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Abstract The mesophotic zone represents one of our planet’s largest and least explored biomes. An increasing number of studies evidence the importance of macrofouling species in marine ecosystems, but information on these communities and the factors influencing their structures at mesophotic depths remain poor. This lack of understanding limits our ability to predict anthropogenic impacts or conduct restoration operations in the mesophotic and the lower boundary of the euphotic zones. In this study, we performed a 24-month experiment in a natural environment to investigate three factors influencing the macrobenthic community structure of the mesophotic and the euphotic lower boundary: depth, substrate orientation and substrate material. Using a manned submersible, several recruitment panels of two different materials were deployed at 100, 200 and 400 meters in vertical and horizontal positions. All three factors contributed to structuring the macrofouling communities, but depth and substrate orientation displayed the strongest effects. This study not only advances our understanding of lower boundary euphotic and mesophotic macrofouling communities but also establishes a foundation for future research and restoration efforts of mesophotic environments in the Madeira archipelago, where mesophotic habitats are amongst the least studied marine habitats in the Northeast Atlantic.

Abstract Background Imported malaria from southern Mozambique drives low levels of disease transmission in KwaZulu-Natal, South Africa. Therefore, the South African Department of Health funded implementation of indoor residual spraying (IRS) in Mozambiquan districts identified as sources of malaria infection for border communities in KwaZulu-Natal. IRS was initiated in districts of Guija, Inharrime, Panda and Zavala. To determine impact of spraying on malaria transmission in these districts, data relating to incidence and prevalence was collected before spraying (2018) and before the second round of spraying was completed (2023). Implementation of IRS was also monitored to ensure optimal spray coverage was achieved. Methods The study was a cross-sectional survey conducted in 6 sentinel sites in each of the four afore-mentioned districts, focusing on children 6 months to 95%) resulted in greater population protection. Conclusion The study revealed that IRS implementation decreased malaria prevalence in Inharrime and Panda but not in Guija and Zavala. To ensure that cross-border movement of people does not result in increased malaria transmission, targeting areas identified as source of infection in travelers is paramount to reaching elimination.

Abstract Background Monitoring HIV infection estimates is critical to guide health interventions and assess their impact, especially in highly vulnerable groups to the infection such as African pregnant women. This study describes the trends of HIV infection over eleven years in women attending selected antenatal care (ANC) clinics from southern Mozambique. Methods We performed a secondary analysis of data registered at the ANC clinic of the Manhiça District Hospital and from the Ministry of Health's HIV National Program Registry between 2010 and 2021. HIV incidence was calculated using prevalence estimates. HIV incidence trends over time were obtained by fitting splines regression model. Results Data from 21,810 pregnant women were included in the analysis. Overall HIV prevalence was 29.3% (95% CI: 28.7–29.9), with a reduction from 28.2% (95% CI: 25.6–30.8) in 2010 to 21.7% (95% CI: 19.8–23.6) in 2021, except for a peak in prevalence (35.3%, 95% CI: 30.1–40.8) in 2016. Over the study period, by maternal age group, the largest reduction in HIV prevalence was in the 15–20 year-old group [62% reduction, from 14.3% (95% CI 10.8–18.4) to 5.3% (95% CI: 3.6–7.5)], followed by the 20–25 year old group [43% reduction, from 29.0% (95% CI: 24.2–34.5) to 16.6% (95% CI: 13.6–19.8)] and the 25–30 year old group [13% reduction, from 36.9% (95% CI: 31.0–43.1) to 32.0% (95% CI: 27.3–37.0)] (p

Abstract Background We evaluated the accuracy of magnetic resonance imaging (MRI) computed tomography (CT)-like sequences compared to normal-resolution CT (NR-CT) and super-high-resolution CT (SHR-CT) for planning of cochlear implantation. Methods Six cadaveric temporal bone specimens were used. 3-T MRI scans were performed using radial volumetric interpolated breath-hold (STARVIBE), pointwise-encoding time reduction with radial acquisition (PETRA), and ultrashort time of echo (UTE) sequences. CT scans were performed on two scanners for SHR-CT and NR-CT acquisitions. Two radiologists evaluated accuracy based on preimplantation metrics and the ability to identify various anatomical structures, particularly the facial recess and round window. Wilcoxon rank-sum test and intraclass correlation coefficient (ICC) were used. Results The facial nerve was always clearly visible (score ≥ 2) in the MRI, NR-CT, and SHR-CT scans (p ≥ 0.621). However, the chorda tympani nerve (CTN) was clearly visualized in UTE, STARVIBE, and PETRA sequences in only 33% (2/6 specimens, p = 0.016), 50% (3/6 specimens, p = 0.038), and 83% (5/6 specimens, p = 0.017) of cases, respectively, whereas it was always clearly visualized in SHR and NR-CT (p = 0.426). The round window (RW) was never visualized in MRI sequences (p ≤ 0.010), whereas it was identified in all cases in SHR and NR-CT (p = 1.000). There was a strong correlation between measurements obtained from MRI and CT modalities (ICC ≥ 0.837). Conclusion MRI CT-like sequences assessed the facial nerve in all cases and the CTN in up to 87% of cases. However, the detection of the RW was insufficient for surgical planning. CT and MRI measurements were in agreement. Relevance statement CT-like MRI sequences can image the anatomy of the facial recess and the length of the basal turn of the cochlea with similar accuracy as conventional CT, although they cannot image the round window. Key Points CT-like MRI sequences are not widely used in preoperative cochlear implantation imaging. CT-like sequences can image the facial recess as well as conventional CT. CT-like sequences can image the basal turn length of the cochlea as well as conventional CT. Round window depiction is not possible with CT-like MRI sequences. Graphical Abstract

Abstract Sponges are key ecosystem engineers that shape, structure and enhance the biodiversity of marine benthic communities globally. Sponge aggregations and reefs are recognized as vulnerable marine ecosystems (or VMEs) due to their susceptibility to damage from bottom-contact fishing gears. Ensuring their long-term sustainability, preservation, and ecosystem functions requires the implementation of sound scientific conservation tools. Here, the genetic diversity, structure, and connectivity of the deep-sea glass sponge, Vazella pourtalesii (Schmidt, 1870), was investigated using 1,102 neutral SNPs obtained in RADseq. This species is distributed across the northwest Atlantic from Florida, USA to Nova Scotia, Canada and we sequenced samples covering this full distribution and provided evidence of strong genetic structure with two distinct clusters: Florida together with the Carolina Shelves and the Scotian Shelf. We estimated moderate levels of diversity with low migration across large distances (> 1000 kms) and high connectivity at smaller scales (

Abstract Background Injury to the knee joint is associated with physical disability, stiffness, pain, restriction of movement and impairment of the person’s quality of life, with a few treatment options, including surgery and rehabilitation. This study aims to evaluate the impact of a rehabilitation program on the quality of life reported by patients living in rural and urban areas after knee surgery, using patient-reported outcome measures (PROMs). Methods This quasi-experimental study with two groups of participants undergoing primary knee surgery was carried out in two rehabilitation centers, one in an urban area and another in a rural one. The same intervention was structured, with assessments at the start of the study (t0) and after a 4-week program (t1), and a comparison was made between the gains in rural and urban areas. We used descriptive and inferential analysis to analyze the effect of the intervention on health-related quality of life (HRQoL) using a linear regression model. Results Participants (n = 62 aged between 19 and 84 years (40% of the sample aged over 65years) and 61.9% female, showed improvements in their EQ-5D-5L and HADS scores after the rehabilitation program. Considering the dimensions of HRQoL in both groups, there was a significant improvement in all the components in the rural context (p

Abstract Streptococcus pneumoniae and influenza A virus (IAV) are significant agents of pneumonia cases and severe respiratory infections globally. Secondary bacterial infections, particularly by Streptococcus pneumoniae, are common in IAV-infected individuals, leading to critical outcomes. Despite reducing mortality, pneumococcal vaccines have high production costs and are serotype specific. The emergence of new circulating serotypes has led to the search for new prevention strategies that provide a broad spectrum of protection. In this context, vaccination using antigens present in all serotypes, such as Pneumococcal Surface Protein A (PspA), can offer broad coverage regardless of serotype. Employing the reverse genetics technique, our research group developed a recombinant influenza A H1N1 virus that expresses PspA (Flu-PspA), through the replacement of neuraminidase by PspA. This virus was evaluated as a bivalent vaccine against infections caused by influenza A and S. pneumoniae in mice. Initially, we evaluated the Flu-PspA virus’s ability to infect cells and express PspA in vitro, its capacity to multiply in embryonated chicken eggs, and its safety when inoculated in mice. Subsequently, the protective effect against influenza A and Streptococcus pneumoniae lethal challenge infections in mice was assessed using different immunization protocols. Analysis of the production of antibodies against PspA4 protein and influenza, and the binding capacity of anti-PspA4 antibodies/complement deposition to different strains of S. pneumoniae were also evaluated. Our results demonstrate that the Flu-PspA virus vaccine efficiently induces PspA protein expression in vitro, and that it was able to multiply in embryonated chicken eggs even without exogenous neuraminidase. The Flu-PspA-based bivalent vaccine was demonstrated to be safe, stimulated high titers of anti-PspA and anti-influenza antibodies, and protected mice against homosubtypic and heterosubtypic influenza A and S. pneumoniae challenge. Moreover, an efficient binding of antibodies and complement deposition on the surface of pneumococcal strains ascribes the broad-spectrum vaccine response in vivo. In summary, this innovative approach holds promise for developing a dual-protective vaccine against two major respiratory pathogens.

Abstract Background Youth is a critical stage for developing healthy lifestyles, as the habits and behaviors formed during this period can persist into adulthood. Understanding the relationship between family factors and the lifestyles of university students can contribute to creating strategies to improve this important health determinant. This research aimed to analyze the relationship between social support, family dynamics, and lifestyles in young university students. Design: A cross-sectional descriptive study. Methods A probability sample of 530 young university students was analyzed. The main measurements included social support, family dynamics, and lifestyles. Descriptive analysis of quantitative and qualitative variables was performed. Pearson correlation coefficient was used for bivariate analysis, and Student’s t-test was used to analyze differences between male and female participants. Additionally, multivariate analysis was conducted using multiple linear regression. Results For the total sample, a positive and moderate association was found between family dynamics (r = 0.28) and social support (r = 0.32) with the lifestyles of young individuals. Conclusions Our results indicated that social support and family dynamics are possible protective factors that have a positive effect on the lifestyles of university students. The findings of this study highlight the importance of family and familial support in adopting healthy lifestyles among university students.

In the field of computational chemistry, computer models are quickly and cheaply constructed to predict toxicology hazards and results, with no need for test material or animals as these computational predictions are often based on physicochemical properties of chemical structures. Multiple methodologies are employed to support in silico assessments based on machine learning (ML) and deep learning (DL). This review introduces the development of computational toxicology, focusing on ML and DL and emphasizing their importance in the field of toxicology. A fine balance between target potency, selectivity, absorption, distribution, metabolism, excretion, toxicity (ADMET) and clinical safety properties should be achieved to discover a potential new drug. It is advantageous to perform virtual predictions as early as possible in drug development processes, even before a molecule is synthesized. Currently, there are numerous commercially available and free web-based programs for toxicity prediction, which can be used to construct various predictive models. The key features of the QSAR method are also outlined, and the selection of appropriate physicochemical descriptors is a prerequisite for robust predictions. In addition, examples of open-source tools applied to toxicity prediction are included, as well as examples of the application of different computational methods for the prediction of toxicity in drug design and environmental toxicology.

PLA biocomposites, incorporating 5% wt. of lignocellulosic fibres (LF) from Posidonia oceanica waste with different degrees of cellulose purification, were obtained by melt blending and compression moulding. The LF were obtained after removing part of the non-cellulosic components by subcritical water extraction at 150 and 170 °C and after bleaching the extracted residues with hydrogen peroxide or sodium chlorite. The non-bleached LF provided the composites with a brown colour and opacity, while the bleached LF impacted the optical properties of composites to a lower extent, depending on their whiteness. The LF composition had a noticeable effect on the composites’ mechanical and barrier properties. All LF reduced the water vapour barrier capacity while promoting the oxygen barrier of the films. Bleached LF enhanced the film stiffness and reduced extensibility and resistance to break, whereas non-bleached LF had lower impacts on the tensile parameters. Considering the mechanical and barrier performance of the composites, the fibres obtained at 170 °C and bleached with sodium chlorite exhibited the best behaviour. Nevertheless, if transparency and colour are not limiting for the use of the films, untreated LF allowed for good preservation of the water vapour permeability of PLA films and enhanced the oxygen barrier capacity, with a similar mechanical response as the other non-bleached fractions.

This paper addresses the issue of agricultural land fragmentation in Islamic countries. In the se countries, agricultural land is fragmented into tiny and unproductive holdings. Fragmentation of agricultural holdings reduces production due to difficulties in applying modern technology, lack of access to loans, and the challenges in marketing small quantities. The inheritance system, based on Islamic law, is one of the biggest reasons for land fragmentation. Previous complex laws to address land fragmentation often conflicted with national constitutions or Islamic law, making their implementation difficult. A mixed-methods approach was employed, combining qualitative analysis with a one-way analysis of variance (ANOVA) to examine differences in productivity and operational costs per hectare under various land management systems. The findings demonstrate that implementing waqf (endowment) as a land management strategy can significantly mitigate land fragmentation. Waqf preserves agricultural land as a single, indivisible entity, allowing for long-term planning, farm expansion, and sustainable investment. This approach enhances productivity and supports sustainable agricultural development. This study concludes that waqf aligns with Islamic principles and offers a practical, culturally appropriate solution to land fragmentation. By mitigating fragmentation and promoting sustainable development, waqf ensures continuity, supports agricultural growth, and contributes to broader development goals.

Abstract Background The lack of compatibility between acoustic telemetry equipment from different manufacturers has been a major obstacle to consolidating large collaborative tracking networks. Undisclosed encrypted signal coding protocols limit the use of acoustic telemetry to study animal movements over large spatial scales, reduce competition between manufacturers, and stifle innovation. The European Tracking Network, in collaboration with several acoustic telemetry manufacturers, has worked to develop new transparent protocols for acoustic tracking. The results are energy-efficient transmission protocols accessible to all researchers and manufacturers. Today, the Open Protocols (OP) are already available to manufacturers and developers, and the first transmitters and receivers to implement them are already in the water. Results The main objective of this study was to confirm the compatibility between devices from different manufacturers using OP, characterise the acoustic range of each transmitter–receiver manufacturer combination, compare the detection efficiency to the standard protocols used at present (R64K and encrypted protocols), and assess its robustness against spurious detections. An international collaborative effort was made to conduct acoustic range tests in four main aquatic habitats: a river, a coastal lagoon, a coastal habitat, and the open sea. Receivers and transmitters from different manufacturers were deployed at increasing distances from each other using the same experimental design at each location. The decay of detection probability with distance was modelled for each transmitter–receiver manufacturer combination by applying logistic regression using a Bayesian approach. Furthermore, to thoroughly assess performance differences in an applied research context, we conducted a direct field comparison between groups of smolts tagged with OP and R64K tags, tracking their migration to the sea. Conclusions Our results confirm full compatibility between the tested devices, with negligible differences in the measured acoustic ranges between OP manufacturers and when compared to encrypted protocols. The OP was also robust against spurious detections, and the field comparison between OP and R64K showed equal performance. We hope these novel insights will encourage international research groups to promote OP-based studies to ensure compatibility and maximise the benefits of acoustic telemetry networks.

Abstract Technological disasters in the Americas have significant public health and environmental implications, but there is limited epidemiological analysis of these events. This study aims to characterize the epidemiological profile of technological disasters in the Americas from 2000 to 2021, focusing on morbidity and mortality trends. A retrospective cross-sectional study was conducted. The ANOVA test was applied in the mean rates calculated for each type of disaster. The Mann-Kendall test assessed the presence or absence of temporal trends, and the Dickey-Fuller augmented test was used to determine if the time series were stationary. Predictions were made up to the year 2030 to mean mortality rate per million inhabitants, mean rate of people affected per million inhabitants, and mean rate of people injured per million inhabitants. A total of 733 technological disasters were recorded in the Americas. Statistically significant differences were found between the mean rates of people affected and the mean mortality rates per million inhabitants for each type of technological disaster. No trends were identified. The highest mean mortality rates occurred because of industrial accidents.

The study aimed to explore the spatiotemporal patterns and characteristics of cold wave mortality in Bangladesh by developing a cold wave dataset using content analysis. Due to the absence of a formal database about cold wave-related mortality in Bangladesh, we first developed a cold wave mortality dataset using content analysis of four (04) leading national daily newspapers’ cold wave-related news from 2000 to 2019 and crosschecked with other related reports. Then, we analyzed the data to obtain the spatiotemporal trends and characteristics of cold wave mortality in Bangladesh. A total of 5610 people died in 81 cold wave events (spells) in Bangladesh during the 20 years, with an average of 281 deaths per year. The average duration of cold waves (spells) in Bangladesh was 25.4 days per year, with a statistically significant increasing trend over the period. The highest cold wave mortality rate was found in the Kurigram District; the rate was 163.63 deaths per million people per year. About 58% of cold wave spells and 58.5 % of cold wave mortality occurred in January, followed by December (22%) during the study period. However, cold wave mortality varied from district to district; northwestern districts of Bangladesh were more prone to cold waves and reported a higher mortality rate. During the study period, more children and males died due to cold waves than females in Bangladesh. The study findings serve as a foundation for future research and policy development to establish cold wave management guidelines to reduce the risk of cold wave exposures among vulnerable people in the country.

Abstract Macropinocytosis has emerged as a scavenging pathway that cancer cells exploit to survive in a nutrient-deprived microenvironment. Tumor cells are especially reliant on glutamine for their survival, and in pancreatic ductal adenocarcinoma (PDAC) cells, glutamine deficiency can enhance the stimulation of macropinocytosis. Here, we identify the atypical protein kinase C (aPKC) enzymes, PKCζ and PKCι, as regulators of macropinocytosis. In normal epithelial cells, aPKCs associate with the scaffold proteins Par3 and Par6 to regulate cell polarity, affecting several targets, including the Par1 kinases and we find that each of these proteins is required for macropinocytosis. Mechanistically, aPKCs are regulated by EGFR signaling or by the transcription factor CREM to promote the Par3 relocation to microtubules, facilitating macropinocytosis in a dynein-dependent manner. Importantly, cell fitness impairment caused by aPKC depletion is rescued by the restoration of macropinocytosis and aPKCs support PDAC growth in vivo. Our findings enhance our understanding of the mechanistic underpinnings that control macropinocytic uptake in the context of metabolic stress.

Abstract Objective To present the first Brazilian real-world results with galcanezumab and provide a consensus expert opinion on the prophylactic treatment of cluster headache (CH) in Brazil. Methods The first part of the study (real-world results) was observational, prospective, uncontrolled, and descriptive. A sample of 44 consecutive patients with episodic or chronic CH were evaluated and treated in a traditional tertiary clinic from March 2020 to June 2024. The second part (consensus expert opinion) consisted of a survey completed by ten Brazilian headache clinicians with at least 25 years of clinical experience, who published at least 15 headache papers and attended at least 15 national or international headache conferences. Results Forty-four patients (86.4% men, 13.6% women) were included. The average age was 45.9 ± 14.2 years. The diagnosis was made 27.3 ± 13.6 years after the onset of headache bouts. In 84.1% of the patients, CH was classified as episodic. Verapamil, lithium, or verapamil plus lithium were prescribed to respectively, 25%, 9.1%, and 6.8% of patients. Galcanezumab was prescribed to all and the majority (65.9%) used a dose of 300 mg once. There was a reduction in headache frequency of ≥ 50% at 3 weeks in 65.9% of patients for all doses of galcanezumab, and in 72.4% of those using galcanezumab 300 mg. Verapamil was recommended as a first-line treatment by 6 of 10 experts and a second-line treatment by the other 4 experts; galcanezumab was recommended as a first-line treatment by 4 of 10 experts and as a second-line treatment by 3 of 10 experts. Conclusions This study presented the first real-world data with galcanezumab in Brazilian patients with CH and showed a reduction in headache frequency in most patients. A survey of Brazilian experts not meant to represent the country’s guidelines, favored galcanezumab as either the first or the second option in prophylaxis. Collectively, these results highlighted galcanezumab’s promising efficacy as a new tool in CH patients.

RESUMO Este estudo teve como objetivo desenvolver um instrumento para analisar atitudes de mulheres acerca da permanência feminina em relacionamentos abusivos, assim como avaliar suas propriedades psicométricas (estrutura interna e relações com variáveis externas). O estudo foi realizado em duas etapas: 1. coleta das atitudes de 27 universitárias, de 18 a 42 anos (M=23,37; DP = 5,79), todas em um relacionamento amoroso; 2. elaboração, estrutura interna e relações com variáveis externas da escala desenvolvida a partir dos resultados da etapa anterior, junto a 875 mulheres, de 18 a 49 anos (M=28,35; DP=6,87), a maioria em um relacionamento amoroso, com escolaridade entre ensino médio incompleto e nível superior. Os resultados evidenciaram propriedades psicométricas adequadas para o instrumento, permitindo demonstrar que a permanência de mulheres em relacionamentos abusivos está associada diretamente às normas subjetivas, enquanto as atitudes e o controle comportamental não desempenham funções preditivas importantes.

Manufacturers are always looking for new ways to minimize breakdowns and failures to improve productivity and efficiency of the production process. VIEXPAND is a multiview AI-enhanced video processing and transmission system, operating in real-time, for industrial supervision, inspection, surveillance and security applications, on the road to Industry 4.0. It focuses on professional applications where remote monitoring of large industrial areas requires wide fields of view and multiple views, demanding for efficient data transmission, in real-time. This paper covers a use case in a glass bottle production industry to reduce raw material use and energy waste, increase production efficiency and improve safety of operations.

Pulmonary arterial hypertension (PAH) is a form of precapillary pulmonary hypertension caused by a complex process of endothelial dysfunction and vascular remodeling. If left untreated, this progressive disease presents with symptoms of incapacitating fatigue causing marked loss of quality of life, eventually culminating in right ventricular failure and death. Patient management is complex and based on accurate diagnosis, risk stratification, and treatment initiation, with close monitoring of response and disease progression. Understanding the underlying pathophysiology has enabled the development of multiple drugs directed at different targets in the pathological chain. Vasodilator therapy has been the mainstay approach for the last few years, significantly improving quality of life, functional status, and survival. Recent advances in therapies targeting dysfunctional pathways beyond endothelial dysfunction may address the fundamental processes underlying the disease, raising the prospect of increasingly effective options for this high-risk group of patients with a historically poor prognosis. Resumo: A hipertensão arterial pulmonar (HAP) é um tipo de hipertensão pulmonar pré-capilar causada por um processo complexo de disfunção endotelial e remodelação vascular desfavorável. A história natural desta doença progressiva inclui sintomatologia de insuficiência cardíaca e perda de qualidade de vida, culminando em falência ventricular direita e morte. A gestão dos doentes é complexa, baseando-se num diagnóstico preciso, estratificação de risco e início de terapêutica adequada, sendo essencial a monitoração apertada da resposta e progressão da doença.A compreensão da fisiopatologia subjacente permitiu o desenvolvimento de múltiplos fármacos dirigidos a diferentes alvos na cadeia patológica. A terapêutica vasodilatadora destaca-se como a abordagem de base nas últimas décadas, tendo permitido melhoria significativa da qualidade de vida, estado funcional e sobrevida dos doentes. Os avanços terapêuticos recentes, com o advento da utilização de fármacos dirigido aos mecanismos subjacentes à doença, trazem a promessa de opções terapêuticas cada vez mais eficazes para este grupo de doentes de alto risco, com um prognóstico historicamente reservado.

Abstract Background The rectus femoris muscle plays an important role in maintaining lower limb stability and biomechanical control during basic physical activities. Both reduced quadriceps strength and decreased muscle thickness of the rectus femoris, as measured by ultrasound, are associated with an increased risk of falls in older adults. We estimated the relative and absolute intra-rater, inter-rater, and inter-day reliability of the procedure. Methods A female biologist and a male physical educator, both holding a master’s degree in human movement and rehabilitation, captured ultrasound images of the right rectus femoris muscle in 106 healthy participants (58 females and 48 males), aged 18 to 73 years. Each rater captured three images per participant during each visit, with two visits 7 to 10 days apart. A third person subsequently measured the muscle thickness. We calculated the Intraclass Correlation Coefficients (ICC) using a two-way random model and determined the 95% minimal detectable difference (MDD). Results The mean muscle thickness was 2.12 cm. The reliability based on single measurements was as follows: the intra-rater ICC for raters A and B was 0.998 at both visits (MDDs: 0.074–0.082 cm). The inter-rater ICC was 0.976 at visit 1 and 0.977 at visit 2 (MDDs: 0.269–0.270 cm). The inter-day ICC was 0.973 for rater A and 0.972 for rater B (MDDs: 0.286–0.291 cm). Sensitivity analyses accounting for age, sex, and the use of mean measurements produced similar results. The results were homoscedastic. Conclusions The rectus femoris muscle thickness was measured with good reliability using ultrasonography across all the settings.

Abstract Inherited retinal dystrophies/degenerations (IRDs) are the leading cause of visual impairment and incurable familial blindness in the Western world. Given the clinical and genetic heterogeneity, establishing a molecular diagnosis is especially relevant. The aim of this study was to perform the first nationwide survey to understand the prevalence and current management of IRDs in Portugal. A response was obtained from 26 healthcare providers (HCP) (76.5% response rate). Only 4 respondents reported not managing IRD patients. Most HCPs (68.1%) reported managing up to 100 patients, while three currently manage between 501 and 1000 patients. Based on the Portuguese population, an estimated IRD prevalence of 0.031%, i.e., about 1 in 3000 individuals, was calculated. In most HCPs (86.3%), most patients are adults, and non-syndromic retinitis pigmentosa is the most frequent diagnosis. Only 4 HCPs currently use the national, web-based IRD registry (IRD-PT). However, all but one respondent expressed interest in participating in such a registry. Genetic testing is available in 54.5%, with 58.3% HCPs reporting solved rates between 61–80%, but 4 to 9 months to get a genetic test result in 83.4% of cases. Based on this survey, the prevalence of biallelic RPE65-associated disease in Portugal is 0.00031%, i.e., approximately 1:300,000 individuals. Data from this study provide vital background information on national differences in the diagnosis and management of IRD patients. Nationwide implementation of the IRD-PT registry should be encouraged and supported to provide population-based reference data and to identify patients eligible for current and future therapies.

Higher education institutions (HEIs) offer promising opportunities to develop strategies and actions for managing Solid Waste (SW). This study aimed to analyze the perceptions of employees working at HEIs in Boa Vista, Roraima, Brazil, on how their institutions manage SW. HEIs 1 and 2 (public) and HEI 3 (private) were evaluated. The study method was qualitative and quantitative. Face-to-face interviews were conducted using a questionnaire addressing five domains of Waste Management: I − Recycling program; II − Treatment of organic waste; III − Campaign to reduce the use of paper and plastic; IV − Treatment of inorganic waste; and V − Treatment of toxic waste. A multidimensional similarity analysis was carried out between the HEIs. HEI2 showed better overall performance when compared to the other HEIs (p = 0.012). In domain I, only HEI 2 has a selective waste collection program and disposes of waste properly (score = 150, p

One of the persistent problems faced by the university education system is the dropout rate. The main aim of this research was to identify the profile characteristics of those students who drop out of their studies, seeking in-depth knowledge of the reality behind the issue. The responses to a questionnaire of 149,837 students from three Spanish universities (La Laguna, Zaragoza and Huelva) who had dropped out of their undergraduate studies were analysed. The outcomes enabled us to identify a number of features associated with the likelihood of dropping out of university studies. Specifically, it was found that the university of study, sex, age, study branch, entry qualification, scholarship or grant, nationality and job are predictors of dropout. The results obtained have an important transfer value, with a view to implementing actions for the adaptation of students and to avoid university dropout.

ABSTRACT This study aimed to investigate the effect of different intensities of Inspiratory Muscle Exercise (IME) on cardiac autonomic control during the period of post-exertion recovery in healthy adults. Thus, an experimental, controlled, and randomized study was conducted with 15 men aged from 18 to 40 years, including sedentary and healthy individuals. Participants underwent four IME sessions: a sham session, followed by sessions with 30%, 40%, and 60% of maximal inspiratory pressure. Pulse intervals were recorded using digital infrared photoplethysmography to obtain heart rate (HR) values. Measurements included HR, interbeat interval, standard deviation of all normal RR intervals (SDNN), root mean square of successive differences between adjacent normal RR intervals (RMSSD), percentage of adjacent RR intervals greater than 50ms (pNN50) (time domain), total power, power of low-frequency spectral bands (LF), and power of high-frequency spectral bands (HF) (ms²), LF and HF (n.u.), and LF/HF (frequency domain). These measures were assessed simultaneously for 10 minutes at rest and during recovery period (15, 30, 45, and 60 minutes). Two-way analysis of variance was used, considering a 5% significance level. We observed that RMSSD and pNN50 showed higher values compared to baseline (Time Effect: P=0.004; P0.05). Additionally, there was no difference in the comparison between intensities for all HRV measures (Session Effect: p>0.05). We conclude that, regardless of the applied load, there is a similar increase in parasympathetic cardiac autonomic modulation indices in the post-IME recovery period in healthy adults.

Abstract This study aimed to assess the combined antibacterial effect of lectins and antibiotics on S. aureus ATCC 25923, multidrug-resistant E. coli ATCC 11303 and S. aureus ATCC 700698. Using the checkerboard assay, we evaluated the antibacterial effects of eight lectins isolated from marine organisms combined with two common antibiotics, oxacillin and tetracycline, on three virulent bacterial strains. Initially, none of the tested lectins exhibited antibacterial effects when used individually. However, when combined with antibiotics, the lectins exhibited synergistic, additive, antagonistic, or no interaction. Overall, the tested lectins alone had no effect on the efficacy of oxacillin. On the other hand, different lectins in combination with tetracycline potentiated its antimicrobial effect. Lectins from red algae of the Bryothamnium genus, for example, exhibited the most significant synergistic effects, reducing the minimum inhibitory concentration (MIC) of tetracycline by up to 16 times. Lectins from the Hypnea genus also reduced the MIC of tetracycline. Our findings suggest that some lectins binding to complex carbohydrates containing fucosylated cores (α1-6) are excellent candidates to boost the efficacy of some antibiotics.

Abstract This paper presents a novel method for identifying critical transmission lines (CTLs) in power systems subjected to cascading overload outages, leveraging the Natural Connectivity (NC) index. Unlike previous studies that employed suboptimal weights for the edges, this work introduces a new weighting strategy that enhances the effectiveness of NC in CTLs identification. The proposed Weighted Natural Connectivity-based (WNC-based) method is validated through comparisons with established methods, including the catastrophic expectation index, and the cascading failure simulation index, using IEEE test systems of 30, 39, 57, and 118 buses and the 400 kV Mexican power system. The experimental results demonstrate that the WNC-based method accurately identifies critical lines, providing a practical balance between simplicity and precision. This study challenges prior conclusions that natural connectivity is unsuitable for CTLs identification, showcasing its potential in power system applications. Furthermore, the method's applicability extends to interconnected systems, such as the integration of power transmission, gas distribution, and telecommunication networks, paving the way for future research. The WNC-based method offers a practical tool for preventing blackouts and enhancing power grid resilience, contributing significantly to the field of power system reliability and stability.

Abstract The electric sector simultaneously faces two challenges: decarbonization to mitigate, and adaptation to manage, the impacts of climate change. In many regions, these challenges are compounded by an interdependence of electricity and water systems, with water needed for hydropower generation and electricity for water provision. Here, we couple detailed water and electricity system models to evaluate how the Western Interconnection grid can both adapt to climate change and develop carbon-free generation by 2050, while accounting for interactions and climate vulnerabilities of the water sector. We find that by 2050, due to climate change, annual regional electricity use could grow by up to 2% from cooling and water-related electricity demand, while total annual hydropower generation could decrease by up to 23%. To adapt, we show that the region may need to build up to 139 GW of additional generating capacity between 2030 and 2050, equivalent to nearly thrice California’s peak demand, and could incur up to $150 billion (+7%) in extra costs.

Abstract Background The heterogeneity of acute respiratory distress syndrome (ARDS) patients is a challenge for the development of effective treatments. This study aimed to identify and characterize novel respiratory subphenotypes of COVID-19 ARDS, with potential implications for targeted patient management. Methods Consecutive ventilated patients with PCR-confirmed COVID-19 infection, in which prone positioning was clinically indicated for moderate or severe ARDS, were included in a prospective cohort. The patients were assigned to development or validation cohorts based on a temporal split. The PaO2/FiO2 ratio, respiratory compliance, and ventilatory ratio were assessed longitudinally throughout the first prone session. The subphenotypes were derived and validated using machine learning techniques. A K-means clustering implementation designed for joint trajectory analysis was utilized for the unsupervised classification of the development cohort. A random forest model was trained on the labeled development cohort and used to validate the subphenotypes in the validation cohort. Results 718 patients were included in a prospective cohort analysis. Of those, 504 were assigned to the development cohort and 214 to the validation cohort. Two distinct subphenotypes, labeled A and B, were identified. Subphenotype B had a lower PaO2/FiO2 response during the prone session, higher ventilatory ratio, and lower compliance than subphenotype A. Subphenotype B had a higher proportion of females (p

Introduction and Objectives: Atrial fibrillation (AF) and heart failure (HF) often coexist. AF catheter ablation improves left ventricular ejection fraction (LVEF), but its impact varies between patients. We aimed to identify predictors of LVEF improvement in HF patients with impaired LVEF undergoing AF ablation. Methods: We conducted a retrospective single-center study in HF patients with LVEF

Abstract Long-duration energy storage (LDES) is a key resource in enabling zero-emissions electricity grids but its role within different types of grids is not well understood. Using the Switch capacity expansion model, we model a zero-emissions Western Interconnect with high geographical resolution to understand the value of LDES under 39 scenarios with different generation mixes, transmission expansion, storage costs, and storage mandates. We find that a) LDES is particularly valuable in majority wind-powered regions and regions with diminishing hydropower generation, b) seasonal operation of storage becomes cost-effective if storage capital costs fall below US$5 kWh−1, and c) mandating the installation of enough LDES to enable year-long storage cycles would reduce electricity prices during times of high demand by over 70%. Given the asset and resource diversity of the Western Interconnect, our results can provide grid planners in many regions with guidance on how LDES impacts and is impacted by energy storage mandates, investments in LDES research and development, and generation mix and transmission expansion decisions.

Abstract Background To address the societal burden of low back pain (LBP), several health systems have adopted Models of Care (MoCs). These evidence-informed models aim for consistent care and outcomes. However, real-world applications vary, with each setting presenting unique challenges and nuances in the primary healthcare landscape. This scoping review aims to synthesize the available evidence regarding the use of implementation theories, models or frameworks, context-specific factors, implementation strategies and outcomes reported in MoCs targeting LBP in primary healthcare. Methods MEDLINE(Pubmed), EMBASE, Cochrane Central Register of Controlled Trials, PEDro, Scopus, Web of Science and grey literature databases were searched. Eligible records included MoCs for adults with LBP in primary healthcare. Two reviewers independently extracted data concerning patient-related, system-related and implementation-related outcomes. The implementation processes, including guiding theories, models or frameworks, barriers and facilitators to implementation and implementation strategies were also extracted. The data were analysed through a descriptive qualitative content analysis and synthesized via both quantitative and qualitative approaches. Results Eleven MoCs (n = 29 studies) were included. Implementation outcomes were assessed in 6 MoCs through quantitative, qualitative, and mixed methods approaches. Acceptability and appropriateness were the most reported outcomes. Only 5 MoCs reported underlying theories, models, or frameworks. Context-specific factors influencing implementation were identified in 3 MoCs. Common strategies included training providers, developing educational materials, and changing record systems. Notably, only one MoC included a structured multifaceted implementation strategy aligned with the evaluation of patient, organizational and implementation outcomes. Conclusions The implementation processes and outcomes of the MoCs were not adequately reported and lacked sufficient theoretical support. As a result, conclusions about the success of implementation cannot be drawn, as the strategies employed were not aligned with the outcomes. This study highlights the need for theoretical guidance in the development and implementation of MoCs for the management of LBP in primary healthcare. Registration Open Science Framework Registries ( https://osf.io/rsd8x ).

OBJECTIVE: Gastric cancer (GC) is one of the most common cancers, and its incidence increases with age. The objective of the study was to evaluate the response rate (RR), overall survival (OS), and toxicity in patients aged over 60 years, with metastatic GC and who were undergoing chemotherapy. METHODS: This is a retrospective study developed in a university hospital. Medical records of patients treated in the last 4 years were analyzed. RESULTS: Twenty-one patients were included; the average age was 69.6 ± 7.6 years, 76.2% men, 61.9% Karnofsky Performance Status (KPS) ≥ 70, 85.7% had weight loss > 10% in 6 months, 28.6% had at least 2 sites of metastasis, and 42.9% had unfavorable histology (diffuse). Most of the patients (85.7%) were treated with combination regimens (4.6 cycles on average). Patients with better nutritional status had a non-statistically significant better tolerance to the treatment (p = 0.17). The median progression-free survival (PFS) was 9.0 months and the median OS was 13.8 months. Toxicity grade 1–2 was observed in 61.9%, and grade 3–4, in 14.3%. Less than two sites of metastasis (hazard ratio [HR] = 0.15; CI95% 0.02 – 0.93), absence of metastasis to non-regional lymph nodes (HR = 0.04; CI95% > 0.01 – 0.44), higher number of chemotherapy cycles (HR = 0.72; CI95% 0.53 – 0.97), objective response (HR = 0.06; CI95% 0.01 – 0.69) were associated with higher OS. Higher body mass index (BMI) was related with a not statistically significant better OS (HR = 0.84; CI95% 0.64 – 1.10). CONCLUSIONS: Patients treated in our hospital showed results compatible with literature. The doublet chemotherapy is feasible in elderly individuals with manageable toxicity.

ABSTRACT Objective: This study tests a suitable model for training robot-assisted peripheral vascular interventions and examines the learning curves of endovascular surgeons with different levels of previous experience and main focus of work, analyzing procedure time, fluoroscopy time, use of contrast, and radiation emission. Methods: Sixteen endovascular surgeons with different previous experience and training performed nine manual and 18 robotic angioplasties using the CorPath GRX platform on a 3D-printed life-size immersed infragenicular arterial phantom. Results: All participants considered the model reliable. When analyzing manual angioplasty outcomes, the juniors took significantly longer to perform angioplasties than the seniors (p=0.044). Among the seniors, interventionists were faster only on the first angioplasty (p=0.046). Analysis of the robotic angioplasty results showed that only one junior failed to cannulate one of the target arteries once. The total duration, fluoroscopy time, and radiation emission did not differ between juniors and seniors (p=0.095, p=0.60, and p=0.64, respectively). In addition, the learning curves for the maximum benefit required two attempts for procedure duration, one for fluoroscopy time, and three for radiation emission. There were no significant differences between senior vascular surgeons and interventionists. Among juniors, residents had a significantly lower procedure duration (p=0.042) and radiation emission (p=0.046) only for the first angioplasty. Conclusion: The learning curves for robotic peripheral arterial interventions were short, with a plateau for the procedure and fluoroscopy times and radiation emission after the third attempt. We observed no differences in the learning curves in relation to previous experience or training.

Although chimeric antigen receptor (CAR) T cell therapy has revolutionized type B cancer treatment, efficacy remains limited in various lymphomas and solid tumors. Reinforcing conventional CAR-T cells to release cytokines can improve their efficacy but also increase safety concerns. Several strategies have been developed to regulate their secretion using minimal promoters that are controlled by chimeric proteins harboring transactivators. However, these chimeric proteins can disrupt the normal physiology of T cells. Here, we present the first transactivator-free anti-CD19 CAR-T cells able to control IL-18 expression (iTRUCK19.18) under ultra-low doses of doxycycline and without altering cellular fitness. Interestingly, IL-18 secretion requires T cell activation in addition to doxycycline, allowing the external regulation of CAR-T cell potency. This effect was translated into an increased CAR-T cell antitumor activity against aggressive hematologic and solid tumor models. In a clinically relevant context, we generated patient-derived iTRUCK19.18 cells capable of eradicating primary B cells tumors in a doxycycline-dependent manner. Furthermore, IL-18-releasing CAR-T cells polarized pro-tumoral macrophages toward an antitumoral phenotype, suggesting potential for modulating the tumor microenvironment. In summary, we showed that our platform can generate exogenously controlled CAR-T cells with enhanced potency and in the absence of transactivators.

On 19 September 2021, a strombolian volcanic eruption began on the island of La Palma in the Canary Islands. This event resulted in the destruction of 73 km of roads, urban infrastructure, numerous houses, and agricultural crops, affecting approximately 7200 people and causing losses exceeding 1.2 billion euros. Around 12 km2 were covered by aa and pahoehoe lava flows, which reached thicknesses of over 70 m. Following the end of the eruption, thermal, geological, and geotechnical site investigations were carried out for the reconstruction and territorial and urban planning, with the main objectives focused on opening roads through hot lava, constructing new urban settlements in areas covered by lava flows, and facilitating the agricultural recovery. The primary challenges to reconstruction included the very slow cooling rate of the lava, resulting in persistent high temperatures, exceeding 500 °C, its highly heterogeneous geotechnical properties with numerous cavities and lava caves, and the presence of toxic gases. Site investigations included geotechnical boreholes, seismic geophysics and ground-penetration radar, and temperature measurements of lava flows using drones and thermocouple devices inside boreholes. To estimate the cooling rates of the lava flows, two physical cooling models were developed based on thermal behavior and geological–geotechnical data. The results indicated that lava cooling durations in some areas exceed practical waiting times for commencing reconstruction. This led to the development of geological engineering solutions that permit road construction and urban and agricultural reconstruction to begin sooner than estimated by the cooling models. On the other hand, potential hazards arising from the eruption process have also been taken into account. Stability analyses of the 200 m high volcanic cone formed during the eruption indicate the possibility of failure in the event of heavy rain and consequently lahar hazards. The results of the investigations carried out and their applications to post-disaster reconstruction may be useful for other volcanic regions, contributing to minimizing risk to infrastructure and urban settlements.

Phytophthora infestans remains a major threat to global potato production. This study focused on characterizing and assessing the pathogenicity of P. infestans isolates on detached potato leaves and in greenhouse trials across four cultivars. Seven isolates were obtained from high potato-producing regions in the department of Nariño, Colombia. The isolates were analyzed using 12 microsatellite markers to determine genetic distances. Two genetically distinct isolates showed markedly different pathogenicity on detached leaves: isolate P00921 caused complete infection by day five, whereas P00321 showed no symptoms. These two isolates (P00921 and P00321) selected for having the greatest genetic distance and highest pathogenicity among the seven analyzed were further tested in a greenhouse setup on four potato cultivars using a randomized block design. Disease progression was monitored over nine days. The results indicated significant variations in pathogenicity linked to genetic diversity among isolates. Notably, Capiro and Margarita cultivars were more prone to severe disease than Suprema and Única. These findings highlight the complex nature of host–pathogen interactions and suggest the need for tailored approaches in disease management and cultivar selection.

Urea is the primary source of nitrogen (N) used in agriculture. However, it has a high N loss potential through volatilization. Various mechanisms can be employed to reduce N volatilization losses by inhibiting urease. When added to urea, iodine (I) has high potential for this purpose. Thus, this study aimed to determine whether adding I to urea reduces volatilization losses and increases N uptake in maize plants. Maize plants were cultivated in greenhouse conditions for 36 days. Urea treatments were applied at 15 days of testing, including iodine-enriched urea, conventional urea, and no urea application. Additionally, a study concerning N volatilization from urea was conducted using the same treatments under the same environmental conditions. Iodine was incorporated and adhered to urea, at an I concentration of 0.2%, using potassium iodate (KIO3). Under controlled conditions and over a short period of time, it was observed that the application of iodine-enriched urea increased the chlorophyll b content, root N accumulation, and total N accumulation in maize plants compared with conventional urea. Moreover, iodine-enriched urea reduced N losses from volatilization by 11% compared with conventional urea. The reduction in N volatilization correlated positively with the increased chlorophyll b, total chlorophyll, root N accumulation, and total N accumulation favored by the iodine-enriched urea treatment. Our findings demonstrated that adding I to urea is an efficient and promising strategy to reduce N losses and increase N uptake in plants.

Partiendo de los trabajos seminales de Manuel Seco, complementados con importantes hallazgos recientes de Sandra Iglesia Martín, se estudian los principales rasgos del Diccionario nacional o Gran diccionario clásico de la lengua española de Ramón Joaquín Domínguez: un repertorio lexicográfico (y enciclopédico) que a menudo se aparta del principio de la objetividad lexicográfica para adoptar una actitud crítica y humorística que tiene a la Academia y su diccionario en el punto de mira.

Abstract The evolution of the COVID-19 pandemic has been associated with variations in clinical presentation and severity. Similarly, prediction scores may suffer changes in their diagnostic accuracy. The aim of this study was to test the 30-day mortality predictive validity of the 4C and SEIMC scores during the sixth wave of the pandemic and to compare them with those of validation studies. This was a longitudinal retrospective observational study. COVID-19 patients who were admitted to the Emergency Department of a Spanish hospital from December 15, 2021, to January 31, 2022, were selected. A side-by-side comparison with the pivotal validation studies was subsequently performed. The main measures were 30-day mortality and the 4C and SEIMC scores. A total of 27,614 patients were considered in the study, including 22,361 from the 4C, 4,627 from the SEIMC and 626 from our hospital. The 30-day mortality rate was significantly lower than that reported in the validation studies. The AUCs were 0.931 (95% CI: 0.90–0.95) for 4C and 0.903 (95% CI: 086–0.93) for SEIMC, which were significantly greater than those obtained in the first wave. Despite the changes that have occurred during the coronavirus disease 2019 (COVID-19) pandemic, with a reduction in lethality, scorecard systems are currently still useful tools for detecting patients with poor disease risk, with better prognostic capacity.

Abstract The oleaginous yeast species Rhodotorula toruloides is a promising candidate for applications in circular bioeconomy due to its ability to efficiently utilize diverse carbon sources being tolerant to cellular stress in bioprocessing. Previous studies including genome-wide analyses of the multi-stress tolerant strain IST536 MM15, derived through adaptive laboratory evolution from a promising IST536 strain for lipid production from sugar beet hydrolysates, suggested the occurrence of significant modifications in the cell wall. In this study, the cell wall integrity and carbohydrate composition of those strains was characterized to gain insights into the physicochemical changes associated to the remarkable multi-stress tolerance phenotype of the evolved strain. Compared to the original strain, the evolved strain exhibited a higher proportion of glucomannans, fucogalactomannans, and chitin relative to (1→4)-linked glucans, and an increased presence of glycoproteins with short glucosamine derived oligosaccharides, which have been found to be associated to ethanol stress tolerance and physical strength of the cell wall. Furthermore, the evolved strain cells were found to be significantly smaller than the original strain and more resistant to thermal and mechanical disruption, consistent with higher proportion of beta-linked polymers instead of glycogen, conferring a more rigid and robust cell wall. These findings provide further insights into the cell wall composition of this basidiomycetous red yeast species and into the alterations occurring in a multi-stress tolerant evolved strain. This new information can guide yeast genome engineering towards more robust strains of biotechnological relevance.

Abstract Background Fabry disease (FD) is a rare X-linked lysosomal storage disorder marked by alpha-galactosidase-A (α-Gal A) deficiency, caused by pathogenic mutations in the GLA gene, resulting in the accumulation of glycosphingolipids within lysosomes. The current screening test relies on measuring α-Gal A activity. However, this approach is limited to males. Infrared (IR) spectroscopy is a technique that can generate fingerprint spectra of a biofluid’s molecular composition and has been successfully applied to screen numerous diseases. Herein, we investigate the discriminating vibration profile of plasma chemical bonds in patients with FD using attenuated total reflection Fourier-transform IR (ATR-FTIR) spectroscopy. Results The Fabry disease group (n = 47) and the healthy control group (n = 52) recruited were age-matched (39.2 ± 16.9 and 36.7 ± 10.9 years, respectively), and females were predominant in both groups (59.6% and 65.4%, respectively). All patients had the classic phenotype (100%), and no late-onset phenotype was detected. A generated partial least squares discriminant analysis (PLS-DA) classification model, independent of gender, allowed differentiation of samples from FD vs. control groups, reaching 100% sensitivity, specificity and accuracy. Conclusion ATR-FTIR spectroscopy harnessed to pattern recognition algorithms can distinguish between FD patients and healthy control participants, offering the potential of a fast and inexpensive screening test.

Abstract Background Sinetrol® Xpur is a polyphenolic ingredient rich in citrus flavonoids that has shown weight loss effects in previous studies. The dose dependent nature, gut microbial actions of this product has not been explored previously, thus presented in this study. Methods In this open label study, we evaluated the effect of Sinetrol® Xpur supplementation on healthy but overweight/obese adults (20–50 yrs) for 16 weeks. Participants (n = 20) were randomly allocated to a high dose group (HD, 1800 mg/day) or low dose group (LD, 900 mg/day) of the product for 16 weeks. Fat composition, gut microbial composition, were evaluated using MRI and 16S rDNA sequencing respectively at week 1 and 16. Results We observed HDL, HbA1C, LDL and leptin improved significantly over 16 weeks, irrespective of the dosage. There was a trend for decrease in visceral adipose tissue (VAT), BMI over time and body weight displayed a trend for dose dependent decrease. Eubacterium xylanophilum, Ruminococcacea UCG-004 genus which increased in HD and LD respectively were negatively associated to VAT. Both doses increased butyrate producers such as Eubacterium ruminantium and Ruminococcaceae NK4A214 genus. Conclusions Overall chronic supplementation of Sinetrol® Xpur, irrespective of their dose improved HDL, HbA1c, LDL and leptin and tended to decrease visceral adipose tissue via changes in gut microbiota. Trial registration number NCT03823196.

Abstract RTS,S/AS01E, the first approved malaria vaccine, demonstrated moderate efficacy during the phase 3 pediatric trial. We previously investigated cell-mediated immune (CMI) responses following the primary 3-dose immunization and now report responses to the booster dose given 18 months later. Thirty CMI markers were measured by Luminex in supernatants of peripheral blood mononuclear cells from 709 children and infants after RTS,S/AS01E antigen stimulation, and their associations with malaria risk and antibodies one month post-booster and one year later were assessed. IL-2, IFN-γ, IL-17, IL-5, and IL-13 were associated with RTS,S/AS01E booster vaccination, and IL-2 responses to the circumsporozoite protein (CSP) remained higher after one year. IL-2 was associated with reduced malaria risk in one site, and IL-10 was associated with increased risk in infants. Anti-CSP IgG and IL-2 were moderately correlated one year after booster. This study highlights the moderate cell-mediated immunogenicity of the RTS,S/AS01E booster dose that aligns with partial recovery of RTS,S/AS01E vaccine efficacy.

En este trabajo se observó la subordinación desde la noción propuesta por la gramática funcional tipológica (Cristofaro, 2003; Givón, 2001, 2009; Haspelmath, 2016, 2021; Van Gijn, Haude y Muysken, 2011). Primero, se elaboró un criterio de análisis de la subordinación conceptual para el español, proponiendo una recategorización de su codificación en formas típicas y alternativas (Alvarado, 2020; Alvarado y Koza, 2018; Crespo y Alvarado, 2021). Posteriormente, se aplicó ese criterio para analizar las narraciones orales de un mismo grupo de escolares hispanohablantes a los 5, 7 y 10 años. Los resultados permitieron ver que la construcción de instancias de subordinación conceptual se incrementaba significativamente a medida que los niños crecían en edad, y, en esta misma lógica, la proporción de formas típicas seleccionadas aumentaba en desmedro de las alternativas.

Background: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is associated with acute brain injury (ABI), including central nervous system (CNS) ischemia (defined as ischemic stroke or hypoxic-ischemic brain injury [HIBI]) and intracranial hemorrhage (ICH). Data on prediction models for neurologic outcomes in VV-ECMO are limited. Methods: We analyzed adult (age ≥18 years) VV-ECMO patients in the Extracorporeal Life Support Organization (ELSO) Registry (2009-2021) from 676 centers. ABI was defined as CNS ischemia, ICH, brain death, and seizures. Data on 67 variables were extracted, including clinical characteristics and pre-ECMO/on-ECMO variables. Random forest, CatBoost, LightGBM, and XGBoost machine learning (ML) algorithms (10-fold leave-one-out cross-validation) were used to predict ABI. Feature importance scores were used to pinpoint the most important variables for predicting ABI. Results: Of 37,473 VV-ECMO patients (median age, 48.1 years; 63% male), 2644 (7.1%) experienced ABI, including 610 (2%) with CNS ischemia and 1591 (4%) with ICH. The areas under the receiver operating characteristic curve for predicting ABI, CNS ischemia, and ICH were 0.70, 0.68, and 0.70, respectively. The accuracy, positive predictive value, and negative predictive value for ABI were 85%, 19%, and 95%, respectively. ML identified higher center volume, pre-ECMO cardiac arrest, higher ECMO pump flow, and elevated on-ECMO serum lactate level as the most important risk factors for ABI and its subtypes. Conclusions: This is the largest study of VV-ECMO patients to use ML to predict ABI reported to date. Performance was suboptimal, likely due to lack of standardization of neuromonitoring/imaging protocols and data granularity in the ELSO Registry. Standardized neurologic monitoring and imaging are needed across ELSO centers to detect the true prevalence of ABI.

Abstract Antimicrobial resistance (AMR) as a result of antimicrobial overuse and misuse in agriculture is a growing concern, especially in the predominant but poorly regulated backyard or smallholder swine farms of the Philippines. A city-scale surveillance of antimicrobial resistance genes (ARGs) was conducted through selected backyard swine farms to obtain a comprehensive understanding of the AMR situation in the backyard sector of Davao City, Philippines. The ARGs encoding resistance to four antimicrobial classes (β-lactams: bla CTX−M, bla OXA, bla SHV, bla TEM, mecA; quinolones: qnrS and qnr-A2; macrolides: ermA and ermB; tetracycline: tetM) were quantified in swine feces via real-time PCR, and point maps were generated to visualize the ARG geographic distribution. The ARGs bla- TEM, ermB, qnrS, and tetM were detected in all farms at relatively intermediate to high levels, consistently representing the four most used antimicrobial classes in Philippine farms. All the investigated ARGs were present in some local barangay units, indicating potential emergence of AMR hotspots. A 0.5 quantile regression analysis identified specific backyard farm attributes associated with ARG occurrence and diversity, which may influence the ecological spread of the ARGs. These findings provide support for evidence-based guidelines to reinforce a One Health framework for the Philippine National Action Plan to Combat AMR.