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Abstract Clinical outcomes of arteriovenous fistulae (AVF) for hemodialysis remain inadequate since biological mechanisms of AVF maturation and failure are still poorly understood. Aortocaval fistula creation (AVF group) or a sham operation (sham group) was performed in C57BL/6 mice. Venous limbs were collected on postoperative day 7 and total RNA was extracted for high throughput RNA sequencing and bioinformatic analysis. Genes in metabolic pathways were significantly downregulated in the AVF, whereas significant sex differences were not detected. Since gene expression patterns among the AVF group were heterogenous, the AVF group was divided into a ‘normal’ AVF (nAVF) group and an ‘outliers’ (OUT) group. The gene expression patterns of the nAVF and OUT groups were consistent with previously published data showing venous adaptive remodeling, whereas enrichment analyses showed significant upregulation of metabolism, inflammation and coagulation in the OUT group compared to the nAVF group, suggesting the heterogeneity during venous remodeling reflects early gene expression changes that may correlate with AVF maturation or failure. Early detection of these processes may be a translational strategy to predict fistula failure and reduce patient morbidity.

Summary: We investigate the distribution and evolution of prokaryotic cell size based on a compilation of 5,380 species. Size spans four orders of magnitude, from 100 nm (Mycoplasma) to more than 1 cm (Thiomargarita); however, most species congregate heavily around the mean. The distribution approximates but is distinct from log normality. Comparative phylogenetics suggests that size is heritable, yet the phylogenetic signal is moderate, and the degree of heritability is independent of taxonomic scale (i.e., fractal). Evolutionary modeling indicates the presence of an optimal cell size to which most species gravitate. The size is equivalent to a coccus of 0.70 μm in diameter. Analyses of 1,361 species with sequenced genomes show that genomic traits contribute to size evolution moderately and synergistically. Given our results, scaling theory, and empirical evidence, we discuss potential drivers that may expand or shrink cells around the optimum and propose a stability landscape model for prokaryotic cell size.

Generative adversarial networks (GANs) have become a recent and rapidly developing research topic in machine learning. Since their inception in 2014, a significant number of variants have been proposed to address various topics across many fields, and they have particularly excelled not only in image and language processing but also in the medical and data science domains. In this paper, we aim to highlight the significance of and advancements that these GAN models can introduce in the field of Business Economics, where they have yet to be fully developed. To this end, a review of the literature of GANs is presented in general together with a more specific review in the field of Business Economics, for which only a few papers can be found. Furthermore, the most relevant papers are analysed in order to provide approaches for the opportunity to research GANs in the field of Business Economics.

BackgroundContextual variables that capture the characteristics of delimited geographic or jurisdictional areas are vital for health and social research. However, obtaining data sets with contextual-level data can be challenging in the absence of monitoring systems or public census data. ObjectiveWe describe and implement an 8-step method that combines web scraping, text mining, and spatial overlay analysis (WeTMS) to transform extensive text data from government websites into analyzable data sets containing contextual data for jurisdictional areas. MethodsThis tutorial describes the method and provides resources for its application by health and social researchers. We used this method to create data sets of health assets aimed at enhancing older adults’ social connections (eg, activities and resources such as walking groups and senior clubs) across the 374 health jurisdictions in Catalonia from 2015 to 2022. These assets are registered on a web-based government platform by local stakeholders from various health and nonhealth organizations as part of a national public health program. Steps 1 to 3 involved defining the variables of interest, identifying data sources, and using Python to extract information from 50,000 websites linked to the platform. Steps 4 to 6 comprised preprocessing the scraped text, defining new variables to classify health assets based on social connection constructs, analyzing word frequencies in titles and descriptions of the assets, creating topic-specific dictionaries, implementing a rule-based classifier in R, and verifying the results. Steps 7 and 8 integrate the spatial overlay analysis to determine the geographic location of each asset. We conducted a descriptive analysis of the data sets to report the characteristics of the assets identified and the patterns of asset registrations across areas. ResultsWe identified and extracted data from 17,305 websites describing health assets. The titles and descriptions of the activities and resources contained 12,560 and 7301 unique words, respectively. After applying our classifier and spatial analysis algorithm, we generated 2 data sets containing 9546 health assets (5022 activities and 4524 resources) with the potential to enhance social connections among older adults. Stakeholders from 318 health jurisdictions registered identified assets on the platform between July 2015 and December 2022. The agreement rate between the classification algorithm and verified data sets ranged from 62.02% to 99.47% across variables. Leisure and skill development activities were the most prevalent (1844/5022, 36.72%). Leisure and cultural associations, such as social clubs for older adults, were the most common resources (878/4524, 19.41%). Health asset registration varied across areas, ranging between 0 and 263 activities and 0 and 265 resources. ConclusionsThe sequential use of WeTMS offers a robust method for generating data sets containing contextual-level variables from internet text data. This study can guide health and social researchers in efficiently generating ready-to-analyze data sets containing contextual variables.

Endometriosis (EM) is a chronic inflammatory estrogen-dependent disorder that affects 10% of women worldwide. It affects the female reproductive tract and its resident microbiota, as well as distal body sites that can serve as surrogate markers of EM. Currently, no single definitive biomarker can diagnose EM. For this pilot study, we analyzed a cohort of 21 patients with endometriosis and infertility-associated conditions. A microbiome dataset was created using five sample types taken from the reproductive and gastrointestinal tracts of each patient. We evaluated several machine learning algorithms for EM detection using these features. The characteristics of the dataset were derived from endometrial biopsy, endometrial fluid, vaginal, oral, and fecal samples. Despite limited data, the algorithms demonstrated high performance with respect to the F1 score. In addition, they suggested that disease diagnosis could potentially be improved by using less medically invasive procedures. Overall, the results indicate that machine learning algorithms can be useful tools for diagnosing endometriosis in low-resource settings where data availability and availability are limited. We recommend that future studies explore the complexities of the EM disorder using artificial intelligence and prediction modeling to further define the characteristics of the endometriosis phenotype.

The use of UCH-L1 detection with point-of-care (POC) assay alone has not been characterized for clinical use. This study compares the accuracies of POC UCH-L1 and Neuron-Specific Enolase (NSE) Elecsys® levels for identifying TBI patients with structural abnormalities on neuroimaging.The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Phase 1 Cohort, enrolled 1375 TBI patients (GCS 3–15) presenting to one of 18 US Level I trauma centers within 24 h of injury who had an admission head CT; blood samples were collected, along with 122 orthopedic and 209 healthy controls. The TBI cohort consisted of 810 CT-negative (CT-) and 549 CT-positive (CT+) subjects. Of the CT- subjects who had MRIs, 121 were MRI-positive (MRI+) and 333 were MRI-negative (MRI-). UCH-L1 POC showed best diagnostic performance for CT + versus CT-, 0–8 h post-injury with an AUC of 0·779 [0·708–0.850] when compared to the 0–25 h interval, with an AUC of 0.684 [0.655–0.712]. NSE assay has an AUC of 0.695 [0.619–0.770] for the 0–8 h interval and 0.634 [0.603–0.665] for the 0–25 h interval. During the first 8 after injury, POC UCH-L1 outperforms NSE in identifying TBI patients with structural abnormalities on neuroimaging.

Background: Chronic use of Angiotensin-converting enzyme (ACE) inhibitors (ACEi) and aldosterone-receptor blockers (ARB) is not associated with worse outcomes in patients with COVID-19. However, evidence on the impact of their discontinuation during hospital admission is scarce. Our aim was to determine whether withdrawal of ACEi, ARB and mineralocorticoid receptor antagonists (MRA) is associated with all-cause mortality in a real-life large cohort of patients with SARS-CoV-2 infection. Methods: Observational cohort study from a large referral center from 1 March 2020 to 20 April 2020. Withdrawal of renin-angiotensin-aldosterone system inhibitors was defined as the absence of any received dose during hospital admission in patients receiving chronic treatment. Prescriptions during admission were confirmed by data from the central pharmacy computerized system. Results: A total of 2042 patients (mean age 68.4±17.6, 57.1% male) with confirmed COVID-19 were included. During a median follow-up of 57 (21-55) days, 583 (28.6%) died. Prior to hospital admission 468 (22.9%), 343 (16.8%) and 83 (4.1%) patients were receiving ACEi, ARB and MRA respectively. During the study period, 216 (46.2%), 193 (56.3%) and 41 (49.4%) were withdrawn from the corresponding drug. After adjusting for age, cardiovascular risk factors, baseline comorbidities and in-hospital COVID-19 dedicated treatment, withdrawal of ACE inhibitors (hazard ration [HR] 1.48 [95% confidence interval –CI– 1.16-1.89]) and MRA (HR 2.01 [95% CI 1.30-3.10]) were shown to be independent predictors of all-cause mortality. No independent relationship between ARB withdrawal and mortality was observed. Conclusion: ACEi and MRA withdrawal were associated with higher mortality. Strong consideration should be given to not discontinuing these medications during hospital admission. Resumo: Introdução: O uso crónico de inibidores da ECA (IECA) e de antagonistas dos recetores de aldosterona (ARA) não está associado a resultados piores em doentes com Covid-19. No entanto, a evidência relativa ao impacto da sua retirada durante a admissão hospitalar é escassa. O nosso objetivo foi determinar se a retirada do IECA, ARA e antagonistas dos recetores dos mineralocorticóides (ARM) está associada à mortalidade por todas as causas numa grande coorte real de doentes com infeção por SRA-CoV-2. Métodos: Estudo coorte observacional a partir de um grande centro de referência de 1 de março de 2020 a 20 de abril de 2020. A retirada dos inibidores do sistema RAAS foi definida como a ausência de qualquer dose recebida durante a admissão hospitalar em doentes que recebem tratamento prolongado. As prescrições durante a admissão foram confirmadas por dados do sistema informático da farmácia central. Resultados: Um total de 2042 doentes (idade média de 68,4 ±17,6, 57,1% do sexo masculino) com COVID-19 confirmado foram incluídos. Durante um acompanhamento médio de 57 (21-55) dias, 583 (28,6%) morreram. Conclusão: A retirada do IECA e do ARM foi associada a uma mortalidade mais elevada. Deve ser dada grande atenção para não interromper estes medicamentos durante a admissão hospitalar.

Introducción. El presente trabajo se llevó a cabo para evaluar segmentos de Cordia trichotoma en el Laboratorio de Biotecnología de la Facultad de Ciencias Agrarias de la Universidad Nacional de Asunción, Paraguay. Objetivo. Evaluar la sobrevivencia de segmentos nodales de Cordia trichotoma (peterevy) cultivados in vitro. Materiales y métodos. Fueron sembrados 80 segmentos nodales en medio Murashige y Skoog (MS) y medio de cultivo MS+CA 2 ml.l-1, distribuidos en unidades experimentales constituidas por 5 segmentos nodales por unidad experimental, expuestos a 4 tratamientos con 4 repeticiones cada uno. El diseño experimental utilizado fue completamente al azar y las variables evaluadas fueron la contaminación microbiana y oxidación fenólica para determinar la sobrevivencia de los segmentos. El análisis estadístico consistió en ANAVA con un nivel de significancia del 5% y la prueba de Chi cuadrado para el análisis de fidelidad. Resultados. Se registró una contaminación microbiana de hasta 20% de segmentos nodales, en tanto que la oxidación fenólica se mantuvo en un rango de 40 a 45%, como la mayor limitante. Conclusión. 30 días posteriores a la siembra, la sobrevivencia de los segmentos nodales fue entre 35 a 55%, se verificó que los segmentos con brotes y los segmentos indiferentes de brotación estaban libres de contaminación microbiana y oxidación fenólica, aunque no registraron diferencias estadísticas significativas.

Case presentation: This case describes the classic imaging findings of pyolaryngocele and highlights the importance of prompt imaging for diagnosis of clinically occult airway lesions. The case also highlights how pyolaryngoceles can become large and present with acute-onset clinical symptoms, including stridor and dyspnea. Discussion: Pyolaryngoceles represent an uncommon but life-threatening complication of laryngoceles. Laryngoceles are frequently seen as an incidental, abnormal, air-filled dilation of the laryngeal saccule related to various local pathologies of the larynx. They are often asymptomatic. Occasionally they can become secondarily infected, in which case they are called pyolaryngocele, and they can cause rapid-onset, life-threatening airway compromise.

Abstract We present a novel approach to coherent photonic THz systems supporting complex modulation. The proposed scheme uses a single optical path avoiding the problems of current implementations, which include: phase decorrelation, 3-dB power loss, and polarization and power matching circuits. More importantly, we show that our novel approach is compatible with direct modulation of the output of an optical frequency comb (i.e., not requiring the demultiplexing of two tones from the comb), further simplifying the system and enabling an increase in the transmitted RF power for a fixed average optical power injected into the photodiode.

Precision chemical thinning is the most common method of thinning apple fruitlets because it requires little time and is cost-effective. The aims of the current study were I.- to investigate the effect of the application of metamitron at different rates on ‘Gala’ apples; II.- to determine which fruit diameters were most sensitive to metamitron spray at several rates (between 180 and 500 ppm); and III- to identify the key environmental factors that explain Metamitron efficacy on a year-to-year basis. Eighteen trials were conducted over seven seasons, from 2015 to 2022 in ‘Gala’ apple orchards in Geneva (New York State). Metamitron was applied at different rates between 180 and 500 ppm, and the timing of the application was between petal fall (4.5 mm) and 18.5 mm fruit size. In each of the studies and years, the effect of meteorological parameters was evaluated. Our results suggest that a linear rate effect was observed in all trials, but that there were differences between the slopes of the regression every year because chemical thinning efficacy was variable year to year. The maximum metamitron efficacy was between 9.5 and 11 mm king fruit diameter; however, metamitron showed thinning efficacy at all phenological stages, from petal fall to 18.5 mm in ‘Gala’ apples. Our results suggest that the important meteorological factors affecting thinning efficacy were temperature and solar radiation on the day of application and for the next 6 days. The solar radiation after application of metamitron was the most important meteorological factor. Fruit drop caused by metamitron increased with low solar radiation. The minimum and maximum temperatures were also important factors in determining metamitron efficacy. A high minimum temperature (during the night) increased the fruit drop caused by metamitron and the maximum temperature during the day showed a negative correlation with the efficacy of metamitron.

T cells and macrophages play an important role in the formation of allograft vasculopathy, which is the predominant form of chronic rejection in cardiac transplants. Arteries express Ephrin-B2 as a marker of arterial identity, whereas circulating monocytes express the cognate receptor EphB4, which facilitates monocyte adhesion to the endothelial surface. Adherent monocytes transmigrate and differentiate into macrophages that activate T cells and are a main source of tissue damage during rejection. We hypothesized that inhibition of Ephrin-B2-EphB4 binding would decrease immune cell accumulation within a transplanted graft and prevent allograft vasculopathy. We used EphB4 monomer to inhibit Ephrin-B2-EphB4 binding in a rat infrarenal aortic transplant model. Rats treated with EphB4 monomer had fewer macrophages and T cells in the aortic allografts at 28 days, as well as significantly less neointima formation. These data show that the Ephin-B2-EphB4 axis may be an important target for prevention or treatment of allograft vasculopathy.

Summary: Background: Surgical glove perforation constitutes a risk for the maintenance of aseptic technique and the risk of surgical site infection and occupational exposure to blood borne infections for healthcare workers. Aim: To identify the frequency of glove perforation in selected surgical procedures. Methods: A cross-sectional descriptive observational study was carried out in the surgical unit of the Joaquin Albarrán Hospital (La Habana, Cuba) during the period September–December 2019. Gloves used by surgeons in major urgent or elective surgical procedures were collected and tested for perforations. Findings: 757 gloves from 149 surgeons and 8 surgical specialties were tested and 95 (25.8%) had perforations. The highest frequencies of glove perforations were reported in vascular surgery (50.0%), proctology (37.9%), urology (28.0%) and general surgery (26.1%). The selected surgical procedures with the highest frequencies were open radical nephrectomy (87.5%), splenectomy (57.1%), open adenomectomy (55.6%), limb amputation (46.2%) and hysterectomy (41.7%). Glove perforation occurred more frequently in consultant surgeons (28.8%) than in residents (20.9%) (P = 0.021), in surgeons with more years of surgical experience (P = 0.003) and longer procedure duration (P =

Precision crop load management of apple requires counting fruiting structures at various times during the year to guide management decisions. The objective of the current study was to evaluate the accuracy of and compare different commercial computer vision systems and computer applications to estimate trunk cross-sectional area (TCSA), flower cluster number, thinning efficacy, and yield estimation. These studies evaluated two companies that offer different vision systems in a series of trials across 23 orchards in four states. Orchard Robotics uses a proprietary camera system, and Pometa (previously Farm Vision) uses a cell phone camera system. The cultivars used in the trials were ‘NY1’, ‘NY2’, ‘Empire’, ‘Granny Smith’, ‘Gala’, ‘Fuji’, and ‘Honeycrisp’. TCSA and flowering were evaluated with the Orchard Robotics camera in full rows. Flowering, fruit set, and yield estimation were evaluated with Pometa. Both systems were compared with manual measurements. Our results showed a positive linear correlation between the TCSA with the Orchard Robotics vision system and manual measurements, but the vision system underestimated the TCSA in comparison with the manual measurements (R2s between 0.5 and 0.79). Both vision systems showed a positive linear correlation between nubers of flowers and manual counts (R2s between 0.5 and 0.95). Thinning efficacy predictions (in June) were evaluated using the fruit growth rate model, by comparing manual measurements and the MaluSim computer app with the computer vision system of Pometa. Both systems showed accurate predictions when the numbers of fruits at harvest were lower than 200 fruit/tree, but our results suggest that, when the numbers of fruits at harvest were higher than 200 fruit/tree, both methods overestimated final fruit numbers per tree when compared with final fruit numbers at harvest (R2s 0.67 with both systems). Yield estimation was evaluated just before harvest (August) with the Pometa system. Yield estimation was accurate when fruit numbers were fewer than 75 fruit per tree, but, when the numbers of fruit at harvest were higher than 75 fruit per tree, the Pometa vision system underestimated the final yield (R2 = 0.67). Our results concluded that the Pometa system using a smartphone offered advantages such as low cost, quick access, simple operation, and accurate precision. The Orchard Robotics vision system with an advanced camera system provided more detailed and accurate information in terms of geo-referenced information for individual trees. Both vision systems evaluated are still in early development and have the potential to provide important information for orchard managers to improve crop load management decisions.

Abstract Background The determination of taxon-specific composition of microbiomes by combining high-throughput sequencing of ribosomal genes with phyloinformatic analyses has become routine in microbiology and allied sciences. Systematic biases to this approach based on the demonstrable variability of ribosomal operon copy number per genome were recognized early. The more recent realization that polyploidy is probably the norm, rather than the exception, among microbes from all domains of life, points to an even larger source bias. Results We found that the number of 16S or 18S RNA genes per cell, a combined result of the number of RNA gene loci per genome and ploidy level, follows an allometric power law of cell volume with an exponent of 2/3 across 6 orders of magnitude in small subunit copy number per cell and 9 orders of magnitude in cell size. This stands in contrast to cell DNA content, which follows a power law with an exponent of ¾. Conclusion In practical terms, that relationship allows for a single, simple correction for variations in both copy number per genome and ploidy level in ribosomal gene analyses of taxa-specific abundance. In biological terms, it points to the uniqueness of ribosomal gene content among microbial properties that scale with size. Video Abstract

The molecular evolution of medulloblastoma is more complex than previously imagined, as emerging evidence suggests that multiple interactions between the tumor cells and components of the tumor microenvironment (TME) are important for tumor promotion and progression. The identification of several molecular networks within the TME, which interact with tumoral cells, has provided new clues to understand the tumorigenic roles of many TME components as well as potential therapeutic targets. In this review, we discuss the most recent studies regarding the roles of astrocytes in supporting sonic hedgehog (SHH) subgroup medulloblastoma (MB) and provide an overview of MB progression through SHH expression and signal transduction mechanisms into the complex tumor microenvironment. In addition, we highlight the associations between tumor and stromal cells as possible prognostic markers that could be targeted with new therapeutic strategies.

This study explores the sense of belonging of rural middle and high school Latinx science students in Wisconsin. Between 2000 and 2015, the Latinx population was the fastest growing ethnic group in Wisconsin and increased by 95%. Yet, little is known about the experiences of these students in rural schools or their engagement in science learning. Our research contributes to addressing this knowledge gap and provides insights into Latinx student experiences relative to the science classroom and community. Our findings indicate that a primary determinant of Latinx science students' positive sense of belonging is a positive relationship with their teachers.

The weather variations around the world are already having a profound impact on agricultural production. This impacts apple production and the quality of the product. Through agricultural precision, growers attempt to optimize both yield and fruit size and quality. Two experiments were conducted using field-grown “Gala” apple trees in Geneva, NY, USA, in 2021 and 2022. Mature apple trees (Malus × domestica Borkh. cv. Ultima “Gala”) grafted onto G.11 rootstock planted in 2015 were used for the experiment. Our goal was to establish a relationship between stem water potential (Ψtrunk), which was continuously measured using microtensiometers, and the growth rate of apple fruits, measured continuously using dendrometers throughout the growing season. The second objective was to develop thresholds for Ψtrunk to determine when to irrigate apple trees. The economic impacts of different irrigation regimes were evaluated. Three different water regimes were compared (full irrigation, rainfed and rain exclusion to induce water stress). Trees subjected the rain-exclusion treatment were not irrigated during the whole season, except in the spring (April and May; 126 mm in 2021 and 100 mm in 2022); that is, these trees did not receive water during June, July, August and half of September. Trees subjected to the rainfed treatment received only rainwater (515 mm in 2021 and 382 mm in 2022). The fully irrigated trees received rain but were also irrigated by drip irrigation (515 mm in 2021 and 565 mm in 2022). Moreover, all trees received the same amount of water out of season in autumn and winter (245 mm in 2021 and 283 mm in 2022). The microtensiometer sensors detected differences in Ψtrunk among our treatments over the entire growing season. In both years, experimental trees with the same trunk cross-section area (TCSA) were selected (23–25 cm−2 TCSA), and crop load was adjusted to 7 fruits·cm−2 TCSA in 2021 and 8.5 fruits·cm−2 TCSA in 2022. However, the irrigated trees showed the highest fruit growth rates and final fruit weight (157 g and 70 mm), followed by the rainfed only treatment (132 g and 66 mm), while the rain-exclusion treatment had the lowest fruit growth rate and final fruit size (107 g and 61 mm). The hourly fruit shrinking and swelling rate (mm·h−1) measured with dendrometers and the hourly Ψtrunk (bar) measured with microtensiometers were correlated. We developed a logistic model to correlate Ψtrunk and fruit growth rate (g·h−1), which suggested a critical value of −9.7 bars for Ψtrunk, above which there were no negative effects on fruit growth rate due to water stress in the relatively humid conditions of New York State. A support vector machine model and a multiple regression model were developed to predict daytime hourly Ψtrunk with radiation and VPD as input variables. Yield and fruit size were converted to crop value, which showed that managing water stress with irrigation during dry periods improved crop value in the humid climate of New York State.

We developed a computer-assisted platform using laser scanning confocal microscopy to 3D reconstruct in real-time interactions between metastatic breast cancer cells and human umbilical vein endothelial cells (HUVECs). We demonstrate that MB-231 cancer cells migrate toward HUVEC networks, facilitated by filopodia, migrate along the network surfaces, penetrate into and migrate within the HUVEC networks, exit and continue migrating along network surfaces. The system is highly amenable to 3D reconstruction and computational analyses, and assessments of the effects of potential anti-metastasis monoclonal antibodies and other drugs. We demonstrate that an anti-RHAMM antibody blocks filopodium formation and all of the behaviors that we found take place between MB-231 cells and HUVEC networks.

Objective: Arteriovenous fistulae (AVF) placed for hemodialysis have high flow rates that can stimulate left ventricular (LV) hypertrophy. LV hypertrophy generally portends poor cardiac outcomes, yet clinical studies point to superior cardiac-specific outcomes for patients with AVF when compared with other dialysis modalities. We hypothesize that AVF induce physiologic cardiac hypertrophy with cardioprotective features. Methods: We treated 9- to 11-week-old C57Bl/6 male and female mice with sham laparotomy or an aortocaval fistula via a 25G needle. Cardiac chamber size and function were assessed with serial echocardiography, and cardiac computed tomography angiography. Hearts were harvested at 5 weeks postoperatively, and the collagen content was assessed with Masson's trichrome. Bulk messenger RNA sequencing was performed from LV of sham and AVF mice at 10 days. Differentially expressed genes were analyzed using Ingenuity Pathway Analysis (Qiagen) to identify affected pathways and predict downstream biological effects. Results: Mice with AVF had similar body weight and wet lung mass, but increased cardiac mass compared with sham-operated mice. AVF increased cardiac output while preserving LV systolic and diastolic function, as well as indices of right heart function; all four cardiac chambers were enlarged, with a slight decrement in the relative LV wall thickness. Histology showed preserved collagen density within each of the four chambers without areas of fibrosis. RNA sequencing captured 19 384 genes, of which 857 were significantly differentially expressed, including transcripts from extracellular matrix-related genes, ion channels, metabolism, and cardiac fetal genes. The top upstream regulatory molecules predicted include activation of angiogenic (Vegf, Akt1), procardiomyocyte survival (Hgf, Foxm1, Erbb2, Lin9, Areg), and inflammation-related (CSF2, Tgfb1, TNF, Ifng, Ccr2, IL6) genes, as well as the inactivation of cardiomyocyte antiproliferative factors (Cdkn1a, FoxO3, α-catenin). The predicted downstream effects include a decrease in heart damage, and increased arrhythmia, angiogenesis, and cardiogenesis. There were no significant sex-dependent differences in the AVF-stimulated cardiac adaptation. Conclusions: AVF stimulate adaptive cardiac hypertrophy in wild-type mice without heart failure or pathologic fibrosis. Transcriptional correlates suggest AVF-induced cardiac remodeling has some cardioprotective, although also arrhythmogenic features. (JVS–Vascular Science 2021;2:110-28.) Clinical Relevance: Arteriovenous fistulae (AVF) are commonly used as access for hemodialysis in patients with end-stage renal disease. AVF induce a high-output state that is associated with long-term structural cardiac remodeling, including left ventricle hypertrophy, but this element has uncertain clinical significance. Although left ventricle hypertrophy has traditionally been associated with an increased risk of cardiovascular disease, clinical studies have suggested that cardiac-specific outcomes of patients with end-stage renal disease were better with AVF compared with other dialysis modalities. This study uses a mouse model of AVF to study the structural, functional, and molecular correlates of AVF-induced cardiac remodeling. It finds that AVF causes an adaptive cardiac hypertrophy without functional decline or fibrosis. Transcriptional correlates suggest an electrical remodeling and the upregulation of proangiogenic, procardiogenic, and prosurvival factors, implying that AVF-induced cardiac hypertrophy is potentially cardioprotective, but also arrhythmogenic.

The adhesion complex (Nap) in Mycoplasma genitalium is composed of the adhesin proteins P110 and P140 and essential for infectivity, motility and adhesion of this human pathogen. Here, the author present the structures of P140 alone and the P140/P110 complex in closed and open conformations and based on their structural data and further functional studies propose a mechanism for the attachment and release of M. genitalium to the host cell receptor.

Abstract Background Sex is recognized as a significant determinant of outcome among glioblastoma patients, but the relative prognostic importance of glioblastoma features has not been thoroughly explored for sex differences. Methods Combining multi-modal MR images, biomathematical models, and patient clinical information, this investigation assesses which pretreatment variables have a sex-specific impact on the survival of glioblastoma patients (299 males and 195 females). Results Among males, tumor (T1Gd) radius was a predictor of overall survival (HR = 1.027, p = 0.044). Among females, higher tumor cell net invasion rate was a significant detriment to overall survival (HR = 1.011, p

Background: The clinical characteristics of the most frequent arbovirosis (Dengue, Zika, Chikungunya) are very similar, which is a diagnostic challenge for clinicians. Objective: To identify the presence of clinical characteristics related to Zika virus infection confirmed by the laboratory in patients during an epidemic of co-infection with Zika and Dengue viruses. Method: Cross-sectional descriptive study of patients with clinical - epidemiological suspicion of Zika virus infection, who were admitted in the Hospital “Joaquín Albarrán” (La Habana, Cuba), during June 1 to October 31 of 2017. Demographic and symptoms and signs were recorded. By PCR for Zika virus (in blood or urine) the disease was confirmed. Results: 1541 patients were studied. The most frequent symptoms and signs were rash (93.8%), pruritus (77.9%), arthralgia (60.0%), headache (50.8%), myalgia (46.1%), fever (34.7%), asthenia (31.7%), and conjunctivitis (27.9%). Zika virus infection was confirmed in 279 patients (18.1%). Greater frequency of arthralgia, asthenia, and diarrhea was demonstrated in Zika confirmed patients. Conclusion: Minor clinical relevance was observed in the symptoms or signs of arboviral disease to support the clinical diagnosis of Zika virus infections by clinician during a Zika-Dengue epidemic. The assessment of the temporality of the onset of Zika and Dengue symptoms of these infections is recommended to assist clinicians in the differential diagnosis. Keywords: Non-specific febrile syndrome, Zika, Infection, Clinical picture, Cuba

In this paper we propose multicore fiber (MCF) as the medium to transport the different signals associated with various wireless applications (ranging from access to fronthauling and backhauling) from the baseband unit (BBU) to the cell-site. Using 1 km of a 7-core MCF, we simultaneously transmit fronthaul and backhaul signals from the BBU to the cell site, where they are converted to carrier frequencies in the mm-wave and sub-THz band, respectively. The backhaul is evaluated with a 12.5 GBd 16-quadrature amplitude modulation (QAM) signal, whereas the fronthaul is evaluated with a 7 Gbit/s on-off keying (OOK) signal carrying 14 LTE-compatible channels. The fronthaul signal is generated with a novel compression technique that achieves an efficiency 3-times higher than the one obtained with the common public radio interface (CPRI) protocol. Optical heterodyning is implemented at the cell site for optical-to-RF conversion. The local oscillator (LO) signal required for optical heterodyning is transmitted in a dedicated core, reducing the system complexity and enabling its straight-forward reuse for uplink (UL) transmission. The experimental demonstration includes the simultaneous full-duplex transmission of both the fronthaul and backhaul signals, using 6 cores of the MCF at the same time and achieving a gross data rate of 57 Gbit/s.

Objective: The arteriovenous fistula (AVF) is the preferred method of dialysis access because of its proven superior long-term outcomes. However, women have lower rates of AVF patency and utilization than men. We used a novel mouse AVF model that recapitulates human AVF maturation to determine whether there are differences in AVF patency in female and male mice. Methods: Aortocaval fistulas were created in female and male C57BL/6 mice (9-10 weeks). At days 0, 3, 7, and 21, infrarenal inferior vena cava (IVC) and aortic diameters and flow velocity were monitored by Doppler ultrasound and used to calculate the vessel diameter, blood flow, and shear stress. AVF were harvested, and expression of proteins was examined by proteomic analysis and immunofluorescence and of messenger RNA by quantitative polymerase chain reaction analysis. Results: At baseline, female mice weighed less and had lower IVC velocity and smaller magnitudes of shear stress, but there was no significant difference in IVC diameter and thickness. After AVF creation, both female and male mice had similar IVC dilation and thickening with no significant differences in IVC wall thickness at day 21. However, female mice had diminished AVF patency by day 42 (25.7% vs 64.3%; P = .039). During fistula remodeling, female mice had lower IVC mean velocity and shear stress magnitude and increased spectral broadening (days 0-21). Messenger RNA and protein expression of Krüppel-like factor 2, endothelial nitric oxide synthase, and vascular cell adhesion molecule 1 was similar at baseline in female and male mice but increased in the AVF only in male mice but not in female mice (day 21). Proteomic analysis of female and male mice detected 56 proteins expressed at significantly higher levels in the IVC of female mice and 67 proteins expressed at significantly higher levels in the IVC of male mice (day 7); function-specific analysis showed that the IVC of male mice overexpressed proteins that belong to pathways implicated in the regulation of vascular function, thrombosis, response to flow, and vascular remodeling. Conclusions: AVF in female mice have diminished patency, preceded by lower velocity, reduced magnitudes of shear stress, and less laminar flow during remodeling. There is also sex-specific differential expression of proteins involved in thrombosis, response to laminar flow, inflammation, and proliferation. These findings suggest that hemodynamic changes during fistula maturation may play an important role underlying the diminished rates of AVF utilization in women. : Clinical Relevance: Women have lower rates of arteriovenous fistula (AVF) utilization than men. Using a mouse AVF model that recapitulates human AVF maturation, we show that female mice have similar AVF remodeling but diminished patency. AVF remodeling in female mice is associated with reduced shear stress and laminar flow; lack of increased transcription and translation of several anti-inflammatory, antiproliferative, and laminar flow response proteins (endothelial nitric oxide synthase, Krüppel-like factor 2, and vascular cell adhesion molecule 1); and different patterns of expression of pathways that regulate thrombosis and venous remodeling. Identifying downstream targets involved in these mechanisms may improve AVF outcomes in female patients.

Abstract Wound healing is the physiologic response to a disruption in normal skin architecture and requires both spatial and temporal coordination of multiple cell types and cytokines. This complex process is prone to dysregulation secondary to local and systemic factors such as ischemia and diabetes that frequently lead to chronic wounds. Chronic wounds such as diabetic foot ulcers are epidemic with great cost to the healthcare system as they heal poorly and recur frequently, creating an urgent need for new and advanced therapies. Stem cell therapy is emerging as a potential treatment for chronic wounds, and adult-derived stem cells are currently employed in several commercially available products; however, stem cell therapy is limited by the need for invasive harvesting techniques, immunogenicity, and limited cell survival in vivo. Induced pluripotent stem cells (iPSC) are an exciting cell type with enhanced therapeutic and translational potential. iPSC are derived from adult cells by in vitro induction of pluripotency, obviating the ethical dilemmas surrounding the use of embryonic stem cells; they are harvested non-invasively and can be transplanted autologously, reducing immune rejection; and iPSC are the only cell type capable of being differentiated into all of the cell types in healthy skin. This review focuses on the use of iPSC in animal models of wound healing including limb ischemia, as well as their limitations and methods aimed at improving iPSC safety profile in an effort to hasten translation to human studies.

The increasing prevalence of chronic and end-stage renal disease creates an increased need for reliable vascular access; although arteriovenous fistulae (AVF) are the preferred mode of hemodialysis access, 60% fail to mature and only 50% remain patent at 1 year. Fistulae mature by diameter expansion and wall thickening; this outward remodeling of the venous wall in the fistula environment relies on a delicate balance of extracellular matrix remodeling, inflammation, growth factor secretion, and cell adhesion molecule upregulation in the venous wall. AVF failure occurs via two distinct mechanisms with early failure secondary to lack of outward remodeling, that is, insufficient diameter expansion or wall thickening, whereas late failure occurs with excessive wall thickening due to neointimal hyperplasia and insufficient diameter expansion in a previously functional fistula. In recent years, the molecular basis of AVF maturation and failure are becoming understood to develop potential therapeutic targets to aid maturation and prevent access loss. Erythropoietin-producing hepatocellular (Eph) carcinoma receptors, along with their ligands and ephrins, determine vascular identity and are critical for vascular remodeling in the embryo. Manipulation of Eph receptor signaling in adults, as well as downstream pathways, is a potential treatment strategy to improve the rates of AVF maturation and patency. This review examines our current understanding of molecular changes occurring following fistula creation, factors predictive of fistula success, and potential areas of intervention to decrease AVF failure.

The current need for power-system control-room operational tools to increase real-time situational awareness has led to various proposals on data analytics algorithms to obtain operational information from SCADA and PMU power system networks. Most of the proposals are implemented in simulation, with reduced practical significance for system operators. This work proposes a web-based simple algorithm to identify the dynamic parameters of a reduced-order model of power system frequency dynamics that is implemented with industrial hardware on a PMU network in the Chilean power system. To demonstrate the applicability of the proposed tool, the algorithm is implemented in a web page with real-time monitoring of the frequency of the Chilean power system, so that utilities and academic institutions with access to PMU measurements can apply the proposed concepts regardless of the topology of the monitored system.

Contextualización: los modelos neuronales artificiales son modelos diseñados a partir de métodos numéricos denominados Redes Neuronales Artificiales. El uso de estos, como herramienta de predicción de la Demanda Bioquímica de Oxígeno (DBO), ha demostrado diversas ventajas, entre otras, la reducción del tiempo y los costos económicos asociados a este parámetro. La DBO generalmente requiere de 5 a 7 días, así como múltiples reactivos químicos, para poder establecer los niveles de materiales orgánicos en las aguas. Vacío de investigación: los modelos neuronales artificiales permiten calcular la DBO en tiempo real, a partir de variables fisicoquímicas registradas in situ. A pesar de ello, las redes neuronales artificiales no han sido utilizadas hasta ahora como método de estimación de la DBO en aguas marinas de Colombia. Propósito del estudio: teniendo en cuenta este aspecto, en la presente investigación se elaboró un modelo neuronal artificial que permite estimar la DBPO en aguas del Mar Caribe Colombiano. Metodología: para elaborar el modelo fue necesario realizar cinco simulaciones (constituidas por un número de 2 a 3 capas ocultas, y de 5 a 20 neuronas por capa). El desempeño predictivo de cada una de estas se evaluó a través del coeficiente de correlación. Resultados y conclusiones: los valores más altos de este indicador estadístico (0,937, 0,951, 0,953, y 0,941), se obtuvieron para el modelo que utilizó 3 capas, de 20 neuronas cada una, en sus cuatro etapas de aprendizaje (entrenamiento, validación, prueba, y todos los datos). Estas cifras indican un cercano ajuste entre los datos observados y las estimaciones hechas por la red. Estos resultados demuestran además que la Demanda Bioquímica de Oxígeno puede ser estimada numéricamente, en aguas marinas, a través de modelos neuronales artificiales.

Patients with COVID-19 often need therapeutic interventions that are considered high aerosol-generating procedures. These are either being performed by healthcare providers with potentially inadequate personal protective equipment or the procedures are being delayed until patients clear their viral load. Both scenarios are suboptimal. We present a simple, cost-effective method of creating a portable negative pressure environment using equipment that is found in most hospitals to better protect healthcare providers and to facilitate more timely care for patients with COVID-19.

Introduction: In the process of caring for patients with suspected coronavirus infection (COVID-19), elements that must be considered in transmission prevention strategies are included.Objective: To describe, based on the presentation of a case confirmed with COVID-19, the chronology of patients suspected or confirmed with the disease and the need to optimize diagnosis times in the transmission prevention.Case presentation: Fifty-nine-year-old male patient with a history of high blood pressure and gout, working as a taxi driver. Seven days before admission, he began with symptoms. A rapid test for COVID-19 was performed, which was negative. On the fifth day of isolation in a private room, PCR was performed and coronavirus infection was confirmed. He was moved to an institution dedicated to the care of these patients where he recovered without complications. Time intervals concerning care are described with special emphasis on diagnostic delay.Conclusion: Monitoring of the care dynamics of patients suspected of COVID-19 is required with a special focus on strengthening the prevention of nosocomial transmission and the prevention of the spreading of the disease in the community.

Glioblastomas are aggressive primary brain tumors known for their inter- and intratumor heterogeneity. This disease is uniformly fatal, with intratumor heterogeneity the major reason for treatment failure and recurrence. Just like the nature vs nurture debate, heterogeneity can arise from intrinsic or environmental influences. Whilst it is impossible to clinically separate observed behavior of cells from their environmental context, using a mathematical framework combined with multiscale data gives us insight into the relative roles of variation from different sources. To better understand the implications of intratumor heterogeneity on therapeutic outcomes, we created a hybrid agent-based mathematical model that captures both the overall tumor kinetics and the individual cellular behavior. We track single cells as agents, cell density on a coarser scale, and growth factor diffusion and dynamics on a finer scale over time and space. Our model parameters were fit utilizing serial MRI imaging and cell tracking data from ex vivo tissue slices acquired from a growth-factor driven glioblastoma murine model. When fitting our model to serial imaging only, there was a spectrum of equally-good parameter fits corresponding to a wide range of phenotypic behaviors. When fitting our model using imaging and cell scale data, we determined that environmental heterogeneity alone is insufficient to match the single cell data, and intrinsic heterogeneity is required to fully capture the migration behavior. The wide spectrum of in silico tumors also had a wide variety of responses to an application of an anti-proliferative treatment. Recurrent tumors were generally less proliferative than pre-treatment tumors as measured via the model simulations and validated from human GBM patient histology. Further, we found that all tumors continued to grow with an anti-migratory treatment alone, but the anti-proliferative/anti-migratory combination generally showed improvement over an anti-proliferative treatment alone. Together our results emphasize the need to better understand the underlying phenotypes and tumor heterogeneity present in a tumor when designing therapeutic regimens.

Background: Hand hygiene plays a key role in the prevention of healthcare-associated infection in critical patients. Objective: The current study aimed to evaluate compliance with hand hygiene practices. Methods: An observational and descriptive study was carried out in a 35-bed medical-surgical critical care unit in La Habana (Cuba) from January 2017 to December 2018. The observational method recommended by the World Health Organization (WHO) was used. Results: Overall compliance was 34.2% (5516/16 125), with better compliance among physicians (39%) compared with nurses (31.4%) and ancillary staff (19.5%). Better compliance was observed after patient contact (65.7%) and after contact with patients’ surroundings (42.0%) in comparison with greater focus on patient safety as before patient contact (23.3%) and before an aseptic task (11.4%). Hand washing was performed more frequently than hand rubs. Conclusion: Compliance with hand hygiene practices is low and no improvement in compliance was observed during the study period. This practice is related to the high risk of transmission of healthcare-related infections in critical patients and requires quality improvement interventions.

Smart buildings seek to have a balance between energy consumption and occupant comfort. To make this possible, smart buildings need to be able to foresee sudden changes in the building’s energy consumption. With the help of forecasting models, building energy management systems, which are a fundamental part of smart buildings, know when sudden changes in the energy consumption pattern could occur. Currently, different forecasting methods use models that allow building energy management systems to forecast energy consumption. Due to this, it is increasingly necessary to have appropriate forecasting models to be able to maintain a balance between energy consumption and occupant comfort. The objective of this paper is to present an energy consumption forecasting strategy that allows hourly day-ahead predictions. The presented forecasting strategy is tested using real data from two buildings located in Valladolid, Spain. Different machine learning and deep learning models were used to analyze which could perform better with the proposed strategy. After establishing the performance of the models, a model was assembled using the mean of the prediction values of the top five models to obtain a model with better performance.

Latin American countries have experienced demographic and linguistic changes since Educación Intercultural Bilingüe (EIB) was first developed. Yet, ministries of education continue to impose generic models that do not reflect the realities of migrant Indigenous groups, who experience linguistic and ethnic minoritisation processes. Based on our ongoing work with a migrant Salasaka Indigenous community from the Ecuadorian Andes living in Galapagos, a region in which the majority of the population does not identify as Indigenous nor speak Kichwa, we propose Contextualización Transformativa de Educación Intercultural Bilingüe (CTEIB). CTEIB 1) considers processes of enacting Indigeneity in migratory contexts; 2) reflects the dialogic influence of place on migrant Indigenous communities' languages, traditional ecological knowledge, and culture; and 3) acknowledges the agency and creativity of Indigenous groups as transformative agents in maintaining their languages and Indigeneity outside their ancestral lands. This paper describes the theoretical underpinnings of CTEIB by building on the work of the Salasaka community in contextualising and adapting the Ecuadorian EIB programme to Galapagos. Beyond the importance of this work for migrant Indigenous communities, this work advocates for EIB programmes to address Indigenous migration in their design and implementation with implications for educational researchers, policy makers, and educators.