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BackgroundBreast cancer is thought to arise in mammary epithelial stem cells. However, the identity of these stem cells is unknown.MethodsStudies in the haematopoetic and muscle systems show that stem cells have the ability to efflux the dye Hoechst 33342. Cells with this phenotype are referred to as the side population (SP). We have adapted the techniques from the haematopoetic and muscle systems to look for a mammary epithelial SP.ResultsOf mammary epithelial cells isolated from both the human and mouse mammary epithelia, 0.2-0.45% formed a distinct SP. The SP was relatively undifferentiated but grew as typical differentiated epithelial clones when cultured. Transplantation of murine SP cells at limiting dilution into cleared mammary fat pads generated epithelial ductal and lobuloalveolar structures.ConclusionThese data demonstrate the existence of an undifferentiated SP in human and murine mammary epithelium. Purified SP cells are a live single-cell population that retain the ability to differentiate in vitro and in vivo. Studies of haematopoetic cells have suggested that the SP phenotype constitutes a universal stem cell marker. This work therefore has implications for mammary stem cell biology.

Background/Objectives: The COVID-19 pandemic has put nurses under extreme pressure, especially affecting them by significantly increasing their workload and compromising their well-being. The lack of balance between work and personal life has caused greater stress and burnout in these professionals, deteriorating their quality of life and the care they provide. This study aims to synthesize the scientific evidence on the relationship between work–family balance and the perceived quality of life of nurses during the COVID-19 pandemic. Methods: A scoping review was carried out based on the Joanna Briggs Institute methodology, following the PRISMA-ScR guidelines in the PubMed, CINAHL, SCOPUS, WOS, Cochrane Library, and PsycINFO databases. The quality of the articles was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Five studies involving 1641 nurses from Spain, India, Jordan, South Korea, and Turkey focused on three key areas: (1) work–life balance, (2) quality of life, and (3) factors associated with quality of life during the COVID-19 pandemic. Conclusions: The pandemic exacerbated pre-existing challenges related to work–life balance and quality of life, particularly for nurses with rigid and extended work hours, increasing stress and negatively impacting their well-being. The study emphasizes the need for flexible labor policies, psychological support, and strong social networks to prevent burnout and improve nurses’ quality of life.

Background: Thoracic surgery is an expanding surgical specialty, but a shortage of qualified and motivated thoracic surgery residents is expected. It is estimated that around 23 % of all surgical specialist jobs will be vacant by 2030. We therefore need to assess the current clinical situation and urgently improve the recruitment and training of our next generation of surgeons. Methods: Using the online survey (Lime Survey), a questionnaire (28 questions) was created to analyze the current nationwide situation of residency in thoracic surgery. The survey was sent to all postgraduate trainees in thoracic surgery departments in Germany. The current status on residency-programs, scientific interest, the attractiveness of thoracic surgery, and the demographics of the participants were evaluated. The survey also evaluated specific ways to increase attractiveness.The survey was conducted in collaboration with “Frauen in der Thoraxchirurgie” by the “Junges Forum der Deutschen Gesellschaft für Thoraxchirurgie”. The survey was sent to all residents and young specialists in Germany. A total of 187 participants responded. Results: Out of 187 participants, 123 questionnaires (65.8 %) were completed. Mean age was 36.3 ± 6.9 years. 62.6 % of the participants were male. About 70 % work in an independent thoracic surgery department, while the rest is affiliated with another specialty department. 50 % have completed a doctorate in medicine. Conclusion: The development of an objective and structured training plan could define the roles and responsibilities of the senior surgeon and the trainee, leading to improved training and, at the very least, ensuring good recruitment of junior thoracic surgeons.

Abstract This retrospective population-based study investigated the impact of elexacaftor/tezacaftor/ivacaftor (ETI) therapy on inhaled medication adherence in people with cystic fibrosis (pwCF). Prescription refill rate (PRR) for several inhaled medications were compared before and after ETI introduction in three major Italian CF centers. We found a significant decrease in PRR for most inhaled antibiotics and dornase-alpha after ETI implementation.This suggests that patients may be reducing their adherence to inhaled medications, potentially due to improved respiratory symptoms and quality of life. The study highlights the challenges of maintaining adherence to chronic inhaled medications in pwCF, even after the introduction of breakthrough therapies like ETI. Monitoring adherence remains crucial for optimizing patient outcomes, and the PRR emerges as a valuable tool for tracking adherence in real-world settings.

Objetivo: Identificar as características dos distúrbios miofuncionais orofaciais em idosos institucionalizados. Métodos: A amostra foi constituída por 7 indivíduos do sexo feminino e 6 do sexo masculino, com idades entre 60 e 74 anos, abrigados na Casa de Longa Permanência Ieda Lucena, na cidade de Recife, Pernambuco, no período de setembro a novembro de 2009. Foi aplicado o Protocolo de Avaliação Miofuncional Orofacial. Também foram realizadas a avaliação das estruturas orofaciais, por meio da observação, palpação e movimentos dos órgãos fonoarticulatórios; observação do processo de mastigação e deglutição e avaliação global da fala. Resultados: Foram constatadas alterações estruturais quanto a postura, tonicidade e mobilidade dos órgãos fonoarticulatórios e desempenho das funções estomatognáticas, interferindo na comunicação oral e na alimentação dos idosos. Observou-se um número significativo de idosos desdentados (8 pessoas), condição que afeta a mastigação, alimentação, comunicação e interação social, com impacto negativo na qualidade de vida do idoso. Conclusão: As alterações no sistema estomatognático são frequentes no idoso e podem trazer consequências que interferem na melhoria das condições de vida desses indivíduos, especialmente nos idosos institucionalizados, que se apresentam fragilizados, por aspectos de ordem psicológica (solidão provocada pelo isolamento social, falta do convívio familiar) e precariedade econômica. Diante dessa realidade, conclui-se que a atuação fonoaudiológica configura-se como instrumento fundamental no diagnóstico e atendimento dessa clientela.

Abstract Objectives To validate the performance of Mirai, a mammography-based deep learning model, in predicting breast cancer risk over a 1–5-year period in Mexican women. Methods This retrospective single-center study included mammograms in Mexican women who underwent screening mammography between January 2014 and December 2016. For women with consecutive mammograms during the study period, only the initial mammogram was included. Pathology and imaging follow-up served as the reference standard. Model performance in the entire dataset was evaluated, including the concordance index (C-Index) and area under the receiver operating characteristic curve (AUC). Mirai’s performance in terms of AUC was also evaluated between mammography systems (Hologic versus IMS). Clinical utility was evaluated by determining a cutoff point for Mirai’s continuous risk index based on identifying the top 10% of patients in the high-risk category. Results Of 3110 patients (median age 52.6 years ± 8.9), throughout the 5-year follow-up period, 3034 patients remained cancer-free, while 76 patients developed breast cancer. Mirai achieved a C-index of 0.63 (95% CI: 0.6–0.7) for the entire dataset. Mirai achieved a higher mean C-index in the Hologic subgroup (0.63 [95% CI: 0.5–0.7]) versus the IMS subgroup (0.55 [95% CI: 0.4–0.7]). With a Mirai index score > 0.029 (10% threshold) to identify high-risk individuals, the study revealed that individuals in the high-risk group had nearly three times the risk of developing breast cancer compared to those in the low-risk group. Conclusions Mirai has a moderate performance in predicting future breast cancer among Mexican women. Critical relevance statement Prospective efforts should refine and apply the Mirai model, especially to minority populations and women aged between 30 and 40 years who are currently not targeted for routine screening. Key Points The applicability of AI models to non-White, minority populations remains understudied. The Mirai model is linked to future cancer events in Mexican women. Further research is needed to enhance model performance and establish usage guidelines. Graphical Abstract

Abstract China’s global infrastructure financing flagship, the Belt and Road Initiative (BRI) encompasses countries hosting over 60% of the global population and one-third of worldwide GDP. It is based mainly on long-term loans that will mature decades into the future, and timely repayments are only possible if they remain commercially viable. But despite its vast global scope, little is known about the climate risks that could imperil the operations of BRI projects over the next few decades, and, consequently, threaten their long-term sustainability. We narrow this gap by estimating the impacts of future climate change on 217 BRI projects across 70 countries and 9 sectors in two dimensions. First, the effects of increased heat stress on human physical work capacity are calculated using the wet bulb globe temperature and an assessment of the workload for each selected BRI project. Second, the potential structural damages from more frequent flooding incidents are measured by return period (RP), where a shorter RP signals heightened risk. Both have direct impacts on human productivity and infrastructural integrity, which are essential to maintaining the operational viability and financial stability of BRI projects. We compared projected changes on both measures for the mid- and late-twentieth centuries (2041–2060 and 2081–2100) to the historical baseline (1981–2010). We found that BRI projects face escalating vulnerability to climatic risks on both counts. The results underscore a broad variance across different future carbon emission scenarios measured under the Shared Socioeconomic Pathways (including SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). BRI’s aggregated climatic risks are substantially elevated under a high carbon emission scenario compared to a low emission scenario. By the end of the twentieth century, labor workability under SSP3-7.0 (31%) could potentially decrease three times more compared to SSP1-2.6 (10%). Under an intermediate-emission scenario (SSP2-4.5), floods with a historical return period of 10 years could have a return period of 5 years in the future. Significantly hampering the utilization and economic return generation potential of infrastructure projects. In addition, regional geography contributes to risk heterogeneity, with 100-year floods occurring every 15 years in South Asia and every 24 years in Sub-Saharan Africa. Such climate risk implications, potentially overlooked by development financiers, represent significant risks to the sustenance of the BRI, estimated to be worth $1 trillion.

Abstract Background Intragastric botulinum neurotoxin injections (IBNI) are offered off-label in the private medical sector in a few European countries as a safe and effective weight-loss measure. In February and March 2023, an outbreak of iatrogenic botulism occurred in several European countries following IBNI treatment in Turkey. This case series describes the clinical features of severe iatrogenic botulism after IBNI. Methods We retrospectively summarize the clinical course and emergency department and intensive care unit interventions in ten cases of severe iatrogenic botulism that occurred after receiving IBNI in this sudden outbreak in Austria and Germany. Results Seven out of ten cases initially showed characteristic symptoms of botulism with diplopia, dysphagia, dysarthria, dysarthrophonia, and descending paralysis. All patients were hospitalized, six in an intensive care unit and partially requiring mechanical ventilation. All patients recovered and were discharged without relevant permanent deficits. Conclusion Our study highlights ten clinical cases in this iatrogenic botulism outbreak, representing the largest reported outbreak worldwide. Clinicians should be aware of the risks associated with medical procedures involving botulinum neurotoxins and ensure measures to minimize the risk of iatrogenic botulism.

Abstract Background Countries with formal policies for palliative care, and advanced and integrated practices in this field, such as Portugal, face challenges in achieving excellence in care, particularly in home-based assistance. Issues include care coordination among providers, confusion regarding the roles of each health care professional in the network, and a lack of monitoring and evaluation of actions. Our objective was to analyze the implementation of palliative care in primary health care in Portugal. Methods We conducted a qualitative, descriptive, and exploratory study in Portugal involving health care professionals with experience in palliative care. The data were collected through semistructured interviews and focus groups between March and October 2023. Eighteen health care professionals participated. We used the Alceste software for lexicographic analysis. The research was authorized by an Ethics Committee. Results Four classes were identified; classes 1 and 2, comprising 77% of the corpus, addressed the study objectives. Participants highlighted inequitable access, strategic development plans with unattainable short-term goals; and low literacy. They emphasized the importance of legislation, professional training initiatives for generalist palliative care at home, and early referral. Home-based challenges included professionals’ lack of exclusive dedication, absence of 24/7 coverage, and unavailability of capable family caregivers. The networks’ response to hospital admissions and patient transitions from hospital to home, with access to the specialized team, was also inadequate. Conclusions Health care professionals aim to increase patients’ time spent at home, reduce emergency department visits, and minimize hospitalizations by leveraging the resources of the national palliative care network. In addition to investments to sustain network implementation and legally guaranteed palliative care rights, the country must focus on measurable indicators for evaluating and monitoring actions, providing better guidance in the short, medium, and long term.

This paper assessed the phytoplankton structure and its relationship with the physical environment in the coastal region off Mazatlán, Mexico, in two seasons of 2022, a year in which a strong La Niña event took place: (1) the warmer (August) and (2) the transitional period to the cold phase (November), based on hydrographic data and samples collected in two systematic scientific expeditions. The results showed clear differences between both seasons. Regarding total abundance, August reached 125,200 cells L−1, while November amounted to 219,900 cells L−1. Regarding species composition, the diatoms Cylindrotheca closterium and Planktoniella sol were dominant in August, while Thalassionema nitzschioides and Tetramphora decussata dominated the assemblages in November. The dinoflagellate Protoperidinium punctulatum was dominant in both seasons. However, very marked differences in its abundance are reported. The differences observed in the species richness and abundance could be attributed to the physical configuration of the water column, particularly the surface temperature, which showed clear changes between both seasons. The results presented here confirmed the high phytoplankton richness (some of them with the potential to generate harmful algal blooms), abundance, and diversity values of the region, suggesting a strong relationship with the physical environment.

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Background Data on the epidemiology of amyloidosis are scarce worldwide, making it difficult to understand its true incidence and mortality.Aim The aim of this study is to estimate the incidence and mortality rate of systemic amyloidosis in people affiliated to a Medical Care Program in the city of Buenos Aires, Argentina.Methods This is a hospital-based prospective study. All affiliates over 17 years to the Medical Care Program of the Hospital Italiano de Buenos Aires, and incident cases and deaths due to amyloidosis from the Institucional Amyloidosis Registry from 1 January 2011 to 31 December 2022 were included. Incidence and mortality rates were reported per million person-year with their respective 95% CIs. Crude, standardised and stratified rates were determined.Results During the study period, the crude incidence rate was 63 (95% CI 52 to 76) and the crude mortality rate was 31 (95% CI 23 to 40) cases per million person-year, with the wild-type transthyretin amyloidosis (ATTRwt) subtype having the highest rates. Men were more affected, especially from the age of 70 years onwards. In addition, an increase in the incidence and mortality rate was observed throughout the period studied.Conclusion The results of this study indicate that amyloidosis remains a rare disease but with an increase in incidence in recent years, especially in elderly people. This underlines the importance of further research in epidemiology for a better understanding of the pathology and its evolution.

Abstract Civil engineering plays a pivotal role in advancing sustainability by offering increasingly viable and cutting-edge alternatives in materials management. In this context, the objective of this study is to assess the feasibility of reusing water for mixing concrete test specimens after employing a ceramic filter as a means of water purification. Additionally, we aim to compare the properties of the concrete and the chemical parameters of the water. To achieve this, a quantitative and qualitative investigation was conducted through laboratory tests to characterize the materials and perform a physical-chemical analysis of water from two samples sourced from the water table drawdown. One sample was in its raw form, while the other was treated with a ceramic filter. Mechanical strength tests were also carried out. Upon analyzing the obtained results, it was observed that the filtered water exhibited an 8.66% increase in compressive strength compared to the raw water. In the physical analysis of the water, both samples met the criteria for pH, color, and total dissolved substances. Furthermore, the chemical analysis of the water revealed a decrease in five out of the six parameters analyzed, specifically total alkalinity, chloride, phosphate, nitrate, sulfate, and zinc content. In conclusion, it can be inferred that there is potential to reduce certain elements in untreated water that adversely affect concrete strength and quality, in addition to improving the pH levels. Another noteworthy finding was the enhanced compressive strength of concrete when using treated water as opposed to raw water.

Background: The modern approach to treating rectal cancer, which involves total mesorectal excision directed by imaging assessments, has significantly enhanced patient outcomes. However, locally recurrent rectal cancer (LRRC) continues to be a significant clinical issue. Identifying LRRC through imaging is complex, due to the mismatch between fibrosis and inflammatory pelvic tissue. This work aimed to develop a machine learning model for predicting LRRC using radiomic features extracted from 18F-FDG Positron Emission Tomography/Computed Tomography (PET/CT). Methods: CT and PET images of PET/CT examinations were retrospectively collected from 44 patients, with 29 cases of recurrence (66 %) and 15 cases with no local recurrence (34 %). The whole analysis was conducted separately for CT and PET images to evaluate their different predictive power. Radiomic features were extracted from suspected lesion volumes identified by physicians and the most relevant radiomic features were selected to predict the presence or absence of LRRC. Feature selection was performed using a novel approach derived from gene expression analysis, based on the DNetPRO algorithm. The prediction was done using a Support Vector Classifier (SVC) with a 10-fold cross-validation. The efficiency of the pipeline in predicting LRRC was evaluated according to the sensitivity, specificity, Balanced Accuracy Score (BAS) and Matthews's Correlation Coefficient (MCC). Results: CT features were found to be the most predictive, showing a sensitivity of 0.80, a specificity of 0.82, a BAS of 0.81 and an MCC of 0.61. PET features obtained a sensitivity of 0.93, a specificity of 0.61, a BAS of 0.77 and a MCC of 0.52. The combination of PET and CT features obtained a sensitivity of 0.80, a specificity of 0.75, a BAS of 0.77 and a MCC of 0.53. Conclusions: To the best of our knowledge, the DNetPRO algorithm was applied for the first time to medical image analysis and proved suitable for the selection of radiomic features with the highest predictive power, a crucial step in a radiomic pipeline. Our results confirmed the efficiency of radiomic features in predicting LRRC, with CT features outperforming PET features in identifying the characteristic texture of LRRC. The combination of both yielded no performance improvement.

Este artigo apresenta uma revisão de escopo com o objetivo de identificar as principais linguagens e ferramentas utilizadas na especificação formal de software. A revisão foi realizada em quatro bases de dados (ACM Digital Library, IEEE Xplore, Scopus e Web of Science), utilizando uma string de busca específica e critérios de inclusão e exclusão bem definidos. Após as etapas definidas no protocolo e pesquisa, foram retornados 736 trabalhos na primeira fase, 194 na segunda, 74 na terceira e 17 selecionados para a última fase, onde foram analisados detalhadamente e tiveram suas informações extraídas, verificando-se todos os critérios pré-definidos. Os resultados permitiram identificar as principais linguagens e ferramentas empregadas na especificação formal de software. Revelou-se que a utilização de linguagens formais, ferramentas de verificação e simulação são eficazes para garantir a correta implementação dos requisitos de segurança e para detectar erros em especificações. Além disso, foram discutidos os desafios enfrentados pelas abordagens tradicionais de especificação formal, como a necessidade de habilidades especializadas e a complexidade dos modelos resultantes. Este artigo destaca a importância de tornar as ferramentas de especificação formal mais acessíveis e simplificadas, visando aumentar a adoção e eficácia dessas abordagens.

Objetivo: Relatar intervenção de promoção da saúde realizada a uma pessoa com Transtorno Afetivo Bipolar, à luz da Teoria Human Becoming e das competências de promoção da saúde do Consenso de Galway. Método: Estudo descritivo, do tipo relato de experiência, desenvolvido em janeiro de 2021, por acadêmicos de enfermagem da Universidade Estadual Vale do Acaraú junto a uma pessoa com Transtorno Afetivo Bipolar. A intervenção foi desenvolvida em quatro etapas conforme os domínios de competência de promoção da saúde do Consenso de Galway e os princípios da Teoria Human Becoming. Resultados: Na intervenção, foi possível identificar os significados, as repercussões biopsicossociais e as das principais necessidades de saúde do sujeito no enfrentamento ao transtorno bipolar. Por meio disso, desenvolveu-se quatro ações educativas, que objetivaram auxiliar o paciente a lidar com as dificuldades vivenciadas, a modificar seus hábitos de vida e a identificar medidas de cuidado para favorecer a melhora da saúde mental e do controle dos sintomas do transtorno. Conclusão: A intervenção reforça a importância de referenciais teóricos e competências de promoção da saúde no cuidado a pessoa com transtorno bipolar, haja vista que promovem uma abordagem inovadora, holística e humanizada para favorecer a reabilitação e o autocuidado do sujeito.

Introducción: la infección por parvovirus B19 (B19V) durante el embarazo puede transmitirse al feto y ocasionar complicaciones graves como hidropesía y muerte fetal. La preexistencia de IgG específica previene la transmisión vertical. La seroprevalencia en edad fértil es variable (50-70%) y depende de la región/circulación viral, además de factores como edad materna y exposición frecuente a niños. Objetivos: determinar seroprevalencia para B19V en embarazadas del Hospital Universitario de Maternidad y Neonatología (HUMN), analizar su asociación con factores predictores y describir los casos de infección por B19V. Métodos: estudio observacional, transversal. Se incluyeron pacientes atendidas en HUMN durante 2021-2022 y se registraron datos demográficos y clínicos compatibles. Se cuantificó IgG específica y se analizó su asociación con factores predictores mediante análisis bivariado (p

Introduction To evaluate the accuracy of different neuronavigation systems and establish factors that influence their accuracy and their indications for use.

Conflict of interest: No Introduction and Objectives: The progressive increase in the prevalence of MASLD and its impact on morbidity and mortality require dietary options for its prevention and treatment, with the Mediterranean diet (MD) being the most scientifically supported. This study analyzes the similarities and differences of this diet with respect to the dietary habits of the different regions of Argentina, focusing on the content of flavonoids, carotenoids, and Omega 3, 6 and 9 fatty acids. Objective: To compare the content of flavonoids, carotenoids, and omegas 3, 6 and 9 between the MD and the usual consumption according to regions of Argentina, for a transcultural adaptation. Patients / Materials and Methods: Observational, cross-sectional, and descriptive study. A survey was conducted with 225 individuals to evaluate dietary habits. The primary data were quantitatively transformed for the calculation of the aforementioned nutrient content, in selected foods from both diets. Chi2 was used to establish correlations between variables. Results and Discussion: The comparison of both diets shows that the nutrients analyzed were found to be below that suggested, with a high Omega6/Omega3 ratio. (Table1) To meet the recommendations, it is only necessary to increase the consumption of the analyzed food sources. Significant relationships were found (chi2, P between 0.0001 and 0.04) in the comparison of olive/fish consumption vs geographical region, vegetables/sex/pathologies vs BMI, and physical activity vs referred pathology. Conclusions: Adaptation would be possible in all regions of the Argentine Republic through the substitution of non-locally produced foods with regional products that allow reaching the nutrient amounts, considering cost and culinary traditions. Some adaptation suggestions are the inclusion of chocolate, chia, amaranth, quinoa, and the replacement of olive oil with canola, chia, flax, grape or soybean oil. The proposed adapted Mediterranean diet provides the recommended amount of nutrients and its cost is similar to that of the usual Argentine diet.

Small-Cell Lung Cancer (SCLC) accounts for 15 % of all lung cancer cases. Due to comorbidities and its aggressive behaviour, patients are highly symptomatic even at a non-metastatic stage. Standardizing the care pathway and introducing a simultaneous care approach could address the unmet needs of this disease. However, there is no uniformity in the involvement of palliative care physicians and in the simultaneous use of palliative care and cancer therapies. In this context, 13 experts from Lazio region undertook a process to deepen their understanding of the regional provision of simultaneous care to patients with SCLC by structuring and carrying out a survey. The survey covered 35–52 % of SCLC cases in the region, confirming heterogeneous results in both management and therapeutic approach, particularly in the area of simultaneous care. The working group met to define practical recommendations with the aim of standardizing the management of this disease.

Abstract High-hazard seismic zones can remain silent over centuries with meager seismicity rates challenging our understanding of seismic processes. We focus on the comprehensive analysis of cascading episodes of swarms and seismic sequences following the 2009 L’Aquila mainshock (MW 6.3) in the southern-central Apennine that previously experienced ~ M7 earthquakes. We enhance the seismic catalog, unmasking low-magnitude seismicity down to completeness magnitude ML ~ 0, and we unveil that the microseismicity might be secondarily triggered by the L’Aquila mainshock, influencing the frictional properties in the nearby fault zones or opening fault valves generating the intense seismic activity detected from 2009 to 2013. The diffusivity, observed in the most seismic episodes, and the high Vp/Vs values (> 1.88) indicate fluid circulation promoting multilayered extensional seismicity within 11–15 km and 16–23 km depth ranges. Mapping the 3D distribution of seismicity alongside geological data reveals an evident tectonic influence, unveiling unknown geometric aspects and providing the first evidence of a NNE-dipping deformation zone bounding at depths of 11–15 km the overlying fault system. Deeper seismicity suggests a mantellic CO2 ascending shape. These findings enrich the literature on tectonic seismic swarms in extensional domains, providing essential constraints on fluid involvement in the seismic processes and contributing to forthcoming discussions on the seismotectonic setting in high-seismic-risk areas of the Apennines of Italy.

This study evaluated the ingestion of microplastics (MP) by copepods in Terminos Lagoon (TL), a RAMSAR-listed site in the southern Gulf of Mexico. The evaluation was carried out in two contrasting seasons of 2022, as follows: the dry (April) and the rainy (October). Copepods were collected using a conical plankton net (mesh size of 200 μm). In the laboratory, a pool of all pelagic adult copepod taxa was picked, and the MP inside the organisms were extracted, classified, and photographed using traditional optical and scanning electron microscopy. A total of 268 MP particles were extracted from the interior of copepods; among them, 149 and 119 corresponded to the dry and rainy seasons, respectively. The ingestion rate in the dry season was 0.14, while in the rainy season, it was 0.11. In addition, fibers, plastic fragments, and microspheres with different colors (blue, red, black, green, transparent, and multicolored), sizes, forms (angular, round, triangular, and twisted), and textures were also detected. Fibers were the most abundant MP found in a proportion of more than 85%. In addition, in some sampling sites, microspheres were observed with high relative abundance values (80%). In some sites, fragments reach 20% of the total abundance. Significant differences were observed between the two seasons. The sites closest to the urban area adjacent to TL observed high diversity and abundance of MP. The higher abundance of MP in the dry season is due to lower river discharge, on the other hand. Thus, MP particles accumulate and become available for consumption by copepods. This is the first study that has revealed that the MP was ingested by the copepods in TL. Furthermore, this study provides a baseline information for future research on the abundance of MP in the Gulf of Mexico region.

Abstract Background Astrocytes are the most abundant cell type of the central nervous system and are fundamentally involved in homeostasis, neuroprotection, and synaptic plasticity. This regulatory function of astrocytes on their neighboring cells in the healthy brain is subject of current research. In the ischemic brain we assume disease specific differences in astrocytic acting. The renin–angiotensin–aldosterone system regulates arterial blood pressure through endothelial cells and perivascular musculature. Moreover, astrocytes express angiotensin II type 1 and 2 receptors. However, their role in astrocytic function has not yet been fully elucidated. We hypothesized that the angiotensin II receptors impact astrocyte function as revealed in an in vitro system mimicking cerebral ischemia. Astrocytes derived from neonatal wistar rats were exposed to telmisartan (angiotensin II type 1 receptor-blocker) or PD123319 (angiotensin II type 2 receptor-blocker) under normal conditions (control) or deprivation from oxygen and glucose. Conditioned medium (CM) of astrocytes was harvested to elucidate astrocyte-mediated indirect effects on microglia and cortical neurons. Result The blockade of angiotensin II type 1 receptor by telmisartan increased the survival of astrocytes during ischemic conditions in vitro without affecting their proliferation rate or disturbing their expression of S100A10, a marker of activation. The inhibition of the angiotensin II type 2 receptor pathway by PD123319 resulted in both increased expression of S100A10 and proliferation rate. The CM of telmisartan-treated astrocytes reduced the expression of pro-inflammatory mediators with simultaneous increase of anti-inflammatory markers in microglia. Increased neuronal activity was observed after treatment of neurons with CM of telmisartan- as well as PD123319-stimulated astrocytes. Conclusion Data show that angiotensin II receptors have functional relevance for astrocytes that differs in healthy and ischemic conditions and effects surrounding microglia and neuronal activity via secretory signals. Above that, this work emphasizes the strong interference of the different cells in the CNS and that targeting astrocytes might serve as a therapeutic strategy to influence the acting of glia-neuronal network in de- and regenerative context.

Abstract Background Mechanical stimulation (MS) significantly increases the release of adenine and uracil nucleotides from bone marrow-derived mesenchymal stem cells (BM-MSCs) undergoing osteogenic differentiation. Released nucleotides acting via ionotropic P2X7 and metabotropic P2Y6 purinoceptors sensitive to ATP and UDP, respectively, control the osteogenic commitment of BM-MSCs and, thus, bone growth and remodelling. Yet, this mechanism is impaired in post-menopausal (Pm)-derived BM-MSCs, mostly because NTPDase3 overexpression decreases the extracellular accumulation of nucleotides below the levels required to activate plasma membrane-bound P2 purinoceptors. This prompted us to investigate whether in vitro MS of BM-MSCs from Pm women could rehabilitate their osteogenic commitment and whether xenotransplantation of MS purinome-primed Pm cells promote repair of critical bone defects in an in vivo animal model. Methods BM-MSCs were harvested from the neck of femora of Pm women (70 ± 3 years old) undergoing total hip replacement. The cells grew, for 35 days, in an osteogenic-inducing medium either submitted (SS) or not (CTR) to MS (90 r.p.m. for 30 min) twice a week. Increases in alkaline phosphatase activity and in the amount of osteogenic transcription factors, osterix and osteopontin, denoted osteogenic cells differentiation, while bone nodules formation was ascertain by the alizarin red-staining assay. The luciferin-luciferase bioluminescence assay was used to quantify extracellular ATP. The kinetics of the extracellular ATP (100 µM) and UDP (100 µM) catabolism was assessed by HPLC. The density of P2Y6 and P2X7 purinoceptors in the cells was assessed by immunofluorescence confocal microscopy. MS-stimulated BM-MSCs from Pm women were xenotransplanted into critical bone defects drilled in the great trochanter of femora of one-year female Wistar rats; bone repair was assessed by histological analysis 10 days after xenotransplantation. Results MS-stimulated Pm BM-MSCs in culture (i) release 1.6-fold higher ATP amounts, (ii) overexpress P2X7 and P2Y6 purinoceptors, (iii) exhibit higher alkaline phosphatase activity and overexpress the osteogenic transcription factors, osterix and osteopontin, and (iv) form larger bone nodules, than CTR cells. Selective blockage of P2X7 and P2Y6 purinoceptors with A438079 (3 µM) and MRS 2578 (0.1 µM), respectively, prevented the osteogenic commitment of cultured Pm BM-MSCs. Xenotransplanted MS purinome-primed Pm BM-MSCs accelerated the repair of critical bone defects in the in vivo rat model. Conclusions Data suggest that in vitro MS restores the purinergic cell-to-cell communication fostering the osteogenic differentiation and osteointegration of BM-MSCs from Pm women, a strategy that may be used in bone regeneration and repair tactics.

Enquadramento: A satisfação das pessoas que utilizam os cuidados de saúde é um indicador crucial da qualidade e eficácia dos serviços prestados. Objetivo: Validar psicometricamente a Escala de Satisfação dos Utentes, desenvolvida pela Comissão de Qualidade de uma unidade Hospitalar no norte do país e atualmente em uso na instituição. Metodologia: Procedeu-se à análise fatorial exploratória e confirmatória, com uma amostra de 231 pessoas com doença crónica, em acompanhamento na consulta externa, da referida unidade. Resultados: Emergiram dois componentes principais - Qualidade de atendimento e satisfação das pessoas que utilizam os cuidados de saúde e infraestrutura e logística do serviço. A escala mostrou-se robusta, com um Alfa de Cronbach de 0,97. Conclusão: Este estudo contribui de forma relevante para a área da saúde em Portugal, disponibilizando um instrumento validado para avaliações futuras, com vista à melhoria contínua da qualidade dos serviços de saúde.

El desgaste ocupacional se relaciona con riesgos psicosociales como alta exposición social y largas jornadas. Este fenómeno se observa en la medicina, aunque cada especialidad enfrenta retos distintos. Objetivo: Determinar la presencia de desgaste ocupacional en docentes y residentes de los programas quirúrgicos en una universidad pública y las principales características del entorno académico y asistencial relacionadas. Metodología: Estudio descriptivo de corte transversal realizado entre agosto y noviembre de 2021. Participaron 36 profesores y 48 residentes de programas quirúrgicos de la Universidad del Valle en Cali, Colombia. La encuesta contenía información sociodemográfica, hábitos, descripción de entornos y las escalas MBI-HSS, PHQ-9 y GAD-7. Resultados: No se encontró presencia de burnout entre los profesores, 32% de los residentes cumplían criterios para burnout. Al realizar la discriminación por subescalas se identificó presencia alta y moderada de agotamiento emocional tanto en docentes como en residentes, altos niveles de despersonalización en residentes, inversamente proporcional a los niveles de realización personal. 28% de los docentes manifestaba algún nivel de ansiedad y 31% diferentes niveles de depresión. En los residentes 84% presentaba algún nivel de ansiedad y 59% diferentes niveles de depresión. Entre los factores del entorno académico asistencial relacionados al agotamiento emocional se encuentran, pasar más de 60 horas mensuales en el hospital, un alto número de turnos y pacientes por turno, turnos nocturnos y menos tiempo de descanso, hallazgos que coinciden con la subescala de despersonalización. Conclusiones: La presencia de burnout se relaciona con síntomas depresivos y ansiosos. Más de un tercio de la muestra de profesores y residentes presentaba depresión y ansiedad, siendo más frecuente en cirujanos en formación. Los estudiantes de posgrados quirúrgicos muestran una alta presencia de síndrome de desgaste ocupacional, con significativo agotamiento emocional, despersonalización y baja realización personal, a diferencia de sus docentes, quienes evidencian agotamiento emocional, ansiedad y depresión, pero no desgaste ocupacional.

Este texto presenta ideas y elementos para la configuración de un sistema de seguimiento del uso del territorio en América Latina, para monitorear el proceso de integración, con la elaboración y acción de políticas gubernamentales nacionales. Se reflexiona sobre la necesidad de retomar la discusión sobre la dimensión territorial de las funciones públicas de interés común y colectivo, considerando la integración como una forma de subsidiar políticas continentales, nacionales, regionales y locales que minimicen las desigualdades socioespaciales, características perversas de la sociedad latinoamericana, realidad agravada por la globalización. Se trata también de la creación de una base de datos multidisciplinaria de interés común en el continente, que podría vincularse a la UNILA – Universidad de Integración de América Latina, instrumento del proceso de integración continental. Estas ideas parten de un fundamento teórico geográfico y de las características del mundo globalizado, para delinear la planificación territorial de la integración. Geografía, Geopolítica y Geopoética amplían las perspectivas de esta reflexión.

El presente estudio tuvo como objetivo proponer el rediseño del Parque Veracruz en Puyo, Pastaza, mediante un diagnóstico exhaustivo del estado actual del parque y la implementación de infraestructuras gris, verde y azul para mejorar su imagen escénica y funcionalidad. Utilizando una metodología de investigación experimental y descriptiva, se evaluaron los componentes vegetales de los estratos arbóreo, arbustivo y herbáceo, así como la infraestructura física del parque. El programa Sketchup Pro fue empleado para visualizar el rediseño propuesto. El diagnóstico identificó deficiencias en los sistemas de drenaje y la calidad del agua, en respuesta a esto se rediseño el parque. Se introdujeron cuatro especies herbáceas (Turnera ulmifolia L., Ruellia tuberosa L., Phaius tankervilleae (Banks ex L'Hér.) Blume, Duranta repens L.) para mejorar la estética y reforzar la identidad cultural. El estrato arbustivo se enriqueció con Megaskepasma erythrochlamy Lindau, Bougainvillea spectabilis Willd., Mussaenda erythrophylla S., Allamanda cathartica L. Las especies arbóreas Terminalia catappa L., Bismarckia nobilis H. y Archontophoenix myolensis Dowe, se seleccionaron para mejorar el paisaje, proporcionar sombra. La infraestructura azul, que incluye sistemas de drenaje sostenible y áreas de retención de agua, fue implementada para gestionar eficientemente el agua de lluvia, reduciendo riesgos de inundaciones y mejorando la calidad ambiental del parque. En conjunto, estas intervenciones promueven un entorno urbano más atractivo, sostenible y ecológicamente diverso, elevando la calidad de vida de los residentes

Objetivo: analisar a literatura sobre cuidados perdidos em enfermagem utilizando técnicas de análise bibliométrica. Metodologia: estudo bibliométrico a partir de artigos publicados na base de dados Scopus entre 2006 e 2024, utilizando termos relacionados a cuidados perdidos de enfermagem. A análise dos dados utilizou os softwares Bibliometrix e VOSviewer. Resultados: os resultados mostraram um aumento significativo na produção científica sobre o tema, com uma taxa d e crescimento anual de 25,06%. A maioria dos documentos são artigos originais, refletindo um foco na apresentação de novos dados. As análises de coautoria e coocorrência de palavras-chave revelaram uma colaboração internacional substancial e a identificação de temas centrais e emergentes. Conclusão: conclui-se que, embora haja um forte embasamento teórico e uma rede de colaboração robusta, ainda existem áreas que necessitam de maior desenvolvimento, particularmente em temas emergentes que podem revitalizar e diversificar o campo de estudo sobre cuidados perdidos em enfermagem.

BackgroundBrown tumors are rare bone manifestations of primary hyperparathyroidism (PHPT) that may occur at different sites either as single or multiple lesions and they can easily be mistaken for malignant lesions. Neither bone site nor morphological or functional imaging are useful to drive the differential diagnosis and biopsy is often the only conclusive procedure.Case descriptionWe report the case of a 53 years-old man referred to our outpatient clinic for severe symptomatic PHPT complicated by nephrolithiasis and osteoporosis. Neck ultrasound and computed tomography (CT) scan showed a large irregular lesion posterior to the lower pole of the right thyroid lobe consistent with an enlarged parathyroid gland. Moreover, two bone lytic lesions were described at the left scapula and the contiguous 7th rib that showed an increased uptake at total bone scintigraphy. Given the clinical and biochemical picture, the features of the parathyroid lesion and the presence of bone lytic lesions, the suspicion of metastatic parathyroid carcinoma (PC) was raised. However, a CT-guided biopsy performed on the left scapula revealed a brown tumor. The patient underwent en-bloc resection of the right inferior parathyroid grand with the ipsilateral thyroid gland lobe. Histopathology confirmed the diagnosis of PC. Post-surgical biochemical evaluations showed that the patient was cured. A repeated total body CT scan revealed an osteoblastic appearance of the bone lesions ascribed to the partial regression of the brown tumors following surgery.ConclusionsThe implication of a diagnosis of brown tumor or bone metastasis is widely different; in fact, the first tends to regress with the surgical treatment of PHPT, whereas the latter has limited cure option and negatively affects the prognosis of patients. Therefore, although brown tumors are extremely rarer than in the past, they must always be taken into consideration in the presence of bone lesions, even in cases of high suspicion of malignancy, to avoid unnecessary and harmful surgical interventions.

Pain is a subjective concept which is ever-present in the medical field. Health professionals are confronted with a variety of pain types and sources, as well as the challenge of managing a patient with acute or chronic suffering. An even bigger challenge is presented in the pediatric population, which often cannot quantify pain in a numerical scale like adults. Infants and small children especially show their discomfort through behavioral and physiological indicators, leaving the health provider with the task of rating the pain. Depending on the pathophysiology of it, pain can be classified as neuropathic or nociceptive, with the first being defined by an irregular signal processing in the nervous system and the second appearing in cases of direct tissue damage or prolonged contact with a certain stimulant. The approach is generally either pharmacological or non-pharmacological and it can vary from using NSAIDs, local anesthetics, opiates to physical and psychological routes. Unfortunately, some pathologies involve either intense or chronic pain that cannot be managed with traditional methods. Recent studies have involved nanoparticles with special characteristics such as small dimension and large surface area that can facilitate carrying treatments to tissues and even offer intrinsic analgesic properties. Pediatrics has benefited significantly from the application of nanotechnology, which has enabled the development of novel strategies for drug delivery, disease diagnosis, and tissue engineering. This narrative review aims to evaluate the role of nanotechnology in current pain therapy, with emphasis on pain in children.

Purpose: evaluate the impact of the implementation of the project “Polish-Kazakh Regional Center for Training, Safety and Rescue” within the framework of the “RITA - Region in Transition” program on the level of knowledge, skills and abilities in the field of medical care. Material and methods. The study involved 646 participants in the first aid training using the BLS algorithm based on the Non-Profit Joint Stock Company “K. Zhubanov Aktobe Regional University.” The study involved: determining the level of stress in the event of being in a situation where it is necessary to provide assistance to a person who has lost consciousness; assessment of the Basic Life Support (BLS) algorithm of actions; assessing the effectiveness of chest compressions on the Laerdal Little Anne QCPR manikin. Results. It was revealed that after completing the BLS training, the project participants’ stress level, if they find themselves in a situation where it is necessary to provide assistance to a person who has lost consciousness, has decreased significantly. Based on the results of testing the assessment of the BLS action algorithm, it was found that the level of knowledge and skills in providing first aid improved by 75,9%. It was found that the efficiency of pressing on the chest of the manikin improved by 53,3% after training. Positive changes in all indicators indicate that BLS training using the KISS (keep it short and simple) methodology is accessible, understandable and effective for all project participants. It was found that indicators of stress level, BLS action algorithm and QCPR effectiveness both at the beginning and at the end of the study have a correlation dependence. Reduced stress levels occur due to increased preparedness among participants and contributes to more effective care delivery. The reliable nature of the connections confirms the assumptions made and gives grounds to assert that the goal of the project has been achieved. Conclusions. The results obtained prove the effectiveness of the implementation of the project “Polish-Kazakh Regional Center for Training, Safety and Rescue”. Thanks to the events carried out, a large number of voters approved the formation of comprehensive competence to provide first aid in the case of Sudden Cardiac Arrest. As a result of the trainings, participants acquired practical skills in carrying out resuscitation measures, mastered the algorithm for providing assistance, and increased the level of confidence in their own theoretical knowledge and practical skills. This project proves that social activism and collaboration between scientists can be very effective and lead to systemic change. In Kazakhstan, where high rates of Sudden Cardiac Arrest are recorded, thanks to the implementation of international projects, a number of events and trainings have already been introduced, largely popularizing the ability to provide first aid, which will further influence the activities of governmental and non-governmental organizations. The results obtained allow us to recommend similar projects for implementation in other countries

Regorafenib is a multikinase inhibitor approved for treatment of patients with metastatic Colo-Rectal Cancer (mCRC) and Gastro-Intestinal Stromal Tumor (GIST) progression after the administration of other tyrosine-kinase inhibitors such as imatinib and sunitinib.Only a handful of severe side effects such as intestinal perforations and fistulas have been described in the literature in patients undergoing multikinase inhibitor treatment. We report a case of a patient with peritoneal mCRC who experienced an intestinal perforation during the administration of Regorafenib and review the literature. A 48-year-old man with previously resected sigmoid colon cancer and peritoneal metastatic disease under Regorafenib treatment presented to our Emergency Department with severe abdominal pain and asthenia. Abdominal X-ray and contrast-enhanced computed tomography examination revealed an intestinal perforation. The patient underwent emergency surgery which demonstrated acute diffuse peritonitis, necrosis, and perforation of a distal ileal loop affected by peritoneal metastatic disease. The necrosis of peritoneal implants on bowel walls could be regarded as a potential factor leading to intestinal perforation in metastatic colorectal cancer patients undergoing Regorafenib treatment complaining of severe abdominal pain and asthenia.Surgeons, radiologists and oncologists should always keep in mind this rare adverse event during Regorafenib administration. Appropriate diagnostic tests and treatments should be carried out.

Con este artículo, tomando el caso de la ciudad de Madrid durante la dictadura franquista, queremos contribuir a la discusión en torno a las concepciones teóricas sobre urbanismo de zonas denominadas suburbiales y cómo se articulan con la planificación de políticas urbanas y de control social, sobre dichos espacios. A través de la revisión historiográfica y un trabajo de consulta en diferentes archivos, queremos mostrar cómo en la conceptualización, legislación y gestión en torno al “problema de la vivienda” de la capital española, la dictadura franquista acompañó políticas para el control espacial y social de la población de sus suburbios.

Abstract Autism Spectrum Disorders (ASD) are principally diagnosed by three core behavioural symptoms, such as stereotyped repertoire, communication impairments and social dysfunctions. This complex pathology has been linked to abnormalities of corticostriatal and limbic circuits. Despite experimental efforts in elucidating the molecular mechanisms behind these abnormalities, a clear etiopathogenic hypothesis is still lacking. To this aim, preclinical studies can be really helpful to longitudinally study behavioural alterations resembling human symptoms and to investigate the underlying neurobiological correlates. In this regard, the BTBR T+ Itpr3tf/J (BTBR) mice are an inbred mouse strain that exhibits a pattern of behaviours well resembling human ASD-like behavioural features. In this study, the BTBR mice model was used to investigate neurochemical and biomolecular alterations, regarding Nerve Growth Factor (NGF) and Brain-Derived Neurotrophic Factor (BDNF), together with GABAergic, glutamatergic, cholinergic, dopaminergic and noradrenergic neurotransmissions and their metabolites in four different brain areas, i.e. prefrontal cortex, hippocampus, amygdala and hypothalamus. In our results, BTBR strain reported decreased noradrenaline, acetylcholine and GABA levels in prefrontal cortex, while hippocampal measurements showed reduced NGF and BDNF expression levels, together with GABA levels. Concerning hypothalamus, no differences were retrieved. As regarding amygdala, we found reduced dopamine levels, accompanied by increased dopamine metabolites in BTBR mice, together with decreased acetylcholine, NGF and GABA levels and enhanced glutamate content. Taken together, our data showed that the BTBR ASD model, beyond its face validity, is a useful tool to untangle neurotransmission alterations that could be underpinned to the heterogeneous ASD-like behaviours, highlighting the crucial role played by amygdala.

Objetivo: identificar as necessidades humanas básicas de gestantes de alto risco hospitalizadas com base na Teoria de Wanda Horta. Método: pesquisa-cuidado realizada com dezesseis gestantes de alto risco hospitalizadas em maternidade de referência no Ceará entre setembro e novembro de 2019. As informações foram coletadas através de diário de campo e formulário para caracterização das gestantes e registros das necessidades humanas básicas. Os resultados foram analisados por estatística descritiva simples e abordagem compreensiva à luz do referencial de Wanda Horta. Resultados: as gestantes apresentaram necessidades psicobiológicas, psicossociais e psicoespirituais, sendo prevalentes: ausência de atividades de lazer, insegurança emocional, conhecimento deficiente, sono e repouso prejudicado e atividades físicas restritas por indicação de repouso. Considerações finais: acredita-se que o raciocínio crítico e o julgamento clínico dos enfermeiros estiveram focados na individualidade das gestantes, identificando necessidades nos três níveis propostos pela teoria, apontando caminhos para qualificar a assistência de enfermagem às gestantes de alto risco.

Gender-based violence among young people is a pressing global problem, causing injury and disability to women and posing physical, mental, sexual, and reproductive health risks. This study aimed to psychometrically validate the Dating Violence Questionnaire—Revised (DVQ-R) in a sample of 340 Ecuadorian university students. The study included 340 male and female students from two universities in Ecuador. The reliability and validity of the questionnaire were rigorously assessed by exploratory and confirmatory factor analyses, which revealed a four-factor model as the most parsimonious solution (RMSEA = 0.012). The factors were labelled as follows: ‘emotional neglect and contempt’, ‘physical violence and aggression’, ‘coercion and control’, and ‘emotional manipulation and testing’. The validated scale yielded a Cronbach’s alpha (α) of 0.839, with individual alpha values of 0.872, 0.764, 0.849, and 0.729 for each dimension. Convergent validity was established, as the mean variance extracted per factor exceeded 0.4. Divergent validity was confirmed, as the variance retained by each factor was greater than the variance shared between them (mean variance extracted per factor > ϕ2). These results indicate that the DVQ-R is a valid and reliable instrument to assess dating violence among Spanish-speaking young adults, which supports future research and prevention programmes.

This paper offers a reflective account of delivering art workshops in women’s prisons in England, as one method in a larger, qualitative study around the role of food in prisons. We present reflections around the role of art workshops in building relationships and community between the researcher and the participants, and the participants themselves. We found that building connection through art workshops, in a hostile and challenging environment like prison, enabled us to gather richer and deeper data during the qualitive interviews that succeeded the art workshops. We propose that attention from researchers to the ‘unintended consequences’ can contribute to research projects which are impactful for both the participants and researchers. This paper addresses gaps in literature around the use of visual art as method in women’s prisons and the role of arts-based methods in larger qualitative research projects in secure settings.

Este trabalho tem por objetivo analisar as formas pelas quais o romance Flores Artificiais, de Luiz Ruffato, promove uma renovação de elementos históricos e estéticos da tradição literária ocidental. A proposta interpretativa encontra-se ancorada na perspectiva teórica de Mikhail Bakhtin, no que se refere às tipologias históricas do romance; e nos estudos de Walter Benjamin, Theodor Adorno e Jaime Ginzburg, no que se refere à composição dos narradores da obra literária.

Introduction Cardiovascular diseases remain a leading cause of death worldwide. Recovery from myocardial infarction is challenging as the causes of symptoms span multiple aspects of health not just physical conditions. Evidence has shown a gap between the waycare is provided in the clinical setting and the person’s needs and preferences. The implementation of person-centred care (PCC) interventions can promote recovery from myocardial infarction by allowing a greater understanding of the person’s perception and its role on the overall recovering process. This study aims to culturally adapt an evidence-based PCC intervention to enhance self-efficacy in patients after myocardial infarction within a Portuguese healthcare context.Methods and analysis The Portuguese person-centred care for myocardial infarction recovery (P2MIR) intervention is set to be developed from an evidence-based intervention, rooted in the ethics of PCC. An intervention of PCC for patients with acute coronary syndrome, which has been successfully implemented and evaluated in the Swedish healthcare context will be validated, culturally adapted and harmonised to the Portuguese healthcare context by using qualitative methods. To evaluate its acceptability, appropriateness and feasibility, a sample of stakeholders, consisting of a sample of healthcare professionals and a sample of people who suffered a myocardial infarction, will be recruited from a hospital, including both inpatient and outpatient departments. The stakeholders will be invited to semistructured focus group discussions, aiming to gather their perceptions about the P2MIR intervention, which will be previously presented to them. Data analysis will be conducted using content analysis following a deductive-inductive approach to further inform the intervention adaptation process to its final intervention in a Portuguese healthcare context.Ethics and dissemination The study has been reviewed and approved by the Health Ethics’ Committees of the Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (registry number 20170700050). The results will be disseminated through peer-reviewed journals and conference presentations.

This study reports four new records of gymnosome pteropods (Pteropoda, Gymnosomata): Pneumodermopsis macrochira Meisenheimer, 1905, Spongiobranchaea intermedia Pruvot-Fol, 1926, Schizobrachium cf. polycotylum Meisenheimer, 1903, and Cliopsis krohnii Troschel, 1854, collected at different depths in the Campeche Canyon, southern Gulf of Mexico, during the winter storm season in 2011 (“Nortes”). These species are illustrated and described, increasing the knowledge of this group in the region. We also present hydrographic conditions of the stations and depths where the organisms were collected.

Abstract Background A previous study on mechanical complications after central venous catheterisation demonstrated differences in complication rates between male and female operators. The objective of this subgroup analysis was to further investigate these differences. The hypothesis was that differences in distribution of predefined variables between operator genders could be identified. Methods This was a subgroup analysis of a prospective, multicentre, observational cohort study conducted between March 2019 and December 2020 including 8 586 patients ≥ 16 years receiving central venous catheters at four emergency care hospitals. The main outcome measure was major mechanical complications defined as major bleeding, severe cardiac arrhythmia, pneumothorax, arterial catheterisation, and persistent nerve injury. Independent t-test and χ2 test were used to investigate differences in distribution of major mechanical complications and predefined variables between male and female operators. Multivariable logistic regression analysis was used to determine association between operator gender and major mechanical complications. Results Female operators had a lower rate of major mechanical complications than male operators (0.4% vs 0.8%, P = .02), were less experienced (P

Osteosarcoma (OS) of the head and neck is a rare and aggressive disease characterized by the formation of osteoid by malignant osteoblasts. The mandible or maxilla are the most common sites of presentation. Radiologically, these tumors show considerable, destructive growth with periosteal reaction, which can suggest the diagnosis of OS. 3D printing, as an emerging technology, can play a role in orthopedic oncology by providing patient-specific 3D printed models to improve surgical planning and facilitate patient understanding.We present the case of a male in his early 30s with a final histological diagnosis of recurrent osteosarcoma of the left maxilla, where a 3D printed model was helpful for the diagnostic workup, surgical planning, and the procedure.

Although dune systems play a crucial ecological role and offer various ecosystem services, they are listed among the habitat types of community interest in the European Union that are undergoing the most severe conservation challenges. The subject of this study was the monitoring of habitat types protected under Directive 92/43/EEC (Habitats Directive) along the coastal dune systems of the Taranto Ionian Arc. Vegetation sociological surveys, GIS mapping, landscape metrics, NBR and dNBR indices were employed to assess the conservation status of the dune system and the impact of disturbance factors. Special attention was given to habitat 2250* (Coastal dunes with Juniperus spp.), revealing that it expanded from 2006 to 2019 but then significantly reduced between 2019 and 2022, with increasing fragmentation, mainly due to wildfires. The study also highlighted the impact of invasive species such as Acacia saligna and Carpobrotus acinaciformis, which compete for space and vital resources. These findings provide scientific evidence for the management and restoration of coastal dune ecosystems, emphasizing the need for targeted conservation strategies to mitigate the effects of these disturbances.

Background: Next-generation sequencing (NGS) is gradually replacing Sanger sequencing for HIV genotypic drug resistance testing (GRT). This work evaluated the concordance among different NGS-GRT interpretation tools in a real-life setting. Methods: Routine NGS-GRT data were generated from viral RNA at 11 Italian laboratories with the AD4SEQ HIV-1 Solution v2 commercial kit. NGS results were interpreted by the SmartVir system provided by the kit and by two online tools (HyDRA Web and Stanford HIVdb). NGS-GRT was considered valid when the coverage was >100 reads (100×) at each PR/RT/IN resistance-associated position listed in the HIVdb 9.5.1 algorithm. Results: Among 629 NGS-GRT, 75.2%, 74.2%, and 70.9% were valid according to SmartVir, HyDRA Web, and HIVdb. Considering at least two interpretation tools, 463 (73.6%) NGS-GRT had a valid coverage for resistance analyses. The proportion of valid samples was affected by viremia 10% showed fair concordance among different interpretation tools. Conclusion: This Italian survey on NGS resistance testing suggests that viremia levels and HIV subtype affect NGS-GRT coverage. Within the current routine method for NGS-GRT, only mutations with frequency >10% seem reliably detected across different interpretation tools.

Food waste and by-products are intricately linked to sustainable food production, as reducing waste can play a significant role in achieving a more sustainable and efficient food system. Sustainable utilization and recovery of by-products can significantly contribute by creating strategies that can lead to cost savings and increased efficiency across the food supply chain. Worldwide, more than 40% of whey from cheese production is discarded, resulting in the loss of valuable nutrients and potentially polluting the environment. Effective use of whey reduces environmental impact and enhances manufacturing sustainability. Thus, a circular approach to food waste management in the dairy industry supports sustainability goals and creates opportunities for innovation. Whey contains most of the soluble components of milk, including a large number of serum proteins and all the essential amino acids, making it suitable for producing beverages with high nutritional value. This study aims to produce whey-based beverages with different additions to obtain dairy products with high nutritional value. Three different ingredients, sea buckthorn, ginger, and cinnamon, were chosen for their numerous health benefits to the consumer. Six samples were prepared utilizing both unmodified and deproteinized whey in a 75% proportion, with the addition of 25% sea buckthorn juice, 0.75% ginger juice, and 0.2% cinnamon powder. The resultant samples were packaged in 200 mL bottles and maintained at a controlled temperature of 6 °C to ensure optimal preservation. Given the paramount importance of consumer acceptability in novel beverage development, a comprehensive evaluation was conducted to assess the sensory properties of the formulated beverages. In addition, physico-chemical properties and their evolution over 14 days of storage were examined. The sample containing whey, sea buckthorn juice, ginger juice, and cinnamon powder received the highest marks from the tasters. The values of the physico-chemical parameters varied depending on the type of whey used and the storage period. Thus, a pH of approximately 5 and an acidity between 30 and 80 °T were recorded. The average lactose content was 4%, the average protein content was 2.5%, and the total soluble solids content was 11.5 °Brix. The beverages developed in this study represent viable alternatives for diversifying food production through sustainable, environmentally friendly technological variants. By applying circular economy principles, these products contribute to reducing food waste in the dairy industry.

Abstract Introduction: The skin is of all the organs of the body that is directly and constantly exposed to external agents. Hence the importance of providing all the necessary nutrients to keep it healthy, cared for and hydrated. When this does not happen, the skin begins to lose water, becomes dehydrated, and can be seriously injured. With this intention, a moisturizing serum with natural active ingredients has been designed and developed. It has been developed and characterized through various studies. In addition, it includes a strain of the probiotic species Lactobacillus fermentum CECT 5716, as an innovation, to enhance the synergistic effect of the product. Method: The cited product is characterized by pH, conductivity, and viscosity measurements to test its stability. Besides it is studied to probiotic viability and consumers’ perception of the product’s efficacy. Results: Data extracted from pH and conductivity measurements assure that the topical application of our serum is safe, as it does the consumers’ perception of the product’s efficacy study, offering it a better appearance in terms of smoothness and luminosity. This research has revealed the serum’s pseudoplastic characteristics, optimal for its purpose. Lastly, it has been seen that probiotic viability decreases with time. Conclusions: Based on the results we obtained; it can be affirmed that our moisturizing serum is safe and effective in skin hydration, due to the properties of the raw materials incorporated and the competitive mechanism of the probiotics included.