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Wildlife biodiversity is essential for healthy, resilient and sustainable ecosystems. For biologists, this diversity also represents a treasure trove of genetic, molecular and developmental mechanisms that deepen our understanding of the origins and rules of life. However, the rapid decline in biodiversity reported recently foreshadows a potentially catastrophic collapse of many important ecosystems and the associated irreversible loss of many forms of life on our planet. Immediate action by conservationists of all stripes is required to avert this disaster. In this Spotlight, we draw together insights and proposals discussed at a recent workshop hosted by Revive & Restore, which gathered experts to discuss how stem cell technologies can support traditional conservation techniques and help protect animal biodiversity. We discuss reprogramming, in vitro gametogenesis, disease modelling and embryo modelling, and we highlight the prospects for leveraging stem cell technologies beyond mammalian species.

This journal explained about The Relation Between Self Concept and Students’ Academic Procratination Behaviour at SMAN 4 Kota Bogor. The aim of this research is to know there positive relationship between them at SMAN 4 Kota Bogor. This research used quantitative method, the samples was taken by sampling randomly technic with 190 respondences. The data was collected by questionaire, and analyzed by product moment pearson. The count result is 0,360. The index corelation number is not negative sign between 0,20-0.40. It can be concluded that between self concept and students’ academic procratination behaviour is low effecct. It means that there is positive Relationship Betwen Self Concept and Students’ Academic Prokratination Behaviour at SMAN 4 Bogor.

Stem cells exist in vitro in a spectrum of interconvertible pluripotent states. Analyzing hundreds of hiPSCs derived from different individuals, we show the proportions of these pluripotent states vary considerably across lines. We discover 13 gene network modules (GNMs) and 13 regulatory network modules (RNMs), which are highly correlated with each other suggesting that the coordinated co-accessibility of regulatory elements in the RNMs likely underlie the coordinated expression of genes in the GNMs. Epigenetic analyses reveal that regulatory networks underlying self-renewal and pluripotency are more complex than previously realized. Genetic analyses identify thousands of regulatory variants that overlapped predicted transcription factor binding sites and are associated with chromatin accessibility in the hiPSCs. We show that the master regulator of pluripotency, the NANOG-OCT4 Complex, and its associated network are significantly enriched for regulatory variants with large effects, suggesting that they play a role in the varying cellular proportions of pluripotency states between hiPSCs. Our work bins tens of thousands of regulatory elements in hiPSCs into discrete regulatory networks, shows that pluripotency and self-renewal processes have a surprising level of regulatory complexity, and suggests that genetic factors may contribute to cell state transitions in human iPSC lines.

Abstract Background SARS-CoV-2 infection has become a major international issue, not only from a medical point of view, but also social, economic and political. Most of the available information comes from the United States, Europe, and China, where the population and the socioeconomic status are very different from Latin American countries. This study evaluates the effect of regional socioeconomic characteristics on mortality due SARS-CoV-2 infection in patients with immune-mediated rheumatic diseases (IMRD) from Argentina, Mexico and Brazil. Methods Data from three national registries, SAR-COVID (Argentina), CMR-COVID (Mexico) and ReumaCoV-Brasil (Brazil), were combined. Adult IMRD patients with SARS-CoV-2 infection were recruited. National data for each province/state, including population density, number of physicians per inhabitant, income, unemployment, GINI index, Municipal Human Development Index (MHDI), stringency index, vaccination rate and most frequent viral strains per period were assessed as risk factors for mortality due to COVID-19. Results A total of 4744 patients were included, 2534 (53.4%) from SAR-COVID, 1166 (24.6%) from CMRCOVID and 1044 (22.0%) from ReumaCoV-Brasil. Mortality due to COVID-19 was 5.4%. In the multivariable analysis, higher number of physicians per 1000 inhabitants and being infected during the vaccination period of each country were associated with lower mortality. After adjustment for socioeconomic factors, there was no association with country of residence and mortality. Conclusion These findings corroborate the complex interplay between socioeconomic factors, rheumatic disease activity, and regional disparities as determinants of death due to COVID-19 in Argentina, Brazil and Mexico. Thus, this research provides valuable insights for guiding public health policies and clinical practice in the ongoing fight against the COVID-19 pandemic.

PURPOSE The experience of ethnically diverse parents of children with serious illness in the US health care system has not been well studied. Listening to families from these communities about their experiences could identify modifiable barriers to quality pediatric serious illness care and facilitate the development of potential improvements. Our aim was to explore parents' perspectives of their children's health care for serious illness from Somali, Hmong, and Latin-American communities in Minnesota. METHODS We conducted a qualitative study with focus groups and individual interviews using immersion-crystallization data analysis with a community-based participatory research approach. RESULTS Twenty-six parents of children with serious illness participated (8 Somali, 10 Hmong, and 8 Latin-American). Parents desired 2-way trusting and respectful relationships with medical staff. Three themes supported this trust, based on parents' experiences with challenging and supportive health care: (1) Informed understanding allows parents to understand and be prepared for their child's medical care; (2) Compassionate interactions with staff allow parents to feel their children are cared for; (3) Respected parental advocacy allows parents to feel their wisdom is heard. Effective communication is 1 key to improving understanding, expressing compassion, and partnering with parents, including quality medical interpretation for low-English proficient parents. CONCLUSIONS Parents of children with serious illness from Somali, Hmong, and Latin-American communities shared a desire for improved relationships with staff and improved health care processes. Processes that enhance communication, support, and connection, including individual and system-level interventions driven by community voices, hold the potential for reducing health disparities in pediatric serious illness. https://doi.org/10.1370/afm.3106, INTRODUCTION In the United States, nearly 500,000 children live with a serious or life-threatening illness, (1,2) defined by the Institute of Medicine as those who carry a substantial probability of [...]

Abstract Background There has been a substantial increase in the use of laparoscopic sleeve gastrectomy (SG) to treat morbid obesity despite observational evidence demonstrating the superiority of Roux-en-Y gastric bypass (RYGB) for reducing low-density lipoprotein (LDL) cholesterol. The main aim was to ascertain whether high LDL cholesterol levels should be considered when selecting the most appropriate surgical procedure for each patient (RYGB or SG). Methods In this single-center, randomized clinical trial using intention-to-treat analysis, 38 patients with severe obesity and elevated levels of LDL cholesterol were randomly assigned to undergo RYGB or SG. The primary outcome was LDL cholesterol remission at 12 months, defined as LDL cholesterol

Introdução: A Criptococose é uma doença causada pelos fungos leveduriformes Cryptococcus gatti ou Cryptococcus neoformans. Os quadros invasivos são mais frequentes em imunossuprimidos, porém, há ocorrência de casos em pacientes imunocompetentes. A criptococose pulmonar pode apresentar-se clinicamente com quadro de tosse com expectoração mucoide, febre, dispneia, hemoptise, dor torácica, perda ponderal e pode evoluir para insuficiência respiratória e óbito. Na tomografia computadorizada (TC) de tórax os achados mais frequentes são nódulos pulmonares, consolidações, opacidade em vidro fosco e cavitações. Por outro lado, a neoplasia pulmonar tem incidência maior que a criptococose pulmonar e seu principal fator de risco é o tabagismo. Clinicamente, apresenta sintomas semelhantes a quadros infecciosos pulmonares com exames de imagem com padrão de acometimento variável conforme o tipo histológico e malignidade. Objetivo: Relatar caso de paciente idoso, tabagista e imunocompetente com quadro de criptococose mimetizando neoplasia pulmonar. Método: Relato de caso e revisão de literatura. Resultados: Paciente do sexo masculino, idoso, tabagista e imunocompetente, com quadro de dispneia progressiva e emagrecimento iniciados cerca de 30 dias do primeiro atendimento, com TC de tórax que evidenciava nódulos de características malignas em pulmão esquerdo. Foi submetido a biópsia por radiointervenção cujo resultado foi negativo para neoplasia, mas foram visualizadas estruturas compatíveis com leveduras e a pesquisa adicional com coloração de Grocott confirmou que se tratava de leveduras capsuladas características de Cryptococcus. Paciente foi tratado com Fluconazol por 12 meses, com boa resposta clínica e radiológica. Conclusão: Casos como este refletem a importância do diagnóstico diferencial frente à hipótese inicial de uma neoplasia pulmonar e a inclusão sistemática das micoses endêmicas entre os diagnósticos diferenciais na investigação de nódulos pulmonares. Em geral há atraso significativo no diagnóstico das micoses pulmonares pois a investigação acaba se limitando às neoplasias e à tuberculose pulmonar entre as etiologias infecciosas, de modo que os testes diagnósticos adequados não são solicitados. Sendo assim, é fundamental o compartilhamento de casos como esse para reforçar a importância das micoses endêmicas no cenário das patologias pulmonares a contribuir para uma suspeição precoce e investigação adequada.

Introdução: A Endocardite Infecciosa (EI) por bactérias gram-negativas, especialmente do grupo não-HACEK, é uma condição rara e geralmente associada a indivíduos que fazem uso de drogas injetáveis ou relacionada à assistência à saúde e com altas taxas de letalidade. A EI por Pseudomonas aeruginosa é ainda menos frequente do que as EI causadas por bactérias da família Enterobacteriaceae, com poucas séries de casos descritas na literatura, porém sabidamente associada a quadros mais graves, com maior necessidade de intervenção cirúrgica. Objetivo: Relatar caso de EI de coração direito por Pseudomonas aeruginosa em paciente jovem imunocompetente. Método: Relato de caso e revisão de literatura. Resultados: Paciente jovem, com hepatite C crônica, sem cirrose hepática, com EI de valva tricúspide por P. aeruginosa decorrente do uso inadequado de um portocath em veia subclávia direita. Tal dispositivo fora instalado alguns anos antes em outro serviço devido à necessidade de frequentes infusões EV de analgésicos por um quadro possível de fibromialgia evoluindo com dores crônicas de difícil manejo. Havia a hipótese de adicção a opioides. Na admissão chegou a apresentar quadro de sepse, evoluindo com sinais de insuficiência hepática, com melhora após tratamento. Apresentou complicações como embolia séptica para o parênquima pulmonar e para os grandes vasos pulmonares. O portocath foi retirado e posteriormente foi submetida à ressecção da vegetação em valva tricúspide e trombectomia em vasos pulmonares associadas a antibioticoterapia EV por 6 semanas com Cefepime (6g/dia) em regime de internação hospitalar. Paciente apresentou boa evolução clínica e recebeu alta para casa após término do tratamento. Conclusão: A rápida identificação da Pseudomonas nas hemoculturas, o início precoce de antibioticoterapia efetiva e a intervenção cirúrgica em tempo hábil foram fundamentais para a boa resposta clínica da paciente. Além disso, por se tratar de cepa com boas opções terapêuticas foi possível manter a monoterapia direcionada e com o menor espectro antimicrobiano possível, propiciando um menor risco de eventos adversos e menor risco de seleção de cepas resistentes. Não há consenso na literatura quanto à necessidade ou não da associação de antimicrobianos para o tratamento de EI por bacilos gram-negativos não HACEK, de modo que é fundamental o compartilhamento de experiências de casos de endocardite por patógenos pouco habituais.

Introdução: A meningite e a ventriculite relacionadas à assistência à saúde podem ocorrer após procedimentos neurocirúrgicos invasivos de urgência ou eletivos, na maioria das vezes associadas à presença de dispositivos como de derivação ventricular externa (DVE) ou peritoneal (DVP). A dificuldade em ultrapassar a barreira hematoencefálica é um desafio para a antibioticoterapia, gerando a necessidade de tempo prolongado de níveis elevados de antibióticos por via endovenosa (EV) e mesmo assim com altas chances de falha terapêutica. Uma alternativa a esse obstáculo é a terapia intraventricular ou intratecal, na qual o antibiótico é injetado diretamente no ventrículo cerebral ou no líquor da região lombar por meio de punção local. Objetivo: Relatar um caso de sucesso de ventriculite crônica relacionada à assistência à saúde tratada com antibioticoterapia intratecal. Método: Relato de caso. Resultados: Este caso descreve um paciente em pós-operatório de neurocirurgia devido TCE grave com implantação de DVE para manejo de hidrocefalia pós-traumática, o qual evoluiu nas primeiras semanas de internação com quadro de meningite tratada de forma convencional. Todavia, apresentou nos meses seguintes recidivas da infecção e necessidade de implantação de DVP devido hidrocefalia crônica com sinais de hipertensão intracraniana, com posterior evolução para quadro de ventriculite crônica e infecção do circuito de DVP com culturas positivas para Pseudomonas aeruginosa, Klebsiella oxytoca, Klebisiella pneumoniae e Staphylococcus epidermidis. Após sucessivas internações e ciclos de antimicrobiano EV, foi optado por terapia intraventricular com Vancomicina e Amicacina por 14 dias. Paciente recebeu alta em uso de DVP e antibioticoterapia mantida por 6 semanas com Ciprofloxacino e Rifampicina e, após esse período, evoluiu de maneira satisfatória e sem novas internações. Conclusão: A terapia intraventricular ainda não é realizada de forma rotineira na prática clínica, apesar do aumento dos casos de infecções do sistema nervoso relacionadas à assistência à saúde. Ademais, a ausência de um guideline e de uma série de casos brasileiros sobre o tema dificulta a indicação e a realização desse tipo de terapia, sendo realizada somente como última alternativa para pacientes com casos crônicos que não respondem à terapia convencional. Dessa forma, o relato de um caso de sucesso contribui com a possibilidade de implementação de um protocolo que inclua a terapia intraventricular de forma mais precoce nos casos de difícil tratamento.

Introdução: Pasteurella multocida (PM) é um cocobacilo gram negativo tipicamente colonizador da cavidade oral e nasofaringe de vários animais, sobretudo gatos. Pode ser transmitida após mordedura ou contato com suas secreções nasais, sendo comumente associada a quadros de celulite. A minoria dos casos evolui com infecção de corrente sanguínea e a endocardite infecciosa (EI) é uma complicação rara. Diante dos poucos relatos de EI por PM, não há um consenso sobre qual seria o tratamento mais adequado. Objetivo: Relatar um caso de EI por PM com boa evolução clínica, descrevendo o tratamento realizado e procurando agregar dados na literatura sobre as opções terapêuticas para esse tipo de endocardite. Método: Relato de caso e revisão de literatura. Resultados: Sexo feminino, 40 anos, antecedente de prótese metálica em valva mitral, foi internada com quadro de dor abdominal, diarreia, febre e calafrios iniciados 5 dias antes da admissão. Apresentava hipotensão e foi detectada a presença sopro diastólico em foco mitral. Diante da hipótese inicial de abdome agudo inflamatório foi iniciado tratamento empírico com Ceftriaxone 2g/dia e Metronidazol 500mg 8/8horas. Hemoculturas vieram positivas após cerca de 7h da admissão, com identificação posterior de P. multocida multissensível. Paciente negava histórico de contato recente com animais. Foi solicitada ecocardiografia transtorácica que evidenciou vegetação de 0,6 cm aderida à prótese mitral. Na investigação complementar apresentou múltiplos êmbolos sépticos em RNM de crânio e insuficiência renal aguda, com glomerulonefrite com C3 e C4 baixos. Recebeu tratamento com Ceftriaxone 2 g/dia e Ciprofloxacino 400 mg 2 × /dia por 6 semanas, com transição para terapia parenteral ambulatorial (Ceftriaxone) e oral (Ciprofloxacino) após 3 semanas de internação. Não houve indicação de abordagem cirúrgica pelas equipes de cirurgia cardíaca e neurocirurgia. Conclusão: Não há consenso a respeito da terapia mais adequada para o tratamento de EI por PM. Há múltiplos relatos em literatura trazendo experiências de tratamento muito diversas, tanto em termos de uso de terapia simples ou combinada, escolha das drogas, via de administração e tempo de tratamento. Em guidelines de EI há sugestões de tratamentos de EI por bacilos gram-negativos não HACEK com terapia combinada, envolvendo aminoglicosídeos ou quinolonas associadas principalmente a betalactâmicos, sem pormenorizar a possibilidade de terapia por via oral ou parenteral ambulatorial.

Introdução: A tricomoníase pulmonar, inicialmente considerada rara, pode ser subestimada principalmente devido ao desafio de reconhecer essa doença. Essa dificuldade surge de métodos microbianos insensíveis e da ausência de características clínicas específicas, mesmo em paciente com fatores de risco. Objetivo: A tricomoníase pulmonar é uma condição incomum e/ou subdiagnosticada mesmo em pacientes com os fatores de risco bem estabelecidos para a doença. O caso a seguir propõe relatar no entanto a presença de empiema pleural por tricomonadídeo visualizado por microscopia direta em paciente sem esses fatores de risco. Método: Foi levantado na literatura para este relato através da base de dados da PubMed artigos que se referem à incidência de infecções por Trichomonas fora do trato urogenital, suas características clínicas e os métodos de microbiologia molecular utilizados para realização diagnóstica. Resultados: J.L.P., 35 anos, sem fatores de risco prévios, apresentou inicialmente queixa de otalgia bilateral, seguida por odinofagia intensa, febre e dispneia progressiva com insuficiência respiratória, levando à descoberta de hidropneumotórax em exame de imagem. Drenagem torácica revelou empiema com visualização de Trichomonas spp em microscopia direta, além de cultura positiva para Klebsiella pneumoniae e Enterobacter cloacae. Realizada drenagem de tórax com paciente mantendo alto débito do dreno durante grande parte da internação, tendo levantada suspeita de fístula quilosa associada, que foi posteriormente descartada, e após grande curso de antibioticoterapia endovenosa com cefepime (6 g/dia) e metronidazol (1,5 g/dia) por 04 semanas, com controle de foco, paciente evolui favoravelmente com critérios de alta hospitalar. Conclusão: Na maioria das infecções do trato respiratório, o patógeno causador permanece desconhecido, havendo uma necessidade urgente de melhorar os métodos de detecção. Várias espécies de Trichomonas podem ser responsáveis por infecções pulmonares, sendo o mais comum o T. tenax, um protozoário anaeróbico de difícil cultivo, altamente prevalente em doenças periodontais. Estudos mostram resultados promissores para o uso do nested-PCR e nMGS para detecção desses patógenos em lavado bronco-alveolar. A co-infecção com bactérias anaeróbias é considerável, e em pacientes que não respondem clinicamente à terapia antimicrobiana empírica inicial a associação de nitromidazóis é recomendada, principalmente em pacientes com fatores de risco.

IntroductionTo increase the population's ability to handle emergencies, life-saving maneuvers should be universally acquired as an automatic skill starting from school through frequent and practical retraining. Teachers could be ideal multipliers, but it is necessary to design pathways that train and motivate them, since Basic Life Support and Defibrillation (BLSD) skills are not part of their academic curricula. This study explores innovative training solutions and facilitating factors to enhance BLSD education in schools by focusing on the training and motivation of teachers.MethodsIn the 1st year, an in-service training program for teachers was provided and assessed in a lower middle school in central Italy. The study compared the skills of a group of students trained by teachers with those trained by certified instructors, immediately after the course and 6 months later. Both the procedural skills and the quality of cardiopulmonary resuscitation (CPR) were evaluated, through a hands-on simulation. Over the next 5 years, the project was expanded to three more schools, and a field study was conducted where researchers monitored the teachers in their classroom work, supporting them in resolving critical issues.ResultsQuantitative assessments showed significant differences in student abilities immediately after the course, which diminished after 6 months. Qualitative evaluations indicated that teachers, initially reluctant, gained confidence and effectively taught BLSD skills. Over 5 academic years, the project expanded to additional schools, training 5,661 students in life-saving maneuvers with a ratio of 1 teacher for every 111 trained students, over the whole period of time. Sustainability factors included regular retraining of teachers, continually updated and free didactic materials and equipment, internal coordinators, allowing teachers the freedom to structure a customized course schedule in terms of timing and delivery methods.ConclusionThe study highlights the effectiveness of trained teachers as BLSD knowledge multipliers. Standardizing teacher training, including follow-up retraining, is crucial, but flexibility in student training is beneficial, allowing adaptation to the specific needs of schools. Future research should focus on the long-term sustainability of chain training in larger areas, identifying strategies to overcome organizational and motivational barriers.

Objetivos: Comparar la validez diagnóstica entre la escala Neuropathy Disability Score (NDS) sin Monofilamento (MF) y NDS modificada con MF frente a Electromiograma (EMG) de extremidades Inferiores. Concordancia entre neuropatía detectada y registrada en Historial Clínico Informatizado (HCI) Metodología: Estudio de concordancia. Duración: 12 meses. Ámbito: Dos centros de Atención Primaria (AP) del Institut Català de Salut. Población diana: Personas con EMG registrado en HCI por sospecha de neuropatía diabética y otras neuropatías de extremidad inferior. Muestreo: Para un coeficiente kappa de 0,8 y precisión de 0,2 necesitamos 104 personas. Criterios de inclusión por Grupos: A: DM con registros del pie de riesgo sin neuropatía. B: DM con diagnóstico de neuropatía. C: Sin neuropatía ni DM conocidas. Selección: Simple, mediante listado de candidatos por centros participantes. Captación: Telefónica y programados en agenda única. Intervenciones: Entrevista clínica (Cuestionario sintomático Neuropathy Symptoms Score) (NSS) (0-9 puntos), Examen clínico: (Valoración sensitivomotora mediante escala NDS modificada (0-5 puntos por pie). Neuropatía si NDS > 6 puntos). Exploraciones: Tres por Enfermería, dos consecutivas y una espaciada 2 semanas. Variables Independientes: Puntuación de NDS y NSS. Dependientes: Factores de Riesgo Cardiovascular. Complicaciones DM. Análisis estadístico: Si la muestra es homogénea, mediante t de Student y ANOVA. Se calculará la fiabilidad y validez inter observador. Concordancia mediante Kappa, sin descartar métodos no paramétricos si la distribución lo aconseja. STATA. Resultados esperados: Disponer de un procedimiento exploratorio que mejore la actual valoración del pie de riesgo en AP. Aplicabilidad: Mejorar el diagnóstico de neuropatía diabética en AP. ABSTRACT Objectives: Compare the diagnostic validity between the Neuropathy Disability Score (NDS) scale without Monofilament (MF) and NDS modified with the MF and Lower Extremity Electromyogram (EMG). Concordance between neuropathy detected and recorded in the Computerized Clinical History (HCI) Methodology: Concordance study. Duration: 12 months. Setting: Two Primary Care (PC) centers of the Institut Català de Salut. Target population: People with EMG recorded in HCI for suspected diabetic neuropathy and other lower extremity neuropathies. Sampling: For a kappa coefficient of 0.8 and precision of 0.2 we need 104 people. Inclusion criteria by Groups: A: DM with risk foot records without neuropathy. B: DM with diagnosis of neuropathy. C: No known neuropathy or DM. Selection: Simple, through a list of candidates by participating centers. Capture: Telephone and scheduled in a single agenda. Interventions: Clinical interview (Neuropathy Symptoms Score) (NSS) symptomatic questionnaire (0-9 points), Clinical examination: (Sensorimotor assessment using modified NDS scale) (0-5 points per foot). Neuropathy if NDS > 6 points. Examinations: Three per Nursing, two consecutive and one spaced 2 weeks apart.Variables Independent: NDS and NSS score. Dependents: Cardiovascular Risk Factors. DM complications. Statistical analysis: If the sample is homogeneous, using Student's t-test and ANOVA. Inter-observer reliability and validity will be calculated. Agreement using Kappa, without ruling out non-parametric methods if the distribution recommends it. STATA. Expected results: To have an exploratory procedure that improves the current assessment of the risk foot in PC. Applicability: Improve the diagnosis of diabetic neuropathy in PC.

Objective: The objective of this article was to examine the eco-innovation performance of the European Un-ion’s economies in terms of eco-innovation outcomes with a particular focus on resource efficiency and socio-economic outcomes. Research Design & Methods: We used quantitative research methods, such as descriptive statistics, Euclidean distance, and Pearson’s correlation index. We based the comparative analysis of the eco-innovation indices related to outputs and outcomes on the Eco-innovation Scoreboard. We conducted it for the years 2013-2022. Findings: The research results showed that EU countries considered as one group improved their eco-innovation performance as measured by the Eco-innovation Index (EII), as well as in terms of the EII composite indices related to innovation outcomes during the study period. We also observed improvement in the EII and the EII thematic areas observed for both the eco-innovation leaders and catching-up economies. However, the leading countries maintained and even slightly increased the distance to the EU-27 average in terms of the total EII index, while significantly increasing the distance in terms of socio-economic outcomes and eco-innovation outputs. Moreover, the rates of growth of eco-innovation outputs and outcomes were much higher for these countries than the growth rate of their eco-innovation inputs. Implications & Recommendations: The study highlights the importance of the effective conversion of the eco-innovation inputs into eco-innovation outputs and outcomes, which is a big challenge, especially for the economies with poorer eco-innovation performance. The increase in eco-innovation inputs alone does not translate directly into an increase in eco-innovation outcomes in all conditions. Creating appropriate conditions for the development of eco-innovation requires a coordinated political approach, especially between innovation, research and environmental policy. Contribution & Value Added: The study contributes to a better understanding of eco-innovation for better policymaking. In particular, it can give a comprehensive picture of eco-innovation outcomes in the European Union as one of the key components of eco-innovation performance. The article also addresses the vital issue of the relationship between eco-innovation inputs and eco-innovation outputs and outcomes.

IntroductionIn collaboration with the Minnesota Hmong community, we have previously discovered significant differences in allele frequencies for key Single Nucleotide Variations (SNVs) within Very Important Pharmacogenes (VIPs) between Hmong and East Asians. Recognizing the potential clinical implications of these observed differences, we sought to validate these observations in a Hmong cohort residing in California, the state with the largest Hmong population in the US. Robust validation of these differences would affect motivation for clinicians treating individuals who identify as Hmong to consider pharmacogenomic (PGx) testing as a means to improve clinical decision making when using therapeutic agents in this unique population.MethodGuided by California Hmong community leaders and utilizing the basic approach of community-based participatory research, demographic, clinical information and a buccal swab was obtained from Hmong adults residing in California. A commercial PGx testing panel was performed on these samples and specific allele frequencies of interest were compared between California and Minnesota Hmong. Allele frequency differences between California Hmong, East Asians and Europeans, were also compared. Return-of-PGx-results and presentations of group data were made to members of the Hmong along with PGx educational sessions to help interpret the observations.ResultsIn 118 California Hmong who completed the study, the allele frequencies for SNV’s were similar to previous Minnesota Hmong results. Furthermore, out of the 18 SNVs that were not previously reported in Hmong, allele frequencies were statistically different in 38% (7/18) of SNVs comparing California Hmong to East Asians, and in 77.8% (14/18) SNVs comparing California Hmong to Europeans.ConclusionThese results validate the original study’s findings that Hmong people living in different US locations have similar allele frequencies for key PGx genes. Further, for many of these PGx genes, their allele frequencies are significantly different compared to either East Asians or Europeans. Clinicians should consider these important differences when prescribing medications for people who identify as Hmong.

Introduction: Prevention of diabetes requires sustained lifestyle changes as well as identification of groups at higher risk. Objective: The aim of this research was to estimate the risk of diabetes in vulnerable subjects from a primary care center in northern Argentina, with no known glucose abnormalities, using the FINDRISC questionnaire, investigate the relationship between survey variables and the final score, and explore its association with metabolic risk factors and body composition. Methodology: This cross-sectional design included 498 patients without type 2 diabetes or known glycemic abnormalities. All subjects underwent a complete medical history and completed the FINDRISC questionnaire. Results: The predominant age group was 18-45 years old. Around 64% were physically active and 44% reported daily consumption of fruit and vegetables. Most of them had a BMI higher than 25 kg/m2. Regarding the risk of developing type 2 diabetes in the next 10 years, 24.3% were at low risk and the remaining fraction was distributed in slightly elevated, moderate, high and very high risk. All variables influenced the individuals' variance (p < 0.05). The hierarchical clustering and principal component analysis (PCA) revealed that elevated FINDRISC score was strongly associated with: age > 65 years, fasting blood glucose, BMI ? 30 kg/m2 and antihypertensives use. CONCLUTION: We found a high percentage of obesity and overweight, as well as a high risk of cardiometabolic disease and of developing T2D. In addition, in the population studied, the variables that compose the FINDRISC did not influence the highest score in the same way.