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In this paper, we analyzed the local stability of three species in two fractional tritrophic systems, with Caputo's fractional derivative and Holling type Ⅱ and Ⅲ functional responses, when the prey density has a linear growth. To begin, we obtained the equilibria in the first octant under certain conditions for the parameters. Subsequently, through linearization and applying the Routh-Hurwitz Criterion, we concluded that only the system with Holling type Ⅲ exhibits an asymptotically stable equilibrium point, where the fractional derivative order belongs to the interval $ (0, 1] $. Finally, we obtained the solution of the system with the Holling type Ⅲ functional response, using the multistage homotopic perturbation method, and presented an example that shows the dynamics of the solutions around the stable equilibrium point.

Background. In the United States, no published guidelines promote exposure to technical variants (ie, living donor or split liver) during transplant fellowship. Simulation with hands-on liver models may improve training in transplantation. This pilot study addressed 3 overall goals (material and model creation tools, recruitment rates and assessment of workload, and protocol adherence). Methods. A patient-specific hands-on liver model was constructed from clinical imaging, and it needed to be resilient and realistic. Multiple types of materials were tested between January 2020 and August 2022. Participants were recruited stepwise. A left lateral segmentectomy simulation was conducted between August 2022 and December 2022 to assess protocol adherence. Results. Digital anatomy 3-dimensional printing was considered the best option for the hands-on liver model. The recruitment rate was 100% and 47% for junior attendings and surgical residents, respectively. Ten participants were included and completed all the required surveys. Seven (70%) and 6 (60%) participants “agreed” that the overall quality of the model and the material were acceptable for surgical simulation. Five participants (50%) “agreed” that the training improved their surgical skills. Nine participants (90%) “strongly agreed” that similar sessions should be included in surgical training programs. Conclusions. Three-dimensional hands-on liver models have the advantage of tactile feedback and were rated favorably as a potential training tool. Study enrollment for further studies is possible with the support of leadership. Rigorous multicenter designs should be developed to measure the actual impact of 3-dimensional hands-on liver models on surgical training.

Background. Living donation is paramount for expanding the donor pool. The aim of this study was to assess changes over time in self-reported mental health of living donor kidney applicants in efforts to inform patient-centered discussions with potential donors. Methods. Kidney donor applications from 2017 through 2021 were compiled. Data included age, gender, race, ethnicity, applicant–recipient relationship, medical history, and medications. Trends over time were analyzed and post hoc analyses were performed. Results. During the study period, 2479 applicants to the living donor kidney program were evaluated; 73% of applicants were female individuals. More than half of applicants were not related to their intended recipient; this fraction increased from 46% in 2017 to 58% in 2021 (P

Background: Atopic dermatitis (AD) profoundly impacts quality of life as a chronic inflammatory skin disease. Allergen exposure triggers specific IgE antibodies, initiating allergy symptoms. Cross-reactivity, linked to auto-IgE responses, potentially influences AD severity. Exploring new allergens and self-autoantigens, like Aspergillus fumigatus, enhances knowledge of AD triggers. Our focus was on analyzing molecular mimicry between human AQP3 and A. fumigatus aquaporin, alongside various allergenic sources. Objective: Conduct an in silico assessment of potential molecular mimicry between human aquaporins, A. fumigatus, and diverse allergenic sources. Methods: Amino acid sequences of human AQP3 and A. fumigatus aquaporin were compared through multiple alignments with 25 aquaporins from diverse allergenic sources. Phylogenetic analysis and homology-based modeling were executed, and ElliPro server predicted conserved antigenic regions on 3D structures. Results: Global identity among studied aquaporins was 32.6%, with a specific conserved local region at 71.4%. Five monophyletic clades (A-E) were formed, and Group B displayed the highest identity (95%), including 6 mammalian aquaporins, notably AQP3. A. fumigatus aquaporin exhibited the highest identity with Malassezia sympodialis (35%). Three linear and three discontinuous epitopes were identified in both human and A. fumigatus aquaporins. The Root Mean Square Deviation (RMSD) from overlapping aquaporin structures was 1.006. Conclusion: Identification of potential linear and conformational epitopes on human AQP3 suggests likely molecular mimicry with A. fumigatus aquaporins. High identity in a specific antigenic region indicates potential autoreactivity and a probable antigenic site involved in cross-reactivity. Validation through in vitro and in vivo studies is essential for further understanding and confirmation.

Objetivo: Evaluar el riesgo de sensibilización IgE y síntomas a camarón en una población que ha recibido AIT con extracto polimerizado para ácaros. Métodos: Se incluyeron pacientes con rinitis alérgica sensibilizados a ácaros del polvo (Dermatophogides spp) con indicación de AIT para ácaros. Aquellos pacientes que no habían aún recibido AIT o llevaban menos de seis dosis, fueron incluidos como controles, y aquellos que llevaban más de 24 dosis de AIT, fueron incluidos como casos. Se evaluó la sensibilización a camarón mediante prueba cutánea con extracto completo de camarón y/o IgE específica a camarón. Resultados: En total, 68 pacientes fueron incluidos; 47 casos y 21 controles. Al calcular el odds ratio de la sensibilización de acuerdo al tiempo con la inmunoterapia, observamos que no había diferencias entre el grupo de casos y controles (OR 0,76 95% IC 0,26 a 2,22 p 0,7 por técnica de MacNemar). Factores como el consumo o no de camarón y la frecuencia de consumo, no parecen estar relacionados con el desenlace. Conclusión: A diferencia de lo reportado con extractos acuosos, observamos de AIT con extractos polimerizados para no es un factor de riesgo para la sensibilización a camarón. Es necesario reproducir estos resultados con un mayor tamaño de muestra que permita explorar otros factores.

Background Cranial neuropathies (CN) are a rare neuropsychiatric SLE (NPSLE) manifestation. Previous studies reported that antibodies to the kinesin family member 20B (KIF20B) (anti-KIF20B) protein were associated with idiopathic ataxia and CN. We assessed anti-KIF20B as a potential biomarker for NPSLE in an international SLE inception cohort.Methods Individuals fulfilling the revised 1997 American College of Rheumatology (ACR) SLE classification criteria were enrolled from 31 centres from 1999 to 2011 and followed annually in the Systemic Lupus Erythematosus International Collaborating Clinics inception cohort. Anti-KIF20B testing was performed on baseline (within 15 months of diagnosis or first annual visit) samples using an addressable laser bead immunoassay. Logistic regression (penalised maximum likelihood and adjusting for confounding variables) examined the association between anti-KIF20B and NPSLE manifestations (1999 ACR case definitions), including CN, occurring over the first 5 years of follow-up.Results Of the 1827 enrolled cohort members, baseline serum and 5 years of follow-up data were available on 795 patients who were included in this study: 29.8% were anti-KIF20B-positive, 88.7% female, and 52.1% White. The frequency of anti-KIF20B positivity differed only for those with CN (n=10) versus without CN (n=785) (70.0% vs 29.3%; OR 5.2, 95% CI 1.4, 18.5). Compared with patients without CN, patients with CN were more likely to fulfil the ACR haematological (90.0% vs 66.1%; difference 23.9%, 95% CI 5.0%, 42.8%) and ANA (100% vs 95.7%; difference 4.3%, 95% CI 2.9%, 5.8%) criteria. In the multivariate analysis adjusting for age at baseline, female, White race and ethnicity, and ACR haematological and ANA criteria, anti-KIF20B positivity remained associated with CN (OR 5.2, 95% CI 1.4, 19.1).Conclusion Anti-KIF20B is a potential biomarker for SLE-related CN. Further studies are needed to examine how autoantibodies against KIF20B, which is variably expressed in a variety of neurological cells, contribute to disease pathogenesis.

The sparse treatment of highly toxic leachates produced in landfills due to the excessive generation of urban solid waste is a common problem worldwide. For this reason, this research aims to show the convenience of the use of algal biotechnology in leachate bioremediation processes. Nannochloris sp. species was used in this research. It was isolated and cultured for bioassays. The leachate was diluted to 5 and 10% in the microalgae cultures during a period of 8 d in which the growth of the species. Then removal of nutrients (phosphate and nitrate) and the production of lipids by the microalgae were measured. Nannochloris sp. removed more than 70% of the phosphates and 60% of the nitrates from samples. This result shows the benefits of using these microalgae to treat landfill leachate at low cost and also with the potential to obtain bio-lipids that may be useful for biodiesel production.

Introducción: las quitinasas son enzimas modificadoras de quitina y se han reportado como alérgenos en plantas y poco en animales, aunque poseen reactividad cruzada debido a su alta conservación. Objetivo: explorar el potencial alergénico y el mimetismo molecular entre quitinasas de fuentes alergénicas comunes mediante bioinformática. Métodos: se utilizaron ElliPro y BepiPred para predecir epítopos de células B y T. Se realizaron estudios filogenéticos, de identidad y de conservación estructural con MEGA 5, PRALINE y Consurf. Se obtuvieron modelos 3D de quitinasas no reportadas en el Protein Data Bank mediante Swiss model. La capacidad de unión de ligandos se exploró con AutoDock Vina, utilizando Bisdionina C, Bisdionina F y Montelukast como ligandos. Resultados: la quitinasa de P. americana (Per a 12) comparte un 44% de identidad con homólogos en P. vannamei, ácaros e insectos, y una identidad moderada con la quitinasa humana. Se reveló una alta homología estructural. Un epítopo lineal entre los residuos 127 y 144 está altamente conservado en todas las quitinasas. Se predijeron tres epítopos de células T conservados. Las simulaciones de acoplamiento molecular revelaron el sitio activo y el potencial de unión de varios ligandos, identificando residuos críticos. Conclusión: proponemos a las quitinasas como un nuevo grupo potencial de panalérgenos, explicando casos de sensibilización a varias fuentes alérgenas. Dado su homología con proteínas humanas, merece una exploración inmunológica para apoyar su implicación en la respuesta autoinmune.

Objective Evobrutinib is a highly selective, orally administered Bruton's tyrosine kinase (BTK) inhibitor. The objective of this phase II, multicenter, randomized, double‐blind, placebo‐controlled trial was to evaluate the efficacy and safety of evobrutinib in patients with active autoantibody‐positive systemic lupus erythematosus (SLE). Methods Patients were diagnosed with SLE by either the Systemic Lupus International Collaborating Clinics criteria or at least four American College of Rheumatology criteria 6 months or more prior to screening, had an SLE Disease Activity Index‐2000 score of 6 or more, were autoantibody‐positive and on standard‐of‐care therapy. Randomization was 1:1:1:1 to oral evobrutinib 25 mg once daily (QD), 75 mg QD, 50 mg twice daily, or placebo. Primary efficacy endpoints were SLE responder index (SRI)‐4 response at week 52 and SRI‐6 response at week 52 in the high disease activity subpopulation. Safety endpoints included treatment‐emergent adverse events (TEAEs). Results A total of 469 patients were randomized and received at least one dose of evobrutinib or placebo at the time of primary analysis. Mean (SD) age at baseline was 40.7 (±12.3) years; 94.9% of patients were female. Neither primary efficacy endpoint was met. All doses of evobrutinib were well tolerated, and there was no clear dose effect on the incidence of reported TEAEs, or serious TEAEs, including severe infections. Conclusion This phase II, dose‐ranging trial in SLE failed to show a treatment effect of evobrutinib versus placebo at any dose. Evobrutinib was generally well tolerated, with no dose effect observed for TEAEs. These results suggest that BTK inhibition does not appear to be an effective therapeutic intervention for patients with SLE.

Ground-based high-resolution and space-based low-resolution spectroscopy are the two main avenues through which transiting exoplanet atmospheres are studied. Both methods provide unique strengths and shortcomings, and combining the two can be a powerful probe into an exoplanet’s atmosphere. Within a joint atmospheric retrieval framework, we combined JWST NIRSpec/G395H secondary eclipse spectra and Gemini South/IGRINS pre- and post-eclipse thermal emission observations of the hot Jupiter WASP-77A b. Our inferences from the IGRINS and NIRSpec data sets are consistent with each other, and combining the two allows us to measure the gas abundances of H _2 O and CO, as well as the vertical thermal structure, with higher precision than either data set provided individually. We confirm WASP-77A b’s subsolar metallicity ([(C+O)/H] = −0.61 ${}_{-0.09}^{+0.10})$ and solar C/O ratio (C/O = 0.57 ${}_{-0.06}^{+0.06})$ . The two types of data are complementary, and our abundance inferences are mostly driven by the IGRINS data, while inference of the thermal structure is driven by the NIRSpec data. Our ability to draw inferences from the post-eclipse IGRINS data is highly sensitive to the number of singular values removed in the detrending process, potentially due to high and variable humidity. We also search for signatures for atmospheric dynamics in the IGRINS data and find that propagated ephemeris error can manifest as either an orbital eccentricity or a strong equatorial jet. Neither are detected when using more up-to-date ephemerides. However, we find moderate evidence of thermal inhomogeneity and measure a cooler nightside that presents itself in the later phases after secondary eclipse.

La planta Hevea brasiliensis se utiliza ampliamente en la industria como fuente de extracción de caucho, un elemento empleado en diversas áreas comerciales y médicas. Los estudios inmunológicos de esta especie indican que es una fuente alergénica importante, que puede provocar sensibilización y alergia. Se han identificado diferentes componentes alergénicos de esta planta, con diversas propiedades inmunitarias y bioquímicas, y estudiado más de diez tipos diferentes de alérgenos, cada uno con distinta capacidad de inducir síntomas alérgicos. En esta revisión informamos los avances actuales en el estudio de Hevea brasiliensis.

The classical Probabilistic Safety Analysis (PSA) does not include any time dependence explicitly. However, the success criteria (SC) could evolve during the cycle for some initiating events. In that sense, there is a type of sequence in which this time-dependency is quite important, the family of Anticipated Transient without Scram (ATWS) sequences in Pressurized Water Reactors. Therefore, a new risk-informed approach is proposed in this paper, which makes it possible to obtain the time-dependent SC evolution of the safety functions affected by the Moderator Temperature Coefficient (MTC) value. Then, the evolution of the ATWS conditional core damage probability (CCDP) could be obtained using a PSA model. To quantify the CCDP, the average values of the time-dependent failure probabilities must be computed. Finally, the comparison between the CCDP obtained through the application of the classical PSA approach and the new one makes it possible to quantify the impact of time-dependence on the SC of the headers that this new risk-informed ATWS approach can provide.

Background. Venous thromboembolism (VTE) occurs in 0.4% to 15.5% and bleeding occurs in 20% to 35% of patients after liver transplantation (LT). Balancing the risk of bleeding from therapeutic anticoagulation and risk of thrombosis in the postoperative period is challenging. Little evidence exists regarding the best treatment strategy for these patients. We hypothesized that a subset of LT patients who develop postoperative deep vein thromboses (DVTs) could be managed without therapeutic anticoagulation. We implemented a quality improvement (QI) initiative using a standardized Doppler ultrasound-based VTE risk stratification algorithm to guide parsimonious implementation of therapeutic anticoagulation with heparin drip. Methods. In a prospective management QI initiative for DVT management, we compared 87 LT historical patients (control group; January 2016–December 2017) to 182 LT patients (study group; January 2018–March 2021). We analyzed the rates of immediate therapeutic anticoagulation after DVT diagnosis within 14 d of LT, clinically significant bleeding, return to the operating room, readmission, pulmonary embolism, and death within 30 d of LT before and after the QI initiative. Results. Ten patients (11.5%) in the control group and 23 patients (12.6%; P = 0.9) in the study group developed DVTs after LT. Immediate therapeutic anticoagulation was used in 7 of 10 and 5 of 23 patients in the control and study groups, respectively (P = 0.024). The study group had lower odds of receiving immediate therapeutic anticoagulation after VTE (21.7% versus 70%; odds ratio = 0.12; 95% confidence interval, 0.019-0.587; P = 0.013) and a lower rate of postoperative bleeding (8.7% versus 40%; odds ratio = 0.14, 95% confidence interval, 0.02-0.91; P = 0.048). All other outcomes were similar. Conclusions. Implementing a risk-stratified VTE treatment algorithm for immediate post-LT patients appears to be safe and feasible. We observed a decrease in the use of therapeutic anticoagulation and a lower rate of postoperative bleeding without adverse impacts on early outcomes.

The dataset of spectroscopic analysis performed on starting materials, intermediates, and products relating to the synthesis of Hedione are hereby presented. The data were acquired in Durham university during the period between October 2020 and September 2021 for the development of a preparative method to Dehydrohedione. The latter is a key intermediate for the synthesis of cis-Hedione, an important fragrance ingredient. Proton, Carbon-13, and Fluorine-19 Nuclear magnetic resonance of the compounds were recorded employing a Varian 600 MHz, and a Bruker Avance-400 instrument. The IR spectra were recorded in a Perkin Elmer Spectrum Two UATR Two FT-IR and the accurate mass employing a Waters QtoF premier as mass spectrometer.

Characterization of HIV risk factors among transwomen and men who have sex with men (MSM) should be assessed separately and independently. However, due to several constraints, these populations continue to be conflated in clinical research and data. There are limited datasets globally powered to make such comparisons. The study aimed to use one of the largest surveys of transwomen and MSM in Latin America to determine differences in HIV risk and related correlates between the two populations. Secondary data analysis was completed using a cross-sectional biobehavioral survey of 4413 MSM and 714 transwomen living in Perú. Chi Square analysis of selected HIV correlates was conducted to examine differences between transwomen and MSM. Additionally, stratified binary logistic regression was used to split data for further comparative analyses of correlates associated with transwomen and MSM separately. HIV prevalence among transwomen was two-fold greater than among MSM (14.9% vs. 7.0%, p

Objective To evaluate hydroxychloroquine (HCQ)-related retinal toxicity in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort.Methods Data were collected at annual study visits between 1999 and 2019. We followed patients with incident SLE from first visit on HCQ (time zero) up to time of retinal toxicity (outcome), death, loss-to-follow-up or end of study. Potential retinal toxicity was identified from SLICC Damage Index scores; cases were confirmed with chart review. Using cumulative HCQ duration as the time axis, we constructed univariate Cox regression models to assess if covariates (ie, HCQ daily dose/kg, sex, race/ethnicity, age at SLE onset, education, body mass index, renal damage, chloroquine use) were associated with HCQ-related retinal toxicity.Results We studied 1460 patients (89% female, 52% white). Retinal toxicity was confirmed in 11 patients (incidence 1.0 per 1000 person-years, 0.8% overall). Average cumulative time on HCQ in those with retinal toxicity was 7.4 (SD 3.2) years; the first case was detected 4 years after HCQ initiation. Risk of retinal toxicity was numerically higher in older patients at SLE diagnosis (univariate HR 1.05, 95% CI 1.01 to 1.09).Conclusions This is the first assessment of HCQ and retinal disease in incident SLE. We did not see any cases of retinopathy within the first 4 years of HCQ. Cumulative HCQ may be associated with increased risk. Ophthalmology monitoring (and formal assessment of cases of potential toxicity, by a retinal specialist) remains important, especially in patients on HCQ for 10+ years, those needing higher doses and those of older age at SLE diagnosis.

The contribution of the HLA-E/NKG2X axis in NK-mediated control of HIV infection remains unclear. We have studied the relationship between HLA-E expression and phenotypical as well as functional characteristics of NK cells, in the context of chronic HIV infection and in an in vitro model of acute infection. High viremia in HIV+ individuals was related to increased HLA-E expression, and changes in NK subpopulations, especially a reduction of the CD56bright as well as an increase in adaptive NK subpopulation. Uncontrolled HIV infection was also characterized by a reversion of the NKG2A/NKG2C expression ratio and a loss of positive and negative regulation of NK mediated by HLA-E. This was reflected in a lower cytotoxic, degranulation and cytokine production capacity, especially in CD56bright and adaptive NK. In line with these results, HLA-E expression showed a positive correlation with viral growth inhibition in an in vitro model of acute infection at day 7, which was lost after 14 days of culture. Using HLA-E expressing K562 cells, we determined that only one out of 11 described HIV-derived HLA-E epitopes increased HLA-E surface stability. In spite of that, eight of the 11 epitopes were capable of increasing degranulation and three drove differences in NK-cell mediated cell lysis or cytokine secretion. In conclusion, our results indicate that HLA-E molecules presenting HIV-derived epitopes may sensitize target cells for NK lysis in early HIV infection. However, prolonged exposure to elevated HLA-E expression levels in vivo may lead to NK cell dysfunction and reduced viral control In chronic infection.

In this paper, we define a new Riemann–Liouville fractional integral with random order, from this Caputo and Riemann–Liouville fractional derivatives are straightforward obtained, where the fractional order of these operators is a simple random variable. We derive useful properties analogous to those of the fractional operators with constant order, such as the semigroup property. As an application, we study a boundary value problem for the fractional oscillator with random order, using a random integral equation of Fredholm type. Finally, in order to solve this problem, we adapt the Nystrom method to get a numerical solution.

The Choloepus Hoffmani is a mammal belonging to the Xenarthra superorder; xenarthrans are distributed from North to South America. It is common for these animals to require medical attention at wildlife rescue centers after being attacked by domestic animals or run over by cars. A proper understanding of this species’ anatomy is vital in order to be able to offer them a proper level of clinical attention. This publication aims to describe the spine’s anatomical and radiographic characteristics of the Choloepus Hoffmani. Four individuals were used in this research; the spine bones were cleaned by boiling and maceration. In the results, it was possible to observe how the postcranial axial skeleton in the sloths is made up by five of distinctive vertebra types. In the spine were found: six cervical vertebrae, a variable number of thoracic vertebrae, xenarthrous lumbar vertebrae, and a fusion between the sacrum and coxal bone. Finally, four underdeveloped caudal vertebrae were also identified in a small stump-like tail. Radiographically, no pathologies were observed in the alignment or structure of the spine. In conclusion, the present study described both the osteology alongside the anatomical radiography of the vertebral column of the Choloepus hoffmani, highlighting the particularities that are not found in domestic mammals and other members of the Xenarthra superorder. Information of this kind is relevant for forensic wildlife analysis, alongside aiding the treatment of animals in this species who suffered lesions in their spine.

Abstract We study an initial-boundary value problem for a n-dimensional stochastic diffusion equation with fractional Laplacian on R + n $\mathbb{R}_{+}^{n}$ . In order to prove existence and uniqueness, we generalize the Fokas method to construct the Green function for the associated linear problem and then we apply a fixed point argument. Also, we present an example where the explicit solutions are given.

Su Chul Jang et al. develop exoSTING, consisting of an engineered extracellular vesicle loaded with a potent cyclic dinucleotide (CDN) agonist of the STING pathway. They find that exoSTING shows more than 100-fold increased potency in in vivo tumor models and has increased tumor retention and lower levels of systemic inflammatory cytokine production as compared to free CDN.

BackgroundAcademic surgery has been a traditionally male-dominated field. Female contribution remains challenging. In Mexico, there is no published evidence regarding gender disparity in academic surgery. We aimed to analyze the female role in clinical research submitted to the Asociación Mexicana de Cirugía General (AMCG).MethodsRetrospective study evaluating abstracts submitted to AMCG annual meetings from 2013 to 2019. Categorical variables were compared using χ2 test. Univariate logistic regression was performed to calculate odds ratios (OR) followed by a log-binomial logistic regression model to obtain the adjusted relative risk (aRR) for acceptance as an oral presentation.ResultsOverall, 7,439 abstracts were analyzed of which 24.2% were submitted by females. Female-submitted abstracts increased from 22.5% to 25.3% during 2013–2019 (p = 0.15). The proportion of 47 abstracts submitted by females was higher in the resident group (27.7% vs. 18.8%; p

Knowing the difficulty of a given task is crucial for improving the learning outcomes. This paper studies the difficulty level classification of memorization tasks from pupillary response data. Developing a difficulty level classifier from pupil size features is challenging because of the inter-subject variability of pupil responses. Eye-tracking data used in this study was collected while students solved different memorization tasks divided as low-, medium-, and high-level. Statistical analysis shows that values of pupillometric features (as peak dilation, pupil diameter change, and suchlike) differ significantly for different difficulty levels. We used a wrapper method to select the pupillometric features that work the best for the most common classifiers; Support Vector Machine (SVM), Decision Tree (DT), Linear Discriminant Analysis (LDA), and Random Forest (RF). Despite the statistical difference, experiments showed that a random forest classifier trained with five features obtained the best F1-score (82%). This result is essential because it describes a method to evaluate the cognitive load of a subject performing a task using only pupil size features.

This work presents a novel use case with Time-Sensitive Networks (TSN) for implementing a deterministic system allowing the joint transmission of all substation communications over the same Ethernet-based infrastructure. This approach streamlines the transition to Smart Grid by simplifying the typically complex architecture of electrical substations, characterized by multiple field buses and bridging devices. Thus, Smart Grid represents a disruptive innovation advancing substations to an “all-digital” environment with a uniform interface to access, manage, and update their communications and variables. TSN can serve as its underlying foundation as it is based on open, interoperable standards and enhancements for Ethernet that can establish deterministic communications with bounded end-to-end latency. This is shown with a TSN Proof of Concept (PoC) in a real-life substation that can integrate its most usual signals: digitized analog triggers for critical events or interlocks, GOOSE signaling (IEC 61850), and Best-Effort “Internet-like” traffic. This TSN PoC is shown to be versatile enough to propagate digitized critical events around 160 μs earlier than legacy substation equipment while preserving the integrity of background traffic. Furthermore, its flexibility was characterized in-depth in controlled laboratory tests, thereby confirming TSN as a viable alternative for supporting Smart Grid so long as the appropriate configuration is supplied.

Abstract Introduction Although pre‐exposure prophylaxis (PrEP) is a remarkable biomedical advance to prevent HIV, ongoing research on PrEP contributes to and interacts with a legacy of HIV experimentation on marginalized communities in resource‐limited settings. This paper explores the complexity of PrEP research mistrust among Peruvian transgender (trans) women who completed a PrEP adherence intervention and those who refused participation (i.e. declined to enrol, voluntarily withdrew, and/or were lost to follow‐up). Methods Data were derived from 86 trans women (mean age 29 years) participants in the formative (four focus groups (n = 32), 20 interviews) and the evaluation stages (34 interviews) of a social network‐based PrEP intervention for trans women in Lima, Peru. The formative stage took place from May to July 2015, while the evaluative stage took place from April to May 2018. Audio files were transcribed verbatim and analysed via an immersion crystallization approach using Dedoose (v.6.1.18). Results Three paradoxes of trans women’s participation in PrEP science as a “key” population emerged as amplifying mistrust: (1) increases in PrEP research targeting trans women but limited perceived improvements in HIV outcomes; (2) routine dismissal by research physicians and staff of PrEP‐related side effects and the social realities of taking PrEP, resulting in questions about who PrEP research is really for and (3) persistent limitations on PrEP access for trans women despite increasing involvement in clinical trials, fostering feelings of being a “guinea pig” to advance PrEP science. Conclusions Findings highlight the wisdom inherent in PrEP mistrust as a reflection of trans women’s experiences that underscore the broken bonds of trust between communities, researchers and the research enterprise. PrEP mistrust is amplified through perceived paradoxes that suggest to trans women that they are key experimental participants but not target PrEP users outside of research settings. Findings highlight the urgent need to reframe mistrust not as a characteristic of trans women to be addressed through education and outreach, but as a systemic institutional‐ and industry‐level problem replicated, manifested and ultimately to be corrected, through global HIV science.

(1) Objective: To determine the incidence, visual outcomes and risk factors associated with the recurrence of primary retinal detachment (RD) in a tertiary hospital. (2) Methods: A retrospective observational study was conducted, and data were collected on all eyes diagnosed with primary RD between January 2017 and December 2020. A detailed database was generated with data on anatomic and visual outcomes, and surgical technique information, for all the cases. (3) Results: 570 eyes with primary RD were included. Mean annual incidence of primary RD was 21.8 cases per 100,000 inhabitants. Mean follow-up time was 465 (±410.5) days. Mean time to redetachment was 114.4 (±215.8) days, with the median being 35 days. Statistically significant variables related to a higher risk of recurrence were: male sex (p = 0.04), type of tamponade (p = 0.01), surgeon (p = 0.035), inferonasal (p = 0.002) and inferotemporal (p = 0.032) involvement, complex RD (p < 0.001) and ocular comorbidity (p < 0.001). More satisfactory final visual acuity (VA) in patients not suffering redetachment was associated with shorter duration of central vision loss. (4) Conclusions: Sex, type of tamponade, inferior detachment, RD complexity, surgeon and ocular comorbidity were identified as prognostic factors for recurrence. Worse final postoperative VA was found in patients referring central vision loss for more than 4 days before surgery.

Inherited retinal dystrophies (IRDs) affect an estimated 1 in every 2000 people, this corresponding to nearly 2 million cases worldwide. Currently, 270 genes have been associated with IRDs, most of them altering the function of photoreceptors and retinal pigment epithelium. Gene therapy has been proposed as a potential tool for improving visual function in these patients. Clinical trials in animal models and humans have been successful in various types of IRDs. Recently, voretigene neparvovec (Luxturna®) has been approved by the US Food and Drug Administration for the treatment of biallelic mutations in the RPE65 gene. The current state of the art in gene therapy involves the delivery of various types of viral vectors into the subretinal space to effectively transduce diseased photoreceptors and retinal pigment epithelium. For this, subretinal injection is becoming increasingly popular among researchers and clinicians. To date, several approaches for subretinal injection have been described in the scientific literature, all of them effective in accessing the subretinal space. The growth and development of gene therapy give rise to the need for a standardized procedure for subretinal injection that ensures the efficacy and safety of this new approach to drug delivery. The goal of this review is to offer an insight into the current subretinal injection techniques and understand the key factors in the success of this procedure.

The identification of new biomarkers is essential to predict responsiveness to vaccines. We investigated the whole-blood transcriptome and microbiome prior to immunization, in order to assess their involvement in induction of humoral responses two months later. We based our analyses on stool and skin microbiota, and blood transcriptome prior to immunization, in a randomized clinical study in which participants were vaccinated with the MVA-HIV clade B vaccine (MVA-B). We found that the levels of neutralizing antibody responses were correlated with abundance of Eubacterium in stool and Prevotella in skin. In addition, genus diversity and bacterial species abundance were also correlated with the expression of genes involved in B cell development prior to immunization and forecast strong responders to MVA-B. To our knowledge, this is the first study integrating host blood gene expression and microbiota that might open an avenue of research in this field and to optimize vaccination strategies and predict responsiveness to vaccines.

Abstract Background Stigma differentially influences HIV and STI care among MSM, especially regarding partner notification practices. Recognizing the heterogeneous behaviors/identities within the category “MSM,” we used mixed-methods to assess sexual risk behaviors among men who have sex with men only (MSMO) and behaviorally bisexual MSM (MSMW) with HIV and/or other STIs. Methods MSMO/MSMW recently diagnosed (

Currently, there exist different technologies applied in the world of medicine dedicated to the detection of health problems such as cancer, heart diseases, etc. However, these technologies are not applied to the detection of lower body pathologies. In this article, a Neural Network (NN)-based system capable of classifying pathologies of the lower train by the way of walking in a non-controlled scenario, with the ability to add new users without retraining the system is presented. All the signals are filtered and processed in order to extract the Gait Cycles (GCs), and those cycles are used as input for the NN. To optimize the network a random search optimization process has been performed. To test the system a database with 51 users and 3 visits per user has been collected. After some improvements, the algorithm can correctly classify the 92% of the cases with 60% of training data. This algorithm is a first approach of creating a system to make a first stage pathology detection without the requirement to move to a specific place.

It is largely unknown how post-translational protein modifications, including glycosylation, impacts recognition of self and non-self T cell epitopes presented by HLA molecules. Data in the literature indicate that O- and N-linked glycosylation can survive epitope processing and influence antigen presentation and T cell recognition. In this perspective, we hypothesize that glycosylation of viral proteins and processed epitopes contribute to the T cell response to HIV. Although there is some evidence for T cell responses to glycosylated epitopes (glyco-epitopes) during viral infections in the literature, this aspect has been largely neglected for HIV. To explore the role of glyco-epitope specific T cell responses in HIV infection we conducted in silico and ex vivo immune studies in individuals with chronic HIV infection. We found that in silico viral protein segments with potentially glycosylable epitopes were less frequently targeted by T cells. Ex vivo synthetically added glycosylation moieties generally masked T cell recognition of HIV derived peptides. Nonetheless, in some cases, addition of simple glycosylation moieties produced neo-epitopes that were recognized by T cells from HIV infected individuals. Herein, we discuss the potential importance of these observations and compare limitations of the employed technology with new methodologies that may have the potential to provide a more accurate assessment of glyco-epitope specific T cell immunity. Overall, this perspective is aimed to support future research on T cells recognizing glycosylated epitopes in order to expand our understanding on how glycosylation of viral proteins could alter host T cell immunity against viral infections.

Objective. To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least one group received dry needling combined with other interventions for TrPs associated with neck pain. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the quality of evidence was assessed by using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated. Results. Eight trials were included. Dry needling combined with other interventions reduced pain intensity at short-term (SMD −1.46, 95% CI −2.25 to −0.67) and midterm (SMD −0.38, 95% CI −0.74 to −0.03) but not immediately after or at long-term compared with the other interventions alone. A small effect on pain-related disability was observed at short-term (SMD −0.45, 95% CI −0.87 to −0.03) but not at midterm or long-term. The inclusion of dry needling was also effective for improving pressure pain thresholds only at short-term (MD 112.02 kPa, 95% CI 27.99 to 196.06). No significant effects on cervical range of motion or pain catastrophism were observed. Conclusion. Low-to-moderate evidence suggests a positive effect to the combination of dry needling with other interventions for improving pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion in people with neck pain associated with TrPs at short-term. No midterm or long-term effects were observed.