spp. through molecular techniques. Results. Angiostrongylus spp. were identified in both L. fulica and C. aspersum. Angiostrongylus costaricensis was detected in 18 pooled prevalence of 30% (95% CI = 19.2-43.3), and Medellín was the municipality with the highest number of positive samples (33.3%). Seventy-two-point-two percent of the positive places reported the presence of rodents. None of the tests were positive for A. cantonensis. Conclusion. Our findings provide important insights into the epidemiology and distribution of Angiostrongylus spp. in Antioquia, Colombia. The identification of these parasitic nematodes in L. fulica and C. aspersum highlights the potential role of these snails as intermediate hosts in the transmission of Angiostrongylus spp. infections in the Valle de Aburrá, with implications for human and veterinary health.

El objetivo es analizar las prácticas de aprendizaje en la configuración del saber pedagógico de los docentes de facultades de educación en el contexto de la pandemia por COVID-19, a través del estudio arqueológico en escogidas universidades colombianas. El modelo y diseño de análisis se basaron en la tematización de Foucault y Barragán, así como en las prácticas de subjetivación. Se aplicó además un enfoque exploratorio del entorno físico y estructuras sociales en la formación de la subjetividad humana, desde distintas perspectivas. Se configura el saber pedagógico de los docentes, descrito en las variaciones de los discursos sobre las prácticas de aprendizaje, y se identifica la posición de los docentes. Estos resultados ayudan a mejorar la calidad educativa y el bienestar de los estudiantes.

Los puertos dinamizan las actividades económicas y las gestiones inherentes a él crean externalidades tanto positivas como negativas, el concepto de puerto, muelle y terminal se confunden y en ocasiones se utilizan como si fueran conceptos idénticos cuando en realidad no lo son. En este artículo se abordará el tema de las terminales portuarias como su nombre lo indica es el sitio en donde termina las personas, y mercancías para transportarse, ese espacio físico que se convierte como puente de la cadena logística de pasajeros y mercancías y muchas veces por estar centrados en temas de calidad, de desempeño logístico en cuanto al manejo oportuno de pasajeros o de carga. Agentes externos se presentan en el escenario, exigencias internacionales y otras disposiciones que hacen de las terminales portuarias un territorio amplio por explorar. En este artículo entonces también se indaga sobre las actividades y estilos de terminales que existen y los que más se utilizan en Colombia. Se especifica las zonas portuarias y su comportamiento.

Abstract Methylation-based liquid biopsies show promises in detecting cancer using circulating cell-free DNA; however, current limitations impede clinical application. Most assays necessitate substantial DNA inputs, posing challenges. Additionally, underrepresented tumor DNA fragments may go undetected during exponential amplification steps of traditional sequencing methods. Here, we report linear amplification-based bisulfite sequencing (LABS), enabling linear amplification of bisulfite-treated DNA fragments in a genome-wide, unbiased fashion, detecting cancer abnormalities with sub-nanogram inputs. Applying LABS to 100 patient samples revealed cancer-specific patterns, copy number alterations, and enhanced cancer detection accuracy by identifying tissue-of-origin and immune cell composition.

Introducción: Las enfermedades coronarias son una de las principales causas de muerte en todo el mundo. El tratamiento para la enfermedad coronaria puede ser farmacológico y no farmacológico. Cuando el diagnóstico es reciente, los pacientes inician un proceso adaptativo y con esto hay posibilidad de desarrollar síntomas depresivos. Objetivo: Identificar la prevalencia de síntomas depresivos y factores asociados al inicio del programa de rehabilitación cardíaca en pacientes con enfermedad coronaria en una institución de salud. Materiales y método: Estudio transversal analítico, en 95 pacientes con enfermedad coronaria que iniciaron el programa de rehabilitación cardíaca. Se analizaron datos sociodemográficos, factores de riesgo cardiovascular y actividad física. Los puntajes de la subescala de síntomas depresivos fueron medidos con DASS-21. Se estimaron prevalencias y razones de prevalencia mediante modelos de regresión de Poisson con varianza robusta, con niveles de confianza del 95%. Resultados: El 70.5% de los pacientes que iniciaron el programa presentaron síntomas depresivos. El régimen de salud (RP: 0.75; IC 95%: 0.60- 0.94; p = 0.013), el riesgo cardiovascular (RP: 0.62; IC 95%: 0.50-0.77; p < 0.001) y la esternotomía previa (IC 95%: 1.01-1.62; p = 0.040) son factores asociados para síntomas depresivos en estos pacientes. Conclusiones: Siete de cada diez pacientes con enfermedad coronaria que iniciaron el programa, presentaron síntomas depresivos.

The population of Hispanic older adults is growing along with the burden of chronic diseases. This cross-sectional study aims to assess the factors associated with frailty among community-dwelling Hispanic women aged ≥60 years ( n = 357) enrolled in the Panama Aging Research Initiative—Health Disparities study of cognitive-functional health of older persons in Panama. Cognitive function was assessed with a neuropsychological test battery. Depression was measured with the Geriatric Depression Scale. Frailty was defined using the Fried criteria and participants were classified as non-frail, pre-frail or frail. A subsample ( n = 281) provided fasting blood samples for quantification of protein biomarkers. Associations were examined using hierarchical multiple linear regressions. 59.4% and 9.0% of participants ( M = 69.2 years, SD = 6.3) were pre-frail and frail, respectively. Having more depression (β = .28, p

Abstract Background Olfactory neuroblastoma is a rare malignancy of the anterior skull base typically treated with surgery and adjuvant radiation. Although outcomes are fair for low-grade disease, patients with high-grade, recurrent, or metastatic disease oftentimes respond poorly to standard treatment methods. We hypothesized that an in-depth evaluation of the olfactory neuroblastoma tumor immune microenvironment would identify mechanisms of immune evasion in high-grade olfactory neuroblastoma as well as rational targetable mechanisms for future translational immunotherapeutic approaches. Methods Multispectral immunofluorescence and RNAScope evaluation of the tumor immune microenvironment was performed on forty-seven clinically annotated olfactory neuroblastoma samples. A retrospective chart review was performed and clinical correlations assessed. Results A significant T cell infiltration was noted in olfactory neuroblastoma samples with a stromal predilection, presence of myeloid-derived suppressor cells, and sparse natural killer cells. A striking decrease was observed in MHC-I expression in high-grade olfactory neuroblastoma compared to low-grade disease, representing a mechanism of immune evasion in high-grade disease. Mechanistically, the immune effector stromal predilection appears driven by low tumor cell MHC class II (HLA-DR), CXCL9, and CXCL10 expression as those tumors with increased tumor cell expression of each of these mediators correlated with significant increases in T cell infiltration. Conclusion These data suggest that immunotherapeutic strategies that augment tumor cell expression of MHC class II, CXCL9, and CXCL10 may improve parenchymal trafficking of immune effector cells in olfactory neuroblastoma and augment immunotherapeutic responses.

Abstract Background Utilizing clinical tests, such as objective cough measurement, can assist in predicting the success of the weaning process in critically ill patients. Methods A multicenter observational analytical study was conducted within a prospective cohort of patients recruited to participate in COBRE-US. We assessed the capability of objective cough measurement to predict the success of the spontaneous breathing trial (SBT) and extubation. Intra- and inter-observer reproducibility of the cough test and was evaluated using the intraclass correlation coefficient (ICC) and Cohen’s weighted kappa. We used receiver operating characteristic curves (ROC-curve) to evaluate the predictive ability of objective cough measurement. Results We recruited 367 subjects who were receiving invasive mechanical ventilation. A total of 451 objective cough measurements and 456 SBTs were conducted. A significant association was found between objective cough measurement and successful SBT (OR: 1.68; 95% CI 1.48–1.90; p = 0.001). The predictive capability of the objective cough test for SBT success had a ROC-curve of 0.58 (95% CI: 0.56–0.61). Objective cough measurement to predict successful extubation had a ROC-curve of 0.61 (95% CI: 0.56–0.66). The intraobserver reproducibility exhibited an ICC of 0.94 (95% CI: 0.89–0.96; p

Abstract Background Congenital ichthyosis (CI) is a collective group of rare hereditary skin disorders. Patients present with epidermal scaling, fissuring, chronic inflammation, and increased susceptibility to infections. Recently, there is increased interest in the skin microbiome; therefore, we hypothesized that CI patients likely exhibit an abnormal profile of epidermal microbes because of their various underlying skin barrier defects. Among recruited individuals of Southeast Asian ethnicity, we performed skin meta-genomics (i.e., whole-exome sequencing to capture the entire multi-kingdom profile, including fungi, protists, archaea, bacteria, and viruses), comparing 36 CI patients (representing seven subtypes) with that of 15 CI age-and gender-matched controls who had no family history of CI. Results This case–control study revealed 20 novel and 31 recurrent pathogenic variants. Microbiome meta-analysis showed distinct microbial populations, decreases in commensal microbiota, and higher colonization by pathogenic species associated with CI; these were correlated with increased production of inflammatory cytokines and Th17- and JAK/STAT-signaling pathways in peripheral blood mononuclear cells. In the wounds of CI patients, we identified specific changes in microbiota and alterations in inflammatory pathways, which are likely responsible for impaired wound healing. Conclusions Together, this research enhances our understanding of the microbiological, immunological, and molecular properties of CI and should provide critical information for improving therapeutic management of CI patients.

Abstract NADH autofluorescence imaging is a promising approach for visualizing energy metabolism at the single-cell level. However, it is sensitive to the redox ratio and the total NAD(H) amount, which can change independently from each other, for example with aging. Here, we evaluate the potential of fluorescence lifetime imaging microscopy (FLIM) of NADH to differentiate between these modalities. We perform targeted modifications of the NAD(H) pool size and ratio in cells and mice and assess the impact on NADH FLIM. We show that NADH FLIM is sensitive to NAD(H) pool size, mimicking the effect of redox alterations. However, individual components of the fluorescence lifetime are differently impacted by redox versus pool size changes, allowing us to distinguish both modalities using only FLIM. Our results emphasize NADH FLIM’s potential for evaluating cellular metabolism and relative NAD(H) levels with high spatial resolution, providing a crucial tool for our understanding of aging and metabolism.

Abstract Background The characteristics of optimal virtual pulmonary rehabilitation (PR) for individuals with post-COVID syndrome (PCS) have not been identified. This study aimed to assess the feasibility, safety, and satisfaction associated with a virtual PR program with the exercise component delivered through group or self-directed sessions. Methods Adults with PCS-respiratory symptoms were randomly assigned to the video conference (PRVC) or self-directed (PRSD) group and completed an exercise program (aerobic, strengthening, and breathing exercises) three times/week for eight weeks. PRVC sessions were led by a physiotherapist via Zoom, whereas the PRSD group exercised individually following a pre-recorded video. Both groups received personalized exercise recommendations, education related to the condition, and a weekly follow up call. Satisfaction was assessed through a patient survey. Lung function, dyspnea, fatigue, sit-to-stand capacity, health-related quality of life, and participation were assessed pre- and post-PR. Results Fourteen PCS individuals (49 ± 9 years, 86% females) completed 83% of the sessions. All participants were satisfied with information provided by the therapist and frequency of data submission, whereas most were satisfied with the frequency and duration of exercise sessions (88% in PRVC and 83% in PRSD). A higher proportion of participants in the PRVC (88%) were satisfied with the level of difficulty of exercises compared with the PRSD (67%), and 84% of the sample reported a positive impact of the program on their health. No adverse events were reported. Significant changes in sit-to-stand capacity (p = 0.012, Cohen’s r = 0.67) and questions related to fatigue (p = 0.027, Cohen’s r = 0.58), neurocognitive (p = 0.045, Cohen’s r = 0.53), and autonomic (p = 0.024, Cohen’s r = 0.60) domains of the DePaul Symptom Questionnaire short-form were also found between groups. Conclusion Virtual PR with exercises delivered via video conference or pre-recorded video were feasible, safe, and well-received by individuals with PCS. Trial registration NCT05003271 (first posted: 12/08/2021).

Abstract Background The transitivity assumption is the cornerstone of network meta-analysis (NMA). Violating transitivity compromises the credibility of the indirect estimates and, by extent, the estimated treatment effects of the comparisons in the network. The present study offers comprehensive empirical evidence on the completeness of reporting and evaluating transitivity in systematic reviews with multiple interventions. Methods We screened the datasets of two previous empirical studies, resulting in 361 systematic reviews with NMA published between January 2011 and April 2015. We updated our evidence base with an additional 360 systematic reviews with NMA published between 2016 and 2021, employing a pragmatic approach. We devised assessment criteria for reporting and evaluating transitivity using relevant methodological literature and compared their reporting frequency before and after the PRISMA-NMA statement. Results Systematic reviews published after PRISMA-NMA were more likely to provide a protocol (odds ratio (OR): 3.94, 95% CI: 2.79–5.64), pre-plan the transitivity evaluation (OR: 3.01, 95% CI: 1.54–6.23), and report the evaluation and results (OR: 2.10, 95% CI: 1.55–2.86) than those before PRISMA-NMA. However, systematic reviews after PRISMA-NMA were less likely to define transitivity (OR: 0.57, 95% CI: 0.42–0.79) and discuss the implications of transitivity (OR: 0.48, 95% CI: 0.27–0.85) than those published before PRISMA-NMA. Most systematic reviews evaluated transitivity statistically than conceptually (40% versus 12% before PRISMA-NMA, and 54% versus 11% after PRISMA-NMA), with consistency evaluation being the most preferred (34% before versus 47% after PRISMA-NMA). One in five reviews inferred the plausibility of the transitivity (22% before versus 18% after PRISMA-NMA), followed by 11% of reviews that found it difficult to judge transitivity due to insufficient data. In justifying their conclusions, reviews considered mostly the comparability of the trials (24% before versus 30% after PRISMA-NMA), followed by the consistency evaluation (23% before versus 16% after PRISMA-NMA). Conclusions Overall, there has been a slight improvement in reporting and evaluating transitivity since releasing PRISMA-NMA, particularly in items related to the systematic review report. Nevertheless, there has been limited attention to pre-planning the transitivity evaluation and low awareness of the conceptual evaluation methods that align with the nature of the assumption.

Virtual culinary medicine education interventions have the potential to improve dietary behaviors, nutrition knowledge, cooking skills, and health outcomes for ethnically diverse individuals with type 2 diabetes. The purpose of this study is to describe the adaptation of the Nourishing the Community through Culinary Medicine (NCCM) program for virtual delivery, and the protocol for pilot testing this intervention. The intervention includes five 90-min virtual NCCM sessions streamed live from a Teaching Kitchen. Feasibility outcomes are recruitment, retention, acceptability, and satisfaction. Short-term effectiveness outcomes are measured through self-administered questionnaires, including perceived health, average daily servings of fruits and vegetables, frequency of healthy food consumption, shopping, cooking, and eating behaviors, cooking self-efficacy, diabetes self-management, perceived barriers to healthy eating, and nutrition knowledge. Demographics and biometric outcomes are sourced from the patient’s electronic medical records including glycosylated hemoglobin (HbA1c), Body Mass Index, and blood pressure. We will conduct a single-arm pilot study to test the feasibility and short-term effectiveness of NCCM program with individuals with type 2 diabetes.

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Abstract Volcanic eruptions carry essential information on the dynamics of volcanic systems. Studies have documented variable eruption styles and eruptive surface deformation. However, co‐eruptive subsurface structural changes remain poorly understood. Here we characterize the seismic velocity changes from July 2019 to July 2023 at Great Sitkin Volcano in the central Aleutian volcanic arc, using single‐station ambient noise interferometry at five three‐component seismic stations. Coincident with the lava effusion since late July 2021, about two months after the explosive eruption on 26 May 2021, we observe a sustained velocity increase, most prominently to the northwest of the caldera. We attribute this velocity increase to the structural changes with magma extrusion, with the spatial variation controlled by the geometry of the magma system or the property of shallow volcaniclastics. Our findings offer insights into understanding co‐eruptive structural modifications at active volcanoes.

Vinasse is an effluent generated during the distillation process of mezcal and other alcoholic beverages. This substance typically shows an acidic pH and a high concentration of organic matter, causing a potentially polluting byproduct if not subjected to appropriate treatment and disposal methods. However, used efficiently, the high organic load within this effluent can be a rich source of soluble carbon and other organic nutrients, such as nitrogen and phosphorus, for microalgae growth. This study evaluated the tolerance of Stigeoclonium nanum to mezcal vinasse, using dilutions of 10, 20, 30, and 40 %, using complementary inoculum fractions in BG11 mineral medium over an eleven-day kinetic period. Daily determinations of photosynthetic pigments, nitrate nitrogen, and total phosphorus were made, along with the determination of Chemical Oxygen Demand (COD) at the beginning and end of the kinetic. The results revealed optimal growth with a higher production of photosynthetic pigments (compared to the control kinetic in mineral medium) at the 20 % dilution. The results obtained for this dilution were 18 mg L-1 of chlorophyll total production at the end of the kinetic period; additionally, a reduction of nitrate nitrogen on the effluent of 97.23 %, equivalent to 22.77 mg L-1, and a decrease of total phosphorus by 88.33 %, corresponding to 1.74 mg L-1. There was also a decrease of COD by 757 mg L-1, constituting 56.36 % of the total content in the effluent. When contaminants persist in the water with values higher than the allowed limits, it may cause some harmful effects on the environment. Microalgae exhibit remarkable adaptability and have the potential of consuming high amounts of nitrogen and phosphorus from wastewater treating pollutants from it to release them into the environment in compounds with less or no toxicity; thus, avoiding the risk of eutrophication of the water bodies and reducing the toxicity to human health. Utilizing effluents with high organic loads, such as vinasse, presents challenges. Therefore, this study provides a foundation for developing a culturing medium that ensures microalgae biomass growth and offers a phytoremediation alternative for treating industrial effluents.

The Mediterranean will be one of the focal points of climate change. The predicted dry and hot summers will lead to water scarcity in agriculture, which may limit crop production and growth. The olive tree serves as a model woody plant for studying drought stress and improving water resource management; thus, it is critical to identify genotypes that are more drought tolerant and perform better under low irrigation or even rainfed conditions. In this study, the metabolomic approach was used to highlight variations in metabolites in stems and leaves of three Italian olive cultivars (previously characterized physiologically) under two and four weeks of drought stress. Phenolic and lipophilic profiles were obtained by gas chromatography-mass spectrometry and ultra-high performance liquid chromatography-mass spectrometry, respectively. The findings identified the leaf as the primary organ in which phenolic variations occurred. The Maurino cultivar exhibited a strong stress response in the form of phenolic compound accumulation, most likely to counteract oxidative stress. The phenolic compound content of ‘Giarraffa’ and ‘Leccino’ plants remained relatively stable whether they were exposed to drought or not. Variations in the lipid profile occurred in leaves and stems of all the cultivars. A high accumulation of compounds related to epicuticular wax components was observed in the leaf of ‘Giarraffa’, while a strong reduction of lipids and long-chain alkanes occurred in ‘Maurino’ when exposed to drought stress conditions.

BackgroundEvidence suggests that a combination of biological and social factors influence risk of dementia differently for women and men. In healthy older women, several factors may contribute to changes in cognition.ObjectiveDescribe the characteristics associated with variation in cognition in a sample of cognitively healthy older Panamanian women.MethodsThe study includes cross-sectional analyses of cognitive domains at baseline (n = 357) and 17-month (SD = 2.0) follow-up (n = 200) for women aged 60 years and older enrolled in the Panama Aging Research Initiative-Health Disparities (PARI-HD) study. Instruments included clinical questionnaires, physiological measures, and a neuropsychological test battery assessing global cognition and seven cognitive domains. Multiple regression analyses examined the associations between demographic and clinical characteristics and cognition at baseline. Repeated measures analyses were used to investigate changes in cognition from baseline to follow-up.ResultsOn average, participants were 68.6 years of age (SD = 5.9) with 16.1 years of education (SD = 4.7). Age, income, and education showed robust associations with baseline cognition. Subjective cognitive impairment was associated with lower performance in global cognition, verbal learning, and memory domains. Only performance in the attention domain decreased at follow-up, and subjective health state and depressive symptoms significantly predicted the change in attention.DiscussionOur study findings contribute to the investigation of cognitive health in older Hispanic women and to the understanding of sociodemographic and health-related factors associated with cognitive decline and the progression to cognitive impairment and dementia.

Non-governmental organizations play an extremely important role in society, intervening subsidiarily for the welfare of society.This paper describes the results of an exploratory qualitative research, the objective of which is to identify the difficulties and challenges faced by non-governmental organizations, challenges that can generate opportunities for their development. The research was carried out between 2020-2022, on a number of 15 non-governmental organizationsfrom Brasov county. Data collection was carried out through semi-structured interviews. The interviews were carried out with people from the management structures of the non-governmental organizations. The results of the research show that the main difficulties of non-governmental organizations are related to the lack of money, the lack of human resuourses and barriers in promoting the services offered. As opportunities, we can note the development of organisations through reinvention and interdisciplinarity.

Abstract Background The physical activity (PA) prescription workshop for physicians, through the global health initiative “Exercise is Medicine” (EIM), has trained more than 4000 health care professionals (HCPs) in Latin America. It has shown to be effective in increasing PA prescription knowledge and awareness among HCPs. The purpose of this paper is to evaluate the curricular and pedagogical approach used by EIM Colombia at the PA prescription workshops implemented between 2014 and 2015. Methods A mixed methods study, with a sequential explanatory design was implemented among a convenience sample of HCPs attending twenty-six PA prescription workshops. HCPs health status, PA personal habits, and medical practices were collected using a questionnaire at baseline among 795 participants (pre-test measurement), and subsequently quantitatively analyzed. A workshop satisfaction survey was administered after the completion of the workshop among 602 HCPs. The curricular and pedagogical approach of the workshop, the designers’ and students’ contextual factors, and perceptions about the workshop were measured using qualitative methods (analysis of the procedures manual, two workshop observations, three semi-structured interviews, and one focus group including 8 HCPs). Results The workshop is student-centered and guided by an expert with an academic and clinical background. Learning was achieved with theoretical and practical components using authentic performance and collaborative learning. An active teaching and learning approach was used with strategies such as interactive lectures, hands-on elements, and role-playing (patient-counselor). The workshop emphasized an individual approach when prescribing PA integrating in clinical practice not only health benefits but also patient´s beliefs, motivations, needs, and barriers. Conclusions Evidence-based practices and authentic performance were the most salient pedagogical elements used by EIM Colombia at the PA prescription workshop. A knowledge assessment that includes the practical aspect is suggested for future workshops. The curricular and pedagogical approach of the PA prescription workshop implemented in Colombia is well received by the medical community and a useful continuing medical education intervention with a potential contribution to current, and future health promotion needs.

Abstract Objective To evaluate the impact of a curricular intervention to promote health-related fitness (HRF) among medical students in Bogota, Colombia. Method The study was conducted between May 2014 and December 2015 as part of the medical physiology course, in which 208 medical students were enrolled.The curricular intervention included two lectures on physical activity (PA) and student-led group presentations on the physiological effects of exercise on human physiology. An academic incentive (10% of final grade) was given to students who reported and documented regular PA practice during the semester. This study assessed students’ HRF variables, perceptions of the curriculum intervention, and PA practices using quantitative and qualitative approaches. Results 55% of the students were female, with a mean age of 19.5 years. Body fat, estimated maximum oxygen consumption (VO2max), handgrip, and sit-up strength showed statistically significant improvements at the end of the intervention. Students reported that PA practice was positively influenced by the curriculum intervention, particularly the academic incentive and the HRF tests. Students reported a wide variety of PA practices, which were mainly done with friends, classmates, or family members. Lack of time was the main reported barrier to PA practice. Conclusion The curricular intervention was effective in improving HRF and promoting PA. It remains to be investigated whether these gains are sustained over time.

Background and Aims: Survival rates for esophageal squamous cell carcinoma (ESCC) are extremely low due to the late diagnosis of most cases. An understanding of the early molecular processes that lead to ESCC may facilitate opportunities for early diagnosis; however, these remain poorly defined. Tylosis with esophageal cancer (TOC) is a rare syndrome associated with a high lifetime risk of ESCC and germline mutations in RHBDF2, encoding iRhom2. Using TOC as a model of ESCC predisposition, this study aimed to identify early-stage transcriptional changes in ESCC development. Methods: Esophageal biopsies were obtained from control and TOC individuals, the latter undergoing surveillance endoscopy, and adjacent diagnostic biopsies were graded as having no dysplasia or malignancy. Bulk RNA-Seq was performed, and findings were compared with sporadic ESCC vs normal RNA-Seq datasets. Results: Multiple transcriptional changes were identified in TOC samples, relative to controls, and many were detected in ESCC. Accordingly, pathway analyses predicted an enrichment of cancer-associated processes linked to cellular proliferation and metastasis, and several transcription factors were predicted to be associated with TOC and ESCC, including negative enrichment of GRHL2. Subsequently, a filtering strategy revealed 22 genes that were significantly dysregulated in both TOC and ESCC. Moreover, Keratin 17, which was upregulated in TOC and ESCC, was also found to be overexpressed at the protein level in ‘normal’ TOC esophagus tissue. Conclusion: Transcriptional changes occur in TOC esophagus prior to the onset of dysplasia, many of which are associated with ESCC. These findings support the utility of TOC to help reveal the early molecular processes that lead to sporadic ESCC.

Objective: Nurses inevitably encounter patients who require care aimed at limiting therapeutic effort (LTE), even though many of them are not prepared to provide support to individuals with terminal illnesses and their families. One of the contexts in which the LTE is considered is the intensive care unit (ICU). This review is to describe the competencies for the execution of a nursing professional role in the LTE in the ICU. Method: An integrative review of the literature published between the years 2010 and 2023. The search was carried out in five databases: Medline, Wiley Online Library, SciELO, ScienceDirect, and Web of Science. The Critical Appraisal Skills Programme in Spanish was used as the template for study evaluation. The methodology of the Oxford Center for Evidence-Based Medicine (CEBM) was used to assess the level of evidence and the degree of recommendation. Result: A total of 25 articles in a wide range of studies were included. The findings suggest that the competencies for LTE in the ICU are direct patient care, family-centered care, and the role of the nurse within the team. However, more high-quality studies are needed to confirm these conclusions. Three categories were identified: (a) competencies as defender agent between the patient, his family, and the interdisciplinary team; (b) competencies for decision-making in limiting the therapeutic effort; and (c) competencies for nursing therapeutic interventions at the end of life. Conclusion: The competencies of the nursing professionals who work in the adult ICU in the LTE are essential to the patient’s quality of life, dignity of their death, and comprehensive family support for coping with grief.

The best way to represent EMG signals for classification is a topic that has been widely studied due to the need to improve precision when identifying the type of movement being performed. However, by increasing the number of features when forming a matrix that represents the signals, the processing time increases since it not only involves calculating the features that are extracted from the signal but also the time that the classifier takes to answer. The central purpose of this research is to develop and validate a methodology that uses the Fisher Score to select a set of features in the classification of sEMG signals. This selected set is descriptive enough to achieve high levels of accuracy in detecting EMG signal patterns across multiple subjects. The analysis shows that using a variant of MAV, SSC, WAMP, RMS, and the maximum value together with the Shannon entropy and zero crossings of the Wavelet transform has an accuracy greater than 99%. Finally, a group of features is proposed to classify EMG signals that yield an accuracy greater than 98% and do not require more than 15 ms of processing time.

Basil is one type of vegetable that can be consumed without any processing. Unprocessed vegetables can cause contamination from Coliform bacteria. This study aimed to determine the number and identification of coliform fecal bacteria as a biological indicator suitable for consumption. This study used descriptive observational with a cross-sectional from November 2020 to March 2021. The research locations are from 8 Traditional Markets in Jember and the Microbiology Laboratory, Faculty of Medicine Jember University. The sample in this study consisted of 40 samples from basil vegetable sellers. The Most Probable Number method was carried out in two stages in this study. First, a presumptive test using lactose broth, and two, a complete test using Eosin Methylene Blue. The results of the presumptive test obtained 100% of the number of MPNs that exceeded the maximum limit for food quality suitable for consumption, according to BPOM. The complete test results showed that 82.5% of basil was contaminated with fecal coliform bacteria, namely Escherichia coli. Practically all the samples were highly infected with coliform bacteria. Suggestions the community is expected to pay attention to techniques in washing and processing basil vegetables properly to break the chain of bacterial contamination

Objetivos: comprender las experiencias sobre la lactancia materna desde la perspectiva de las mujeres, en un grupo de madres lactantes primerizas. Materiales y métodos: estudio cualitativo, bajo la perspectiva de etnografía, enfocado en un grupo de mujeres de la región oriente del departamento de Antioquia (Colombia). Por muestreo intencional y hasta la saturación de los datos se seleccionaron 16 mujeres lactantes primerizas, de 18 años o más, con hijos menores de 24 meses y que se encontraran amantando o hubiesen amantado de forma exclusiva al menos durante tres meses. Se realizaron entrevistas semiestructuradas y observación participante; el análisis de los datos se desarrolló por triangulación y codificación abierta y axial. Los resultados se presentan a través de la descripción de categorías. Resultados: se identificaron cuatro categorías frente a la experiencia del amamantamiento: el agotamiento y el dolor que se disipan con amor, la lactancia y el nuevo orden de las cosas, las emociones de una mujer en el cuerpo de una madre y la lactancia: un acto social. Conclusiones: proteger la lactancia materna requiere poner especial cuidado a la mujer como sujeto, más allá del amamantamiento, dando prioridad a su salud física y emocional como elementos esenciales que deben ser considerados por los profesionales en salud. Se requieren estudios que evalúen los efectos de la creación de grupos de apoyo que propicien el intercambio de saberes para acompañar a la mujer lactante.

Abstract Background Persistent headache is a frequent symptom after coronavirus disease 2019 (COVID-19) and there is currently limited knowledge about its clinical spectrum and predisposing factors. A subset of patients may be experiencing new daily persistent headache (NDPH) after COVID-19, which is among the most treatment-refractory primary headache syndromes. Methods We conducted a cross-sectional study in Latin America to characterize individuals with persistent headache after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to identify factors associated with NDPH. Participants over 18 years old who tested positive for SARS-CoV-2 infection and reported persistent headache among their symptoms completed an online survey that included demographics, past medical history, persistent headache clinical characteristics, and COVID-19 vaccination status. Based on participants’ responses, NDPH diagnostic criteria were used to group participants into NDPH and non-NDPH groups. Participant data was summarized by descriptive statistics. Student’s t and Mann–Whitney U tests were used according to the distribution of quantitative variables. For categorical variables, Pearson’s chi-square and Fisher’s exact tests were used according to the size of expected frequencies. Binomial logistic regression using the backward stepwise selection method was performed to identify factors associated with NDPH. Results Four hundred and twenty-one participants from 11 Latin American countries met the inclusion criteria. One in four participants met the NDPH diagnostic criteria. The mean age was 40 years, with most participants being female (82%). Over 90% of the participants reported having had mild/moderate COVID-19. Most participants had a history of headache before developing COVID-19 (58%), mainly migraine type (32%). The most predominant clinical characteristics in the NDPH group were occipital location, severe/unbearable intensity, burning character, and radiating pain (p

Abstract Introduction Enteric methane (CH4) emissions are one of the largest components of the anthropogenic CH4 budget, and with accelerating climatic changes, there are calls to reduce anthropogenic greenhouse gas emissions. Certain seaweeds fed as supplements can reduce enteric CH4 emissions from ruminant animals by as much as 80%; however, these studies have yet to analyze downstream impacts that may arise from the deposit of affected manures on pastures or agricultural fields. Materials and Methods Here we conducted a 28‐day soil and manure incubation utilizing manures collected from dairy cows in a seaweed feeding trial to analyze the impacts of manure on greenhouse gas fluxes and nutrient cycling. Cows were fed different diets with a control group (no seaweed supplementation), and a 3% and 6% by dry‐weight seaweed (Chondrus crispus) supplementation. Three soil moisture treatments were also tested, with a field moist capacity [67% gravimetric water content (GWC)], a drier group (50% GWC), and a saturated treatment (84% GWC). Results We found that manure from seaweed‐fed cows reduced emissions of carbon dioxide and had similar emissions of methane and nitrous oxide to the control. Higher moisture levels increased CH4 emissions and nitrous oxide emissions with CH4 emissions trending higher in seaweed supplements trending higher in. Inorganic nitrogen turnover varied more based on moisture levels than seaweed supplements, as did the magnitude of methane and nitrous oxide emissions. Total carbon and nitrogen mostly decreased except in the 3% seaweed supplementation, which increased carbon and nitrogen with a drop in C:N in the 50% GWC group. Conclusion Seaweed supplements may partially reduce climate impacts of manures from cows fed seaweed supplements or at least not cause harm or impact manure quality. Given feeds may reduce enteric CH4 emissions, they may be a part of a successful strategy to reduce climate impacts of cattle.

Bee pollen is recognized as a superfood due to its high content of nutrients and bioactive compounds. However, its bioavailability is restricted by a degradation-resistant outer layer known as exine. Physical and biotechnological techniques have recently been developed to degrade this layer and improve pollen’s nutritional and functional profile. This review examines how processing methods such as fermentation, enzymatic hydrolysis, ultrasound, and drying affect pollen’s chemical profile, nutrient content, and bioactive compounds. The review also considers changes in exine structure and possible synergistic effects between these methods. In addition, the challenges associated with the commercialization of processed bee pollen are examined, including issues such as product standardization, stability during storage, and market acceptance. The objective was to provide an understanding of the efficacy of these techniques, their physicochemical conditions, and their effect on the nutritional value of the pollen. The work also analyzes whether pollen transformation is necessary to maximize its benefits and offers conclusions based on the analysis of available methods, helping to determine whether pollen transformation is a valid strategy for inclusion in functional foods and its impact on consumer health. Although the literature reports that pollen transformation influences its final quality, further studies are needed to demonstrate the need for pollen exine modification, which could lead to greater market availability of pollen-based products with functional properties.

The olive tree is well adapted to the Mediterranean climate, but how orchards based on intensive practices will respond to increasing drought is unknown. This study aimed to determine if the application of a commercial biostimulant improves olive tolerance to drought. Potted plants (cultivars Arbequina and Galega) were pre-treated with an extract of Ascophyllum nodosum (four applications, 200 mL of 0.50 g/L extract per plant), and were then well irrigated (100% field capacity) or exposed to water deficit (50% field capacity) for 69 days. Plant height, photosynthesis, water status, pigments, lipophilic compounds, and the expression of stress protective genes (OeDHN1—protective proteins’ dehydrin; OePIP1.1—aquaporin; and OeHSP18.3—heat shock proteins) were analyzed. Water deficit negatively affected olive physiology, but the biostimulant mitigated these damages through the modulation of molecular and physiological processes according to the cultivar and irrigation. A. nodosum benefits were more expressive under water deficit, particularly in Galega, promoting height (increase of 15%) and photosynthesis (increase of 34%), modulating the stomatal aperture through the regulation of OePIP1.1 expression, and keeping OeDHN1 and OeHSP18.3 upregulated to strengthen stress protection. In both cultivars, biostimulant promoted carbohydrate accumulation and intrinsic water-use efficiency (iWUE). Under good irrigation, biostimulant increased energy availability and iWUE in Galega. These data highlight the potential of this biostimulant to improve olive performance, providing higher tolerance to overcome climate change scenarios. The use of this biostimulant can improve the establishment of younger olive trees in the field, strengthen the plant’s capacity to withstand field stresses, and lead to higher growth and crop productivity.

Silicon (Si) has attracted worldwide attention for its ultrahigh theoretical storage capacity (4200 mA h g−1), low mass density (2.33 g cm−3), low operating potential (0.4 V vs. Li/Li+), abundant reserves, environmentally benign nature, and low cost. It is a promising high-energy-density anode material for next-generation lithium-ion batteries (LIBs), offering a replacement for graphite anodes owing to the escalating energy demands in booming automobile and energy storage applications. Unfortunately, the commercialization of silicon anodes is stringently hindered by large volume expansion during lithiation–delithiation, the unstable and detrimental growth of electrode/electrolyte interface layers, sluggish Li-ion diffusion, poor rate performance, and inherently low ion/electron conductivity. These present major safety challenges lead to quick capacity degradation in LIBs. Herein, we present the synergistic effects of nanostructured silicon and SrTiO3 (STO) for use as anodes in Li-ion batteries. Si and STO nanoparticles were incorporated into a multiwalled carbon nanotube (CNT) matrix using a planetary ball-milling process. The mechanical stress resulting from the expansion of Si was transferred via the CNT matrix to the STO. We discovered that the introduction of STO can improve the electrochemical performance of Si/CNT nanocomposite anodes. Experimental measurements and electrochemical impedance spectroscopy provide evidence for the enhanced mobility of Li-ions facilitated by STO. Hence, incorporating STO into the Si@CNT anode yields promising results, exhibiting a high initial Coulombic efficiency of approximately 85%, a reversible specific capacity of ~800 mA h g−1 after 100 cycles at 100 mA g−1, and a high-rate capability of 1400 mA g−1 with a capacity of 800 mA h g−1. Interestingly, it exhibits a capacity of 350 mAh g−1 after 1000 lithiation and delithiation cycles at a high rate of 600 mA hg−1. This result unveils and sheds light on the design of a scalable method for manufacturing Si anodes for next-generation LIBs.

Inula viscosa is a widely used plant in traditional Mediterranean and Middle Eastern medicine for various illnesses. I. viscosa has been shown to have anticancer effects against various cancers, but its effects against lung cancer have been under limited investigation. At the same time, I. viscosa is rich in terpenoids whose anti-lung cancer effects have been poorly investigated. This study aimed to examine the potential anticancer properties of methanolic and aqueous extracts of stems and leaves of I. viscosa and its terpenoid-rich fraction against human lung cancer A549 cells. Results showed that the methanolic extracts of I. viscosa had significantly higher polyphenol and flavonoid content and radical scavenging capacity than the aqueous extracts. In addition, leaves methanolic extracts (IVLM) caused the highest reduction in viability of A549 cells among all the extracts. IVLM also reduced the viability of human ovarian SK-OV-3, breast MCF-7, liver HepG2, and colorectal HCT116 cancer cells. A terpenoid-rich I. viscosa fraction (IVL DCM), prepared by liquid-liquid separation of IVLM in dichloromethane (DCM), displayed a substantial reduction in the viability of A549 cells (IC50 = 27.8 ± 1.5 µg/mL at 48 h) and the panel of tested cancerous cell lines but was not cytotoxic to normal human embryonic fibroblasts (HDFn). The assessment of IVL DCM phytochemical constituents using GC-MS analysis revealed 21 metabolites, highlighting an enrichment in terpenoids, such as lupeol and its derivatives, caryophyllene oxide, betulin, and isopulegol, known to exhibit proapoptotic and antimetastatic functions. IVL DCM also showed robust antioxidant capacity and decent polyphenol and flavonoid contents. Furthermore, Western blotting analysis indicated that IVL DCM reduced proliferation (reduction of proliferation marker Ki67 and induction of proliferation inhibitor proteins P21 and P27), contaminant with P38 MAP kinase activation, and induced the intrinsic apoptotic pathway (P53/BCL2/BAX/Caspase3/PARP) in A549 cells. IVL DCM also reduced the migration of A549 cells, potentially by reducing FAK activation. Future identification of anticancer metabolites of IVL DCM, especially terpenoids, is recommended. These data place I. viscosa as a new resource of herbal anticancer agents.

La neoplasia ginecológica más frecuente son los leiomiomas uterinos, tumores benignos hormonodependientes que se generan del músculo liso del miometrio. Presentan una alta incidencia en mujeres en edad reproductiva entre la cuarta y quinta década de la vida y suelen disminuir con la menopausia. Generalmente son asintomáticos, pero a menudo se pueden acompañar de dismenorrea, metrorragia o infertilidad. El estudio inicial para su caracterización es la ecografía transvaginal; sin embargo, la resonancia magnética tiene un alto valor diagnóstico, ya que permite una evaluación más específica sobre el tipo, ubicación y número de leiomiomas, así como también permite identificar el tipo de degeneración y diferenciar entre leiomiomas y sus lesiones imitadoras. El objetivo principal de este manuscrito es abordar las principales características en resonancia magnética entre los distintos tipos de degeneración leiomiomatosa, siendo esta una causa de posible dolor abdominal y pélvico agudo.

Las anormalidades de la válvula tricúspide tienen una incidencia menor respecto a los defectos del resto de válvulas cardiacas y pueden deberse a causas primarias o secundarias. Recientemente, se ha estudiado su fisiopatología y su importancia en la morbimortalidad por causas cardiacas. En este sentido, la cirugía valvular tricúspide abierta tiene una tasa de morbimortalidad elevada, más aún cuando se trata de una reoperación. Es por esto que estos procedimientos endovasculares transcatéter cobran relevancia y recientemente se han publicado a lo largo del mundo algunos casos de intervenciones por este método, por medio de implante valvular percutáneo valve-in-valve en posición tricúspide. Se presenta el primer caso reportado de este procedimiento en Colombia en una paciente pediátrica, el cual transcurrió sin complicaciones y con el que se logró una mejoría significativa en la función valvular como paso inicial para continuar desarrollando la técnica y realizando este procedimiento en el país.

Este artículo traza un breve recorrido del concepto práctica artística como investigación en el contexto europeo, partiendo de autores que abren una estela que defiende y corrobora que el análisis de la propia obra artística puede ser científico, que tiene valor como investigación y fuente de conocimiento. Dichos teóricos trascienden la utilización de las artes como método de estudio, reivindicando el derecho de los artistas a contribuir al saber, práctico y no práctico, con la misma legitimidad que la investigación tradicional, monopolizada durante siglos por filósofos, historiadores del arte, filólogos, críticos o comisarios de arte. En estas páginas, describo la transformación de la mirada sobre la obra de arte que propone la práctica artística como investigación, estimulando a las nuevas generaciones de artistas a trabajar bajo el paradigma de libertad creativa; un arte implicado en la sociedad, la historia y la política, que deja de ser representacional para transformarse en autocrítico, en un proceso abierto de reflexión y exploración que nunca se acaba. De ahí no solo es relevante el resultado final de la obra o un concepto artístico, sino por la observación de los propios procesos, que conllevan tanto un mayor desarrollo académico como el avance de proyectos que beneficien a la sociedad en su conjunto, trabajando por el cambio individual y colectivo.

IntroductionCancer stem cells (CSCs), a group of tumor-initiating and tumor-maintaining cells, may be major players in the treatment resistance and recurrence distinctive of chordoma. Characterizing CSCs is crucial to better targeting this subpopulation.MethodsUsing flow cytometry, six chordoma cell lines were evaluated for CSC composition. In vitro, cell lines were stained for B7H6, HER2, MICA-B, ULBP1, EGFR, and PD-L1 surface markers. Eighteen resected chordomas were stained using a multispectral immunofluorescence (mIF) antibody panel to identify CSCs in vivo. HALO software was used for quantitative CSC density and spatial analysis.ResultsIn vitro, chordoma CSCs express more B7H6, MICA-B, and ULBP1, assessed by percent positivity and mean fluorescence intensity (MFI), as compared to non-CSCs in all cell lines. PD- L1 percent positivity is increased by >20% in CSCs compared to non-CSCs in all cell lines except CH22. In vivo, CSCs comprise 1.39% of chordoma cells and most are PD-L1+ (75.18%). A spatial analysis suggests that chordoma CSCs cluster at an average distance of 71.51 mm (SD 73.40 mm) from stroma.DiscussionTo our knowledge, this study is the first to identify individual chordoma CSCs and describe their surface phenotypes using in vitro and in vivo methods. PD-L1 is overexpressed on CSCs in chordoma human cell lines and operative tumor samples. Similarly, potential immunotherapeutic targets on CSCs, including B7H6, MICA-B, ULBP1, EGFR, and HER2 are overexpressed across cell lines. Targeting these markers may have a preferential role in combating CSCs, an aggressive subpopulation likely consequential to chordoma’s high recurrence rate.

In cocoa production, the harvest and postharvest processes tend to generate residues that, if not properly treated or disposed of, become a source of pests or diseases for the crop and the farmer. The residues are environmental contaminants, which are equivalent to 70%–80% of the total fruit (husk, placenta, leachates). In the case of cacao pod husk (CPH), it is hollow form contributes to the accumulation of water or leachates. These residues with no apparent profitable use may have components of agroindustrial interest, such as pectins, cellulose, and starches, in products with high added value. Thus, the physicochemical characterization CPH of clones Castro Naranjal Collection 51 (CCN51), FEDECACAO Arauquita 5 (FEAR5), and FEDECACAO San Vicente 41 (FSV41) is presented to identify different applications such as biopolymers, bioremediation, and renewable energies and their potential biotechnological use in contributing to the circular economy according to the characteristics of each clone. In conclusion, it is important to continue with the research on CPHs of the different clones and to promote the sustainable development of cocoa in the Department of Risaralda, Colombia.

Abstract Conservation funding is currently limited; cost‐effective conservation solutions are essential. We suggest that the thousands of field stations worldwide can play key roles at the frontline of biodiversity conservation and have high intrinsic value. We assessed field stations’ conservation return on investment and explored the impact of COVID‐19. We surveyed leaders of field stations across tropical regions that host primate research; 157 field stations in 56 countries responded. Respondents reported improved habitat quality and reduced hunting rates at over 80% of field stations and lower operational costs per km2 than protected areas, yet half of those surveyed have less funding now than in 2019. Spatial analyses support field station presence as reducing deforestation. These “earth observatories” provide a high return on investment; we advocate for increased support of field station programs and for governments to support their vital conservation efforts by investing accordingly.

Background Chronic cough is a frequent reason for seeking consultation with primary care providers. The recent widespread adoption of virtual care offers a promising alternative that can be used to optimize the assessment and management of this condition. The objective of this review was to map and identify the strategies used to assess and/or manage chronic cough virtually, and to explore their impact on cough severity and patient satisfaction with virtual care. Methods A scoping review was conducted in MEDLINE, EMBASE, and CINAHL in May 2023. Research questions were defined based on the Population, Concept, Context mnemonic, and literature search was conducted using a three-step approach. Study selection involved the steps of identification, screening, eligibility, and inclusion. A descriptive synthesis was performed, and quantitative variables were presented as absolute and relative frequencies. Results A total of 4953 studies were identified and seven met the inclusion criteria. The following mHealth and telehealth strategies were identified: diagnostic website, specialized online clinic, online speech language therapy, and remote follow-up to assess the effectiveness of in-person interventions. Results indicated that these virtual strategies can be useful to assess chronic cough, treat, and track chronic cough symptoms. Overall, patients were satisfied with the approaches. Conclusion Although literature is scarce, evidence suggests that virtual strategies for the assessment and management of chronic cough may be effective and are well-received by patients. However, further research is needed to identify the type and characteristics of virtual approaches leading to optimize and facilitate the care of patients with this condition. This will also help develop a strong body of evidence to support their incorporation into guidelines and clinical practice.

Coronavirus adult respiratory distress syndrome, characterized by decreased surfactant due to lysis of type II pneumocytes and hyaline membrane formation, contributes to severe hypoxemia. The administration of surfactant via high-flow nasal cannula (HFNC) may positively affect lung structure and function in this context. In this study, we report on five clinical cases, encompassing patients aged 40–60 years of both sexes, who tested positive for coronavirus disease 2019 via real-time polymerase chain reaction and exhibited significant pulmonary compromise with elevated inflammatory biomarkers. These patients were treated with aerosol therapy using surfactant delivered through vibrating-mesh nebulizers alongside HFNC. Of these patients, four demonstrated positive responses to the treatment, suggesting that aerosol therapy with surfactant through vibrating-mesh nebulizers could be a viable rescue therapy in adults receiving HFNC oxygen therapy for hypoxemic respiratory failure caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Unfortunately, one patient had a negative outcome and succumbed. The findings from these cases indicate that the use of aerosol therapy with vibrating-mesh nebulizers as rescue therapy might offer an alternative approach for managing adults with hypoxemic respiratory failure due to SARS-CoV-2, as evidenced by the positive outcomes in four out of the five cases presented.

Abstract Introduction Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, is associated with high morbidity and mortality. The aim of the current study was to describe the historical and recent epidemiology of IMD in Colombia. Methods This retrospective surveillance database analysis examined all available data on IMD in Colombia. Data were extracted from publicly available disease event reports and laboratory surveillance reports or obtained directly from hospitals in Cartagena. Results During 2015–2021, the overall incidence of IMD was 0.04–0.18 per 100,000 based on laboratory surveillance reports. IMD incidence was highest among infants aged

Abstract Background Eating disorders (EDs) are serious, complex disorders for which broad-based clinical training is lacking. This study aimed to evaluate the efficacy of a free, brief, web-based curriculum, PreparED, in increasing comfort and confidence with, and knowledge about EDs in healthcare trainees, and to obtain program feedback from key stakeholders (i.e., learners). Methods This programmatic evaluation study was designed as a quantitative, repeated measures (i.e., pre- and post-test intervention) investigation. A convenience sample of two groups of healthcare trainees across geographically diverse training sites completed an anonymous survey pre- and post- engagement with PreparED. The survey included items to assess prior exposure to EDs, as well as program feasibility. The main educational outcomes included (1) Confidence and Comfort with EDs and (2) Knowledge of EDs. User experience variables of interest were likeability, usability, and engagement with the training modules. Mixed effects linear regression was used to assess the association between PreparED and educational outcome variables. Results Participants (N = 67) included 41 nutrition graduate students and 26 nurse practitioner students recruited from Teacher’s College/Columbia University in New York, NY, USA, Columbia University School of Nursing in New York, NY, USA and North Dakota State University School of Nursing in Fargo, ND, USA. Confidence/Comfort scores and Knowledge scores significantly improved following engagement with PreparED (β = for effect of intervention = 1.23, p

Magnesium (Mg) alloys have become a potential material for orthopedic implants due to their unnecessary implant removal, biocompatibility, and mechanical integrity until fracture healing. This study examined the in vitro and in vivo degradation of an Mg fixation screw composed of Mg-0.45Zn-0.45Ca (ZX00, in wt.%). With ZX00 human-sized implants, in vitro immersion tests up to 28 days under physiological conditions, along with electrochemical measurements were performed for the first time. In addition, ZX00 screws were implanted in the diaphysis of sheep for 6, 12, and 24 weeks to assess the degradation and biocompatibility of the screws in vivo. Using scanning electron microscopy (SEM) coupled with energy dispersive X-ray spectroscopy (EDX), micro-computed tomography (μCT), X-ray photoelectron spectroscopy (XPS), and histology, the surface and cross-sectional morphologies of the corrosion layers formed, as well as the bone-corrosion-layer-implant interfaces, were analyzed. Our findings from in vivo testing demonstrated that ZX00 alloy promotes bone healing and the formation of new bone in direct contact with the corrosion products. In addition, the same elemental composition of corrosion products was observed for in vitro and in vivo experiments; however, their elemental distribution and thicknesses differ depending on the implant location. Our findings suggest that the corrosion resistance was microstructure-dependent. The head zone was the least corrosion-resistant, indicating that the production procedure could impact the corrosion performance of the implant. In spite of this, the formation of new bone and no adverse effects on the surrounding tissues demonstrated that the ZX00 is a suitable Mg-based alloy for temporary bone implants.

Green and roasted coffee oils are products rich in bioactive compounds, such as linoleic acid and the diterpenes cafestol and kahweol, being a potential ingredient for food and cosmetic industries. An overview of oil extraction techniques most applied for coffee beans and their influence on the oil composition is presented. Both green and roasted coffee oil extractions are highlighted. Pressing, Soxhlet, microwave, and supercritical fluid extraction were the most used techniques used for coffee oil extraction. Conventional Soxhlet is most used on a lab scale, while pressing is most used in industry. Supercritical fluid extraction has also been evaluated mainly due to the environmental approach. One of the highlighted activities in Brazilian agribusiness is the industrialization of oils due to their increasing use in the formulation of cosmetics, pharmaceuticals, and foods. Green coffee oil (raw bean) has desirable bioactive compounds, increasing the interest of private companies and research institutions in its extraction process to preserve the properties contained in the oils.