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PURPOSE: The aim of this study was to evaluate the visual, pachymetric, tomographic, and biomicroscopic findings in a series of cases presenting laser in situ keratomileusis (LASIK) flap interface fluid syndrome (IFS) after Descemet membrane endothelial keratoplasty (DMEK) surgery. METHODS: Six cases were included in this study; all patients had a history of LASIK surgery and underwent DMEK for the treatment of bullous keratopathy. After uneventful surgery, all patients presented with corneal edema and IFS under the LASIK flap, which was demonstrated with anterior segment optical coherence tomography (AS-OCT). Visual acuity, clinical findings, pachymetry, endothelial cell count, and AS-OCT were documented during the management of these cases. RESULTS: IFS appears 2.33 days (±1.03) after DMEK surgery. One case improved with conservative treatment. In 5 cases, the LASIK flap was lifted, the fluid was drained, and the flap was replaced. The mean best-corrected visual acuity after fluid drainage was 0.44 logMAR (range 0.18-1.0) and mean central corneal thickness was 538 μm ± 160. Total resolution of the IFS was achieved at 14.5 days (range 4-30) after DMEK surgery. AS-OCT showed resolution of the flap interface in 5 of 6 cases, while 1 patient required second DMEK due to reaccumulation of the interface fluid. CONCLUSIONS: IFS can occur after DMEK surgery in patients with previous LASIK surgery. AS-OCT is a valuable tool for monitoring these cases preoperatively and postoperatively. Early surgical management is often needed to achieve resolution.

In the search for solutions to national skill formation challenges, the central and northern Europeans models of good practices in dual vocational education and training (VET) permeated the imaginary of the southern countries. Particularly, the German dual VET system has been predominant in the discourse of policy-makers. This research analyses the role played by the European Union (EU) in the promotion of this model as the reference for the reforming Member States during the policy transfer stage of cross-national attraction. This paper develops a reflexive Thematic Analysis among the fundamental documentation related to VET resulting from the EU Governance Triangle. Its aim is to interpret the EU proposal for the reform of VET, with a focus on the characteristics which shape the way in which the training is developed. This Thematic Analysis reveals that the EU promotes a VET training model based in work-based learning as a pillar, preferably articulated in the form of apprenticeships. This, along with the general principles for the regulation of apprenticeships promoted by the EU, proves the agency role exercised by the EU in the dissemination of dual VET as a model of good practice.

Breast milk is a vital source of nutrients, prebiotics, probiotics, and protective factors, including antibodies, immune cells and antimicrobial proteins. Using bacterial lipopolysaccharide arrays, we investigated the reactivity and specificity of breast milk antibodies towards microbial antigens, comparing samples from rural Kenya and urban Switzerland. Results showed considerable variability in antibody reactivity both within and between these locations. Kenyan breast milk demonstrated broad reactivity to bacterial lipopolysaccharides, likely due to increased microbial exposure. Antibodies primarily recognized the O-antigens of lipopolysaccharides and showed strong binding to specific carbohydrate motifs. Notably, antibodies against specific Escherichia coli O-antigens showed cross-reactivity with parasitic pathogens like Leishmania major and Plasmodium falciparum, thus showing that antibodies reacting against lipopolysaccharide Oantigens can recognize a wide range of antigens beyond bacteria. The observed diversity in antigen recognition highlights the significance of breast milk in safeguarding infants from infections, particularly those prevalent in specific geographic regions. The findings also offer insights for potential immunobiotic strategies to augment natural antibody-mediated defense against diverse pathogens. [ABSTRACT FROM AUTHOR]

The Tourism-Led Growth Hypothesis (TLGH) posits a fundamental area of research, explored in hundreds of papers elucidating the relationship between tourism activity and economic growth. However, proposing the TLGH is not logical as the bidirectional relationship between tourism and economic growth is theoretically undeniable. In this paper, we advocate for a shift in the study perspective towards more ambitious hypotheses that extends the TLGH, which can be summarized in the Tourism as Optimal Choice Hypothesis (TOCH) and the Tourism-Led Genuine Economic Development Hypothesis (TLGDH). [ABSTRACT FROM AUTHOR]

This paper analyses the validity of the tourism-led economic growth hypothesis (TLEGH) for the case of Spain after the COVID pandemic. Advanced tests (dynamic and nonlinear) of non-causality Granger are carried out on time series of tourist arrivals and income as well as the evolution of GDP between the period 1955-2022. After performing an analysis with data up to 2019, we then examine whether the introduction of COVID modifies the conclusions obtained using data up to 2022. As a novelty, our results contradict in some cases (denying the bidirectional relationship between tourism growth and economic development), and qualify in others (pointing out that the TLEGH remains in force only in periods of economic expansion) those obtained by previous literature. [ABSTRACT FROM AUTHOR]

Background: Ambient air pollution has been associated with COVID-19 disease severity and antibody response induced by infection. Objectives: We examined the association between long-term exposure to air pollution and vaccine-induced antibody response. METHODS: This study was nested in an ongoing population-based cohort, COVICAT, the GCAT-Genomes for Life cohort, in Catalonia, Spain, with multiple follow-ups. We drew blood samples in 2021 from 1,090 participants of 2,404 who provided samples in 2020, and we included 927 participants in this analysis. We measured immunoglobulin M (IgM), IgG, and IgA antibodies against five viral-target antigens, including receptor-binding domain (RBD), spike-protein (S), and segment spike-protein (S2) triggered by vaccines available in Spain. We estimated prepandemic (2018-2019) exposure to fine particulate matter [PM [less than or equal to] 2.5 [micro]m in aerodynamic diameter (P[M.sub.2.5])], nitrogen dioxide (N[O.sub.2]), black carbon (BC), and ozone ([O.sub.3]) using Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE) models. We adjusted estimates for individual- and area-level covariates, time since vaccination, and vaccine doses and type and stratified by infection status. We used generalized additive models to explore the relationship between air pollution and antibodies according to days since vaccination. Results: Among vaccinated persons not infected by SARS-CoV-2 (n = 632), higher prepandemic air pollution levels were associated with a lower vaccine antibody response for IgM (1 month post vaccination) and IgG. Percentage change in geometric mean IgG levels per interquartile range of P[M.sub.2.5] (1.7 [micro]g/[m.sup.3]) were -8.1 (95% CI: - 15.9, 0.4) for RBD, -9.9 (-16.2, -3.1) for S, and -8.4 (-13.5, -3.0) for S2. We observed a similar pattern for N[O.sub.2] and BC and an inverse pattern for [O.sub.3]. Differences in IgG levels by air pollution levels persisted with time since vaccination. We did not observe an association of air pollution with vaccine antibody response among participants with prior infection (n = 295). Discussion: Exposure to air pollution was associated with lower COVID-19 vaccine antibody response. The implications of this association on the risk of breakthrough infections require further investigation. https://doi.org/10.1289/EHP11989, Introduction Air pollution has been associated with COVID-19 disease initially in ecological studies and later in cohort studies using individual data. (1-6) There are some differences between findings of individual-based [...]

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The cell surface of Toxoplasma gondii is rich in glycoconjugates which hold diverse and vital functions in the lytic cycle of this obligate intracellular parasite. Additionally, the cyst wall of bradyzoites, that shields the persistent form responsible for chronic infection from the immune system, is heavily glycosylated. Formation of glycoconjugates relies on activated sugar nucleotides, such as uridine diphosphate N-acetylglucosamine (UDP-GlcNAc). The glucosamine-phosphate-N-acetyltransferase (GNA1) generates N-acetylglucosamine-6-phosphate critical to produce UDP-GlcNAc. Here, we demonstrate that downregulation of T. gondii GNA1 results in a severe reduction of UDP-GlcNAc and a concomitant drop in glycosylphosphatidylinositols (GPIs), leading to impairment of the parasite's ability to invade and replicate in the host cell. Surprisingly, attempts to rescue this defect through exogenous GlcNAc supplementation fail to completely restore these vital functions. In depth metabolomic analyses elucidate diverse causes underlying the failed rescue: utilization of GlcNAc is inefficient under glucose-replete conditions and fails to restore UDP-GlcNAc levels in GNA1-depleted parasites. In contrast, GlcNAc-supplementation under glucose-deplete conditions fully restores UDP-GlcNAc levels but fails to rescue the defects associated with GNA1 depletion. Our results underscore the importance of glucosamine-6-phosphate acetylation in governing T. gondii replication and invasion and highlight the potential of the evolutionary divergent GNA1 in Apicomplexa as a target for the development of much-needed new therapeutic strategies. Author summary: Toxoplasma gondii, Plasmodium, and Cryptosporidium spp., pose serious threats to human health. T. gondii, an intracellular and opportunistic pathogen, effectively avoids the host immune defences by forming long-lasting tissue cysts. Finding potent drugs to eliminate these persisting parasites remains a challenge. The glucosamine-phosphate-N-acetyltransferase (GNA1) catalyses a critical key step in the production of activated sugar nucleotides to build glycoconjugates essential for various functions in the cell. In P. falciparum, this enzyme has been identified as a potential target for antimalarial drugs. In this study, we explored the importance of this pathway in T. gondii and discovered that these sugar-containing compounds play a vital role in the parasite's ability to invade and replicate in host cells–crucial processes for its survival and ability to cause disease. Intriguingly, unlike some organisms that can bypass the pathway, T. gondii relies critically on glucosamine-6-phosphate acetylation. This reliance sheds light on the parasite's distinct metabolic properties and highlights the pathway's potential as a target for new therapeutic strategies. [ABSTRACT FROM AUTHOR]

Anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) seroprevalence is used to estimate the proportion of individuals within a population previously infected, to track viral transmission, and to monitor naturally and vaccine‐induced immune protection. However, in sub‐Saharan African settings, antibodies induced by higher exposure to pathogens may increase unspecific seroreactivity to SARS‐CoV‐2 antigens, resulting in false positive responses. To investigate the level and type of unspecific seroreactivitiy to SARS‐CoV‐2 in Africa, we measured immunoglobulin G (IgG), IgA, and IgM to a broad panel of antigens from different pathogens by Luminex in 602 plasma samples from African and European subjects differing in coronavirus disease 2019, malaria, and other exposures. Seroreactivity to SARS‐CoV‐2 antigens was higher in prepandemic African than in European samples and positively correlated with antibodies against human coronaviruses, helminths, protozoa, and especially Plasmodium falciparum. African subjects presented higher levels of autoantibodies, a surrogate of polyreactivity, which correlated with P. falciparum and SARS‐CoV‐2 antibodies. Finally, we found an improved sensitivity in the IgG assay in African samples when using urea as a chaotropic agent. In conclusion, our data suggest that polyreactive antibodies induced mostly by malaria are important mediators of the unspecific anti‐SARS‐CoV‐2 responses, and that the use of dissociating agents in immunoassays could be useful for more accurate estimates of SARS‐CoV‐2 seroprevalence in African settings. [ABSTRACT FROM AUTHOR]