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Background: During the first wave of the pandemic, a constant concern of healthcare workers, who are more vulnerable to contagion, is their personal safety. This is directly related to the availability of adequate PPE, which led to a perception of dissatisfaction and inequality with government responses. We aim t o determines whether perception of adequate PPE availability is associated with depressive, anxiety, and stress symptoms in different types of healthcare workers. Methods: Analytical cross-sectional study surveyed clinical and non-clinical healthcare workers in two third-level hospitals in Lima, Peru. An online self-survey assessed the perception of adequate PPE availability, using a Likert scale question, which was then dichotomized for the analysis. In addition, we assessed the depressive, anxiety, and stress symptoms using validated questionnaires. Results: 563 participants were included. In general, there is no association between perception of PPE availability and three mental health outcomes. However, in the subgroup analysis, physicians with better perception of PPE availability had less moderate-severe outcomes in mental health; in contrast, nurses had higher moderate-severe outcomes. The type of profession in healthcare workers may modify the effect of this association. Conclusion: The association between perception of PPE availability and mental health outcomes is complex in healthcare workers from two third-level hospitals. This association can vary according to the type of work.

The TP53 tumor suppressor is mutated in ~75% of pancreatic cancers. The mutant TP53 protein in pancreatic ductal adenocarcinomas (PDAC) promotes tumor growth and metastasis. Attempts have been made to develop molecules that restore at least some of the properties of wild-type (WT) TP53. APR-246 is one such molecule, and it is referred to as a mutant TP53 reactivator. To understand the potential of APR-246 to sensitize PDAC cells to chemotherapy, we introduced a vector encoding WT-TP53 into two PDAC cell lines, one lacking the expression of TP53 (PANC-28) and one with a gain-of-function (GOF) mutant TP53 (MIA-PaCa-2). APR-246 increased drug sensitivity in the cells containing either a WT or mutant TP53 protein with GOF activity, but not in cells that lacked TP53. The introduction of WT-T53 into PANC-28 cells increased their sensitivity to the TP53 reactivator, chemotherapeutic drugs, and signal transduction inhibitors. The addition of WT-TP53 to PDAC cells with GOF TP53 also increased their sensitivity to the drugs and therapeutics, indicating that APR-246 could function in cells with WT-TP53 and GOF TP53. These results highlight the importance of knowledge of the type of TP53 mutation that is present in cancer patients before the administration of drugs which function through the reactivation of TP53.

Abstract Microarray experiments are capable of determining the relative expression of tens of thousands of genes simultaneously, thus resulting in very large databases. The analysis of these databases and the extraction of biologically relevant knowledge from them are challenging tasks. The identification of potential cancer biomarker genes is one of the most important aims for microarray analysis and, as such, has been widely targeted in the literature. However, identifying a set of these genes consistently across different experiments, researches, microarray platforms, or cancer types is still an elusive endeavor. Besides the inherent difficulty of the large and nonconstant variability in these experiments and the incommensurability between different microarray technologies, there is the issue of the users having to adjust a series of parameters that significantly affect the outcome of the analyses and that do not have a biological or medical meaning. In this study, the identification of potential cancer biomarkers from microarray data is casted as a multiple criteria optimization (MCO) problem. The efficient solutions to this problem, found here through data envelopment analysis (DEA), are associated to genes that are proposed as potential cancer biomarkers. The method does not require any parameter adjustment by the user, and thus fosters repeatability. The approach also allows the analysis of different microarray experiments, microarray platforms, and cancer types simultaneously. The results include the analysis of three publicly available microarray databases related to cervix cancer. This study points to the feasibility of modeling the selection of potential cancer biomarkers from microarray data as an MCO problem and solve it using DEA. Using MCO entails a new optic to the identification of potential cancer biomarkers as it does not require the definition of a threshold value to establish significance for a particular gene and the selection of a normalization procedure to compare different experiments is no longer necessary.

Background: Many engineering education researchers acknowledge that their positionality impacts their research. Practices for reporting positionality vary widely and rarely incorporate a nuanced discussion of the impact of demographic identities on research. Researchers holding marginalized or relatively hidden identities must navigate additional layers regarding transparency of their positionality. Purpose: We identify ways in which positionality impacts research, with a particular emphasis on demographic identity dimensions. We note that whether identities are relatively marginalized, privileged, hidden, or apparent in a research context creates complexities for conceptualizing, practicing, and disclosing one's positionality. Method: In a collaborative inquiry informed by autoethnography, we assemble positionality reflections of current engineering education researchers to demonstrate the primary ways in which positionality impacts research. Results: We find that positionality impacts six fundamental aspects of research: research topic, epistemology, ontology, methodology, relation to participants, and communication. These aspects of research delve deeper than conceptions of positionality as a methodological limitation, a measure to prevent bias, or a requirement for research quality. Conclusion: The impact of positionality on research is complex, particularly when researchers occupy minoritized identities and for research topics that interrogate power relations between identity groups. By demonstrating the practices of interrogating and representing positionality, we hope to encourage more researchers to represent positionality transparently, thus making researchers' transparency safer for all. We argue that positionality is an important tool for reflecting on and dislocating privilege, particularly when working on equity research.

Abstract The Coma Recovery Scale-revised (CRS-r) is the gold standard for the behavioral assessment of patients with Disorders of Consciousness (DoCs). However, the misdiagnosis rate is around 40%. For this reason, recent guidelines suggested enhancing the assessment with neurophysiological measures: among these, surface electromyography (sEMG) represents a convenient bedside solution. This work presents the use of the STRIVEfc system, a wearable device that allows CRS-r administration while recording four sEMG signals. STRIVEfc was employed in 40 sessions on 33 DoCs patients and the sEMG was analyzed to look for voluntary and consistent over threshold (OT) muscular activities. Their duration, amplitude, and number were retained and compared between patients in Unresponsive Wakefulness Syndrome (UWS) and Minimally Conscious State (MCS), revealing more numerous and significantly longer OTs in the latter group. Lastly, the EMG information was exploited to enrich the behavioral assessment by building the instrumented CRS-r score (ICRS-r). In 9/16 UWS sessions, the ICRS-r score suggested a higher-level functioning, not translated into a behavioral response, compatible with MCS diagnosis. Overall, the use of STRIVEfc allows to reveal hidden muscular patterns not detectable by the clinician, thus improving the characterization of DoCs patient’s functional capabilities and supporting the diagnostic process.

Abstract Background and aim Migraine is a common disabling conditions which, globally, affects 15.2% of the population. It is the second cause of health loss in terms of years lived with disability, the first among women. Despite being so common, it is poorly recognised and too often undertreated. Specialty centres and neurologists with specific expertise on headache disorders have the knowledge to provide specific care: however, those who do not regularly treat patients with migraine will benefit from a synopsis on the most relevant and updated information about this condition. This paper presents a comprehensive view on the hallmarks of migraine, from genetics and diagnostic markers, up to treatments and societal impact, and reports the elements that identify migraine specific features. Main results The most relevant hallmark of migraine is that it has common and individual features together. Besides the known clinical manifestations, migraine presentation is heterogeneous with regard to frequency of attacks, presence of aura, response to therapy, associated comorbidities or other symptoms, which likely reflect migraine heterogeneous genetic and molecular basis. The amount of therapies for acute and for prophylactic treatment is really wide, and one of the difficulties is with finding the best treatment for the single patient. In addition to this, patients carry out different daily life activities, and might show lifestyle habits which are not entirely adequate to manage migraine day by day. Education will be more and more important as a strategy of brain health promotion, because this will enable reducing the amount of subjects needing specialty care, thus leaving it to those who require it in reason of refractory condition or presence of comorbidities. Conclusions Recognizing the hallmarks of migraine and the features of single patients enables prescribing specific pharmacological and non-pharmacological treatments. Medical research on headaches today particularly suffers from the syndrome of single-disease approach, but it is important to have a cross-sectional and joint vision with other close specialties, in order to treat our patients with a comprehensive approach that a heterogeneous condition like migraine requires.

IntroductionCD38 is an ectoenzyme receptor found on hematopoietic cells and its expression is used in the flow cytometric analysis of sub-populations of circulating B cells among peripheral blood mononuclear cells (PBMC) to aid in diagnosing patients with different antibody production defects (AbD). Monoclonal antibodies derived from the sea lamprey Variable Lymphocyte Receptor B (VLRB) are emerging as an alternative to conventional mammalian antibodies. We hypothesized that VLRB MM3 (V-CD38) which specifically recognizes CD38 in a manner correlating with its enzymatic activity could identify terminally differentiated B cells in human PBMC. Here we investigate the ability of V-CD38 as a tool to diagnose patients with diverse immune abnormalities including AbD.MethodsThe expression of CD38 on CD3-CD19+CD27+ plasmablasts and CD3-CD19+IgMhiCD27- transitional B cells in PBMC was analyzed by flow cytometry using V-CD38 and compared with a commercial conventional antibody to CD38 (C-CD38).ResultsA highly significant correlation (p

Drought significantly impacts freshwater ecosystems, disrupting all biological levels. In particular, freshwater macroinvertebrates undergo significant changes in taxonomic and functional diversity bioassessments. The effects often synergize with other stressors, such as pollution that drought can exacerbate. Several techniques have been well-developed (traditional) or have the potential (innovative) to address this issue. This review provides a comprehensive description of the impact of drought as a primary stressor on macroinvertebrate diversity. An overview of the research and projections are presented. Three conceptual pillars drive this study: taxonomic-functional responses, simultaneous pressure dynamics, and innovative techniques. Few studies have been conducted on lentic water bodies, arid and semi-arid systems, and on multiple continents. Common research keywords across continents are observed less frequently in experimental than in field studies. Most analyzed studies examine community structure, which is more common in field-based than experimental studies. Agricultural land use effect, urbanization, and invasive species are the stressors most associated with drought. Integrating traditional with advanced/innovative techniques that have hardly been applied makes it challenging to understand ecological responses comprehensively. If innovative techniques are employed to consider the dynamics of multiple stressors and to consistently estimate taxonomic and functional diversity, promising avenues for future research could be uncovered.

Abstract Objective With potential therapies for many forms of Charcot‐Marie‐Tooth disease (CMT), responsive outcome measures are urgently needed for clinical trials. Quantitative lower limb MRI demonstrated progressive calf intramuscular fat accumulation in the commonest form, CMT1A with large responsiveness. In this study, we evaluated the responsiveness and validity in the three other common forms, due to variants in GJB1 (CMTX1), MPZ (CMT1B) and MFN2 (CMT2A). Methods 22 CMTX1, 21 CMT1B and 21 CMT2A patients and matched controls were assessed at a 1‐year interval. Intramuscular fat fraction (FF) was evaluated using three‐point Dixon MRI at thigh and calf level along with clinical measures including CMT examination score, clinical strength assessment, CMT‐HI and plasma neurofilament light chain. Results All patient groups had elevated muscle fat fraction at thigh and calf levels, with highest thigh FF and atrophy in CMT2A. There was moderate correlation between calf muscle FF and clinical measures (CMTESv2 rho = 0.405; p = 0.001, ankle MRC strength rho = −0.481; p

Abstract The World Health Organization (WHO) Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders was developed by WHO to address the worldwide challenges and gaps in provision of care and services for people with epilepsy and other neurological disorders and to ensure a comprehensive, coordinated response across sectors to the burden of neurologic diseases and to promote brain health across life-course. Headache disorders constitute the second most burdensome of all neurological diseases after stroke, but the first if young and midlife adults are taken into account. Despite the availability of a range of treatments, disability associated with headache disorders, and with migraine, remains very high. In addition, there are inequalities between high-income and low and middle income countries in access to medical care. In line with several brain health initiatives following the WHOiGAP resolution, herein we tailor the main pillars of the action plan to headache disorders: (1) raising policy prioritization and strengthen governance; (2) providing effective, timely and responsive diagnosis, treatment and care; (3) implementing strategies for promotion and prevention; (4) fostering research and innovation and strengthen information systems. Specific targets for future policy actions are proposed. The Global Action Plan triggered a revolution in neurology, not only by increasing public awareness of brain disorders and brain health but also by boosting the number of neurologists in training, raising research funding and making neurology a public health priority for policy makers. Reducing the burden of headache disorders will not only improve the quality of life and wellbeing of people with headache but also reduce the burden of neurological disorders increasing global brain health and, thus, global population health.

La nueva tendencia del desarrollo de las tecnologías de la información y la comunicación significa un salto en cuanto a la mejora de la calidad, más aún en situación adversas como las derivadas por la pandemia de la COVID-19. El análisis de los riesgos y el aprovechamiento de las oportunidades constituyen las premisas para el presente trabajo el cual se trazó como objetivo el análisis del contexto actual y la propuesta de soluciones de mejora para la entrega de los resultados de los servicios al cliente considerando la digitalización de la información. Para ello se realizó una revisión documental puntualizando en las solicitudes de los clientes, las salidas de los informes, la evaluación de la satisfacción del cliente, los resultados de las propias revisiones por la dirección y los análisis de riesgos realizados en el sistema. Los resultados indicaron la mejora continua del sistema y la fidelización del cliente durante todo el período de estudio. No obstante, dadas las condiciones actuales por las que atraviesa el mundo y en particular Cuba, especialmente para períodos de situaciones adversas, se identificaron brechas que pueden ser enmendadas insertando la gestión de las firmas digitales en los informes de resultado, apoyado en las técnicas criptográficas, de acuerdo con lo dispuesto en la Resolución 23/2022 del Ministerio de Interior.

Abstract The 2030 Agenda for Sustainable Development sets out, through 17 Sustainable Development Goals (SDGs), a path for the prosperity of people and the planet. SDG 3 in particular aims to ensure healthy lives and promote well-being for all at all ages and includes several targets to enhance health. This review presents a “headache-tailored” perspective on how to achieve SDG 3 by focusing on six specific actions: targeting chronic headaches; reducing the overuse of acute pain-relieving medications; promoting the education of healthcare professionals; granting access to medication in low- and middle-income countries (LMIC); implementing training and educational opportunities for healthcare professionals in low and middle income countries; building a global alliance against headache disorders. Addressing the burden of headache disorders directly impacts on populations’ health, as well as on the possibility to improve the productivity of people aged below 50, women in particular. Our analysis pointed out several elements, and included: moving forward from frequency-based parameters to define headache severity; recognizing and managing comorbid diseases and risk factors; implementing a disease management multi-modal management model that incorporates pharmacological and non-pharmacological treatments; early recognizing and managing the overuse of acute pain-relieving medications; promoting undergraduate, postgraduate, and continuing medical education of healthcare professionals with specific training on headache; and promoting a culture that favors the recognition of headaches as diseases with a neurobiological basis, where this is not yet recognized. Making headache care more sustainable is an achievable objective, which will require multi-stakeholder collaborations across all sectors of society, both health-related and not health-related. Robust investments will be needed; however, considering the high prevalence of headache disorders and the associated disability, these investments will surely improve multiple health outcomes and lift development and well-being globally.

Abstract Background Metastatic disease in tumors originating from the gastrointestinal tract can exhibit varying degrees of tumor burden at presentation. Some patients follow a less aggressive disease course, characterized by a limited number of metastatic sites, referred to as “oligo-metastatic disease” (OMD). The precise biological characteristics that define the oligometastatic behavior remain uncertain. In this study, we present a protocol designed to prospectively identify OMD, with the aim of proposing novel therapeutic approaches and monitoring strategies. Methods The PREDICTION study is a monocentric, prospective, observational investigation. Enrolled patients will receive standard treatment, while translational activities will involve analysis of the tumor microenvironment and genomic profiling using immunohistochemistry and next-generation sequencing, respectively. The first primary objective (descriptive) is to determine the prevalence of biological characteristics in OMD derived from gastrointestinal tract neoplasms, including high genetic concordance between primary tumors and metastases, a significant infiltration of T lymphocytes, and the absence of clonal evolution favoring specific driver genes (KRAS and PIK3CA). The second co-primary objective (analytic) is to identify a prognostic score for true OMD, with a primary focus on metastatic colorectal cancer. The score will comprise genetic concordance (> 80%), high T-lymphocyte infiltration, and the absence of clonal evolution favoring driver genes. It is hypothesized that patients with true OMD (score 3+) will have a lower rate of progression/recurrence within one year (20%) compared to those with false OMD (80%). The endpoint of the co-primary objective is the rate of recurrence/progression at one year. Considering a reasonable probability (60%) of the three factors occurring simultaneously in true OMD (score 3+), using a significance level of α = 0.05 and a test power of 90%, the study requires a minimum enrollment of 32 patients. Discussion Few studies have explored the precise genetic and biological features of OMD thus far. In clinical settings, the diagnosis of OMD is typically made retrospectively, as some patients who undergo intensive treatment for oligometastases develop polymetastatic diseases within a year, while others do not experience disease progression (true OMD). In the coming years, the identification of true OMD will allow us to employ more personalized and comprehensive strategies in cancer treatment. Trial registration ClinicalTrials.gov ID NCT05806151.

The present study provides a detailed macroscopic examination (with some microscopic insights) of the genital apparatus of seven adult and intact male sugar gliders, as well as one castrated individual. The scrotum is pendulous and attached to the ventral abdominal wall, situated in the caudal part of the abdomen and cranial to the cloacal opening. The testes are oval shaped with their long axes oriented vertically. The epididymides are attached along the caudomedial border of their respective testes. The head and tail of the epididymides are in close proximity to the poles of the testes but are not directly attached. The deferent ducts are positioned laterally to their ipsilateral ureter as they run near the dorsal surface of the urinary bladder. The ampulla of the deferent duct is absent. The penis is located post-scrotally, lacks insertion into the bony pelvis, and has a bifid distal end. The crura of the penis originate within the ischiocavernosus muscles, and there are two bulbs of the penis. When flaccid, the entire penis is concealed in the perineal region and externalizes through an orifice situated in the ventral part of the cloaca, traversing its floor towards the cloacal opening. The urethral external orifice is positioned at the point where the bifurcation of the free part of the penis begins. The prostate gland resides in the pelvic cavity and consists of two parts: a macroscopically visible body surrounding the urethra and a microscopically identifiable portion embedded within the walls of the duct. Sugar gliders possess two pairs of bulbous bulbourethral glands, located dorsally and laterally to the rectum, but lack vesicular glands.

Fish by-products can be converted into high-value-added products like fish protein hydrolysates (FPHs), which have high nutritional value and are rich in bioactive peptides with health benefits. This study aims to characterise FPHs derived from salmon heads (HPSs) and Cape hake trimmings (HPHs) using Alcalase for enzymatic hydrolysis and Subcritical Water Hydrolysis (SWH) as an alternative method. All hydrolysates demonstrated high protein content (70.4–88.7%), with the degree of hydrolysis (DH) ranging from 10.7 to 36.4%. The peptide profile of FPHs indicated the breakdown of proteins into small peptides. HPSs showed higher levels of glycine and proline, while HPHs had higher concentrations of glutamic acid, leucine, threonine, and phenylalanine. Similar elemental profiles were observed in both HPHs and HPSs, and the levels of Cd, Pb, and Hg were well below the legislated limits. Hydrolysates do not have a negative effect on cell metabolism and contribute to cell growth. HPSs and HPHs exhibited high 2,2′–azino-bis(3 ethylbenzthiazoline-6)-sulfonic acid (ABTS) radical scavenging activity, Cu2+ and Fe2+ chelating activities, and angiotensin-converting enzyme (ACE) inhibitory activity, with HPHs generally displaying higher activities. The α-amylase inhibition of both FPHs was relatively low. These results indicate that HPHs are a promising natural source of nutritional compounds and bioactive peptides, making them potential candidates for use as an ingredient in new food products or nutraceuticals. SWH at 250 °C is a viable alternative to enzymatic methods for producing FPHs from salmon heads with high antioxidant and chelating properties.

A growing interest in the recovery and enhancement of crops, particularly local varieties such as ‘Caaveiro’ wheat, has been observed. This study aims to investigate the impact of cultivation systems (organic versus conventional) on the nutritional quality of ‘Caaveiro’ flour and breads protected by the PGI “Pan Galego,” employing two fermentation methods (sourdough versus sourdough and biological yeast). Organic flour exhibited significantly higher levels of moisture, fat, sucrose, phosphorus (P), sodium (Na), and copper (Cu) while also exhibiting a lower total starch and zinc (Zn) content. Organic bread, produced using both fermentation methods, demonstrated significantly higher protein, carbohydrate, total, resistant, and rapidly digestible starch, ash, Na, P, iron (Fe), and Cu content. Additionally, they contained less moisture compared to conventional bread. Despite variations in nutritional characteristics based on the cultivation system, the organic approach proved effective at producing high-quality products with a positive environmental impact, which is highly appreciated by consumers.

Objetivo: Los trabajadores de la salud se enfrentaron a niveles sin precedentes de carga emocional relacionada con la pandemia de la COVID-19. Este estudio pretende conocer la autopercepción del estado de sobrecarga emocional de los profesionales del Servicio Navarro de Salud-Osasunbidea (SNS-O) en dos momentos durante la pandemia y sus factores asociados. Método: Estudio transversal mediante el uso de un cuestionario que incluye la Escala de Autoevaluación de Sobrecarga Emocional, enviado por correo electrónico a todos los profesionales sanitarios del SNS-O en dos momentos de la pandemia, en octubre de 2020 y octubre de 2021. Los resultados de la escala global y de las subescalas ‘“miedos-ansiedad”’ y ‘“respuesta afectiva”’ se compararon entre los dos momentos de medición según puesto de trabajo, ámbito, área y servicio, mediante modelos ANCOVA?. Resultados: Participaron en la encuesta de 2020 1.485 (11,3%) sanitarios y 950 (7,3%) en la encuesta de 2021 de. La diferencia media para el score global entre 2020 y 2021 fue -1.87 (95% IC: -2.38, -1.35), indicando una reducción de la sobrecarga emocional con la evolución de la pandemia, con algunas diferencias entre categorías profesionales. Conclusiones: El año 2020 tuvo gran impacto en la sobrecarga emocional que disminuyó al año siguiente. Uno de los mayores temores del personal sanitario durante su exposición laboral a enfermedades infecciosas epidémicas sigue siendo el miedo a contraer la enfermedad y transmitirla a sus familiares y entorno social. Conforme aumenta la proximidad con el paciente y su entorno, incrementa la probabilidad de afectación psicoemocional.

Dentro del proceso inversionista del Centro Nacional de Investigaciones Científicas se proyecta la planta de producción industrial del ingrediente activo Palmex, indicado para el tratamiento de la hiperplasia prostática benigna. Esta planta permitirá sustituir importaciones y un significativo aporte al cuadro de medicamentos del país. Para dar cumplimiento a los requerimientos ambientales de la inversión, el presente trabajo se trazó como objetivo caracterizar las aguas residuales de las producciones de este ingrediente, con vistas a proponer un esquema tecnológico de tratamiento para la planta industrial. Estos residuos presentan características oleosas, con variación en su composición y flujo. Los resultados indicaron altas concentraciones de materia orgánica (14 950 mg DQO L- 1), grasas y aceites (263 mg L-1), conductividad eléctrica (8 251 μS cm- 1) y sólidos totales (6 268 mg L-1). Se evaluaron diferentes condiciones, tanto a nivel de laboratorio como de banco. A partir de los resultados de la eficiencia de reducción de los indicadores ambientales obtenidos y de la estimación del balance de la carga contaminante se propuso el esquema de tratamiento, el cual consta de los órganos siguientes: tamiz-sedimentador, tanque homogeneizador-1, trampa de grasas-sedimentador primario, tanque de compensación, tanque homogeneizador-2, sistema de ozonización y tanque séptico-filtro biológico. Esta secuencia garantizó que los efluentes tratados cumplieran con la norma de vertimiento NC 27:2012, al sistema de alcantarillado. Los resultados constituyen la base de la Tarea Técnica de la planta de tratamiento de aguas residuales de la planta de producción a escala industrial presentada, como requerimiento de la inversión,

Abstract Aim When studying brain networks in patients with Disorders of Consciousness (DoC), it is important to evaluate the structural integrity of networks in addition to their functional activity. Here, we investigated whether structural MRI, together with clinical variables, can be useful for diagnostic purposes and whether a quantitative analysis is feasible in a group of chronic DoC patients. Methods We studied 109 chronic patients with DoC and emerged from DoC with structural MRI: 65 in vegetative state/unresponsive wakefulness state (VS/UWS), 34 in minimally conscious state (MCS), and 10 with severe disability. MRI data were analyzed through qualitative and quantitative approaches. Results The qualitative MRI analysis outperformed the quantitative one, which resulted to be hardly feasible in chronic DoC patients. The results of the qualitative approach showed that the structural integrity of HighOrder networks, altogether, had better diagnostic accuracy than LowOrder networks, particularly when the model included clinical variables (AUC = 0.83). Diagnostic differences between VS/UWS and MCS were stronger in anoxic etiology than vascular and traumatic etiology. MRI data of all LowOrder and HighOrder networks correlated with the clinical score. The integrity of the left hemisphere was associated with a better clinical status. Conclusions Structural integrity of brain networks is sensitive to clinical severity. When patients are chronic, the qualitative analysis of MRI data is indicated.

La tercera edición de la norma ISO/IEC 17025 tuvo cambios significativos con respecto a su versión antecesora como son, el enfoque y estructura basados en el proceso, el pensamiento y acción basados en el riesgo y el nuevo requisito de imparcialidad y confidencialidad, entre otros, no menos importantes. El problema fue cómo afrontar la transición hacia esta tercera versión de la norma y cumplir con todos sus requisitos. El Grupo de Gestión de los Servicios Científico-Técnicos DECA (GG SCT-DECA), del CNIC tiene como misión proporcionar Servicios Científico-técnicos (SCT) especializados para la caracterización de aguas, aguas residuales y residuos sólidos, el diseño y la tarea técnica de soluciones tecnológicas de tratamiento, así como servicios en protección de materiales. Todos ellos están cubiertos por un sistema de gestión de acuerdo con la NC- ISO / IEC 17025 y acreditado por el Órgano Nacional de Acreditación de la República de Cuba (ONARC). El trabajo tuvo como objetivo la estrategia a seguir en el Grupo para dar cumplimiento a los nuevos requisitos de la ISO/IEC 17025. El proceder de, tipo descriptivo y cualitativo, tuvo en cuenta los principales cambios, tomando como guía una correlación entre la segunda y tercera edición de la norma, lo cual permitió, conjuntamente con una revisión documental, definir que faltaba por hacer o mejorar. Se definieron las acciones necesarias para dar conformidad a los nuevos requisitos de la tercera edición y se elaboró un plan, estableciendo los plazos de cumplimiento y los responsables para ejecutarlos. Entre otras acciones, se elaboro

Monk Parakeets are considered one of the most invasive bird species given its unique capacity among psittacines to build their own communal nests. Originally introduced as pets in houses from where they escaped or were released, they are currently considered invasive in more than 20 countries worldwide. This is the case in Chile, where Monk Parakeets were introduced during the 1970s. Between 2016 and 2019 we searched Monk Parakeets’ nests structures in the Santiago metropolis region. We identified 1458 Monk Parakeets’ communal nests on 546 trees belonging to 34 tree species. Ninety-one percent of the occupied trees were also introduced. Paraná pine and cedar of Lebanon were the tree species with highest abundance of nests, averaging more than four nests/tree/species, with 23 and 18 maximum number of nests, respectively. Tasmanian blue gum and black locust were selected by parakeets more often than expected, based on availability. From all trees, 24.6% denoted health problems and 47.3% were pruned. The average nest height was 14.2 m and nests were observed mainly in secondary branches (59.3%). The occupancy rate was 89.7% and was associated to nest height and type of branch. During two reproductive seasons we quantified eggs and nestlings in chambers averaging 4.5 and 4.2, respectively. We provide a rough population size estimate and the characteristics of Monk Parakeets nest and tree selectivity, aiming to characterize several decades of a neglected urban invasion to warrant strategies for improved management measures.

Abstract Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability. Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.

A significant number of people, following acute SARS-CoV-2 infection, report persistent symptoms or new symptoms that are sustained over time, often affecting different body systems. This condition, commonly referred to as Long-COVID, requires a complex clinical management. In Italy new health facilities specifically dedicated to the diagnosis and care of Long-COVID were implemented. However, the activity of these clinical centers is highly heterogeneous, with wide variation in the type of services provided, specialistic expertise and, ultimately, in the clinical care provided. Recommendations for a uniform management of Long-COVID were therefore needed. Professionals from different disciplines (including general practitioners, specialists in respiratory diseases, infectious diseases, internal medicine, geriatrics, cardiology, neurology, pediatrics, and odontostomatology) were invited to participate, together with a patient representative, in a multidisciplinary Panel appointed to draft Good Practices on clinical management of Long-COVID. The Panel, after extensive literature review, issued recommendations on 3 thematic areas: access to Long-COVID services, clinical evaluation, and organization of the services. The Panel highlighted the importance of providing integrated multidisciplinary care in the management of patients after SARS-CoV-2 infection, and agreed that a multidisciplinary service, one-stop clinic approach could avoid multiple referrals and reduce the number of appointments. In areas where multidisciplinary services are not available, services may be provided through integrated and coordinated primary, community, rehabilitation and mental health services. Management should be adapted according to the patient’s needs and should promptly address possible life-threatening complications. The present recommendations could provide guidance and support in standardizing the care provided to Long-COVID patients.

En el presente trabajo se presentan los principales resultados obtenidos del análisis del comportamiento de las aguas residuales en la Empresa Centro Nacional de Investigaciones Científicas. Para ello se colectó y analizó la información de los resultados analíticos emitidos por el Laboratorio acreditado “Grupo de Gestión de los Servicios Científico Técnicos – DECA”, por la NC-ISO/IEC 17025:2017, referente a la caracterización de las aguas residuales que se vierten en el centro, contemplando un período de 15 años de trabajo sostenido. La investigación consideró dos etapas, una inicial en condiciones estables de las actividades de la institución y una segunda, en el cual se introducen nuevas descargas generadas de la diversificación de los procesos productivos y su impacto al medio ambiente. Además, tuvo en cuenta el marco legal amparado en las normas cubanas de vertimiento de aguas residuales vigentes. El estudio permitió caracterizar los residuos líquidos, no solo desde el punto de vista físico – químico, sino también de su biodegradabilidad, la carga orgánica dispuesta al sistema de alcantarillado y su aporte al sistema de tratamiento de la comunidad. De esta forma se identifica y sienta la línea base a partir de la cual se mantendrá la evaluación del comportamiento de los vertimientos originados por la incorporación de nuevas líneas de producción o servicios, debido a la reorganización de la empresa hacia una comercialización sostenible, con el control del cumplimiento de las regulaciones ambientales.

Abstract The Global Campaign against Headache, as a collaborative activity with the World Health Organization (WHO), was formally launched in Copenhagen in March 2004. In the month it turns 18, we review its activities and achievements, from initial determination of its strategic objectives, through partnerships and project management, knowledge acquisition and awareness generation, to evidence-based proposals for change justified by cost-effectiveness analysis.

The quest for biocompatible drug-delivery devices that could be able to open new administration routes is at the frontier of biomedical research. In this contribution, porous polysaccharide-based microsponges based on crosslinked alginate polymers were developed and characterized by optical spectroscopy and nanoscopic microscopy techniques. We show that macropores with a size distribution ranging from 50 to 120 nm enabled efficient loading and delivery of a therapeutic peptide (CIGB814), presently under a phase 3 clinical trial for the treatment of rheumatoid arthritis. Alginate microsponges showed 80% loading capacity and sustained peptide release over a few hours through a diffusional mechanism favored by partial erosion of the polymer scaffold. The edible and biocompatible nature of alginate polymers open promising perspectives for developing a new generation of polysaccharide-based carriers for the controlled delivery of peptide drugs, exploiting alternative routes with respect to intravenous administration.

La norma ISO/IEC 17025 es la referencia internacional, desarrollada con el objetivo de establecer requisitos para acreditar el Sistema de Gestión de la Calidad y la Competencia Técnica de los Laboratorios de ensayo y/o calibración. La tercera edición del 2017, presenta una transformación importante, adaptándose a la estructura de alto nivel de las normas para sistemas de gestión de ISO, con una mayor orientación del proceso, la implementación del pensamiento y la acción basados en el riesgo, sustituyendo las acciones preventivas por el análisis de riesgo en varios de sus requisitos. Los servicios analíticos del Laboratorio Grupo de Gestión de los Servicios Científico-Técnicos DECA, del Centro Nacional de Investigaciones Científicas, están cubiertos por un Sistema de Gestión de acuerdo con la NC-ISO / IEC 17025: 2017, que garantiza la validez de los resultados de ensayo y la satisfacción sostenible de las expectativas del cliente y está acreditado por el Órgano Nacional de Acreditación de la República de Cuba. Este trabajo tuvo como objetivo implementar una metodología para abordar la gestión de los riesgos y las oportunidades asociados con las actividades del Laboratorio, satisfaciendo requisitos de la norma. Se realizó una tormenta de ideas, se identificaron los factores internos y externos que pueden limitar el logro de los objetivos del Laboratorio, se confeccionó una matriz de debilidades, amenazas, fortalezas y oportunidades, se identificaron las partes interesadas y sus expectativas. La metodología implementada permitió identificar los riesgos y las oportunidades en el contexto de las operaciones del Laboratorio, analizar la probabilidad de

The biological properties of therapeutic peptides, such as their pharmacokinetics and pharmacodynamics, are correlated with their structure and aggregation properties. Herein, we studied the aggregation properties of a therapeutic peptide (CIGB-814), currently in phase 2 clinical trial, for the treatment of rheumatoid arthritis over a wide range of concentrations (µM–mM). We applied spectroscopic techniques (fluorescence, circular dichroism, resonance, and dynamic light scattering), atomic force microscopy, and molecular dynamics simulations to determine the aggregation mechanism of CIGB-814. We found that the hierarchical aggregation of CIGB-814 at micromolar concentrations was initiated by the formation of peptide oligomers. Subsequently, the peptide oligomers trigger the nucleation and growth of peptide nanostructures (cac = 123 µM), ultimately leading to the fibrillization of CIGB-814 (cac’ = 508 µM). These results pave the way for a deeper understanding of the CIGB-814 therapeutic activity and may give important insights on its pharmacokinetics.

IntroductionBeing able to write is a key competency in educational models; therefore, it is important to have a scale to assess writing self-efficacy.ObjectiveThe study evaluated the internal structure, providing evidence of reliability, validity, and factorial invariance of the self-efficacy for writing scale (SEWS) across sex and age in Peruvian schoolchildren.MethodsAn instrumental study was carried out on 1,107 Peruvian adolescents (early, middle, and late) of school age. A confirmatory factor analysis was carried out and the factorial invariance for sex and age was evaluated.ResultsA good fit was obtained for the total sample (χ2 = 1229.08, df = 101, CFI = 0.997, TLI = 0.997, RMSEA = 0.057 [90% CI: 0.0540.059], and SRMR = 0.029) and presented good α, ω, and H reliability (>0.89). Correlations between another measure of writing self-efficacy (p = 0.76; p < .01), study satisfaction (p = 0.31; p < .01), and burnout (p = −0.12; p < .01) scales supported convergent and concurrent validity. Multigroup factor analysis supported strict invariance for sex and age, for which the SEWS provides evidence of validity and reliability.DiscussionThis adaptation of the SEWS is a valid, reliable, and invariant measure that can be considered for assessing self-efficacy for writing in Peruvian high school students.

BackgroundThere is limited research examining the impact of risk and protective factors on late-life depression using large population-based datasets, particularly those examining differences among older migrants and non-migrants in Europe countries. Thus, the first aim was to analyze differences between migrants and non-migrants regarding socioeconomic status, depression, multimorbidity, healthy aging, and lifestyle behaviors. The second aim was to examine the impact of healthy aging on late-life depression in older migrants compared to their counterparts without a history of international migration in extensive and harmonized data from different population-based cohort studies.Materials and methodsWe analyzed cross-sectional, predominantly nationally representative, community-based data from European participants in the Aging Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) cohort. The descriptive analyses included sociodemographic variables, somatic comorbidities, multimorbidity, healthy aging, and lifestyle behaviors according to migration status. The effects of these variables on late-life depression were examined in a multivariate logistic regression model, including migration status and years since migration as predictors.ResultsData of 122,571 individuals aged ≥ 50 years were analyzed, of which 11,799 (9.60%) were migrants. The descriptive analyses indicated that compared to non-migrants, migrants showed a higher prevalence of diabetes (25.6%), hypertension (38.0%), coronary artery disease (49.4%), stroke (4.9%), and depression (31.1%). Healthy aging was also better in non-migrants (51.7; SD = 9.7) than in migrants (39.6; SD = 18.2). The results of the logistic regression showed that migration status [OR = 1.231 (CIs: 0.914–1.547)] and increased number of years since migration in the host country [OR = 0.003 (CIs: 0.001–0.005)] were associated with greater levels of depressive symptoms. Concerning health variables, multimorbidity was associated with higher levels of depressive symptoms [OR = 0.244 (CIs: 0.211–0.278)], whereas better healthy aging was associated with fewer depressive symptoms [OR = -0.100 (CIs: -0.102 to -0.098)]. The interaction between migration and healthy aging status was also significant [OR. = -0.019 (CIs: -0.025 to -0.014)].ConclusionMigrants reported higher risks for worse health outcomes compared to non-migrants. Significantly, worse healthy aging was associated with a greater risk of depressive symptoms in migrants than in non-migrants. Shedding light on migration and aging processes is essential for promoting a cross-cultural understanding of late-life depression in Europe.

We dissected carcasses of eight mature females, both parous and non-parous specimens, to study the macroscopic anatomy of the female reproductive system in the sugar glider. The genital system includes double organs, namely the right and left ones, which are completely separated. It includes two ovaries, two oviducts, two uteri and a vaginal complex. The uteri are fusiform-shaped and lack horns. The vaginal complex includes two lateral vaginae and a median vagina, also called the ‘birth canal’. The cranial end of both lateral vaginae partially fuses, forming an expansion named the vaginal sinus, which is divided into two parts by a longitudinal septum, one for each vagina, where the ipsilateral uterine cervix opens. The caudal end of the lateral vaginae opens into a medial and impar duct: the urogenital sinus that serves as a common passage for the reproductive and urinary systems. In non-pregnant females, only the lateral vaginae are present. In pregnant and recently parous females, a short median vagina extends from the caudal wall of the vaginal sinus to the cranial end of the urogenital sinus. In the ventral wall of this sinus, next to its caudal opening, there is a forked clitoris.

Abstract Background There have been several calls for estimations of costs and consequences of headache interventions to inform European public-health policies. In a previous paper, in the absence of universally accepted methodology, we developed headache-type-specific analytical models to be applied to implementation of structured headache services in Europe as the health-care solution to headache. Here we apply this methodology and present the findings. Methods Data sources were published evidence and expert opinions, including those from an earlier economic evaluation framework using the WHO-CHOICE model. We used three headache-type-specific analytical models, for migraine, tension-type-headache (TTH) and medication-overuse-headache (MOH). We considered three European Region case studies, from Luxembourg, Russia and Spain to include a range of health-care systems, comparing current (suboptimal) care versus target care (structured services implemented, with provider-training and consumer-education). We made annual and 5-year cost estimates from health-care provider and societal perspectives (2020 figures, euros). We expressed effectiveness as healthy life years (HLYs) gained, and cost-effectiveness as incremental cost-effectiveness-ratios (ICERs; cost to be invested/HLY gained). We applied WHO thresholds for cost-effectiveness. Results The models demonstrated increased effectiveness, and cost-effectiveness (migraine) or cost saving (TTH, MOH) from the provider perspective over one and 5 years and consistently across the health-care systems and settings. From the societal perspective, we found structured headache services would be economically successful, not only delivering increased effectiveness but also cost saving across headache types and over time. The predicted magnitude of cost saving correlated positively with country wage levels. Lost productivity had a major impact on these estimates, but sensitivity analyses showed the intervention remained cost-effective across all models when we assumed that remedying disability would recover only 20% of lost productivity. Conclusions This is the first study to propose a health-care solution for headache, in the form of structured headache services, and evaluate it economically in multiple settings. Despite numerous challenges, we demonstrated that economic evaluation of headache services, in terms of outcomes and costs, is feasible as well as necessary. Furthermore, it is strongly supportive of the proposed intervention, while its framework is general enough to be easily adapted and implemented across Europe.