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Abstract Finding the optimal beam pair and update time in 5G systems operating at mmWave frequencies is time-intensive and resource-demanding. This intricate procedure calls for the proposal of more intelligent approaches. Therefore, this work proposes a machine learning-based method for optimizing beam pair selection and its update time. The method is structured around three main modules: spatial characterization of beam pair service areas, training of a machine learning model using collected beam pair data, and an algorithm that uses the decision function of the trained model to compute the optimal update time for beam pairs based on the spatial position and velocity of user equipment. When the machine learning model is deployed in a network with a single gNB equipped with a $$8\times 8$$ 8 × 8 UPA and one UE equipped with a $$1\times 2$$ 1 × 2 UPA in an mmWave scenario simulated in NS3, improvements in SINR and throughput up to $$407\%$$ 407 % , were observed. Improvements are gathered because of a reduction of $$85.7\%$$ 85.7 % in beam pair selections because of an increase of approximately $$1543\%$$ 1543 % in the effective time between successive beam pair searches. This method could offer real-time optimization of the beam pair procedures in 5G networks and beyond.

A new four-dimensional, multiyear, and near-global climate data record of the fine-mode (submicrometer in terms of diameter) and coarse-mode (supermicrometer in terms of diameter) components of atmospheric pure dust is presented. The separation of the two modes of dust in detected atmospheric dust layers is based on a combination of (1) the total pure-dust product provided by the well-established European Space Agency (ESA) “LIdar climatology of Vertical Aerosol Structure” (LIVAS) database and (2) the coarse-mode component of pure dust provided by the first step of the two-step POlarization LIdar PHOtometer Networking (POLIPHON) technique, developed in the framework of the European Aerosol Research Lidar Network (EARLINET). Accordingly, the fine-mode component of pure dust is extracted as the residual between the LIVAS total pure dust and the coarse-mode component of pure dust. Intermediate steps involve the implementation of regionally dependent lidar-derived lidar ratio values and AErosol RObotic NETwork (AERONET)-based climatological extinction-to-volume conversion factors, facilitating conversion of dust backscatter into extinction and subsequently extinction into mass concentration. The decoupling scheme is applied to observations from the Cloud–Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) at 532 nm. The final products consist of the fine mode and coarse mode of atmospheric pure dust, quality-assured profiles of backscatter coefficient at 532 nm, extinction coefficient at 532 nm, and mass concentration for each of the two components. The datasets are established primarily with the original L2 horizontal (5 km) and vertical (60 m) resolution of the Cloud–Aerosol Lidar with Orthogonal Polarization (CALIOP) along the CALIPSO orbit path and secondly in averaged profiles of seasonal–temporal resolution, 1° × 1° spatial resolution, and the original vertical resolution of CALIPSO, focusing on the latitudinal band extending between 70° S and 70° N and covering more than 15 years of Earth observations (June 2006–December 2021). The quality of the CALIPSO-based fine-mode and coarse-mode dust products is assessed through the use of AERONET fine-mode and coarse-mode aerosol optical thickness (AOT) interpolated to 532 nm and the AERosol properties – Dust (AER-D) campaign airborne in situ particle size distributions (PSDs) as reference datasets during atmospheric conditions characterized by dust presence. The near-global fine-mode and coarse-mode pure-dust climate data record is considered unique with respect to a wide range of potential applications, including climatological, time series, and trend analysis over extensive geographical domains and temporal periods, validation of atmospheric dust models and reanalysis datasets, assimilation activities, and investigation of the role of airborne dust in radiation and air quality.

Autoimmune diseases and thrombophilic disorders, notably antiphospholipid syndrome (APS) and protein S deficiency, present a formidable challenge in pregnancy, substantially increasing the risk of thromboembolic complications by up to 20%. Pulmonary thromboembolism (PTE), characterized by a significantly higher maternal mortality rate, is of particular concern.APS, defined by the presence of antiphospholipid antibodies, emerges as a pivotal risk factor for PTE during pregnancy, especially in women exhibiting triple negativity. Concurrently, protein S deficiency further amplifies vulnerability to thromboembolic events, establishing a high-risk scenario for pregnant individuals.In a case involving a 29-year-old pregnant woman with a history of generalized lupus erythematosus, triple-negative antiphospholipid syndrome, and protein S deficiency, sudden-onset dyspnea prompted thorough investigation. Despite her complex medical history, a multidisciplinary approach led to the accurate diagnosis and successful management of subsegmental pulmonary thromboembolism, ensuring the well-being of both mother and fetus.Effectively managing PTE during pregnancy demands a comprehensive, multidisciplinary approach involving collaboration among obstetricians, internists, rheumatologists, and hematologists. Accurate diagnosis, tailored anticoagulation strategies, and continuous monitoring stand as indispensable pillars for maternal and fetal well-being.

Autoimmune hepatitis (AIH) is a varied inflammatory chronic liver disease. AIH’s prevalence varies and has increased recently. Diagnosis involves the discovery of histologic features following liver biopsy and serologic testing. Clinical features vary, and up to 40% of patients may be asymptomatic. Evaluating thiopurine methyltransferase (TMPM) activity before treatment is crucial for an optimal response. The primary treatment goal is biochemical remission, normalized serum IgG, and liver enzymes. Induction therapy typically involves azathioprine and corticosteroids. Close monitoring of liver function tests and serum immunoglobulin levels is essential. Medications can be tapered after achieving biochemical remission. Liver transplantation may be required for refractory disease or cirrhosis. Further therapeutic approaches are needed, particularly for non-responders to first-line treatments.

BackgroundPeripersonal Space (PS) is represented as the immediate area surrounding an individual. The extent of PS changes in relation to several factors, including emotional states, type of relationship or psychopathology. Attachment anxiety has an impact on the social adaptability of peripersonal space and anxiety and fear are associated with an expansion of peripersonal space, possibly serving as a mechanism of self-protection. Peripersonal space appears to be intricately linked to various psychiatric conditions like anxiety disorders and converging evidence suggests that social maladjustment may predict or exacerbate eating disorder symptoms expression.MethodsFifty-eight healthy adolescents (38F, 20M) performed a comfort distance estimation task to assess peripersonal space. The Adolescent/Adult Sensory Profile (AASP) was used to assess sensory profiles and the SAFA protocol to investigate psychopathological aspects. Data was analysed using Network Analysis, estimating a Gaussian Graphical Models with a Bayesian approach.ResultsWe found that the task related to comfort estimation distance demonstrated a correlation with the visual scale of the Adolescent/Adult Sensory Profile (AASP). Additionally, a correlation was observed with the Eating Disorder scale of the SAFA protocol. The touch scale also was negatively correlated with Eating disorder symptoms but not with the comfort estimation task.ConclusionOur results demonstrate a relation between peripersonal space and eating disorder symptoms in healthy adolescents in line with previous findings in adults with eating disorders diagnosis. These findings suggest that socio-emotional difficulties may be possible precursors or reinforce for the development of an eating disorder symptoms.

Persistence of the rebound-competent viral reservoir (RCVR) within the CD4+ T cell compartment of people living with HIV remains a major barrier to HIV cure. Here, we determined the effects of the pan-lymphocyte-depleting monoclonal antibody (mAb) alemtuzumab on the RCVR in SIVmac239-infected rhesus macaques (RM) receiving antiretroviral therapy (ART). Alemtuzumab administered during chronic ART or at the time of ART initiation induced >95% depletion of circulating CD4+ T cells in peripheral blood and substantial CD4+ T cell depletion in lymph nodes. However, treatment was followed by proliferation and reconstitution of CD4+ T cells in blood, and despite ongoing ART, levels of cell-associated SIV DNA in blood and lymphoid tissues were not substantially different between alemtuzumab-treated and control RM after immune cell reconstitution, irrespective of the time of alemtuzumab treatment. Upon ART cessation, 19 of 22 alemtuzumab-treated RM and 13 of 13 controls rebounded with no difference in the time to rebound between treatment groups. Time to rebound and reactivation rate was associated with plasma viral loads (pVLs) at time of ART initiation, suggesting lymphocyte depletion had no durable impact on the RCVR. However, 3 alemtuzumab-treated RM that had lowest levels of pre-ART viremia, failed to rebound after ART withdrawal, in contrast to controls with similar levels of SIV replication. These observations suggest that alemtuzumab therapy has little to no ability to reduce well-established RCVRs but may facilitate RCVR destabilization when pre-ART virus levels are particularly low.

Abstract While epigenetic modifications have been implicated in ADHD through studies of peripheral tissue, to date there has been no examination of the epigenome of the brain in the disorder. To address this gap, we mapped the methylome of the caudate nucleus and anterior cingulate cortex in post-mortem tissue from fifty-eight individuals with or without ADHD. While no single probe showed adjusted significance in differential methylation, several differentially methylated regions emerged. These regions implicated genes involved in developmental processes including neurogenesis and the differentiation of oligodendrocytes and glial cells. We demonstrate a significant association between differentially methylated genes in the caudate and genes implicated by GWAS not only in ADHD but also in autistic spectrum, obsessive compulsive and bipolar affective disorders through GWAS. Using transcriptomic data available on the same subjects, we found modest correlations between the methylation and expression of genes. In conclusion, this study of the cortico-striatal methylome points to gene and gene pathways involved in neurodevelopment, consistent with studies of common and rare genetic variation, as well as the post-mortem transcriptome in ADHD.

In this study, we present a new approach for the determination of polarization parameters of the Nicosia Cimel CE376 lidar system, using the PollyXT in Limassol as a reference instrument. The method is applied retrospectively to the measurements obtained during the 2021 Cyprus Fall Campaign. Lidar depolarization measurements represent valuable information for aerosol typing and for the quantification of some specific aerosol types such as dust and volcanic ash. An accurate characterization is required for quality measurements and to remove instrumental artifacts. In this article, we use the PollyXT, a widely used depolarization lidar, as our reference to evaluate the CE376 system's gain ratio and channel cross-talk. We use observations of transported dust from desert regions for this approach, with layers in the free troposphere. Above the boundary layer and the highest terrain elevation of the region, we can expect that, for long-range transport of aerosols, local effects should not affect the aerosol mixture enough for us to expect similar depolarization properties at the two stations (separated by ∼ 60 km). Algebraic equations are used to derive polarization parameters from the comparison of the volume depolarization ratio measured by the two systems. The applied methodology offers a promising opportunity to evaluate the polarization parameters of a lidar system, in cases where a priori knowledge of the cross-talk parameters is not available, or to transfer the polarization parameters from one system to the other.

La Lex Criptográfica, que surge en el ámbito de la tecnología blockchain, plantea la posibilidad de conferir empoderamiento a las personas a través de la promoción de la libertad individual y la emancipación. El propósito fundamental de la presente investigación radica en llevar a cabo un análisis exhaustivo de los componentes que integran la Lex Criptográfica, con el fin de delimitarla y, de esta manera, lograr una comprensión más precisa de sus efectos y alcances. El método de análisis-síntesis se empleó como enfoque para desglosar sus elementos constituyentes y, posteriormente, sintetizarlos con miras a su definición y demarcación. Los resultados obtenidos revelan que la Lex Criptográfica se compone de aspectos esenciales, a saber: código, contratos inteligentes, blockchain y criptografía. Adicionalmente, se advierte que la regulación de esta estructura es un desafío de envergadura que requiere de un equilibrio entre el poder tecnológico y los valores de las libertades individuales, la democracia y la libertad de expresión. La imperiosa necesidad de adoptar un enfoque legal renovado se vislumbra como la vía para fomentar el crecimiento económico, consolidar las instituciones democráticas y salvaguardar las libertades individuales, al tiempo que se mitigan los riesgos potenciales.

La investigación aborda la protección jurídica del derecho a la libertad de expresión en la historia constitucional nicaragüense desde el siglo XIX hasta nuestros días, haciendo un estudio pormenorizado en las constituciones políticas que Nicaragua ha tenido como República. Es importante señalar que la inestabilidad reinante en todos los procesos jurídicos, políticos e institucionales son los puntos de coincidencia encontrados en este análisis constitucional, además del tratamiento constitucional sistemático y uniforme otorgado a este derecho. El estudio de las diferentes fundamentaciones teóricas de la libertad de expresión se centra en los límites constitucionales que el ordenamiento jurídico nicaragüense establece a este derecho fundamental.

El objetivo de este trabajo fue diseñar una tipología de redes sociales de excombatientes y víctimas del conflicto armado en Colombia, con miras a entender las dinámicas propias de composición de esta población en cuanto a sus procesos de integración social con la comunidad. Mediante un estudio explicativo transversal se evaluó 120 excombatientes y 120 víctimas de conflicto armado colombiano, primero sus redes sociales personales, las cuales se construyeron con una matriz cuadrada de datos, luego se evaluó sus niveles de apoyo social con el ASSIS. Los resultados mostraron diferencias significativas entre las redes de víctimas y excombatientes de acuerdo con el género e indicadores estructurales, por lo cual se proponen tres grupos de redes: Tipo 1. conformado por excombatientes con mediano nivel de apoyo social y altos indicadores de centralización e intermediación y poca densidad. Tipo 2. conformado por redes densas de víctimas con bajo nivel de apoyo. Tipo 3. con niveles modestos de indicadores estructurales, pero alto nivel de apoyo social. Al final, se entregan comentarios para enlazar dichas características al diseño de programas de intervención con estas poblaciones, las cuales surtan a la comunidad académica y organizaciones gubernamentales de mecanismos para el éxito de los programas.

Introduction and Objectives: Autoimmune liver diseases (AILDs): autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) have different survival outcomes after liver transplant (LT). Outcomes are influenced by factors including disease burden, medical comorbidities, and socioeconomic variables. Materials and Methods: Using the United Network for Organ Sharing database (UNOS), we identified 13,702 patients with AILDs listed for LT between 2002 and 2021. Outcomes of interest were waitlist removal, post-LT patient survival, and post- LT graft survival. A stepwise multivariate analysis was performed adjusting for transplant recipient gender, race, diabetes mellitus, model for end-stage liver disease (MELD) score, and additional social determinants including the presence of education, reliance on public insurance, working for income, and U.S. citizenship status. Results: Lack of college education and having public insurance increased the risk of waitlist removal (HR, 1.13; 95 % CI, 1.05–1.23, and HR, 1.09; 95 % CI, 1.00–1.18; respectively), and negatively influenced post-LT patient survival (HR, 1.16; 95 % CI, 1.06–1.26, and HR, 1.15; 95 % CI, 1.06–1.25; respectively) and graft survival (HR, 1.13; 95 % CI, 1.05–1.23, and HR, 1.15; 95 % CI, 1.06–1.25; respectively). Not working for income proved to have the greatest detrimental impact on both patient survival (HR, 1.41; 95 % CI, 1.24–1.6) and graft survival (HR, 1.21; 95 % CI, 1.09–1.35). Conclusions: Our study highlights that lack of college education and public insurance have a detrimental impact on waitlist mortality, patient survival, and graft survival. Not working for income negatively affects post-LT survival outcomes. Not having U.S. citizenship does not affect survival outcomes in AILDs patients.

Background: The cornerstone treatment for primary biliary cholangitis (PBC) is ursodeoxycholic acid (UDCA), but many patients exhibit an incomplete response, leading to disease progression. Risk prediction models like the GLOBE and UK-PBC scores hold promise for patient stratification and management. We aimed to independently assess the predictive accuracy of these risk scores for UDCA response in a prospective U.S. cohort. Methods: We conducted a prospective cohort study at a U.S. liver center, monitoring UDCA-treated PBC patients over a one-year follow-up. We evaluated the predictive efficacy of the GLOBE and UK-PBC scores for UDCA treatment response, comparing them to the Paris II criteria. Efficacy was assessed using univariate and multivariate analyses, followed by prognostic performance evaluation via receiver operating characteristic (ROC) curve analysis. Results: We evaluated 136 PBC patients undergoing UDCA therapy. Based on the Paris II criteria, patients were categorized into UDCA full-response and non-response groups. The GLOBE score identified a non-responder rate of 18% (p = 0.205), compared to 20% (p = 0.014) with the Paris II criteria. Multivariate analysis, adjusted for age and biochemical markers, showed that both the GLOBE and UK-PBC scores were strongly associated with treatment response (p < 0.001). The area under the ROC curve was 0.87 (95% CI 0.83−0.95) for the GLOBE score and 0.94 (95% CI 0.86−0.99) for the UK-PBC risk score. Conclusions: Our study demonstrates that GLOBE and UK-PBC scores effectively predict UDCA treatment response in PBC patients. The early identification of patients at risk of an incomplete response could improve treatment strategies and identify patients who may need second-line therapies.

Introducción. El manejo perioperatorio de las urgencias hepatobiliares por parte del cirujano general es una competencia esperada y se considera un reto por su relativa frecuencia, impacto en la salud del individuo y la economía, así como las implicaciones en el ejercicio clínico confiable y de alta calidad. Se desconocen los aspectos formales de la educación en cirugía hepatobiliar para el cirujano general en Colombia. El objetivo del presente estudio fue explorar la perspectiva de los cirujanos hepatobiliares sobre esta problemática. Métodos. Se realizó un estudio cualitativo, mediante entrevistas semiestructuradas con 14 especialistas en cirugía hepatobiliar colombianos, en donde se exploraron los desafíos del entrenamiento, el tiempo y las características de una rotación, la evaluación de la confiabilidad, el número de procedimientos y el rol de la simulación. Se hizo un análisis temático de la información. Resultados. Los expertos mencionaron la importancia de la rotación obligatoria por cirugía hepatobiliar para los cirujanos en formación. El tiempo ideal es de tres meses, en el último año de residencia, en centros especializados, con exposición activa y bajo supervisión. Conclusiones. Por las características epidemiológicas del país y la frecuencia de enfermedades hepatobiliares que requieren tratamiento quirúrgico, es necesario que el cirujano general cuente con una formación sólida en este campo durante la residencia. El presente estudio informa sobre las características ideales del entrenamiento en este campo desde la visión de los expertos colombianos.

Background & objectives: This study aimed to: 1) analyze the inflammatory profile of Rheumatoid Arthritis (RA) patients, identifying clinical phenotypes associated with cardiovascular (CV) risk; 2) evaluate biologic and targeted-synthetic disease-modifying antirheumatic drugs (b-DMARDs and ts-DMARDs’: TNFi, IL6Ri, JAKinibs) effects; and 3) characterize molecular mechanisms in immune-cell activation and endothelial dysfunction. Patients & methods: A total of 387 RA patients and 45 healthy donors were recruited, forming three cohorts: i) 208 RA patients with established disease but without previous CV events; ii) RA-CVD: 96 RA patients with CV events, and iii) 83 RA patients treated with b-DMARDs/ts-DMARDs for 6 months. Serum inflammatory profiles (cytokines/chemokines/growth factors) and NETosis/oxidative stress-linked biomolecules were evaluated. Mechanistic in vitro studies were performed on monocytes, neutrophils and endothelial cells (EC). Results: In the first RA-cohort, unsupervised clustering unveiled three distinct groups: cluster 3 (C3) displayed the highest inflammatory profile, significant CV-risk score, and greater atheroma plaques prevalence. In contrast, cluster 1 (C1) exhibited the lowest inflammatory profile and CV risk score, while cluster 2 (C2) displayed an intermediate phenotype. Notably, 2nd cohort RA-CVD patients mirrored C3's inflammation.Treatment with b-DMARDs or ts-DMARDs effectively reduced disease-activity scores (DAS28) and restored normal biomolecules levels, controlling CV risk. In vitro, serum from C3-RA or RA-CVD patients increased neutrophils activity and CV-related protein levels in cultured monocytes and EC, which were partially prevented by pre-incubation with TNFi, IL6Ri, and JAKinibs. Conclusions: Overall, analyzing circulating molecular profiles in RA patients holds potential for personalized clinical management, addressing CV risk and assisting healthcare professionals in tailoring treatment, ultimately improving outcomes.

Background/Objective: Guidelines on obesity management reinforce regular exercise to reduce body fat. Exercise modalities, including high-intensity interval training (HIIT), appear to produce a similar effect to continuous aerobic training (CAT) on body fat. However, they have not addressed the chronic effect of HIIT vs. CAT on body fat assessed by dual energy X-ray absorptiometry (DEXA). Thus, we compared the effectiveness of CAT vs. HIIT protocols on body fat (absolute or relative) (%BF) and abdominal visceral fat reduction, assessed by DEXA, in adults with overweight and obesity. Methods: We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) including both female or male adults with excess body weight. We performed searches in the databases MEDLINE (PubMed), EMBASE, Scopus, LILACS, Web of Science and Cochrane. Results: In our analysis (11 RCTs), we found no greater benefit on %BF of HIIT vs. CAT (MD –0.55%, 95% CI –1.42 to 0.31; p = 0.209). As for abdominal visceral fat, no training modality was superior (SMD: −0.05, 95% CI –0.29 to 0.19; p = 0.997). Regarding secondary outcomes (body weight, BMI, VO2 max, glycemic and lipid profiles), HIIT shows greater benefit than CAT in increasing VO2 max and fasting blood glucose and reducing total cholesterol. Conclusion: HIIT is not superior to CAT in reducing %BF or abdominal visceral fat in individuals characterized by excess weight. However, HIIT showed beneficial effects on cardiorespiratory fitness, total cholesterol and fasting blood glucose when compared to CAT.

Background: Safety and outcome of atezolizumab/bevacizumab in Child-Pugh B patients with hepatocellular carcinoma (HCC) have not been completely characterized. Objectives: In this study, we aimed at addressing safety and efficacy of atezolizumab/bevacizumab in Child-Pugh B patients by reviewing the available data and analyzing them by meta-analysis. Methods: We compared the safety and efficacy of atezolizumab/becavizumab treatment in patients with unresectable HCC and various degrees of liver dysfunction. A total of 8 retrospective, non-randomized, cohort studies were included in this meta-analysis, for a total of 1,071 Child-Pugh A and 225 Child-Pugh B patients. The albumin-bilirubin (ALBI) grade was also used to assess liver function, when available. Results: Grade ≥3 adverse events were observed in 11.8% of Child-Pugh class A and 26.8% class B patients (p = 0.0001), with an odds ratio (OR) of 0.43 (confidence interval [CI] 0.21–0.90; p = 0.02). Progression-free survival (PFS) at both 6 months (4.90 ± 2.08 vs. 4.75 ± 2.08 months; p = 0.0004) and 12 months (8.83 ± 2.32 vs. 7.26 ± 2.33 months; p = 0.002) was lower in Child-Pugh class B patients. A trend toward a higher objective response rate (ORR) was observed in Child-Pugh class A patients (219/856, 25.6%) as compared to Child-Pugh class B patients (25/138, 18.1%; p = 0.070), while the probability of obtaining an ORR was significantly greater in Child-Pugh A patients (OR 1.79, CI 1.12–2.86; p = 0.02). Median overall survival (OS) was 16.8 ± 2.0 and 6.8 ± 3.2 months in Child-Pugh A and B patients, respectively (mean difference 9.06 months, CI 7.01–11.1, p < 0.0001). Lastly, OS was longer in patients with ALBI grades 1–2 than in those with grade 3 (8.3 ± 11.4 vs. 3.3 ± 5.0 months, p = 0.0008). Conclusions: Oncological efficacy of atezolizumab/bevacizumab is moderate in Child-Pugh class B patients, and the shorter PFS and OS associated with the greater likelihood of experiencing treatment-related adverse events observed in these patients suggest great caution and individualization of treatment, possibly with the support of the ALBI grade.

Abstract Functional pituitary adenomas (FPAs) are associated with hormonal hypersecretion resulting in systemic endocrinopathies and increased mortality. The heterogenous composition of the FPA population has made modeling predictive factors of postoperative disease remission a challenge. Here, we aim to define a novel scoring system predictive of disease remission following transsphenoidal surgery (TSS) for FPAs and validate our process using supervised machine learning (SML). 392 patients with FPAs treated at one of the three Mayo Clinic campuses were retrospectively reviewed. Variables found significant on multivariate analysis were incorporated into our novel Pit-SCHEME score. The Pit-SCHEME score with a cut-off value ≥ 6 achieved a sensitivity of 86% and positive likelihood ratio of 2.88. In SML models, without the Pit-SCHEME score, the k-nearest neighbor (KNN) model achieved the highest accuracy at 75.6%. An increase in model sensitivity was achieved with inclusion of the Pit-SCHEME score with the linear discriminant analysis (LDA) model achieving an accuracy of 86.9%, which suggests the Pit-SCHEME score is the variable of most importance for prediction of postoperative disease remission. Ultimately, these results support the potential clinical utility of the Pit-SCHEME score and its prospective future for aiding in the perioperative decision making in patients with FPAs.

El Lupus Eritematoso Sistémico (LES) es uno de los prototipos de las enfermedades autoinmunes, compromete principalmente al sexo femenino, con una proporción 9:1 mujer-hombre. Se caracteriza por la formación de autoanticuerpos con la participación de la inmunidad adaptativa e innata, en interacción con los factores genéticos y medioambientales. Estos autoanticuerpos son parte central de la fisiopatología de la enfermedad, causando desde compromiso orgánico leve hasta compromiso multisistémico grave. El diagnóstico es clínico, orientado por una anamnesis detallada, un examen físico exhaustivo y los marcadores de autoinmunidad; eventualmente podría apoyarse en criterios clasificatorios de algunas sociedades científicas. La actual revisión pretende destacar las generalidades sobre la enfermedad, haciendo énfasis en su fisiopatología, presentación clínica, y su abordaje diagnóstico y terapéutico, sirviendo de apoyo para la formación médica integral en beneficio de los pacientes.

Despite newly available therapies for acute stroke and innovative prevention strategies, stroke remains the third leading cause of disability-adjusted life-years (DALYs) lost worldwide, mostly because more than half of stroke survivors aged 65 and over exhibit an incomplete functional recovery of the paretic limb. Given that a repeated sensory input is one of the most effective modulators of cortical motor and somatosensory structures, focal muscle vibration (fMV) is gaining growing interest as a safe, well-tolerated, and non-invasive brain stimulation technique to promote motor recovery after stroke with a long-lasting and clinically relevant improvement in strength, step symmetry, gait, and kinematics parameters. In this narrative review, we first summarize the structural (neural plasticity) and functional changes (network relearning) triggered by the stroke lesion and carried out at a brain and spinal cord level in an attempt to recover from the loss of function. Then, we will focus on the fMV’s plasticity-based mechanisms reporting evidence of a possible concurrently acting multisite plasticity induced by fMV. Finally, to understand what the most effective fMV rehabilitation protocol could be, we will report the most recent evidence regarding the different clinical approaches and timing of the fMV treatment, the related open issues, and prospects.

Paraphenylenediamine (PPD) is a well-known culprit allergen in the literature and clinical practice. Although this has been described in temporary tattoos, the definite implication of PPD in permanent tattoos has not been described. We report a patient who developed severe allergic contact dermatitis (ACD) requiring skin grafting after receiving a permanent tattoo with ink containing PPD. A 30-year-old female with a past history of atopic dermatitis and psoriasis presented with a 2-week history of cutaneous reaction to a recent tattoo. The patient noticed inflammation and irritation of the tattoo site the day after administration. The patient was previously identified on patch testing to have a PPD allergy after evaluation for dermatitis after hair dye application. Following the tattoo placement, she applied soap and bacitracin cream which she had used several years prior on a similar tattoo. On presentation 2 weeks later, she was found to have a deep ulcerated plaque with an indurated border encompassing the area of the tattoo. She was referred to the emergency department and admitted for treatment, ultimately requiring debridement and skin grafting. The patient obtained the safety data sheets for the tattoo inks which revealed PPD as an ingredient in every color. We believe this is the first confirmed case of PPD being implicated as the causative agent for ACD to a permanent tattoo. Tattoo ink is unregulated, and formulas are proprietary which makes safe practice difficult for patients with sensitivities. We advocate for consistent ingredient labeling, regulation, and transparency within the tattoo ink industry.

Abstract The objective of this work was to evaluate biomass accumulation and photosynthesis in mangabeira, in response to water deficit and to successive soil drying and wetting cycles. Seedlings were grown in pots and subjected to the three following water regimes: soil at 35, 70, and 100% of field capacity (FC), followed by a drying-down period until photosynthesis (measured weekly) was close to zero. Then, the seedlings were rewatered until completing four drying-wetting cycles. The control treatment was a permanently well-irrigated soil. There was a decline in biomass accumulation under water deficit conditions. Photosynthesis responded to soil rewatering only at 70 and 100% FC and was null at 35% FC. The elapsed time for photosynthesis to reach a null value after rewatering increases with successive drying-wetting cycles. In soil at 100% FC, for photosynthesis to approach zero, it takes five weeks in the first and eight weeks in the last rewatering cycle. Photosynthesis improves with progressive drying-wetting cycles, particularly in soil at 100% FC. The pre-acclimation of mangabeira to drying-wetting cycles should be considered before transplanting the seedlings in the field, and pre-acclimation should be carried out initially with soil at its FC.

Abstract Recent postmortem transcriptomic studies of schizophrenia (SCZ) have shown hundreds of differentially expressed genes. However, the extent to which these gene expression changes reflect antipsychotic drug (APD) exposure remains uncertain. We compared differential gene expression in the prefrontal cortex of SCZ patients who tested positive for APDs at the time of death with SCZ patients who did not. APD exposure was associated with numerous changes in the brain transcriptome, especially among SCZ patients on atypical APDs. Brain transcriptome data from macaques chronically treated with APDs showed that APDs affect the expression of many functionally relevant genes, some of which show expression changes in the same directions as those observed in SCZ. Co-expression modules enriched for synaptic function showed convergent patterns between SCZ and some of the APD effects, while those associated with inflammation and glucose metabolism exhibited predominantly divergent patterns between SCZ and APD effects. In contrast, major cell-type shifts inferred in SCZ were primarily unaffected by APD use. These results show that APDs may confound SCZ-associated gene expression changes in postmortem brain tissue. Disentangling these effects will help identify causal genes and improve our neurobiological understanding of SCZ.

A new biosorbent obtained from Calabrese broccoli stalks has been prepared, characterised and used as an effective, low-cost and ecofriendly biomass to remove Pb(II) from aqueous solutions, without any complicated pretreatment. Structural and morphological characterisation were performed by TGA/DGT, FTIR and SEM/EDX; the main components are hemicellulose, starches, pectin, cellulose, lignin and phytochemicals, with important electron donor elements (such as S from glucosinolates of broccoli) involved in Pb(II) sorption. The biosorbent showed values of 0.52 and 0.65 g mL−1 for bulk and apparent densities, 20.6% porosity, a specific surface area of 15.3 m2 g−1, pHpzc 6.25, iodine capacity of 619 mg g−1 and a cation exchange capacity of 30.7 cmol kg−1. Very good sorption (88.3 ± 0.8%) occurred at pH 4.8 with a biomass dose of 10 g L−1 after 8 h. The Freundlich and Dubinin–Radushkevich isotherms and the pseudo-second-order kinetic models explained with good fits the favourable Pb(II) sorption on the heterogeneous surface of broccoli biomass. The maximum adsorption capacity was 586.7 mg g−1. The thermodynamic parameters evaluated showed the endothermic and spontaneous nature of the Pb(II) biosorption. The chemical mechanisms mainly involved complexation, ligand exchange and cation–π interaction, with possible precipitation.

Adenosine triphosphate (ATP) is an energy and signaling molecule. It is synthesized endogenously and can be taken as an oral supplement. This review aimed to identify the effects of oral ATP supplementation on anaerobic exercise in healthy resistance-trained adults. A systematic review and meta-analysis were performed based on the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) criteria. The inclusion criteria were articles published from 2000 to 2022, with anaerobic variables (maximal strength, maximum repetitions, and maximum anaerobic power) measurable in healthy adults with experience in resistance training, only randomized placebo-controlled clinical trials (RCTs), and with the acute (a single dose 30 min to 24 h before the tests) and/or chronic (>1 day) oral supplementation of ATP. A total of five RCTs with 121 adult men were included. The oral ATP supplementation achieved significantly greater gains in maximal strength compared with the placebo (PL) (MD = 8.13 kg, 95%CI [3.36–12.90], p < 0.001). Still, no differences were observed in the maximum number of repetitions or the maximum anaerobic power. Furthermore, 400 mg of ATP showed improvement in anaerobic exercise regardless of the duration of the supplementation protocol. In conclusion, supplementation with 400 mg of ATP doses can improve maximal muscle strength in resistance-trained men.

Biotic samples from Algeciras Bay (South-west Europe) were studied to assess its ecological status, complementing the previous abiotic monitoring of trace metals in water and sediments. This bay is a densely populated area with intense port traffic and is highly industrialised with metal inputs. To study the impact of this, Zn, Cd, Pb, and Cu contents were determined in tissues of benthic (Solea senegalensis) and benthopelagic species (Scorpaena porcus, Trigloporus lastoviza, and Diplodus sargus sargus). Notable levels of Zn and Cu were found in the liver and gills of all fish species. Compared to international muscle guidelines, Pb sometimes exceeded the most restrictive values, outstanding S. porcus with 27% of samples above the permissible value. Metal pollution indexes revealed that the liver and gills of benthic species were more affected by metal pollution than benthopelagic species, especially in most industrialised sites. Particularly, S. senegalensis presented a higher accumulation factor from sediment of Cd and Cu in the liver (30.1 and 345.1), probably due to the close interaction as benthic species. Among the species studied, S. senegalensis and D. sargus sargus proved to be the best representative and useful bioindicators of metal-polluted environments as this bay. The results were consistent with the findings from the abiotic samples.