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Abstract In recent years, graphene field-effect-transistors (GFETs) have demonstrated an outstanding potential for terahertz (THz) photodetection due to their fast response and high-sensitivity. Such features are essential to enable emerging THz applications, including 6G wireless communications, quantum information, bioimaging and security. However, the overall performance of these photodetectors may be utterly compromised by the impact of internal resistances presented in the device, so-called access or parasitic resistances. In this work, we provide a detailed study of the influence of internal device resistances in the photoresponse of high-mobility dual-gate GFET detectors. Such dual-gate architectures allow us to fine tune (decrease) the internal resistance of the device by an order of magnitude and consequently demonstrate an improved responsivity and noise-equivalent-power values of the photodetector, respectively. Our results can be well understood by a series resistance model, as shown by the excellent agreement found between the experimental data and theoretical calculations. These findings are therefore relevant to understand and improve the overall performance of existing high-mobility graphene photodetectors. Graphical Abstract

Abstract Seaweed consumption has gained popularity due to its nutritional value and potential health benefits. However, concerns regarding the bioaccumulation of several trace elements highlight the need for comprehensive studies on exposure associated with seaweed consumption. To address this gap in knowledge, we carried out a feeding intervention study of three common edible seaweeds (Nori, Kombu, and Wakame) in 11 volunteers, aiming to elucidate the extent of both beneficial and harmful trace element exposure through seaweed consumption in humans. Concentrations of total arsenic, cobalt, copper, cadmium, iodine, molybdenum, selenium, and zinc were measured in urine samples before and following seaweed consumption. Elements concentrations were also measured in the seaweeds provided for the study. Descriptive analysis for each element were conducted and we used quantile g-computation approach to assess the association between the 8-element mixture and seaweed consumption. Differences in urine element concentrations and seaweed consumption were analyzed using generalized estimating equations (GEE). Urinary concentrations of iodine and total arsenic increased after seaweed consumption. When we analyze the 8-element mixture, the largest weight was observed for iodine after Kombu consumption while for total arsenic was observed after Wakame consumption. Similar results were observed when we compared the mean differences between the elements before and after seaweed consumption through the GEE. Seaweed consumption relates with increased urinary iodine and total arsenic concentrations, particularly after Kombu and Wakame consumption.

Tunneling nanotubes (TNTs) are open actin- and membrane-based channels, connecting remote cells and allowing direct transfer of cellular material (e.g. vesicles, mRNAs, protein aggregates) from the cytoplasm to the cytoplasm. Although they are important especially, in pathological conditions (e.g. cancers, neurodegenerative diseases), their precise composition and their regulation were still poorly described. Here, using a biochemical approach allowing to separate TNTs from cell bodies and from extracellular vesicles and particles (EVPs), we obtained the full composition of TNTs compared to EVPs. We then focused on two major components of our proteomic data, the CD9 and CD81 tetraspanins, and further investigated their specific roles in TNT formation and function. We show that these two tetraspanins have distinct non-redundant functions: CD9 participates in stabilizing TNTs, whereas CD81 expression is required to allow the functional transfer of vesicles in the newly formed TNTs, possibly by regulating docking to or fusion with the opposing cell.

Introduction and objectivesCorticosteroids are among the drugs demonstrating a mortality benefit for coronavirus disease 2019 (COVID-19). The RECOVERY trial highlighted that dexamethasone reduced 28-day mortality for hospitalized COVID-19 patients requiring either supplemental oxygen or mechanical ventilation. It is noted that approximately 30% of COVID-19 patients, initially presenting with mild symptoms, will advance to acute respiratory distress syndrome (ARDS), especially those with detectable laboratory markers of inflammation indicative of disease progression. Our research aimed to explore the efficacy of dexamethasone in preventing the progression to ARDS in patients hospitalized with COVID-19 pneumonia who do not yet require additional oxygen but are at high risk of developing ARDS, potentially leading to a reduction in morbimortality.MethodsIn this multicenter, randomized, controlled trial, we evaluated the impact of dexamethasone on adult patients diagnosed with COVID-19 pneumonia who did not need supplementary oxygen at admission but were identified as having risk factors for ARDS. The risk of ARDS was determined based on specific criteria: elevated lactate dehydrogenase levels over 245 U/L, C-reactive protein levels exceeding 100 mg/L, and a lymphocyte count below 0.80 × 109/L. Participants were randomly allocated to either receive dexamethasone or the standard care. The primary endpoints included the incidence of moderate or severe ARDS and all-cause mortality within 30 days post-enrollment.ResultsOne hundred twenty-six patients were randomized. Among them, 41 were female (30.8%), with a mean age of 48.8 ± 14.4 years. Ten patients in the dexamethasone group (17.2%) and ten patients in the control group (14.7%) developed moderate ARDS with no significant differences. Mechanical ventilation was required in six patients (4.7%), with four in the treatment group and two in the control group. There were no deaths during hospitalization or during follow-up. An intermediate analysis for futility showed some differences between the control and treatment groups (Z = 0.0284). However, these findings were within the margins close to the region where the null hypothesis would not be rejected.ConclusionIn patients with COVID-19 pneumonia without oxygen needs but at risk of progressing to severe disease, early dexamethasone administration did not lead to a decrease in ARDS development.Clinical trial registrationClinicalTrials.gov, identifier NCT04836780.

Resumen: Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos. Abstract: Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected atthe local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain.

The influence of the oceanic medium on the underwater optical wireless communication (UOWC) highlights the need for an accurate mathematical channel characterization that models the properties of realistic oceanic environments, significantly optimizing the development of practical UOWC system designs. However, a need remains to provide a deeper insight into the behavior of air bubbles in turbid waters. This article presents an analysis and a statistical characterization of the received optical power fluctuations when considering different air bubble sizes and levels of particle-induced scattering. Experimental measurements were conducted in a water tank, manipulating water turbidity levels by dissolving a commercial antacid. Afterward, some evaluation metrics, such as the scintillation index, the average outage duration, and the coherence time, are calculated to provide an analytical framework of the air bubbles-induced fading in turbid environments. Additionally, the statistical behavior of small and large air bubbles are analytically described through the generalized Gamma distribution and a mixture of two generalized Gamma distributions, respectively, and validated with a coefficient of determination above 0.95 for all the considered turbid waters. Results demonstrate that water turbidity dramatically affects the stochastic behavior of the underwater channel in the presence of air bubbles, resulting in a significant reduction in light blockage due to the collection of scattered photons. As a result, the scintillation index and the average outage duration are noticeably reduced for more turbid water.

Background and Purpose: Cotrimoxazole, a commonly prescribed antibiotic, has substantial resistance, especially in Indonesia, with its uropathogenic resistance reaching 67% in 2017. Although cotrimoxazole has been suggested to be co-administered with lactoferrin to enhance its antibacterial effectiveness and this practice has been widely adopted since the Covid-19 pandemic, the impact of lactoferrin on the pharmacokinetics of cotrimoxazole remains relatively unknown. This study aims to conduct a preliminary clinical investigation into the impact of lactoferrin supplementation on the pharmacokinetics of cotrimoxazole, focusing on the elimination rate and excretion of unchanged drug in urine. Experimental Approach: This study employed a blinded, cross-over, single-dose pharmacokinetics investigation, which included five healthy volunteers as participants. In the initial period, the first group received cotrimoxazole (80 mg trimethoprim and 400 mg sulfamethoxazole) along with a lactoferrin-containing supplement, while the second group only received cotrimoxazole. Subsequently, after a washout period, the conditions were reversed. Urine sampling was conducted at intervals from 0 to 24 hours post-medication, and drug levels in the urine were determined using high-performance liquid chromatography. Key Results: The population-based pharmacokinetic analysis revealed that the optimal model was the one-compartment model with first-order elimination and proportional residual error. Conclusion: The findings show that the administration of lactoferrin-containing supplements did not significantly influence the covariate model and, therefore, did not alter the pharmacokinetics parameter of cotrimoxazole in urine with a single administration, implying that lactoferrin did not cause drug interaction problems when given simultaneously.

Abstract Background Accurately determining the epidemiology of dermatological diseases such as hidradenitis suppurativa (HS), psoriasis (PsO), chronic urticaria (CU) and/or atopic dermatitis (AD) is challenging due to variations in prevalence and disease severity in the reported literature. Objectives The DERMACLEAR study aims to use natural language processing (NLP) to assess the proportions of patients with HS, PsO, CU and/or AD, and obtain information on patient profiles, patient journeys, and disease and healthcare burden in Spain. Here, the study design and objectives of the DERMACLEAR study are described and the precision of the NLP system used is assessed. Methods This study will retrospectively collect patient information from electronic health records (EHRs) at dermatology departments from seven tertiary hospitals in Spain. The NLP system was developed by IOMED Medical Solutions and was verified internally (IOMED scientific team) and externally (principal investigators of each hospital) to determine its precision in identifying patients with HS, PsO, CU and/or AD. Furthermore, internal verification was performed on other medical variables relevant to the study. Results To date, the DERMACLEAR study has retrospectively collected data from 54,458 patients with HS, PsO, CU and/or AD (HS: 5045; PsO: 32,559; CU: 8397; AD: 12,492). The average precision of the NLP system to identify patients diagnosed with HS, PsO, CU, and/or AD across all hospitals exceeded 95% via external and internal verification. Conclusions Results from the DERMACLEAR study will increase the real‐world evidence of clinical practice, obtaining a large amount of information on patients with the studied diseases. The NLP system used is precise in identifying patients diagnosed with HS, PsO, CU and/or AD, and other medical variables from EHRs, highlighting that it is a valid system to use in the DERMACLEAR study.

Hypertension is a "silent killer". It is still one of the bigest challenges in Indonesia, where many cases are still found in primary health facilities. Hypertensive patients who require long-term therapy and adherence are very important factors to support the success of therapy. Based on the data from the Ministry of Health of the Republic of Indonesia (2018), 32.3% of hypertensive patients did not take medication regularly. Many factors influence medication adherence, such as level of knowledge, age, gender, working status, and length of illness. This study aimed to determine the effect of the level of knowledge and other factors on the level of medication adherence of hypertensive patients at the Dr. Mintohardjo Naval Hospital (RSAL). This research is a observasional study with a cross-sectional method and uses a questionnaire for data collection. Adherence level questionnaire uses MMAS-8. Analysis of the relationship between factors that influence the level of adherence uses logistic regression. The inclusion criteria of this study included hypertention outpatient aged ≤ 65 years old and are currently receiving antihypertensive therapy. The results of this study showed that out of 284 respondents, 92% of respondents had good knowledge regarding hypertension, while the level of adherence to taking medication was low at 47%. Factors that influence the level of patient adherence to taking medication in this study are gender (p-value =

Underwater optical wireless communication (UOWC) systems provide the potential to establish secure high-data-rate communication links in underwater environments. The uniqueness of oceanic impairments, such as absorption, scattering, oceanic turbulence, and air bubbles demands accurate statistical channel models based on empirical measurements for the development of UOWC systems adapted to different types of water and link conditions. Recently, generalized Gamma and a mixture of two generalized Gamma probability density functions (PDF) were proposed to describe the statistical behavior of small and large air bubbles, respectively, when considering several levels of particle-induced scattering. In this paper, we derive novel closed-form analytic expressions to compute the bit error rate (BER) and outage performance using both proposed PDFs for various scattering conditions. Furthermore, simple asymptotic expressions are obtained to determine the diversity order of each scenario. Monte Carlo simulation results verify the obtained theoretical expressions. Our results also reveal that UOWC systems present lower BER and outage performance under more turbid water cases with respect to the tap water case due to the higher diversity order and despite the significant increases in pathloss at short link distances. Particle-induced scattering provides an inherent mechanism of turbid waters to mitigate air bubble-induced fluctuations and light blockages.

Mobile telephony has developed exponentially, offering a multitude of services that could be optimal for the educational field of physical and sports activity (PSA). The objective of this research was to analyze the use of smartphone by 40 Spanish teenagers and assess the degree of satisfaction of the Polar Beat application within the subject of physical education in high school. The instruments used were two quantitative questionnaires and the data were analyzed with the statistical package SPSS 24.0. The teenagers recognized that they use the smartphone for instant messaging, telephone calls and downloads of games and tunes. The Polar Beat application in physical education classes has allowed them a better understanding of the content developed; the students affirmed that their motivation towards PSA increased with the knowledge and use of the Polar Beat app and that smartphones are innovative and effective tools. With all this, the mobile phone could be an educational tool that awakens interest in teenagers and teachers.

IntroductionLong COVID patients experience a decrease in their quality of life due to the symptomatology produced by the disease. It is also important to understand how long COVID affects both men and women. The objective of this study is to examine the impact of long COVID symptomatology on the quality of life of Spanish adults from a gender perspective.MethodsAn observational and cross-sectional study was carried out. Participants were able to complete an online questionnaire using an online platform. A sample of 206 people participated in the study.ResultsThe 80.6% of the sample were women with a mean age of 46.51 (±8.28) and the 19.4% were men with a mean age of 48.03 (±9.50). The medium score in the PAC19-QoL test was 141.47 (±24.96) and segmented by gender, 141.65 (±23.95) for women and 140.82 (±28.66) for men. The most common symptoms in women were muscle and joint pain (94.6%), fatigue (94.0%), discomfort (92.2%), difficulty concentrating (91.0%), and memory loss (88.6%). For men the symptoms included muscle and joint pain (97.5%) and fatigue (97.5%) both occupying first position, discomfort (92.0%), difficulty concentrating (90.0%), mood disturbances (90.0%), and memory loss (87.5%). The chi-square test showed statistical significance (p

Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain. Resumen: Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos.

New data on the geographic distribution and biology of Machiloides tenuicornis Stach, 1930 is given. This species is the only representative of the genus in the Palaearctic and occurs in the central part of the Spanish Pyrenees. The study of samples collected has allowed us to study their life cycle and mode of reproduction. The number of males and females in the samples show that 33.3 % are bisexual populations and 66.6 % are only female populations. The study of the length of all individuals of each sample suggests that the specimens hatch at the end of spring or beginning of summer and can live at least two years. Finally, analysis of the geographical distribution of bisexual and female populations suggests a possible ecological pattern of geographical parthenogenesis.

The circular economy and sustainable development are critical issues today, given the growing environmental pollution caused by solid waste, especially plastics. Furthermore, plastic waste has raised significant social concerns and alerted plastic product designers. Therefore, developing or redesigning plastic products in the flexible packaging industry is imperative to ensure their recyclability at the end of their life cycle. It is necessary to ensure that the mechanical and barrier properties of the ecological plastic packaging remain intact for specific uses. The current study aims to redesign flexible packaging, focusing on providing the mechanical and barrier properties of the packaging suitable for food industry applications, thus offering a solution through new design proposals that allow the development of sustainable and flexible packaging, emphasizing material reduction and recyclability. This study assessed and compared the mechanical properties of the proposed packaging with those of existing products. The results demonstrated the feasibility of reducing plastic film thickness or eliminating layers in a tri-laminated structure and transitioning to a bi-laminated structure. This adjustment did not compromise the mechanical and barrier properties; the oxygen barrier remained at 35.39 cc/m2*day, and the humidity stood at 0.57 mg/m2*day. This investigation led to a 26.48% reduction in the raw material consumption of laminated coils and 12.68% in Doypack type packaging used in food applications. Consequently, the decreased material usage and adoption of monomaterial structures significantly minimized the environmental impact of plastic waste contamination due to the possibility of mechanically recycling the final product.

We present the consensus document on the immunization schedule for adolescents developed by 3 scientific societies: the Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines (CAV-AEP), the Spanish Society of Adolescent Medicine (SEMA) and the Spanish Association of Vaccinology (AEV). There are particularities in infectious disease during adolescence, such as an increased susceptibility to pertussis, poorer outcomes of chickenpox, mumps and hepatitis A, a high incidence of sexually transmitted infections or increased prevalence of meningococcal carriage. The document analyses the schedule for adolescents in the context of vaccination policy overall. It contemplates the vaccines to be included in the immunization schedule for healthy adolescents: against invasive meningococcal disease (tetravalent ACWY and B), against human papillomavirus (which should be gender-neutral), against pertussis, against influenza and against SARS-CoV-2 (in unvaccinated individuals and at-risk groups). It is worth noting that the 4CMenB vaccine appears to confer some protection against gonococcal infection, which would be a considerable added value for adolescents. The vaccination of adolescents belonging to risk groups or travelling abroad also needs to be contemplated, as is the case in any other age group. Vaccination against hepatitis A, which is included in the routine immunization schedule of Catalonia, Ceuta and Melilla from the second year of life, should also be considered a priority in adolescents traveling to endemic areas. Resumen: El documento de consenso Calendario de vacunaciones del adolescente que se presenta tiene la autoría de tres sociedades científicas: la Asociación Española de Pediatría (AEP) con su Comité Asesor de Vacunas (CAV), la Sociedad Española de Medicina de la Adolescencia (SEMA) y la Asociación Española de Vacunología (AEV). Las infecciones tienen sus peculiaridades en la adolescencia, como la mayor susceptibilidad a la tosferina, la peor evolución de la varicela, la parotiditis y la hepatitis A, la incidencia frecuente de infecciones de transmisión sexual, o el aumento de la tasa de portadores de meningococo. Se analiza el calendario correspondiente a esta franja de edad sin perder la visión global de las inmunizaciones. Se contemplan las vacunaciones del calendario del adolescente sano: frente a la enfermedad meningocócica invasora (tetravalente MenACWY y MenB), frente al virus del papiloma humano (que debe hacerse con independencia de género), frente a la tosferina, frente a la gripe y frente a la covid (en no vacunados y en grupos de riesgo). Se destaca que la vacuna 4CMenB tiene una cierta efectividad frente a la infección por gonococo, que sería una gran ventaja añadida para el adolescente. Los calendarios del adolescente perteneciente a grupos de riesgo y del viajero deben ser considerados, al igual que en todas las edades de la vida. La vacuna de la hepatitis A que está incluida en el calendario de vacunaciones sistemáticas de Cataluña, Ceuta y Melilla, desde el segundo año de vida, debe considerarse con prioridad en el calendario del adolescente viajero.

Background: The endometrium remains a difficult tissue for the analysis of microbiota, mainly due to the low bacterial presence and the sampling procedures. Among its pathologies, endometrial cancer has not yet been completely investigated for its relationship with microbiota composition. In this work, we report on possible correlations between endometrial microbiota dysbiosis and endometrial cancer. Methods: Women with endometrial cancer at various stages of tumor progression were enrolled together with women with a benign polymyomatous uterus as the control. Analyses were performed using biopsies collected at two specific endometrial sites during the surgery. This study adopted two approaches: the absolute quantification of the bacterial load, using droplet digital PCR (ddPCR), and the analysis of the bacterial composition, using a deep metabarcoding NGS procedure. Results: ddPCR provided the first-ever assessment of the absolute quantification of bacterial DNA in the endometrium, confirming a generally low microbial abundance. Metabarcoding analysis revealed a different microbiota distribution in the two endometrial sites, regardless of pathology, accompanied by an overall higher prevalence of pathogenic bacterial genera in cancerous tissues. Conclusions: These results pave the way for future studies aimed at identifying potential biomarkers and gaining a deeper understanding of the role of bacteria associated with tumors.

Wine aroma is one of the most frequently used and explored quality indicators. Typically, its assessment involves estimating the volatile composition of wine or highly trained assessors conducting sensory analysis. However, current methodologies rely on slow, expensive and complicated analytical procedures. Additionally, sensory evaluation is inherently subjective in nature. Therefore, the aim of this work is to verify the feasibility of using FTIR spectroscopy as a fast and easy methodology for the early detection of some of the most common off-odors in wines. FTIR spectroscopy was combined with partial least squares (PLS) regression for the simultaneous measurement of isoamyl alcohol, isobutanol, 1-hexanol, butyric acid, isobutyric acid, decanoic acid, ethyl acetate, furfural and acetoin. The precision and accuracy of developed calibration models (R2P > 0.90, range error ratio > 12.1 and RPD > 3.1) proved the ability of the proposed methodology to quantify the aforementioned compounds.

Background: Climate change represents a serious threat to the health of the population. Nurses are the ideal group to act on the health risks posed by climate change. However, their perception of this phenomenon is unknown, as existing studies are very scarce. An in-depth study of nurses’ perceptions of climate change is needed. For this purpose, qualitative research is the best alternative. Objective: To understand nurses’ perceptions of their role as health assets in relation to climate change. Methods: A qualitative study will be carried out. The sample will be selected by means of purposive sampling with a maximum variation approach and will be defined by the data saturation criterion and will include nurses from different health units and regions of Spain. Semistructured interviews will be conducted using a videoconferencing platform. The interviews will be transcribed and analysed by several researchers using the logic of a three-step thematic analysis. Discussion: The results of this study will provide for the first time a clear, in-depth, and representative picture of Spanish nurses’ perceptions of climate change. This is essential for the development of concrete measures through which nurses become real health assets in the face of climate change.

Approximately 20% of lung adenocarcinomas harbor activating mutations at KRAS, an oncogene with the ability to alter the tumor immune microenvironment. In this retrospective study, we examined 103 patients with KRAS-mutant lung adenocarcinoma who were treated with immunotherapy-based regimens and we evaluated the clinical outcomes according to PD-L1 expression and the type of KRAS mutation. Among all patients included, 47% carried KRAS G12C mutation whereas 53% harbored KRAS non-G12C mutations. PD-L1 status was available for 77% of cases, with higher expression among KRAS G12C tumors (p = 0.01). Better overall survival and progression-free survival were observed in high PD-L1 expression tumors, regardless of KRAS mutation type. The heterogeneous nature of KRAS-mutant tumors and the presence of other co-mutations may contribute to different outcomes to immunotherapy-based strategies.

Introduction: Suicidal behaviour and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviours. Methods: Narrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviours in paediatric emergencies. Results: Mental health consultations were analysed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the SEUP (Spanish Society of Pediatric Emergencies), finding a 122 % increase of the diagnosis of ''non-accidental drug intoxication” and 56 % of “suicide/suicide attempt/suicidal ideation”. In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1 %), 14.8 years old, 34.9 % without previous psychiatric diagnosis; 57.7% with previous suicidal behaviour. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behaviour, although other factors are involved (family, personal or social). Pediatricians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. Conclusions: Primary, hospital and mental health care resources for paediatric population should be strengthened to prevent suicidal behaviours. Specific training for school staff, and child and adolescent psychiatry training for paediatricians and nurses are crucial in the prevention of suicide in children and adolescent population. Resumen: Introducción: Las conductas suicidas y las autolesiones están aumentando en niños y adolescentes. Las autolesiones no suicidas suponen un método disfuncional de regulación emocional. Es importante aprender a distinguirlas de las conductas suicidas. Material y métodos: Revisión narrativa de la situación actual sobre suicidio y autolesiones en España. Estudio descriptivo conductas suicidas en urgencias pediátricas. Resultados: En un estudio multicéntrico de la SEUP (sociedad Española de Urgencias Pediátricas) se analizaron las consultas por salud mental (marzo-2019 a marzo-2020 y marzo-2020 a marzo-2021), encontrándose un aumento de 122% del diagnóstico “intoxicación no accidental por fármacos” y de 56% en “suicidio/ intento de suicidio/ideación autolítica”. En otro análisis prospectivo, se registraron 281 tentativas, siendo el perfil de paciente: sexo femenino (90,1%), 14,8 años, 34,9% sin diagnóstico psiquiátrico previo, 57,7% con conductas suicidas anteriormente. La presencia de trastornos psiquiátricos, en especial de depresión, y de intentos previos, son los factores de riesgo más implicados en la conducta suicida, aunque existen otros de índole diversa (familiares, personales o sociales). Los pediatras deben estar formados para atender consultas sobre suicidio, y adquirir habilidades para realizar una entrevista con actitud de apoyo y empatía. En España los planes de prevención de suicidio son heterogéneos y no existe un plan nacional de prevención del suicidio. Conclusiones: Se deben reforzar los recursos de atención primaria, hospitalaria y de salud mental de población pediátrica. Los centros escolares y la formación en psiquiatría infantil y adolescente para médicos y enfermeras resultan cruciales en la prevención del suicidio en niños y adolescentes.

Abstract Objective The COVID-19 pandemic has caused a global health crisis. This situation has affected the general population, especially the most vulnerable populations such as individuals with cardiovascular diseases. The main objective of this study was to analyse adherence to treatment and psychological well-being in hypertensive patients before and after the COVID-19 lockdown in Spain. Methods A cross-sectional study was performed in a Basic Health Area of Toledo, Spain. Adherence and psychological well-being (resilience, self-esteem, and health-related quality of life [HRQoL]) were measured in hypertensive patients, a group of patients before the COVID-19 lockdown and, in another group after the COVID-19 lockdown using a heteroadministered and anonymous questionnaire. A factorial multivariate analysis of variance (MANOVA) was applied for the outcome variables using pre- and post-COVID-19 lockdown assessment, gender, and age (

Monolayer graphene can support the quantum Hall effect up to room temperature. Here, the authors provide evidence that graphene encapsulated in hexagonal boron nitride realizes a novel transport regime where dissipation in the quantum Hall phase is mediated predominantly by electron-phonon scattering rather than disorder scattering.

An asymmetric dual-grating gate bilayer graphene-based field effect transistor (ADGG-GFET) with an integrated bowtie antenna was fabricated and its response as a Terahertz (THz) detector was experimentally investigated. The device was cooled down to 4.5 K, and excited at different frequencies (0.15, 0.3 and 0.6 THz) using a THz solid-state source. The integration of the bowtie antenna allowed to obtain a substantial increase in the photocurrent response (up to 8 nA) of the device at the three studied frequencies as compared to similar transistors lacking the integrated antenna (1 nA). The photocurrent increase was observed for all the studied values of the bias voltage applied to both the top and back gates. Besides the action of the antenna that helps the coupling of THz radiation to the transistor channel, the observed enhancement by nearly one order of magnitude of the photoresponse is also related to the modulation of the hole and electron concentration profiles inside the transistor channel by the bias voltages imposed to the top and back gates. The creation of local n and p regions leads to the formation of homojuctions (np, pn or pp+) along the channel that strongly affects the overall photoresponse of the detector. Additionally, the bias of both back and top gates could induce an opening of the gap of the bilayer graphene channel that would also contribute to the photocurrent.

Artificial neural networks can be an important tool to improve the search for admissible string compactifications and characterize them. In this paper we construct the heterotic orbiencoder , a general deep autoencoder to study heterotic orbifold models arising from various Abelian orbifold geometries. Our neural network can be easily trained to successfully encode the large parameter space of many orbifold geometries simultaneously, independently of the statistical dissimilarities of their training features. In particular, we show that our autoencoder is capable of compressing with good accuracy the large parameter space of two promising orbifold geometries in just three parameters. Further, most orbifold models with phenomenologically appealing features appear in bounded regions of this small space. Our results hint towards a possible simplification of the classification of (promising) heterotic orbifold models.

The approach that students take in their studies at university is critical not only for their academic success but is equally important in life-long learning for their career and professional development. Cognitive science has demonstrated that retesting oneself on material when learning enhances and promotes greater retention of knowledge compared to rereading the material. Learning that is spaced out over multiple study sessions also allows for greater retention of knowledge in the longer-term compared to "cramming" of information. A survey study with first- and second-year undergraduate students (n = 135) at a university in Spain and in the U.K. was carried out to investigate the study strategies and habits prevalent in these cohorts and to explore the extent of their metacognitive awareness. It was found that most students endorsed self-testing but also suboptimal study methods such as rereading, copying notes, and cramming. There was evidence of differences between the U.K. and Spain in relation to decisions for prioritizing studying, returning to review course material, and time of study. A key conclusion is the need to embed and emphasize effective strategies for learning into curricula and for faculty to have metacognitive awareness in their teaching.

Background: Hyperlipidemia is a condition that is characterized as an increase in total cholesterol and triglyceride levels in the blood. Lactoferrin is a protein that can serve as an antioxidant. This study aims to determine whether lactoferrin can reduce total cholesterol and triglyceride levels. Methods: This study used 24 Sprague–Dawley rat strains, which were divided into six groups: normal group; negative control; positive control; and dose groups 1, 2, and 3. The normal group was given standard feed, whereas the other group was given high cholesterol and fat. The positive control group and dose groups 1, 2, and 3 were given 1.5 mg/kg BW of simvastatin and 100, 200, and 400 mg/kg of BW lactoferrin, respectively. After 6 weeks, total cholesterol and triglyceride levels were measured. Results: This study showed that lactoferrin doses of 100, 200, and 400 mg/kg BW could significantly reduce total cholesterol and triglyceride levels (p < 0.05). Lactoferrin could also significantly reduce activated Kupffer cell and steatosis area in the liver (p < 0.05). Conclusions: Lactoferrin can reduce total cholesterol and triglyceride levels. Thus, further research is needed to address the existing bias and confirm that lactoferrin can reduce cholesterol and triglyceride levels.

Everyone affects by the COVID-19 pandemic. The pandemic would have a vastly different impact on each professor. This study aimed to analyze the lived experiences of graduate school professors in private higher education institutions in the second district of Albay and the challenges experienced during the Covid-19 pandemic. Primarily, this research investigated the experiences brought by the shift to different modes of delivery of education from the traditional face-to-face. This study used qualitative and quantitative research designs interview guide, and a survey questionnaire to obtain necessary data and information. The study found that the majority of professors encountered the same challenges encountered power interruption and low internet connection. The study concludes that the respondents can effectively manage their time and pace because of a new way of instruction on the use of the internet. In regards to and in line with the findings, the professors experienced more negative reactions about internet connectivity and technical difficulties, thus hindering them from fully benefiting from the new learning. Professors should be reflective and adaptable in terms of Instructional delivery, learning environment, time management, and student assessment. They may have had to learn how to use different technological tools through the internet and ensure that it can be delivered effectively online.

Abstract To date several studies address the important role of gut microbiome and its interplay with the human host in the health and disease status. However, the selection of a universal sampling matrix representative of the microbial biodiversity associated with the gastrointestinal (GI) tract, is still challenging. Here we present a study in which, through a deep metabarcoding analysis of the 16S rRNA gene, we compared two sampling matrices, feces (F) and colon washing feces (CWF), in order to evaluate their relative effectiveness and accuracy in representing the complexity of the human gut microbiome. A cohort of 30 volunteers was recruited and paired F and CWF samples were collected from each subject. Alpha diversity analysis confirmed a slightly higher biodiversity of CWF compared to F matched samples. Likewise, beta diversity analysis proved that paired F and CWF microbiomes were quite similar in the same individual, but remarkable inter-individual variability occurred among the microbiomes of all participants. Taxonomic analysis in matched samples was carried out to investigate the intra and inter individual/s variability. Firmicutes, Bacteroidota, Proteobacteria and Actinobacteriota were the main phyla in both F and CWF samples. At genus level, Bacteirodetes was the most abundant in F and CWF samples, followed by Faecalibacterium, Blautia and Escherichia-Shigella. Our study highlights an inter-individual variability greater than intra-individual variability for paired F and CWF samples. Indeed, an overall higher similarity was observed across matched F and CWF samples, suggesting, as expected, a remarkable overlap between the microbiomes inferred using the matched F and CWF samples. Notably, absolute quantification of total 16S rDNA by droplet digital PCR (ddPCR) revealed comparable overall microbial load between paired F and CWF samples. We report here the first comparative study on fecal and colon washing fecal samples for investigating the human gut microbiome and show that both types of samples may be used equally for the study of the gut microbiome. The presented results suggest that the combined use of both types of sampling matrices could represent a suitable choice to obtain a more complete overview of the human gut microbiota for addressing different biological and clinical questions.

Abstract Background Corticosteroids are one of the few drugs that have shown a reduction in mortality in coronavirus disease 2019 (COVID-19). In the RECOVERY trial, the use of dexamethasone reduced 28-day mortality compared to standard care in hospitalized patients with suspected or confirmed COVID-19 requiring supplemental oxygen or invasive mechanical ventilation. Evidence has shown that 30% of COVID-19 patients with mild symptoms at presentation will progress to acute respiratory distress syndrome (ARDS), particularly patients in whom laboratory inflammatory biomarkers associated with COVID-19 disease progression are detected. We postulated that dexamethasone treatment in hospitalized patients with COVID-19 pneumonia without additional oxygen requirements and at risk of progressing to severe disease might lead to a decrease in the development of ARDS and thereby reduce death. Methods/design This is a multicenter, randomized, controlled, parallel, open-label trial testing dexamethasone in 252 adult patients with COVID-19 pneumonia who do not require supplementary oxygen on admission but are at risk factors for the development of ARDS. Risk for the development of ARDS is defined as levels of lactate dehydrogenase > 245 U/L, C-reactive protein > 100 mg/L, and lymphocyte count of

Peritoneal infections still represent a most feared complication of chronic Peritoneal Dialysis, due to their high incidence and relevant clinical consequences, including direct mortality, technique failure and a significant burden for the health system. The practices for prevention and treatment of this complication show a remarkable heterogeneity emerging, among other factors, from the complexity of the problem and from a paucity of quality evidence which could permit to respond clearly to many of the raised questions. The purpose of this document is to provide a complete and updated review of the main methods of diagnosis, prevention and treatment of these infections. The document has been elaborated taking as a reference the most recent guidelines of the International Society of Peritoneal Dialysis (2016). The diagnostic considerations are presented in a narrative style while, for prevention and therapy, we have used a systematic methodology (GRADE), which specifies the level of evidence and the strength of the proposed suggestions and recommendations and facilitates future updates of the document. The length of the document and the many suggestions and recommendations coming out of the review underline the large number and the complexity of the factors to be taken into consideration for an adequate approach to this complication of Peritoneal Dialysis. Resumen: Las infecciones peritoneales siguen constituyendo una complicación muy relevante de la diálisis peritoneal, por su incidencia todavía elevada y por sus importantes consecuencias clínicas, en términos de mortalidad, fracaso de la técnica y costes para el sistema sanitario. Las prácticas de prevención y tratamiento de esta complicación muestran una notable heterogeneidad derivada, entre otros factores, de la complejidad del problema y de la escasez de evidencia clínica que permitan responder de manera clara a muchas de las dudas planteadas. El propósito de este documento es proporcionar una revisión completa y actualizada de los métodos de diagnóstico, prevención y tratamiento de estas infecciones. El documento se ha elaborado tomando como referencia de partida la guía más reciente de la Sociedad Internacional de Diálisis Peritoneal (2016). Mientras que para el capítulo diagnóstico se ha adoptado una estructura más narrativa, el análisis de las medidas de prevención y tratamiento ha seguido una metodología sistemática (GRADE), que especifica el nivel de evidencia y la fuerza de las sugerencias y recomendaciones propuestas, y facilita actualizaciones futuras de la guía. La gran extensión y numerosas recomendaciones o sugerencias emanadas de la revisión ponen de manifiesto la complejidad y gran número de facetas a tener en cuenta para un adecuado abordaje de esta importante complicación de la diálisis peritoneal.

IntroductionThe healthcare and well-being of the population depend on multiple factors and should adapt to societal changes. The opposite is also occurring; society has evolved concerning the individuals’ approach to their care, which includes participation in decision-making processes. In this scenario, health promotion and prevention become crucial to provide an integrated perspective in the organization and management of the health systems.Health status and well-being depend on many aspects, determinants of health, which in turn may be modulated by individual behavior. Certain models and frameworks try to study the determinants of health and individual human behaviors, separately. However, the interrelation between these two aspects has not been examined in our population.Our main objective is to analyze whether personal aptitudes related to behaviors are independently associated with the incidence of morbidity. A secondary objective will enquire whether these personal aptitudes are independently associated with lower all-cause mortality, enhanced adoption of healthy lifestyles, higher quality of life, and lower utilization of health services during follow-up.MethodsThis protocol addresses the quantitative branch of a multicenter project (10 teams) for the creation of a cohort of at least 3,083 persons aged 35 to 74 years from 9 Autonomous Communities (AACC). The personal variables to evaluate are self-efficacy, activation, health literacy, resilience, locus of control, and personality traits. Socio-demographic covariates and social capital will be recorded. A physical examination, blood analysis, and cognitive evaluation will be carried out.Several sets of six Cox models (one for each independent variable) will analyze the incidence of morbidity (objective 1); all-cause mortality and the rest of the dependent variables (objective 2). The models will be adjusted for the indicated covariates, and random effects will estimate Potential heterogeneity between AACC.DiscussionThe analysis of the association of certain behavioral patterns and determinants of health is essential and will contribute to improving health promotion and prevention strategies. The description of the individual elements and interrelated aspects that modulate the onset and persistence of diseases will allow the evaluation of their role as prognostic factors and contribute to the development of patient-tailored preventive measures and healthcare.Clinical Trial Registration: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.