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El objetivo del estudio es determinar los conocimientos básicos en torno a la propiedad intelectual, además de las percepciones y el uso de gestores bibliográficos en estudiantes de ciencias de la salud. Se realizó un estudio descriptivo de corte transversal en estudiantes de odontología, medicina, bacteriología, enfermería e instrumentación quirúrgica. Los resultados demostraron que a los encuestados se les dificulta identificar aspectos básicos en propiedad intelectual y solo una parte de ellos incluye referencias bibliográficas en sus trabajos escritos, por lo que existe un alto riesgo de que los estudiantes cometan plagio. El uso de gestores bibliográficos es poco frecuente entre los estudiantes, principalmente porque no conocen la existencia de estos recursos informáticos, porque no han sido capacitados o porque consideran que se necesita mucho tiempo para aprender a usarlos. Los respondientes concuerdan en que desean recibir capacitación para usar estas herramientas. Se concluye que los estudiantes mostraron falencias respecto a conocimientos básicos en propiedad intelectual y que es necesario capacitarlos en el uso de gestores bibliográficos.

Abstract Science is integral to society because it can inform individual, government, corporate, and civil society decision-making on issues such as public health, new technologies or climate change. Yet, public distrust and populist sentiment challenge the relationship between science and society. To help researchers analyse the science-society nexus across different geographical and cultural contexts, we undertook a cross-sectional population survey resulting in a dataset of 71,922 participants in 68 countries. The data were collected between November 2022 and August 2023 as part of the global Many Labs study “Trust in Science and Science-Related Populism” (TISP). The questionnaire contained comprehensive measures for individuals’ trust in scientists, science-related populist attitudes, perceptions of the role of science in society, science media use and communication behaviour, attitudes to climate change and support for environmental policies, personality traits, political and religious views and demographic characteristics. Here, we describe the dataset, survey materials and psychometric properties of key variables. We encourage researchers to use this unique dataset for global comparative analyses on public perceptions of science and its role in society and policy-making.

Abstract We introduce a family of membrane-targeted azobenzenes (MTs) with a push-pull character as a new tool for cell stimulation. These molecules are water soluble and spontaneously partition in the cell membrane. Upon light irradiation, they isomerize from trans to cis, changing the local charge distribution and thus stimulating the cell response. Specifically, MTs photoisomerization induces clear and reproducible depolarization. The most promising species, MTP2, was extensively studied. Time-resolved spectroscopy techniques provide insights into the excited state evolution and a complete understanding of its isomerization reaction. Molecular Dynamics simulations reveal the spontaneous and stable partitioning of the compound into the cellular membrane, without significant alterations to the bilayer thickness. MTP2 was tested in different cell types, including HEK293T cells, primary neurons, and cardiomyocytes, and a steady depolarization is always recorded. The observed membrane potential modulation in in-vitro models is attributed to the variation in membrane surface charge, resulting from the light-driven modulation of the MT dipole moment within the cell membrane. Additionally, a developed mathematical model successfully captures the temporal evolution of the membrane potential upon photostimulation. Despite being insufficient for triggering action potentials, the rapid light-induced depolarization holds potential applications, particularly in cardiac electrophysiology. Low-intensity optical stimulation with these modulators could influence cardiac electrical activity, demonstrating potential efficacy in destabilizing and terminating cardiac arrhythmias. We anticipate the MTs approach to find applications in neuroscience, biomedicine, and biophotonics, providing a tool for modulating cell physiology without genetic interventions.

Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA. Materials and Methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process. Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in

Abstract Background Despite the benefits of physical activity (PA), cancer survivors report engagement barriers, and existing interventions often lack comprehensive solutions. Theory-based interventions using evidence-based behavior change techniques (BCTs) have been shown to be effective in promoting PA for breast cancer survivors, although their feasibility and acceptability lack evidence. The PAC-WOMAN trial is a three-arm randomized controlled trial aimed at promoting short- and long-term PA and improving the quality of life of breast cancer survivors. This study describes the development of a brief counseling theory-based motivational intervention from the PAC-WOMAN trial, assessing its feasibility and acceptability. Methods A broad search of theory-based interventions for people with chronic diseases was conducted. Key strategies from each intervention helped shape the main components and BCTs used in the eight bimonthly sessions of the PAC-WOMAN brief counseling intervention, which was based on self-determination theory principles and aimed at empowering participants to develop self-regulation resources for PA through basic psychological needs satisfaction. A toolkit and manuals for intervention facilitators and participants were developed. A feasibility study was conducted to monitor implementation fidelity, acceptability, adherence, and participants’ experiences (via a focus group). Results Twelve women (mean age 55.9 ± 6.7 years) participated. Implementation monitoring indicated that the intervention was feasible. The attrition rate was 25%. Focus-group discussion suggested that weekly sessions would increase attendance, highlighted the helpfulness of self-monitoring and the importance of role models for PA, and identified the session on safely exercising at home as key in improving PA levels. Conclusions This research aims to enhance systematic reporting in intervention development by detailing the specific BCTs used, translating them into implementation strategies, providing comprehensive resources for facilitators/participants, and supporting the implementation, dissemination, and adoption of a theory-based intervention informed by previous research. Feasibility testing suggests that the intervention was well accepted by participants and feasible, although it could benefit from adjustments in format to increase compliance. Trial registration NCT05860621, registered 20 April 2023 — retrospectively registered, https://clinicaltrials.gov/study/NCT05860621 . Registered 21 April 2023 — retrospectively registered, https://doi.org/10.17605/OSF.IO/ZAQ9N . UMIN000050945, registered 27 April 2023 — retrospectively registered, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000058070 .

Abstract Antibiotics can trigger antimicrobial resistance and microbiome alterations. Reducing pathogen exposure and undernutrition can reduce infections and antibiotic use. We assess effects of water, sanitation, handwashing (WSH) and nutrition interventions on caregiver-reported antibiotic use in Bangladesh and Kenya, longitudinally measured at three timepoints among birth cohorts (ages 3–28 months) in a cluster-randomized trial. Over 50% of children used antibiotics at least once in the 90 days preceding data collection. In Bangladesh, the prevalence of antibiotic use was 10–14% lower in groups receiving WSH (prevalence ratio [PR] = 0.90 (0.82–0.99)), nutrition (PR = 0.86 (0.78–0.94)), and nutrition+WSH (PR = 0.86 (0.79–0.93)) interventions. The prevalence of using antibiotics multiple times was 26–35% lower in intervention arms. Reductions were largest when the birth cohort was younger. In Kenya, interventions did not affect antibiotic use. In this work, we show that improving WSH and nutrition can reduce antibiotic use. Studies should assess whether such reductions translate to reduced antimicrobial resistance.

Abstract Background Diagnosing headache disorders poses significant challenges, particularly in primary and secondary levels of care (PSLC), potentially leading to misdiagnosis and underdiagnosis. This study evaluates diagnostic agreement for migraine, tension-type headache (TTH), and cluster headache (CH) between PSLC and tertiary care (TLC) and assesses adherence to the International Classification of Headache Disorders 3rd edition (ICHD-3) guidelines. Methods A retrospective, cross-sectional analysis was conducted at Charité - Universitätsmedizin Berlin’s tertiary headache center. The patients’ self-reported diagnoses from the PSLC were compared with those in TLC and with ICHD-3 criteria. Cohen’s kappa (κ) and R² were used to assess diagnostic agreement. Results Among 1,468 patients (43.4 ± 14.4 years; 74.5% women), 69.5% reported a diagnosis in PSLC, and 99.5% were diagnosed at their first TLC visit. Overall agreement between PSLC and TLC was 80% (κ = 0.55; R²=30%). Agreement between the PSLC and ICHD-3 was 77% for migraine, 82% for TTH, and 96% for CH (κ = 0.65; R²=41%). TLC diagnoses aligned with ICHD-3 in over 90%. Conclusion Our findings indicate a significant degree of diagnostic agreement across different levels of care according to the ICHD-3 guidelines. However, there remains insufficient reliability in clinical diagnostics, highlighting the need for continued efforts to improve the early recognition and diagnostic accuracy and consistency of primary headaches to optimize patient care and treatment outcomes in Germany.

Abstract Background Childhood adversities and traumata (CAT) increase the risk for various mental disorders, including the clinical high-risk of psychosis (CHR-P) state and its main comorbidities, i.e., depression, and social phobia. However, these relations are likely mediated by personal coping behaviors. This cross-sectional study investigates the relationships between the main CAT domains, coping, CHR-P, depression, and social phobia. Methods Using path analyses, we analyzed data of 736 patients (mean age 24 years, 67% male) who presented at an early detection service between 2002 and 2013, answered questionnaires on CAT, coping, depressiveness, and social phobia, and underwent clinical examination for CHR-P according to the recommendations of the Guidance project of the European Psychiatric Association. Results All path models (total sample, males and females) showed good to excellent fit to the data. In all models, higher scores on maladaptive coping mediated the negative effect of emotional abuse on mental health outcomes. Additionally, in the total sample and males, lower scores on adaptive coping mediated the negative effect of emotional abuse and neglect, and physical neglect was associated with lower scores on adaptive coping that, in turn, were linked to depression and social phobia but not CHR-P. Overall, effects of maladaptive coping were higher than those of adaptive coping, although adaptive coping was more diversely associated with CAT. Furthermore, the interrelated depression and social phobia were more widely explained by the models than CHR-P, which was not significantly associated with them. Conclusions Our findings underscore the complex interplay of the CAT domains and their relevant mediators with mental health outcomes that likely reflect underlying sex-specific psychological, social, cultural and neurobiological mechanisms. Supporting a broader view on CAT than the traditional focus on sexual abuse, results indicate an important role of emotional abuse that, descriptively, is most strongly mediated by maladaptive coping strategies on mental health outcomes. A detailed understanding of the effects of CAT will in future help to develop a multi-dimensional, holistic and sex-specific approach to the treatment of patients who have experienced CAT. Trial registration The study was registered in the German Clinical Trial Register ( https://drks.de/ ) as DRKS00024469 at 02/24/2021.

Abstract Liver sinusoidal endothelial cells (LSECs) critically regulate homeostatic liver function and liver pathogenesis. However, the isolation of LSECs remains a major technological bottleneck in studying molecular mechanisms governing LSEC functions. Current techniques to isolate LSECs, relying on perfusion-dependent liver digestion, are cumbersome with limited throughput. We here describe a perfusion-independent high-throughput procedure to isolate LSECs with high purity. Indifferently from previous perfusion-independent approaches, chopped liver tissue was incubated in the digestion mix for 30 minutes with intermittent mixing with a serological pipette. This led to the safeguarding of LSEC integrity and yielded 10 ± 1.0 million LSECs per adult mouse liver, which is far higher than previous perfusion-independent protocols and comparable yield to established perfusion-dependent protocols for isolating LSECs. Combining magnetic and fluorescence-activated cell sorting (FACS), LSECs from different zones of the hepatic sinusoid can now be isolated in high numbers in less than two hours for downstream applications including proteomics. Our protocol enables the isolation of LSECs from fibrotic liver tissues from mice and healthy liver tissues from higher vertebrate species (pigs), where traditional perfusion-based digestion protocols have very limited application. In conclusion, these technical advancements reduce post-mortem changes in the LSEC state and aid in reliable investigation of LSEC functions.

Protein kinases (PKs) are an important and very popular family of enzymes that play a vital role in regulating cellular processes via the phosphorylation of targets. Nevertheless, modifications in the expression due to mutations or their dysregulation can lead to diseases, including autoimmune disorders, cardiovascular problems, diabetes, neurological diseases, and cancers. Cyclic ultra-short peptides are amazing structures with unique properties. The cyclicity of cyclic peptides (CPs) can mimic the interactions between PKs and natural substrates, influencing the enzyme activity essential in health and disease physiology. Our review summarized that interference in the signal transduction mechanism of the PKs by CPs implies the inhibition of substrate phosphorylation at the level of the active site, similar to anti-neoplastic drugs. The remarkable capacity of CPs to interact with targets positions them as promising candidates for developing protein kinase inhibitors in treating diseases. This review offers new insights for CPs in molecular mechanisms, cytotoxicity, target selectivity, and the possibility of designing more effective and safe therapeutic agents.

Abstract Background Hansen's disease is an infectious disease with a slow and chronic evolution that can manifest itself through skin lesions, with changes in thermal, painful and tactile sensitivity, and also affect peripheral nerves, causing significant physical disabilities. This study aimed to analyze the meanings and senses for health workers from outpatient services who provide care to people diagnosed with Hansen's disease. Methods This is an exploratory qualitative study that used the Vygotskian theoretical-methodological framework based on the dimension of historical-dialectic materialism that bases its procedures on the use of meaning cores. The study was carried out in Ribeirão Preto, in the inland state of São Paulo, Brazil. In total, 13 health professionals participated in the study, including two nurses, three physicians, five nursing assistants, a physiotherapist and two social workers. Results To understand the meanings and senses of Hansen's disease, we take three cores of meaning as a basis: (1) personal, professional and social aspects of health workers and Hansen's disease, the health workers report that their view of what Hansen's disease was based on the understanding that it was an infectious disease that caused deformities, known as “leprosy”, and that those affected needed to be isolated; (2) Hansen’s disease – neglected, invisible and unknown, the invisibility of Hansen's disease continues to haunt those affected by it, and diagnosis is still late, referring to the marks carried in the history of Hansen's disease that remain today; and (3) challenges and potential in the world of work in the Hansen’s disease reference services, the dichotomies, challenges and potential of working with those affected by Hansen's disease are linked to the creation of bonds, love for the profession, religious beliefs and problems related to the lack of resources for the rehabilitation of those affected. Conclusions The re-elaboration of meaning can occur when professionals are inserted in the world of work. The socially produced senses and meanings surrounding leprosy are related to its invisibility and late diagnosis. Changing the meanings and senses requires mediation and the use of critical active methodologies in health education, with investments from training bodies, social movements and health services.

Background and aims: The COVID-19 pandemic significantly impacted the mental health of healthcare professionals, especially those working in Psychosocial Care Centers (CAPS), which are crucial services in the Brazilian mental health system. This study aimed to investigate the association between job satisfaction, workload, and psychological distress among CAPS professionals during the pandemic. Methods: A cross-sectional study was conducted with 53 professionals from seven CAPS. The Workload Impact Scale (IMPACTO-BR) and Job Satisfaction Scale (SATIS-BR), the General Health Questionnaire (GHQ-12), and a sociodemographic questionnaire were used. Descriptive and analytical statistical analyses were performed. Multiple linear regression analysis was conducted to examine the relationship between job satisfaction, workload, and psychological distress. Results: Professionals reported moderate satisfaction (3.67 ± 0.45) and mild workload (1.82 ± 0.63). One-third of the sample showed scores indicative of psychological distress. Multiple linear regression analysis revealed that workload (p = 0.0025) and low job satisfaction (p = 0.0495) were significantly associated with psychological distress. Conclusions: Low job satisfaction and high professional workload were predictive variables of psychological distress. These findings highlight the need for investments in promoting the quality of life at work for mental health professionals, especially during crises. The implications for human resource management and public policy development emphasize the importance of an integrated approach that considers the well-being of professionals for the effectiveness and sustainability of the psychosocial care model.

Abstract In this paper, we propose the modelling of patterns of financial transactions ‐ with a focus on the domain of cryptocurrencies ‐ as splittings and present a method for generating such splittings utilizing integer partitions. We study current money laundering regulations and directives concerning thresholds for monitoring of financial transactions. We further exemplify that, by having the partitions respect these threshold criteria, the splittings generated from them can be used for modelling illicit transactional behavior such as is shown by smurfing. In addition, we conduct an analysis of the splittings occurring in money laundering efforts that took place in the aftermath of the Upbit hack. Based on the potential weaknesses identified by our research, we finally provide suggestions on how to improve current AML techniques and initiatives towards more effective AML efforts.

Abstract Background/aims Submacular haemorrhages (SMH) cause significant visual impairment. Until now, the comparative effectiveness of different treatment approaches remains inconclusive without clear treatment guidelines. The aim of our study was to evaluate the effectiveness of 5 surgical treatment modalities in terms of visual prognosis and success rate. Methods This retrospective study included 201 patients with SMH. Primary endpoint was best corrected visual acuity (BCVA), secondary endpoints included haemorrhage size and complications. Group 1 was treated with pneumatic displacement and rtPA-injection. Group 2 followed the "Manchester protocol" with rtPA-injection and—if needed—a standardised secondary procedure with pars plana vitrectomy (ppV) and subretinal rtPA. Group 3 underwent vitrectomy with subretinal rtPA, group 4 vitrectomy only and group 5 received subretinal lavage. Results Baseline characteristics were a mean age of 79 years and a follow-up of 4.6 months. Pre-intervention BCVA of 1.7 logMAR improved to 1.4 logMAR at follow-up. A gain of > 0.2 logMAR was achieved in 47% of patients, while 20% lost > 0.2 logMAR. Only group 2 achieved a statistically significant visual gain. While group 5 was statistically larger in haemorrhage size preoperatively (p

Abstract Background Quantification of Amyloid beta (Aβ) oligomers in plasma enables early diagnosis of Alzheimer’s Disease (AD) and improves our understanding of underlying pathologies. However, quantification necessitates an extremely sensitive and selective technology because of very low Aβ oligomer concentrations and possible interference from matrix components. Methods In this report, we developed and validated a surface-based fluorescence distribution analysis (sFIDA) assay for quantification of Aβ oligomers in plasma. Results The blood-based sFIDA assay delivers a sensitivity of 1.8 fM, an inter- and intra-assay variation below 20% for oligomer calibration standards and no interference with matrix components. Quantification of Aβ oligomers in 359 plasma samples from the DELCODE cohort reveals lower oligomer concentrations in subjective cognitive decline and AD patients than healthy Control participants. Conclusions Correlation analysis between CSF and plasma oligomer concentrations indicates an impaired clearance of Aβ oligomers that is dependent on the ApoE ε4 status.

Aims Acute heart failure (AHF) is associated with end‐organ dysfunction. The effect of AHF on the pancreas has not been studied. We aim to evaluate serum markers of pancreatic damage during hospitalization for AHF. Methods and results In data from the Pragmatic Urinary Sodium‐based treatment algoritHm in Acute Heart Failure (PUSH‐AHF) study, amylase and lipase values were extracted from available serum samples at baseline, and at 24 and 72 h after hospitalization. The differences between pancreatic enzymes between timepoints were evaluated using the Friedman test. Associations with N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) were tested using linear regression analysis. The study population consisted of 274 patients. Mean age was 73 ± 11 years, and 117 (43%) were women. Mean left ventricular ejection fraction (LVEF) was 38 ± 14%; 53 (19%) patients had HF with a preserved LVEF (≥50%). At baseline, median amylase and lipase were within normal range (47 [33–63] U/L and 30 [21–44] U/L, respectively). Both enzymes significantly increased in the first 72 h (P‐value for trend

Abstract Inversions are balanced structural variants that often remain undetected in genetic diagnostics. We present a female proband with a de novo Chromosome 15 paracentric inversion, disrupting MEIS2 and NUSAP1. The inversion was detected by short-read genome sequencing and confirmed with adaptive long-read sequencing. The breakpoint junction analysis revealed a 96 bp (bp) deletion and an 18 bp insertion in the two junctions, suggesting that the rearrangement arose through a replicative error. Transcriptome sequencing of cultured fibroblasts revealed normal MEIS2 levels and 0.61-fold decreased expression of NUSAP1. Furthermore, three fusion transcripts were detected and confirmed by Sanger sequencing. Heterozygous loss of MEIS2 (MIM# 600987) is associated with a cleft palate, heart malformations, and intellectual impairment, which overlap with the clinical symptoms observed in the proband. The observed fusion transcripts are likely non-functional, and MEIS2 haploinsufficiency is the likely disease causative mechanism. Altogether, this study’s findings illustrate the importance of including inversions in rare disease diagnostic testing and highlight the value of long read sequencing for the validation and characterization of such variants.

Abstract Background Paratuberculosis, caused by Mycobacterium avium subspecies paratuberculosis (MAP), is a chronic granulomatous enteritis that affects domestic and wild ruminants and camelids. The disease has rarely been reported in alpacas in Germany. This publication describes epidemiologically independent cases of paratuberculosis in two alpacas in Germany. Case presentation Two alpacas, a 26-year-old female zoo animal (case 1) and a 2.5-year-old breeding stallion from a private owner (case 2), presented with progressive emaciation, leading to death (case 2) or euthanasia (case 1) because of deteriorating general condition. In both cases typical granulomatous lesions in the intestinal mucosa and mesenteric lymph nodes were found. In case 2, other lymph nodes were severely enlarged and MAP was detected in the mandibular lymph node, lung, and liver by qPCR. The MAP isolates differed between the alpacas, with two distinct phylogenetic clades (Clade 1 and 8) within Subgroup A of the MAP-C type group and two distinct INMV profiles (INMV 2 and 1) found. These genotypes have been identified in cattle and goats in different regions in Germany. The genotype isolated from case 1 has been detected in goats from the zoo since 2011, indicating transmission between these species. Conclusions MAP can cause severe clinical disease in alpacas of variable age and under different husbandry conditions. Therefore, paratuberculosis should be considered for differential diagnosis in alpacas with emaciation and poor general condition. Although not definitely shown, cross-species infection between ruminant species and camelids is exceedingly likely.

Background and objective: Clinical practice guidelines for prostate cancer (PCa) are a valuable resource for everyday clinical practice. The clinical practice guidelines and recommendations produced by various societies should demonstrate a considerable level of consistency in terms of quality, regardless of the society that developed these given the common evidence base. However, to date, no study has assessed the quality of PCa clinical practice guidelines. As part of the Optimal Treatment for Patients with Solid Tumours in Europe Through Artificial intelligence (OPTIMA) project, we evaluated the quality of the most frequently used national and international clinical practice guidelines for PCa using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool. Methods: The quality of the identified clinical practice guidelines was assessed independently by two assessors using the AGREE II tool. The AGREE II tool comprises 23 different items organised into six domains, rated on a 7-point scale (1: strongly disagree to 7: strongly agree). The total score of the appraisal was the mean value of the two assessments. The agreement between assessors’ scores was calculated using the interclass correlation coefficient (ICC). Four key recommendations were compared among the included clinical practice guidelines to assess consistency. Key findings and limitations: Sixteen clinical practice guidelines were assessed using their latest available version (cut-off April 2024). The European Association of Urology, S3LL PCa, Belgian Health Care Knowledge Centre, National Comprehensive Cancer Network, and Prostatacancer—Nationellt vårdprogram guidelines received the highest overall scores with a mean domain score of 82.4% (range: 75.5–88.3%). The de l’Association Française d’Urologie (AFU), American Urological Association, and National Institute for Health and Care Excellence received a mean domain score of 77.6% (range: 73.7–84.0%). Below average were the European Society for Medical Oncology, localised (L) and systemic (S) CPPC American Society of Clinical Oncology, and Nederlandse Vereniging voor Urologie (NVU) with a mean domain score of 58.4% (range: 43.5–76.3%). The reasons for scoring below average included the following: inadequate information about the methodology applied, limited scope of the guideline, and limited patient engagement. The highest inter-rater variability was observed in NVU (ICC: 0.58) and the lowest in AFU-L (ICC: 0.84). When examining the scores of each domain, “clarity of presentation” (domain 4) achieved the highest score with a mean of 86.9% ± 12.6%. The domain with the lowest score was applicability (domain 5), with a mean of 48.3% ± 24.8%. The ICC was calculated to be 0.72 (±0.08). Conclusions and clinical implications: This is the first study in which a comprehensive quality assessment of the majority of international and national clinical practice guidelines was undertaken, and the key recommendations were compared to assess consistency. Our study shows that the majority of international and national clinical practice guidelines demonstrate high-quality standards when assessed using the AGREE II evaluation tool. The clinical practice guidelines that did not meet the expected standards could be improved by adopting several key recommendations outlined by our study. Patient summary: The OPTIMA project used the Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool to evaluate the quality of 16 commonly used national and international clinical practice guidelines for prostate cancer. While some of these international and national clinical practice guidelines received the highest score, few guidelines scored below average due to methodological deficiencies and limited patient engagement. These findings highlight the need for a standardised process to ensure high-quality, consistent guidelines across practices.

Bartonella quintana infection can cause severe disease that includes clinical manifestations such as endocarditis, chronic bacteremia, and vasoproliferative lesions of the skin and viscera. B. quintana bacteria is transmitted by the human body louse (Pediculus humanus corporis) and is associated with homelessness and limited access to hygienic services. We report B. quintana infection in 2 kidney transplant recipients in the United States from an organ donor who was experiencing homelessness. One infection manifested atypically, and the other was minimally symptomatic; with rapid detection, both recipients received timely treatment and recovered. B. quintana was identified retrospectively in an archived donor hematoma specimen, confirming the transmission link. Information about the organ donor’s housing status was critical to this investigation. Evaluation for B. quintana infection should be considered for solid organ transplant recipients who receive organs from donors with a history of homelessness or of body lice infestation.

Bartonella quintana infection can lead to bacillary angiomatosis, peliosis hepatis, chronic bacteremia, and culture-negative endocarditis. Transmitted by the human body louse (Pediculus humanus humanus), B. quintana infection has become an emerging disease in recent decades among persons experiencing homelessness. By using retrospective laboratory surveillance, we identified 5 cases of left-sided, culture-negative B. quintana endocarditis among persons in New York, New York, USA, during January 1, 2020–November 23, 2023. Identifications were made by using molecular assays. All patients experienced unsheltered homelessness in the year before hospitalization. Of those patients, 4 experienced heart failure, 3 renal failure, and 2 embolic strokes; 2 died. Aortic valve replacement occurred in 4 cases. A history of possible body louse infestation was found in 4 cases. Clinicians should consider housing status and history of lice exposure in patients with suspected bartonellosis and have a low threshold for diagnostic testing and empiric treatment in patients experiencing homelessness.

Abstract Background Family members play a crucial role in supporting women with breast cancer during their recovery. In the complex situation of being an informal caregiver, their own health and ability to support the patient needs to be acknowledged. The aim was to explore the experiences, needs and roles of family members throughout the rehabilitation process of women with breast cancer. Methods A qualitative study was conducted, involving semi-structured individual telephone interviews with 20 purposefully selected family members of women with breast cancer (13 men aged 24–79 years, 7 women aged 19–76 years). Data analysis utilized conventional content analysis and used “casing” as the analysis technique. The study is part of the ReScreen randomized controlled trial and all participants gave informed consent. Results The interviews revealed significant variation among family members, leading to the emergence of different typologies based on their reactions and specific preconditions. These typologies included: 1) The case of the assertive and confident team leader, 2) The case of the frustrated but persistent guardian, 3) The case of the reassured bystander, and 4) The case of the neglected outsider. While not mutually exclusive, the cases demonstrated clear similarities and differences in whether individuals felt secure or insecure in the rehabilitation process and their level of involvement in this process. Some described feelings of being involved and active in the process while others experienced not being involved and described feelings of abandonment. However, regardless of their role, family members reported that their own health was seldom considered by healthcare professionals. Conclusions This study sheds light on the concept of “we-disease,” where the role of a family member is interrelated with factors such as their health literacy, supporting role, level of involvement, relationship, and identity during the patient's rehabilitation process. This highlights significant divergence in whether family members perceive the rehabilitation process as a collaborative effort or an individual challenge. These perceptions greatly impact their own well-being and ability to support women with breast cancer, underscoring the importance of recognizing family members as informal caregivers and offering tailored support from healthcare professionals when needed. Trial registration ClinicalTrials.gov NCT03434717. Registered February 15, 2018.

Abstract Background During the COVID-19 pandemic, health literacy was found to be an asset to manage health-related information. The HLS-COVID-Q22 has been developed to measure COVID-19 health literacy. External validation needs to be assessed in different populations to verify the questionnaire’s functioning. The present study aimed to evaluate the psychometric properties of the HLS-COVID-Q22 in a sample of German school principals. Methods The sample consisted of 2187 German school principals who completed the HLS-COVID-Q22 online from April to March 2021. The data was analyzed using Rasch analysis, applying the Partial Credit Model for polytomous data. Dimensionality, item fit statistics and rating scale functioning was tested. Values for item difficulty and person ability as well as reliability indices were computed. Results Unidimensionality could be confirmed. The rating scale categories worked as intended, participants used every rating step category. Generally, item fit was verified. One item showed potential misfit but could remain in the questionnaire as excluding the item did not reduce reliability. A person separation index of 3.41 and person reliability of 0.92 showed excellent differentiation between COVID-19 health literacy levels. Furthermore, the values for item separation of 20.08 and item reliability of 1.0 indicate good construct validity. Conclusions The German version of the HLS-COVID-Q22 appears to be a reliable measurement tool for the target population. Evidence for construct, statistical and fit validity was collected. Future studies need to test additional types of validity like convergent and divergent validity to further evaluate the questionnaire. Moreover, the psychometric properties of the translated versions of the HLS-COVID-Q22 should be compared using Rasch analysis.

Norovirus is a leading cause of acute gastroenteritis and imposes a substantial disease burden. In California, USA, norovirus surveillance is limited. We evaluated correlations between wastewater norovirus concentrations and available public health surveillance data. Wastewater surveillance for norovirus genotype GII in California provided timely, localized, and actionable data for public health authorities.

Abstract Few aerobic hyperthermophilic microorganisms degrade polysaccharides. Here, we describe the genome-enabled enrichment and optical tweezer-based isolation of an aerobic polysaccharide-degrading hyperthermophile, Fervidibacter sacchari, previously ascribed to candidate phylum Fervidibacteria. F. sacchari uses polysaccharides and monosaccharides for growth at 65–87.5 °C and expresses 191 carbohydrate-active enzymes (CAZymes) according to RNA-Seq and proteomics, including 31 with unusual glycoside hydrolase domains (GH109, GH177, GH179). Fluorescence in-situ hybridization and nanoscale secondary ion mass spectrometry confirmed rapid assimilation of 13C-starch in spring sediments. Purified GHs were optimally active at 80–100 °C on ten different polysaccharides. Finally, we propose reassigning Fervidibacteria as a class within phylum Armatimonadota, along with 18 other species, and show that a high number and diversity of CAZymes is a hallmark of the phylum, in both aerobic and anaerobic lineages. Our study establishes Fervidibacteria as hyperthermophilic polysaccharide degraders in terrestrial geothermal springs and suggests a broad role for Armatimonadota in polysaccharide catabolism.

Background: Assessing the elements of nursing practice environments is crucial, as investing in their improvement will enhance outcomes for nurses, patients, and organizations. Moreover, comparing practice environments from different countries improves the definition of cross-cutting guidelines that can be applied in various contexts. Thus, this study aims to evaluate nursing practice environments in hospitals in Portugal and Brazil. Methods: A multicenter and cross-sectional study was conducted in eight Portuguese and eight Brazilian hospitals. Five hundred eighty-two nurses completed a survey regarding their sociodemographic and professional attributes, as well as the Scale for the Environments Evaluation of Professional Nursing Practice. The data were subjected to comparative analyses between the two countries. We adhered to ethical requirements in both participating countries. Results: In Brazil, the Structure, Process, and Outcome components were considered favorable to the quality of care and well-being of nurses. In Portugal, nurses considered the Structure and Outcome components favorable and the Process component very favorable. Statistically significant differences were found between the two countries in several dimensions of the three subscales. The Structure and Outcome components scored significantly better in hospitals in Brazil, and the Process component scored better in Portuguese hospitals. Conclusions: These conclusions underscore the urgent need for investment in continuous training and a culture of evaluation that promotes continuous improvement. Additionally, promoting the involvement and participation of nurses could simultaneously contribute to the development of more sustainable health systems.

Background/Objectives: In recent years, research has increasingly highlighted the significance of nursing practice environments, linking positive settings with enhanced job satisfaction, professional autonomy, and care quality. Such environments can decrease turnover, stress, and costs while improving patient safety. Despite this extensive literature, there is limited consensus on defining a ‘positive nursing practice environment’, highlighting the need for a systematic analysis to advance understanding and application. This study aims to explore and clarify the concept of a ‘Positive Nursing Practice Environment’. Methods: This study applied Walker and Avant’s approach for concept analysis, conducting a comprehensive database search to gather relevant evidence. To review the available evidence on the concept of nursing practice environments, we followed the methodology proposed by JBI for scoping reviews. Results: The inclusion of 166 studies meeting the criteria provided a broad understanding of the topic, revealing 10 key attributes of a ‘positive nursing practice environment’ and identifying various antecedents and consequences affecting clients, nurses, and institutions. Conclusions: The concept analysis of a ‘Positive Nursing Practice Environment’ offers valuable insights into nurses’ working conditions, systematically identifying characteristics that impact professionals, patients, and institutions. This analysis lays the groundwork for future research and practical improvements in nursing practice environments. This study was not registered.

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods:Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 coun-tries were analyzed descriptively, with a Delphi process used for expert recommendations. Results:Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoosper-mia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differ-entiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions:Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Abstract Objectives Analyse reported processes of co-design and co-production in the context of health and social care to explore the underlying mechanisms that enable inclusive and reciprocal engagement. Search strategy Peer review research was obtained from a prior scoping review searching eight databases consisting of all methodologies relevant to co-design or co-production in the context of health and social care services and involving service-users. Methods of selection Articles were included for synthesis if they reported a process of dialogue, with mutuality, insight and clarification in their engagement process. Ninety-three peer-review articles informed our programme theory development. Analysis Data relating to co-design and co-production processes were extracted and analysed through inductive, abductive, and deductive analysis leading to the development of an initial programme theory. Main results This realist synthesis finds that co-design and co-production can occur at different times, in part or all of the research and participatory process. There is an over reliance on the term ‘co-design’ or ‘co-production’ to convey complex engagement or participatory processes. We identified six mechanisms (intention, assets, dialogue, documentation, interpretation and understanding). Interaction between these six identified mechanisms in context, even if only brief, is important for supporting meaningful engagement, alignment and agreement within a co-design or co-production process. Implications for practice The initial programme theory presented in this article provides clarity by identifying essential mechanisms which can guide the design and implementation of a range of participatory approaches. Rather than relying on a single label to convey complex participatory methods or processes, the values and principles of co-design or co-production, in combination with this programme theory, could be applied to guide implementation and reporting of specific activities within a range of research or participatory methods. Patient and public contribution The initial programme theory was presented and piloted in a series of collaborative workshops between May 2023 and March 2024 with patient and public contributors, health professionals and researchers. This engagement process is currently underway to refine the programme theory and it is anticipated that this next phase will be completed in September 2024.

Abstract We measured concentrations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants, influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, enterovirus D68, human parainfluenza types 1, 2, 3, 4a, and 4b in aggregate, norovirus genotype II, rotavirus, Candida auris, hepatitis A virus, human adenovirus, mpox virus, H5 influenza A virus, and pepper mild mottle virus nucleic acids in wastewater solids prospectively at 191 wastewater treatment plants in 40 states across the United States plus Washington DC. Measurements were made two to seven times per week from 1 January 2022 to 30 June 2024, depending on wastewater treatment plant staff availability. Measurements were made using droplet digital (reverse-transcription–) polymerase chain reaction (ddRT-PCR) following best practices for making environmental molecular biology measurements. These data can be used to better understand disease occurrence in communities contributing to the wastewater.

Abstract Background Misfolding and aggregation of amyloid β (Aβ), along with neurofibrillary tangles consisting of aggregated Tau species, are pathological hallmarks of Alzheimer’s disease (AD) onset and progression. In this study, we hypothesized the clearance of Aβ aggregates from the brain and body into the gut. Methods To investigate this, we used surface-based fluorescence intensity distribution analysis (sFIDA) to determine the Aβ aggregate concentrations in feces from 26 AD patients and 31 healthy controls (HC). Results Aβ aggregates were detectable in human feces and their concentrations were elevated in AD patients compared to HC (specificity 90.3%, sensitivity 53.8%). Conclusion Thus, fecal Aβ aggregates constitute a non-invasive biomarker candidate for diagnosing AD. Whether digestion-resistant Aβ aggregates in feces are secreted via the liver and bile or directly from the enteric neuronal system remains to be elucidated.

Abstract Mental health, cognitive development, and social background are related to educational success. While growing evidence is available in cultural settings other than Western countries, more knowledge is needed, especially regarding interactions among these dimensions. Rather than studying isolated factors, we propose an integrated approach to consider the diverse interrelated dimensions influencing children’s learning. Life course theory supports this approach underlying the role of early events in subsequent life paths and the multidisciplinary nature of these events. The sample consisted of 610 children (49.1% male) attending first grade. The children completed reading, mathematics, and visuospatial working memory (VWM) assessments. Parents completed the Strengths and Difficulties Questionnaire (SDQ-P) and reported their demographic information. A multilevel path model was estimated, including direct relationships between (i) children’s socioemotional behavior (SEB) and learning, (ii) VWM and learning, and (iii) SEB and VWM. The effects of sex and maternal education were also controlled. School and student level variances were modeled. At the school level, VWM, reading, and mathematics have variance, whereas SEB does not. At the student level, VWM, SEB, and maternal education have significant and differential effects on learning. Hyperactivity and peer problems were negatively related to reading and mathematics, while emotional problems were not, and conduct problems exhibited mixed results. These results reinforce developmental life course approaches, that is, from the beginning of schooling, promoting positive mental health can improve children’s learning outcomes.

Abstract Background Cancer affects not only the person with the disease but those around them. Being a family member is described as strenuous and, often, associated with stress, anxiety and feelings of loneliness. There is a heightened risk of distress for family of those with fast-progressing, severe oesophageal or gastric cancer. Early palliative care involving family is vital yet often overlooked. In order to include family members in early palliative care their management in everyday life needs to be explored. Method Qualitative inductive interview study using content analysis guided by Graneheim and Lundman. Result The analysis resulted in the overarching theme “Managing the disease together but still alone”. Three categories were identified: Adapting to the disease, Taking control of the situation, Processing emotions. Each category described family members management in various aspects of everyday life together with the ill person and alone. Conclusion The results may contribute to an awareness of family members’ management of large parts of everyday life and, further, their feelings of loneliness, and indicates that family members should be included early in oesophageal or gastric cancer palliative care. Further studies are needed to develop the content of such family-inclusive early palliative care.

Abstract Since public support is critical for implementing carbon pricing policies, we conduct a systematic review and meta-analysis to examine the survey-based literature on change in public support for direct and indirect carbon pricing policies with and without revenue recycling options. Following a comprehensive and transparent machine-learning assisted screening of the literature, our dataset comprises 35 studies containing 70 surveys across 26 countries with over 100,000 respondents. We find that the introduction of any type of revenue recycling option increases public support for carbon pricing. Results from our meta-regression indicate that green spending (i.e. using revenues for climate-friendly projects) is the only revenue recycling option associated with a statistically significant increase in public support. Our findings moreover suggest that the effects may depend on which region the survey was carried out, highlighting the need for additional research in countries in the regions of Africa and Latin America and the Caribbean.

La evidencia en la dependencia del petróleo en la economía ecuatoriana persiste, a pesar de los esfuerzos por diversificar la matriz productiva. Los obstáculos en términos de inversión, tecnología y estabilidad política y económica han dificultado los avances en esta dirección documental y un análisis de datos secundarios. El presente estudio tiene como objetivo analizar la dependencia petrolera en Ecuador durante el período 2018-2022. Para ello, se utilizó una metodología de investigación documental y un análisis de datos secundarios. Los resultados indican que, durante este período, el sector petrolero ecuatoriano ha enfrentado una serie de desafíos que han limitado su capacidad de producción y refinación. Factores como problemas operativos, limitaciones en la infraestructura y el impacto de la pandemia de COVID-19 han contribuido a una disminución en la producción de crudo, lo que ha tenido un efecto negativo en los ingresos del país y su posición competitiva en el mercado global. Además, este artículo resalta la necesidad de que Ecuador implemente estrategias integrales para reducir su dependencia del petróleo, diversificando sus fuentes de ingresos y promoviendo un desarrollo económico más sostenible a largo plazo.

Employing quantitative structure–activity relationship (QSAR)/ quantitative structure–property relationship (QSPR) models, this study explores the application of fullerene derivatives as nanocarriers for breast cancer chemotherapy drugs. Isolated drugs and two drug–fullerene complexes (i.e., drug–pristine C60 fullerene and drug–carboxyfullerene C60–COOH) were investigated with the protein CXCR7 as the molecular docking target. The research involved over 30 drugs and employed Pearson’s hard–soft acid–base theory and common QSAR/QSPR descriptors to build predictive models for the docking scores. Energetic descriptors were computed using quantum chemistry at the density functional-based tight binding DFTB3 level. The results indicate that drug–fullerene complexes interact more with CXCR7 than isolated drugs. Specific binding sites were identified, with varying locations for each drug complex. Predictive models, developed using multiple linear regression and IBM Watson artificial intelligence (AI), achieved mean absolute percentage errors below 12%, driven by AI-identified key variables. The predictive models included mainly quantitative descriptors collected from datasets as well as computed ones. In addition, a water-soluble fullerene was used to compare results obtained by DFTB3 with a conventional density functional theory approach. These findings promise to enhance breast cancer chemotherapy by leveraging fullerene-based drug nanocarriers.

O presente estudo teve como objetivo discutir a extensão universitária em enfermagem e saúde mental e sua contribuição para a formação do enfermeiro por meio das narrativas de extensionistas. Trata-se de estudo de abordagem qualitativa, do tipo história oral. A coleta de dados foi realizada por meio de entrevistas com enfermeiros que participaram de um projeto de extensão em saúde mental desenvolvido em um Centro de Convivência da Rede de Atenção Psicossocial de Belo Horizonte, Minas Gerais, Brasil. Os dados foram analisados sob a perspectiva da análise de conteúdo. Os resultados apontaram que a vivência no projeto contribuiu para a escolha da especialidade de enfermagem em saúde mental como campo de atuação profissional, influenciando as escolhas profissionais dos extensionistas em áreas afins, como a educação em saúde. As experiências no campo da saúde mental potencializaram a autonomia e a capacidade de planejamento na vida e na profissão, além de oportunizar explorar habilidades, desenvolver competências, reduzir estigma e preconceito em relação ao adoecimento mental, contribuindo para a formação profissional do enfermeiro.

Background: Speech recognition in noise is one of the difficulties faced by people with hearing loss that increases with age. The recently developed Spanish Auditory Test of Speech in Noise (Prueba Auditiva de Habla en Ruido en Español, PAHRE) allows for the identification of these intelligibility difficulties in noise. The aim of this study was to assess speech recognition in noise in people with hearing loss and to test the benefits of the Lombard effect. Methods: The participants were 104 people with hearing difficulties, ranging in age from 37 to 98 years. The variables age, degree of hearing loss, presence of high-frequency dropout, and years of formal education were assessed. Results: Psychometric curves were obtained as a function of signal-to-noise ratio as well as threshold values of speech reception as a function of age group for mild and moderate hearing loss. The results indicated that the speech reception threshold increased with both age and the degree of hearing loss, becoming particularly significant after the age of 70. Furthermore, it was found that the combined factors of age, degree of hearing loss, and educational level predicted a high percentage of the variability in the speech reception threshold. Conclusions: Therefore, the Spanish Auditory Test of Speech in Noise could be a useful clinical tool for diagnosis, monitoring, auditory rehabilitation planning, and hearing aid fitting.

Background: Guidelines recommend preoperative dental screening (PDS) prior to surgical valve replacement (SVR) to reduce risk of prosthetic valve infective endocarditis (IE). Nonetheless, limited data support these recommendations. Objectives: The objective of this study was to investigate the impact of mandatory preoperative dental screening (MPDS) on risk of IE in patients undergoing SVR. Methods: Patients undergoing SVR in Western Denmark from 2020 to 2022 were included in this observational study. Patients were considered based on 2 applied PDS practices: MPDS, and no routine referral to preoperative dental screening (NPDS). Data were retrieved from Danish registries and adjudicated using medical records. The primary endpoint was incidence of IE. Secondary endpoints were all-cause mortality, and the composite endpoint of IE and all-cause mortality. Results: A total of 1,207 patients undergoing SVR were included. Of 805 patients in the MPDS, 93% (n = 751) underwent subsequent PDS, compared to 5% (n = 21) among 402 patients in the NPDS. Patients in the MPDS were older with higher rates of coexisting comorbidities. During a median follow-up of 2.6 years, 3.3% (n = 40) developed IE. The IE incidence rate for MPDS and NPDS was 16.0 (95% CI: 11.3-22.6) and 8.0 (95% CI: 4.0-16.0) per 1,000 person-years, respectively. Mortality rate was higher in MPDS (2-year mortality: 6.2% (95% CI: 4.7-8.1) vs 2.8% (95% CI: 1.6-5.0). Differences in IE rates, all-cause mortality but not composite endpoint were abolished in 370 propensity score-matched patients. Conclusions: Risk of IE was low regardless of PDS practice. MPDS prior to surgery did not alter the risk of IE or all-cause mortality in patients undergoing SVR in Denmark.

Non-communicable chronic diseases (NCDs) are most commonly characterized by age-related loss of homeostasis and/or by cumulative exposures to environmental factors, which lead to low-grade sustained generation of reactive oxygen species (ROS), chronic inflammation and metabolic imbalance. Nuclear factor erythroid 2-like 2 (NRF2) is a basic leucine-zipper transcription factor that regulates the cellular redox homeostasis. NRF2 controls the expression of more than 250 human genes that share in their regulatory regions a cis-acting enhancer termed the antioxidant response element (ARE). The products of these genes participate in numerous functions including biotransformation and redox homeostasis, lipid and iron metabolism, inflammation, proteostasis, as well as mitochondrial dynamics and energetics. Thus, it is possible that a single pharmacological NRF2 modulator might mitigate the effect of the main hallmarks of NCDs, including oxidative, proteostatic, inflammatory and/or metabolic stress. Research on model organisms has provided tremendous knowledge of the molecular mechanisms by which NRF2 affects NCDs pathogenesis. This review is a comprehensive summary of the most commonly used model organisms of NCDs in which NRF2 has been genetically or pharmacologically modulated, paving the way for drug development to combat NCDs. We discuss the validity and use of these models and identify future challenges.

IntroductionAfter the release of the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), US norms, an overestimation of outcome was observed. But, the conformity between the Bayley Scales of Infant Development, second edition (BSID-II), and the Bayley-III German norms is unknown. This retrospective analysis aimed to compare outcomes of very preterm infants tested with BSID-II and Bayley-III German norms.MethodsInfants born from November 2007 to July 2018 were included. Exclusion criteria were death or missing outcome. Infants underwent testing with either BSID-II until December 2013 or Bayley-III from January 2014 onward, at 12 and/or 24 months. BSID-II Mental Developmental Index (MDI) was compared to Bayley-III cognitive score and a combined Bayley-Score (CB-III) consisting of the cognitive and language composite score. BSID-II Psychomotor Developmental Index (PDI) was compared to Bayley-III motor composite score. Abnormal outcomes were defined as scores Results649 infants were included. At 12 months, the Bayley-III cohort achieved higher scores in all domains compared to the BSID-II cohort (all pInterpretationOur findings indicate that the Bayley-III German norms effectively identify children needing interventions, particularly at 24 months corrected age. This supports both clinical application and scientific comparability with the BSID-II.

Foundation: obesity is a chronic disease of multifactorial ethology. The family context, parents and other relatives have a great influence on children, modeling their customs, habits, patterns of behavior, eating and physical activity.Objective: to describe the association of lifestyles and social and family variables with overweight/obesity in adolescents. Methods: a cross-sectional descriptive study was carried out, carried out from June 2023 to June 2024, in six polyclinics in Havana, selected by feasibility. 343 adolescents from 10 to 19 years old were included. The dependent variable was overweight/obesity and the independent variables were lifestyle and social and family variables. Absolute and relative frequencies were calculated to characterize the studied population. The associations between the variables were measured using the contingency coefficient. Results: 22.4 % of the adolescents were overweight/obese. The variables related to lifestyles reveal the highest frequency in adolescents who reported not consuming fruits or vegetables. Physical activity had an inverse correlation, with a decrease in the frequency of overweight/obesity as the intensity increased and in those who consumed electronic screens for more than two hours. The highest frequencies of overweight/obesity were recorded in adolescents from small families, with ontogenesis in the “extensive” classification and in mothers aged 19 to 34 years. Conclusions: overweight/obesity in adolescents had a greater association with physical activity and family size.

ABSTRACT Purpose: Due to the highly individualized clinical manifestation of Parkinson's disease (PD), personalized patient care may require domain‐specific assessment of neurological disability. Evidence from magnetic resonance imaging (MRI) studies has proposed that heterogenous clinical manifestation corresponds to heterogeneous cortical disease burden, suggesting customized, high‐resolution assessment of cortical pathology as a candidate biomarker for domain‐specific assessment. Method: Herein, we investigate the potential of the recently proposed Mosaic Approach (MAP), a normative framework for quantifying individual cortical disease burden with respect to a population‐representative cohort, in predicting domain‐specific clinical progression. Using MRI and clinical data from 135 recently diagnosed PD patients from the Parkinson's Progression Markers Initiative, we first defined an extremity‐specific motor score. We then identified cortical regions corresponding to “extremity functions” and restricted MAP, respectively, and contrasted the explanatory power of the extremity‐specific MAP to unrestricted MAP. As control conditions, domain‐related but less specific general motor function and nondomain‐specific cognitive scores were considered. We also tested the predictive power of the restricted MAP in predicting disease progression over 1 and 3 years using support vector machines. The restricted, extremity‐specific MAP yielded higher explanatory power for extremity‐specific motor function at baseline as opposed to the unrestricted, whole‐brain MAP. On the contrary, for general motor function, the unrestricted, whole‐brain MAP yielded higher power. Finding: No associations were found for cognitive function. The extremity‐specific MAP predicted extremity‐specific motor progression over 1 and 3 years above chance level. The MAP framework allows for domain‐specific prediction of customized PD disease progression, which can inform machine learning, thereby contributing to personalized PD patient care.

ABSTRACT Introduction Cancer patients in rural areas experience greater barriers to treatment access compared with patients in urban areas. There is limited research on how the COVID‐19 pandemic affected cancer treatment delivery for rural patients who were also diagnosed with COVID‐19. This study has two objectives: to assess (1) the urban–rural differences in cancer care and (2) the predictors of cancer treatment delay or discontinuation (TDD) among patients diagnosed with COVID‐19. Methods We used data from the American Society of Clinical Oncology Survey on COVID‐19 in Oncology Registry (March 2020–September 2022), which included cancer patients with test‐confirmed SARS‐CoV‐2 infection (N = 3797). Data included patient sociodemographic characteristics, COVID‐19 diagnosis information, cancer clinical characteristics, and changes to cancer treatment. Cancer TDD was defined as any scheduled treatment by more than 2 weeks. Rurality was examined through both patient residence and oncology practice. We computed adjusted prevalence ratios (aPRs) using multivariable Poisson regressions to assess predictors of cancer TDD in urban and rural areas. Results During the study period, 44.1% of patients with COVID‐19 experienced either cancer treatment delay or discontinuation and 5.7% experienced cancer treatment discontinuation. Controlling for other factors, receiving care in a rural oncology practice was associated with cancer TDD (aPR: 1.25, 95% CI: 1.01–1.55). Differences in cancer TDD were not found across rurality of patient residence. Among rural patients (N = 582), Hispanic/Latinx cancer patients had greater prevalence of cancer TDD (aPR: 1.55, 95% CI: 1.04–2.33) compared with non‐Hispanic White cancer patients. Conclusion Our findings can be used to inform programs and policies to minimize the impact of future public health emergencies on cancer care delivery in rural areas. Additional research is needed to explore potential differences in cancer care delivery across urban and rural oncology practices and patients.

Diabetes is a disease that affects millions of people in the world and its early screening prevents serious health problems, also providing relief in the demand for healthcare services. In the search for methods to support early diagnosis, this article introduces a novel prediabetes risk classification algorithm (PRCA) for type-2 diabetes mellitus (T2DM), utilizing the chemosensitivity of carotid bodies (CB) and K-means clustering technique from the field of machine learning. Heart rate (HR) and respiratory rate (RR) data from eight volunteers with prediabetes and 25 without prediabetes were analyzed. Data were collected in basal conditions and after stimulation of the CBs by inhalation of 100% of oxygen and after ingestion of a standardized meal. During the analysis, a greater variability of groups was observed in people with prediabetes compared to the control group, particularly after inhalation of oxygen. The algorithm developed from these results showed an accuracy of 86% in classifying for prediabetes. This approach, centered on CB chemosensitivity deregulation in early disease stages, offers a nuanced detection method beyond conventional techniques. Moreover, the adaptable algorithm and clustering methodology hold promise as risk classifications for other diseases. Future endeavors aim to validate the algorithm through longitudinal studies tracking disease development among volunteers and expand the study’s scope to include a larger participant pool.

In recent years, the pandemic has altered everyday relationships and social experiences. This research is framed within this context, emphasizing the concept of childhood as a social construct, historically and geographically redefined. The daily experiences and relationships of children worldwide have been significantly affected by the Pandemic. It is essential to understand these transformations through the voices of children. The primary aim of this research was to interpret the educational experiences of young children in Latin America during the Covid-19 health emergency. Data was collected through four strategies based on the mosaic approach: face-to-face interviews, virtual interviews, audio recordings, and drawings, involving a total of 46 children from 7 countries: Chile, Venezuela, Ecuador, Peru, Costa Rica, Brazil, and Argentina. The results show that during the pandemic, there were limitations on play, communication was primarily directed by teachers in virtual settings, children expressed a need for contact with peers, family mediation was crucial for learning, movement was restricted, and here was a greater emphasis on content of the didactic processes. This study aims to contribute to the positioning of participatory research with children as a necessary paradigm for addressing issues that concern them.

Background: Graduate Medical Education programs have implemented holistic review to improve the selection process for new residents. Holistic review will have a profound effect on Health Information Professionals (HIPs) with the arrival of medical residents with different backgrounds and needs. The unique experiences and skills of HIPs will position them well for the new realities in medical residency programs. This article traces the historic roots of holistic review. Methods: The authors employed a scoping review to track the historical traces of holistic review in Graduate Medical Education over the formative period of 1999-2019. Results: Medical residency programs over a 20-year period piloted holistic review in the screening, interview, and multiple time periods in the selection process. These ventures reflected a diversity of approaches and creative adaptations from other disciplines such as personnel management, organizational psychology, and active learning forms of education Conclusion: Health information professionals and medical educators will better engage with the newer cohorts of residents when equipped with a history of holistic review.

ABSTRACT Objective: to identify knowledge production about nurses’ contributions to improving healthy and sustainable public spaces. Methods: an integrative review carried out in February 2023 in electronic databases. Studies that answered the research question and that were available in full, in Portuguese, English and Spanish, were included. Results: a total of five articles were selected. The findings highlighted the importance of educational projects in the training of local managers and community autonomy; citizen participation and health promotion as ways to implement Sustainable Development Goal 11; nurses as facilitators of collective care; new health practices and modes of producing subjectivity; and use of public transportation, bicycles and/or walking in these spaces. Final considerations: there is a clear need for greater incentives from local governments to develop effective sustainability strategies that are led by nurses and the community.

Este artículo recoge y analiza testimonios de las trabajadoras sociales y otros funcionarios del área de previsión social en Chile durante el paso del sistema de Cajas de Previsión a la instauración del sistema de capitalización individual Administradora Fondo de Pensiones (AFP) durante la década de 1980 en el contexto de la Dictadura Militar. El objetivo es entender el impacto que tiene este evento clave para la profesión de Trabajo Social y la seguridad social en Chile hasta la actualidad.