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Abstract Background Pregnant women are a vulnerable population to COVID-19 given an increased susceptibility to severe SARS-CoV-2 infection and pregnancy complications. However, few SARS-CoV-2 serological surveys have been performed among this population to assess the extent of the infection in sub-Saharan countries. The objectives of this study were to determine SARS-CoV-2 seroprevalence among Beninese pregnant women, to identify spatial seropositivity clusters and to analyse factors associated with the infection. Methods A cross-sectional study including women in their third trimester of pregnancy attending the antenatal care (ANC) clinics at Allada (south Benin) and Natitingou (north Benin) was conducted. Rapid diagnostic tests (RDT) for detection of IgG/IgM against the SARS-CoV-2 spike protein were performed using capillary blood. Seroprevalence of SARS-CoV-2 antibodies and associations between SARS-CoV-2 serostatus and maternal characteristics were analyzed by multivariate logistic regression. Spatial analyses were performed using the spatial scan statistics to identify spatial clusters of SARS-CoV-2 infection. Results A total of 861 pregnant women were enrolled between May 4 and June 29, 2022. 58/861 (6.7%) participants reported having received COVID-19 vaccine. None of the participants had been diagnosed with COVID-19 during their pregnancy. SARS-CoV-2 antibodies were detected in 607/802 (75.7%; 95% CI 72.56%–78.62%) of unvaccinated participants. Several urban and rural spatial clusters of SARS-CoV-2 cases were identified in Allada and one urban spatial cluster was identified in Natitingou. Unvaccinated participants from Allada with at least one previous morbidity were at a three-times higher risk of presenting SARS-CoV-2 antibodies (OR = 2.89; 95%CI 1.19%-7.00%). Conclusion Three out of four pregnant women had SARS-CoV-2 antibodies, suggesting a high virus circulation among pregnant women in Benin, while COVID-19 vaccination coverage was low. Pregnant women with comorbidities may be at increased risk of SARS-CoV-2 infection. This population should be prioritized for COVID-19 diagnosis and vaccination in order to prevent its deleterious effects. Trial registration NCT06170320 (retrospectively registered on December 21, 2023).

Abstract Objectives This study aimed to compare the effectiveness and safety of the adjustable trans‐obturator male system (ATOMS®) to treat post‐prostatectomy incontinence (PPI) in radiated patients compared with non‐radiated patients, using propensity score‐matching analysis to enhance the validity of the comparison. Patients and methods Consecutive men with PPI treated with silicone‐covered scrotal port ATOMS (A.M.I., Feldkirch, Austria) in nine different institutions between 2016 and 2022 were included. Preoperative assessment evaluated 24‐h pad usage, urethroscopy and urodynamics, if indicated. Propensity score‐matching analysis was based on age, length of follow‐up, previous PPI treatment, previous bladder neck stricture, androgen deprivation and pad usage. The primary endpoint was dry rate, defined as no pads post‐operatively with a security pad allowed. The secondary endpoints were complications, device removal and self‐perceived satisfaction with the Patient Global Impression of Improvement (PGI‐I) scale. Results Of the 710 included patients, 342 were matched, and the study groups were balanced for the baseline matched variables. The mean baseline 24‐h pad was 4.8 in both groups (p = 0.48). The mean follow‐up was 27.5 ± 18.6 months, which was also equivalent between groups (p = 0.36). The primary outcome was achieved in 73 (42.7%) radiated patients and in 115 (67.3%) non‐radiated patients (p

Este trabajo constituye una primera aproximación al adverbio otrora y, en concreto, a su origen, su distribución geográfica y su comportamiento gramatical a partir de un enfoque descriptivo. Por una parte, a partir de los datos diacrónicos del CORDE y CORDIAM, y de la distribución geográfica que proporciona el CORPES, se muestra que otrora es una incorporación del español de América, en línea con lo señalado por Corominas y Pascual (1980-1991, s. v. otro), y no un lusismo renacentista introducido en el español peninsular, como sugiere Octavio de Toledo (2018, nota 33). Por otra parte, se estudia el comportamiento gramatical de este adverbio: se describen las restricciones que presenta en función de las propiedades semánticas del predicado y se señala a qué elementos puede modificar.

Background: The Emotional Intelligence theory has evolved from the respective definitions of intelligence and emotion. Emotional Intelligence is a fundamental competence for Nursing professionals because it allows developing effective therapeutic relationships, facilitates interaction with other professionals, acts as a significant predictor of conflict management, and is related to a reduction in stress due to overload and work schedules or avoidance behaviours that can affect Nursing care quality but their training is not sufficiently integrated into the training curricula of health professions son the study’s aim is to evaluate the change in Nursing students' perception regarding Emotional Intelligence after carrying out clinical practices in different care services.Materials and methods: A longitudinal and observational study was carried out at differents Spain's universities. 149 students were included in the study, recruited through a accidental sampling in four Spanish universities. The study investigates the emotional change produced by clinical practices through the TMMS-24 questionnaire. Other sociodemographic and academic variables were collected and the Nursing students' stressors in clinical practices by KEZKAK questionnaire and the Nursing students' perceptions of the instructor's care by S-NSPIC, because they have demonstrated their influence in the process.Results: The sample consisted of 88.5% were women (n=131) and 11.5% men (n=17) with a mean age of 23.36 ±4.69 years old. The perception of Emotional Intelligence obtained adequate ranges and it increases after clinical practices (p

Immunotherapy has made significant strides in cancer treatment with strategies like checkpoint blockade antibodies and adoptive T cell transfer. Chimeric antigen receptor T cells (CAR-T) have emerged as a promising approach to combine these strategies and overcome their limitations. This review explores CAR-T cells as a living drug for cancer treatment. CAR-T cells are genetically engineered immune cells designed to target and eliminate tumor cells by recognizing specific antigens. The study involves a comprehensive literature review on CAR-T cell technology, covering structure optimization, generations, manufacturing processes, and gene therapy strategies. It examines CAR-T therapy in haematologic cancers and solid tumors, highlighting challenges and proposing a suicide gene-based mechanism to enhance safety. The results show significant advancements in CAR-T technology, particularly in structure optimization and generation. The manufacturing process has improved for broader clinical application. However, a series of inherent challenges and side effects still need to be addressed. In conclusion, CAR-T cells hold great promise for cancer treatment, but ongoing research is crucial to improve efficacy and safety for oncology patients. The proposed suicide gene-based mechanism offers a potential solution to mitigate side effects including cytokine release syndrome (the most common toxic side effect of CAR-T therapy) and the associated neurotoxicity.

Abstract Background Routine childhood immunisation is one of the most important life-saving public health interventions. However, many children still have inadequate access to these vaccines and millions remain (partially) unvaccinated globally. As the COVID-19 pandemic disrupted health systems worldwide, its effects on immunisation have become apparent. This study aimed to estimate routine immunisation coverage among children under two in Sierra Leone and to identify factors associated with incomplete immunisation during the COVID-19 pandemic. Methods A cross-sectional household survey was conducted in three districts in Sierra Leone: Bombali, Tonkolili and Port Loko. A three-stage cluster sampling method was followed to enrol children aged 10–23 months. Information regarding immunisation status was based on vaccination cards or caretaker’s recall. Using WHO’s definition, a fully immunised child received one BCG dose, three oral polio vaccine doses, three pentavalent vaccine doses and one measles-containing vaccine dose. Following the national schedule, full immunisation status can be achieved at 9 months of age. Data were weighted to reflect the survey’s sampling design. Associations between incomplete immunisation and sociodemographic characteristics were assessed through multivariable logistic regression. Results A total of 720 children were enrolled between November and December 2021. Full vaccination coverage was estimated at 65.8% (95% CI 60.3%-71.0%). Coverage estimates were highest for vaccines administered at birth and decreased with doses administered subsequently. Adjusting for age, the lowest estimated coverage was 40.7% (95% CI 34.5%-47.2%) for the second dose of the measles-containing vaccine. Factors found to be associated with incomplete immunisation status were: living in Port Loko district (aOR = 3.47, 95% CI = 2.00-6.06; p-value

Inflammatory cytokines are involved in attention deficit hyperactivity disorder (ADHD), a highly prevalent neurodevelopmental disorder. To quantify the baseline levels of pro- and anti-inflammatory cytokines and their changes after methylphenidate (MPH), a total of 31 prepubertal children with ADHD were recruited and subclassified into only two ADHD presentations—ADHD attention deficit (n = 13) or ADHD combined (n = 18). The children were also screened for oppositional defiant conduct disorder (ODCD) and anxiety disorder. Blood samples were drawn at 09:00 and after 4.63 ± 1.87 months of treatment. Four pro-inflammatory cytokines (interleukin-1beta (IL-1β), IL-5, IL-6, tumor necrosis factor-alpha (TNF-α)) and three anti-inflammatory cytokines (IL-4, IL-10, IL-13) were measured using a Luminex® assay. For statistics, a factorial analysis was performed in Stata 15.1. Overall, there were no statistically significant differences in the interleukin (IL) values induced by treatment. When grouped by presentation, the differences were present almost exclusively in ADHD-AD, usually with a profile opposite to that observed in ADHD-C, and with interactions between comorbid factors, with IL-1β (p = 0.01) and IL-13 (p = 0.006) being the ones reaching the greatest statistical significance. These differences are probably related to the ODCD factor, and they disappear after treatment. In conclusion, the changes observed in cytokine levels in prepubertal children only in the ADHD-AD presentation are probably related to comorbidities (specifically ODCD) and are mitigated after treatment.

Background: Stress urinary incontinence (SUI) is a common condition with a significant impact on the quality of life of female patients. The limitations of current treatment strategies have prompted the exploration of new effective and minimally invasive alternative approaches, including cell therapy. Methods: A literature search was conducted to update the current clinical status of stem cell therapy in the management of female stress urinary incontinence. Results: Over thirty clinical studies have been designed to assess the feasibility, safety and efficacy of cell therapy for female SUI. Despite differences in cell types and protocols, the overall treatment procedures were similar. Standard subjective and objective assessment tools, and follow-up periods ranged from 6 weeks to 6 years have been used. Cell injection has shown to be a safe therapy in the treatment of female SUI. However, the results from more recent randomized trials have shown less promising results than expected in restoring continence. Heterogeneous research methodologies using different cell types and doses make it difficult to draw conclusions about effectiveness. Several key points remain that need to be further explored in future clinical trials. Conclusion: To advance in the development of cell therapy, it is essential to know the mechanisms involved to be able to direct it properly, its efficacy and the durability of the injected cells. Rigorous and homogenized preclinical and clinical studies that demonstrate its scope and improve its application are necessary for validation in the treatment of female SUI.

Autosomal dominant optic atrophy (ADOA) is a rare progressive disease mainly caused by mutations in OPA1, a nuclear gene encoding for a mitochondrial protein that plays an essential role in mitochondrial dynamics, cell survival, oxidative phosphorylation, and mtDNA maintenance. ADOA is characterized by the degeneration of retinal ganglion cells (RGCs). This causes visual loss, which can lead to legal blindness in many cases. Nowadays, there is no effective treatment for ADOA. In this article, we have established an isogenic human RGC model for ADOA using iPSC technology and the genome editing tool CRISPR/Cas9 from a previously generated iPSC line of an ADOA plus patient harboring the pathogenic variant NM_015560.3: c.1861C>T (p.Gln621Ter) in heterozygosis in OPA1. To this end, a protocol based on supplementing the iPSC culture media with several small molecules and defined factors trying to mimic embryonic development has been employed. Subsequently, the created model was validated, confirming the presence of a defect of intergenomic communication, impaired mitochondrial respiration, and an increase in apoptosis and ROS generation. Finally, we propose the analysis of OPA1 expression by qPCR as an easy read-out method to carry out future drug screening studies using the created RGC model. In summary, this model provides a useful platform for further investigation of the underlying pathophysiological mechanisms of ADOA plus and for testing compounds with potential pharmacological action.

Abstract Eighty percent of the estimated 600 million domestic cats in the world are free-roaming. These cats typically experience suboptimal welfare and inflict high levels of predation on wildlife. Additionally, euthanasia of healthy animals in overpopulated shelters raises ethical considerations. While surgical sterilization is the mainstay of pet population control, there is a need for efficient, safe, and cost-effective permanent contraception alternatives. Herein, we report evidence that a single intramuscular treatment with an adeno-associated viral vector delivering an anti-Müllerian hormone transgene produces long-term contraception in the domestic cat. Treated females are followed for over two years, during which transgene expression, anti-transgene antibodies, and reproductive hormones are monitored. Mating behavior and reproductive success are measured during two mating studies. Here we show that ectopic expression of anti-Müllerian hormone does not impair sex steroids nor estrous cycling, but prevents breeding-induced ovulation, resulting in safe and durable contraception in the female domestic cat.

IntroductionDrought-associated tree mortality has been increasing worldwide since the last decades, impacting structure and functioning of forest ecosystems, with implications for energy, carbon and water fluxes. However, the understanding of the individual vulnerability to drought-induced mortality is still limited.MethodsWe aimed to identify the factors that triggered the mortality of the widely distributed Pinus sylvestris L. in an extensive forest area in central Spain. We compared radial growth patterns in pairs of alive and recently dead individuals that co-occur in close proximity and present similar age and size, thereby isolating the effects of size and environment from the mortality process. Temporal dynamics of growth, growth synchrony, and growth sensitivity to water availability (precipitation minus potential evapotranspiration) were compared between alive and recently dead trees.Results and discussionOver the last 50 years, although we did not detect significant differences in growth between alive and dead trees, an increase in the growth synchrony and sensitivity to water availability (i.e. slope of the climatic water balance in the growth model) was observed in all trees as drought intensity increased. 20 years before mortality, dead individuals showed lower growth synchrony and growth sensitivity to water availability than alive ones, without significant differences in growth. Recorded reduction in growth synchrony and growth sensitivity to water availability in dead trees suggests a decoupling between tree growth and climate, which could increase the risk of hydraulic failure and/or carbon starvation under increasingly arid conditions. Thus, the use of reduced growth sensitivity to water availability as potential early-warning signal of tree mortality, together with reduced growth synchrony, should be further explored, particularly in pine species in seasonally dry areas.

Introduction Malaria infection during pregnancy increases the risk of low birth weight and infant mortality and should be prevented and treated. Artemisinin-based combination treatments are generally well tolerated, safe and effective; the most used being artemether-lumefantrine (AL) and dihydroartemisinin-piperaquine (DP). Pyronaridine-artesunate (PA) is a new artemisinin-based combination. The main objective of this study is to determine the efficacy and safety of PA versus AL or DP when administered to pregnant women with confirmed Plasmodium falciparum infection in the second or third trimester. The primary hypothesis is the pairwise non-inferiority of PA as compared with either AL or DP.Methods and analysis A phase 3, non-inferiority, randomised, open-label clinical trial to determine the safety and efficacy of AL, DP and PA in pregnant women with malaria in five sub-Saharan, malaria-endemic countries (Burkina Faso, Democratic Republic of the Congo, Mali, Mozambique and the Gambia). A total of 1875 pregnant women will be randomised to one of the treatment arms. Women will be actively monitored until Day 63 post-treatment, at delivery and 4–6 weeks after delivery, and infants’ health will be checked on their first birthday. The primary endpoint is the PCR-adjusted rate of adequate clinical and parasitological response at Day 42 in the per-protocol population.Ethics and dissemination This protocol has been approved by the Ethics Committee for Health Research in Burkina Faso, the National Health Ethics Committee in the Democratic Republic of Congo, the Ethics Committee of the Faculty of Medicine and Odontostomatology/Faculty of Pharmacy in Mali, the Gambia Government/MRCG Joint Ethics Committee and the National Bioethics Committee for Health in Mozambique. Written informed consent will be obtained from each individual prior to her participation in the study. The results will be published in peer-reviewed open access journals and presented at (inter)national conferences and meetings.Trial registration number PACTR202011812241529.

Resumen: Objetivo: Explorar las percepciones de profesionales de Atención Primaria (AP) sobre los cambios en las modalidades de consulta y su impacto en los fundamentos de la AP durante la pandemia. Diseño: Investigación cualitativa de diseño exploratorio realizada entre octubre y noviembre de 2021. Emplazamiento: Cuatro centros de salud urbanos y uno rural con diferente perfil socioeconómico en los tres territorios del País Vasco. Participantes: Cuarenta y seis profesionales de distintas categorías del equipo de AP y directores/as de centros de salud. Método: Muestreo intencional. Cinco grupos focales y cuatro entrevistas en profundidad. Análisis temático con apoyo del programa Atlas.Ti. Triangulación de los resultados entre el equipo investigador. Resultados: Las vivencias sobre el desarrollo de la teleconsulta aparecen directamente condicionadas por el contexto pandémico en sus diferentes fases y por la situación de la AP. Los y las profesionales identificaron barreras comunicacionales, así como potencialidades de su uso que requieren de formación y evaluación adecuadas. Se percibieron riesgos de inequidad en la utilización de las teleconsultas que podrían estar afectando a la calidad asistencial. La longitudinalidad se valoró como un factor facilitador y se identificaron problemas en la coordinación y comunicación mediante teleconsulta entre niveles asistenciales. Conclusiones: La sustitución de la consulta presencial por la teleconsulta tuvo impacto en aspectos fundamentales de la AP como la calidad, accesibilidad, equidad, coordinación y longitudinalidad. La teleconsulta en AP requiere siempre ser evaluada considerando las circunstancias y los contextos concretos de su implementación. Abstract: Objective: To explore the perceptions of Primary Health Care (PHC) professionals on changes in consultation modalities and their impact on PHC fundamentals during the pandemic. Design: Qualitative exploratory research conducted between October and November, 2021. Location: Four urban and one rural primary health care centers with different socioeconomic profiles in the three territories of the Basque Country. Participants: Forty-six professionals from different categories of the PHC team and health centre directors. Method: Purposive sampling. Five focus groups and four in-depth interviews. Thematic analysis with the support of the Atlas.ti programme. Triangulation of results among the research team. Results: Experiences with the development of teleconsultation appear to be directly conditioned by the pandemic context in its different phases and by the PC situation. The professionals identified communication barriers, as well as potentialities of its use that require adequate training and evaluation. Risks of inequity were perceived in the use of teleconsultations that could be affecting the quality of care. Longitudinality was assessed as a facilitating factor and problems of coordination and communication through teleconsultation between care levels were identified. Conclusions: The replacement of face-to-face consultation by teleconsultation had an impact on fundamental aspects of PHC such as quality, accessibility, equity, coordination and longitudinality. Teleconsultation in PHC should always be evaluated considering the specific circumstances and contexts of its implementation.

Methicillin-resistant (MR) Staphylococcus aureus (SA) and others, except for Staphylococcus aureus (SOSA), are common in healthcare-associated infections. SOSA encompass largely coagulase-negative staphylococci, including coagulase-positive staphylococcal species. Biofilm formation is encoded by the icaADBC operon and is involved in virulence. mecA encodes an additional penicillin-binding protein (PBP), PBP2a, that avoids the arrival of β-lactams at the target, found in the staphylococcal cassette chromosome mec (SCCmec). This work aims to detect mecA, the bap gene, the icaADBC operon, and types of SCCmec associated to biofilm in MRSA and SOSA strains. A total of 46% (37/80) of the strains were S. aureus, 44% (35/80) S. epidermidis, 5% (4/80) S. haemolyticus, 2.5% (2/80) S. hominis, 1.25% (1/80) S. intermedius, and 1.25% (1/80) S. saprophyticus. A total of 85% were MR, of which 95.5% showed mecA and 86.7% β-lactamase producers; thus, Staphylococcus may have more than one resistance mechanism. Healthcare-associated infection strains codified type I-III genes of SCCmec; types IV and V were associated to community-acquired strains (CA). Type II prevailed in MRSA mecA strains and type II and III in MRSOSA (methicillin-resistant staphylococci other than Staphylococcus aureus). The operon icaADBC was found in 24% of SA and 14% of SOSA; probably the arrangement of the operon, fork formation, and mutations influenced the variation. Methicillin resistance was mainly mediated by the mecA gene; however, there may be other mechanisms that also participate, since biofilm production is related to genes of the icaADBC operon and methicillin resistance was not associated with biofilm production. Therefore, it is necessary to strengthen surveillance to prevent the spread of these outbreaks both in the nosocomial environment and in the community.

Linguistic landscape (LL) studies in bilingual regions can reveal power dynamics between two languages, providing important information regarding their status and vitality. To analyze the relationship between Spanish and English in Ciudad Juárez, a city on the south side of the U.S.-Mexico border, we collected 1649 pictures of public signs in several sections of the city, whose “wellness levels” differ from each other. Pictures were coded for several factors, including language choice, business type, sign type, and the main and informative section, amongst others. Results show that while Spanish is the most frequently used language, English has a strong presence in the LL of Ciudad Juárez. The main factor affecting language choice is “business type”. Certain businesses within the “beauty” category tend to favor the use of English, while businesses within the “home” category favor the use of Spanish. An analysis of socio-economic status (SES) and language choice revealed a direct relationship between them: English is favored in high-income neighborhoods, while Spanish is favored used in low-income areas. The analysis of the main and informative sections on signs further confirmed the prestige assigned to English, which appears mostly in the main and most prominent sections of a sign. Our research shows that although Spanish vitality in Ciudad Juárez is strong, English is used in advertising because it is prestigious and increases the value of products and services, making them more appealing to shoppers.

This study focuses on the thermodynamic modeling of the crystallization by the drowning process for two lithium salts: lithium hydroxide (LiOH) and lithium formate (CHLiO2). The modeling involves utilizing thermodynamic properties, such as the activity, osmotic, and solubility coefficients, within the ternary systems of LiOH + cosolvent + water and CHLiO2 + cosolvent + water, as well as their respective binary constituent systems. Ethanol is chosen as the cosolvent for both salts, facilitating a comparative analysis. Given the limited availability of thermodynamic data for lithium formate with different cosolvents, the study aims to address this gap. The modified Pitzer model was employed for the modeling process, where the parameters were successfully obtained for both systems, with a deviation of less than 1%. Additionally, the mass and energy balance for the drowning-out crystallization process of both salts was performed.

Although ADHD is one of the most prevalent diseases during childhood, we still do not know its precise origin; oxidative/nitrosative stress and the hypothalamic–pituitary–adrenal axis are suggested contributors. Methylphenidate, among others, is the main drug used in ADHD patients, but its effects on relevant markers and structures remain unclear. This study, involving 59 patients diagnosed with ADHD according to DSM-5 criteria, aimed to assess changes in cortisol levels (using cortisol awakening response, CAR) and oxidative/nitrosative status with the treatment. Blood samples before and 3 months after treatment with methylphenidate were used to measure oxidative and inflammatory markers, as well as the endogenous antioxidant activity, while saliva samples tracked cortisol awakening response (CAR). The results showed a treatment-related improvement in the redox profile, with the reduction in advanced oxidation protein products (AOPP), lipid peroxidation (LPO), and nitrite plus nitrate (NOx) levels, and the increase in the enzymatic activities of glutathione reductase (GRd) and catalase (CAT). Moreover, the area under the curve (AUC) of CAR increased significantly, indicating increased reactivity of the HPA axis. These results support, for the first time, the involvement of the endogenous antioxidant system in the pathophysiology of ADHD.

En la actualidad, las características externas de la semilla (masa, ancho, longitud y grosor), así como las características internas (área del embrión, endospermo, perispermo y grosor de la cubierta seminal) de muchas especies del género Cylindropuntia (Cactaceae) son desconocidas. En este estudio se analizaron las variaciones morfológicas de los frutos y las semillas en cuatro estadios de desarrollo del fruto de Cylindropuntia spinosior. Se recolectaron frutos de cuatro estadios de desarrollo y se extrajeron las semillas. Los frutos y semillas se caracterizaron tanto macroscópica como microscópicamente, evaluándose 32 variables morfológicas. El análisis de agrupamiento de esas variables mostró que las características morfológicas de los frutos y semillas del estadio II y estadio III presentaron las características morfológicas similares, mientras que el estadio IV fue el más distante. Además, el análisis de los primeros dos componentes principales mostró que las variables que mostraron las mayores variaciones para los cuatro estadios de desarrollo del fruto fueron el peso del fruto y cáscara, el número de semilla, número de semillas flotantes y el peso total de las semillas. Estas características morfológicas determinadas en el presente estudio sugieren que esta especie todavía no está domesticada debido a que estas características fueron similares a las observadas en frutos de varias especies silvestres de la familia Cactaceae. Estos resultados podrían ayudar en futuros estudios ecológicos basados en la caracterización e identificación de las especies del género Cylindropuntia cuando sólo se dispone de los frutos y semillas. DOI: https://doi.org/10.54167/tch.v17i3.1184

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, and the infiltration of leukemic cells is critical for disease progression and relapse. Nuclear deformability plays a critical role in cancer cell invasion through confined spaces; however, the direct impact of epigenetic changes on the nuclear deformability of leukemic cells remains unclear. Here, we characterized how 3D collagen matrix conditions induced H3K4 methylation in ALL cell lines and clinical samples. We used specific shRNA and chemical inhibitors to target WDR5 (a core subunit involved in H3K4 methylation) and determined that targeting WDR5 reduced the H3K4 methylation induced by the 3D environment and the invasiveness of ALL cells in vitro and in vivo. Intriguingly, targeting WDR5 did not reduce the adhesion or the chemotactic response of leukemia cells, suggesting a different mechanism by which H3K4 methylation might govern ALL cell invasiveness. Finally, we conducted biochemical, and biophysical experiments to determine that 3D environments promoted the alteration of the chromatin, the morphology, and the mechanical behavior of the nucleus in ALL cells. Collectively, our data suggest that 3D environments control an upregulation of H3K4 methylation in ALL cells, and targeting WDR5 might serve as a promising therapeutic target against ALL invasiveness in vivo.

Introduction Malaria in pregnancy is a major driver of maternal and infant mortality in sub-Saharan Africa. The WHO recommends the administration of intermittent preventive treatment with sulfadoxine pyrimethamine (IPTp-SP) at antenatal care (ANC) visits. Despite being a highly cost-effective strategy, IPTp-SP coverage and uptake remains low. A pilot project was conducted to assess the cost-effectiveness (CE) of community-based delivery of IPTp (C-IPTp) in addition to ANC delivery to increase IPTp uptake in the Democratic Republic of Congo (DRC), Madagascar (MDG), Mozambique (MOZ) and Nigeria (NGA).Methods Costs and CE estimates of C-IPTp were calculated according to two scenarios: (1) costs in ‘programmatic mode’ (ie, costs if C-IPTp was to be implemented by national health systems) and (2) costs from the pilot project. The effectiveness of C-IPTp was obtained through estimates of the averted disability-adjusted life-years (DALYs) associated with maternal clinical malaria and anaemia, low birth weight and neonatal mortality.Results Net incremental costs of C-IPTp ranged between US$6138–US$47 177 (DRC), US$5552–US$31 552 (MDG), US$10 202–US$53 221 (MOZ) and US$667–US$28 645 (NGA) per 1000 pregnant women, under scenarios (1) and (2), respectively. Incremental cost-effectiveness ratios (ICERs) ranged between US$15–US$119 in DRC, US$9–US$53 in MDG, US$104–US$543 in MOZ and US$2–US$66 in NGA per DALY averted, under scenarios (1) and (2), respectively. ICERs fall below the WHO recommended CE threshold based on the gross domestic product per capita.Conclusion Findings suggest that C-IPTp is a highly cost-effective intervention. Results can inform policy decisions on adopting and optimising effective interventions for preventing malaria in pregnancy.

Abstract Background Information on the frequency and clinical features of advanced HIV disease (AHD) in pregnancy and its effects on maternal and perinatal outcomes is limited. The objective of this study was to describe the prevalence and clinical presentation of AHD in pregnancy, and to assess the impact of AHD in maternal and perinatal outcomes in Mozambican pregnant women. Methods This is a prospective and retrospective cohort study including HIV-infected pregnant women who attended the antenatal care (ANC) clinic at the Manhiça District Hospital between 2015 and 2020. Women were followed up for 36 months. Levels of CD4 + cell count were determined to assess AHD immune-suppressive changes. Risk factors for AHD were analyzed and the immune-suppressive changes over time and the effect of AHD on pregnancy outcomes were assessed. Results A total of 2458 HIV-infected pregnant women were enrolled. The prevalence of AHD at first ANC visit was 14.2% (349/2458). Among women with AHD at enrolment, 76.2% (260/341) were on antiretroviral therapy (ART). The proportion of women with AHD increased with age reaching 20.5% in those older than 35 years of age (p

Background Malaria in pregnancy is a major public health problem in sub-Saharan Africa (SSA), which imposes a significant economic burden. We provide evidence on the costs of malaria care in pregnancy to households and the health system in four high-burden countries in SSA. Methods Household and health system economic costs associated with malaria control in pregnancy were estimated in selected areas of the Democratic Republic of Congo (DRC), Madagascar (MDG), Mozambique (MOZ) and Nigeria (NGA). An exit survey was administered to 2,031 pregnant women when leaving the antenatal care (ANC) clinic from October 2020 to June 2021. Women reported the direct and indirect costs associated to malaria prevention and treatment in pregnancy. To estimate health system costs, we interviewed health workers from 133 randomly selected health facilities. Costs were estimated using an ingredients-based approach. Results Average household costs of malaria prevention per pregnancy were USD6.33 in DRC, USD10.06 in MDG, USD15.03 in MOZ and USD13.33 in NGA. Household costs of treating an episode of uncomplicated/complicated malaria were USD22.78/USD46 in DRC, USD16.65/USD35.65 in MDG, USD30.54/USD61.25 in MOZ and USD18.92/USD44.71 in NGA, respectively. Average health system costs of malaria prevention per pregnancy were USD10.74 in DRC, USD16.95 in MDG, USD11.17 in MOZ and USD15.64 in NGA. Health system costs associated with treating an episode of uncomplicated/complicated malaria were USD4.69/USD101.41 in DRC, USD3.61/USD63.33 in MDG, USD4.68/USD83.70 in MOZ and USD4.09/USD92.64 in NGA. These estimates resulted in societal costs of malaria prevention and treatment per pregnancy of USD31.72 in DRC, USD29.77 in MDG, USD31.98 in MOZ and USD46.16 in NGA. Conclusions Malaria in pregnancy imposes a high economic burden on households and the health system. Findings emphasize the importance of investing in effective strategies that improve access to malaria control and reduce the burden of the infection in pregnancy.

Introduction Pregnant women are currently considered a vulnerable population to SARS-CoV-2 infection, with increased risk of severe COVID-19, preterm birth and maternal mortality. There is, however, a paucity of data on the burden of maternal SARS-CoV-2 infection in sub-Saharan countries. The objective of this study is to determine the prevalence and health effects of maternal SARS-CoV-2 infection in selected sites from Gabon and Mozambique.Methods and analysis MA-CoV (MAternal CoVid) is an observational, multicentre prospective cohort study where 1000 pregnant women (500 per country) will be enrolled at the antenatal clinic visits. Participants will undergo monthly follow-up at each antenatal care visit, delivery and postpartum visit. The primary study outcome is the prevalence of SARS-CoV-2 infection during pregnancy. The clinical presentation of COVID-19 in pregnancy will also be characterised, and incidence of infection during pregnancy will be evaluated, as well as the risk factors of maternal and neonatal morbidity and mortality associated with SARS-CoV-2 infection and the risk of mother to child transmission of SARS-CoV-2. SARS-CoV-2 infection screening will be performed through PCR diagnosis.Ethics and dissemination The protocol was reviewed and approved by the Comité National d’Éthique pour la Recherche au Gabon, Comité Nacional de Bioética para Saúde de Moçambique and the Ethics Committee of the Hospital Clinic of Barcelona (Spain). Project results will be presented to all stakeholders and published in open access journals.Trial registration number NCT05303168.

Vitis vinifera L. has been present in Ibiza and Formentera, two islands of the Balearic Islands (Spain), since the 7th century BC. In the past few years, there have been several studies and investigations on the Balearic Islands. These have focused mainly on Mallorca and Menorca with a small representation of Ibiza and none that take into account Formentera. This research aims to contribute to the knowledge of Vitis cultivars cultivated on those islands and to investigate whether there are local cultivars still being grown. To do this, using an ethnobotanical approach, 15 persons were interviewed to gather information about local grapevines, and 36 accessions from 12 plots were characterized using ampelographic descriptors and identified using SSR markers. Relationships of the accessions studied with other cultivars were also assessed. The results show 21 different genotypes profiles, where six were new genotypes: ‘Colló de gall’, ‘Grec’, ‘Maçanet’, ‘VIEIV015-Maçanet’, ‘Morzacà’, and ‘Vermelleta’. Ten new synonyms and three homonyms have been proposed. Additionally, we suggest three new relationships for the ‘Hebén’ cultivar, one new relationship for the ‘Llora’ cultivar and one new relationship for the ‘Beba’ cultivar. These results show the first reported information for Ibiza and Formentera on Vitis.

During the last decade, Common Agricultural Policy (CAP) has prioritised measures focused on sustainability and quality over production. The purpose of the AGRICORE project is to develop a tool based on agent-based modelling to assist policymakers in the design of improved policies. The present study belongs to a use case of this project that measures the environmental and climate impact of Measure 11—Organic agriculture—from the 2014–2020 Rural Development Programme of the Andalusian olive sector. As part of this study, a survey campaign was conducted, which collected data from 189 organic olive farmers in Andalusia. The data were analysed in order to characterise organic olive farmers and their farms. This paper presents the resulting characterisation, covering some information gaps detected as part of the AGRICORE project, such as their acceptance of M11 and willingness to innovate and take risks. The results highlight that most of the respondents are unaware of important aspects, such as exploitation costs and their belonging to environmentally protected areas. Furthermore, it is interesting to note that most farmers are approximately 60 years old, and more than 35% are women. Furthermore, most of those studied do not intend to return to conventional production methods. These results help to provide a current perspective of the organic olive sector in Andalusia, which can be used by policymakers to design improved policies that entail an increase in organic olive production.

Esta investigación que presentamos pretende profundizar en las señales de alarma más frecuentes de los niños y las niñas diagnosticados con TEA, atendiendo a su nivel de desarrollo lingüístico. Para ello, analizamos los resultados obtenidos de una muestra de 142 niños y niñas evaluados en los cinco últimos años en el Servicio de Psicomotricidad de la Universidad de La Laguna. El instrumento utilizado es el ADOS-2 y para realizar el análisis estadístico hacemos uso del SPSS. Las conclusiones obtenidas hacen referencia a la ausencia de lenguaje durante los 3 primeros años de vida y a un aumento del porcentaje de sujetos con lenguaje adquirido a partir de esta edad; al escaso uso de la mirada, poco uso de la expresividad facial y gestualidad limitada en la interacción social; o la falta de respuesta cuando se les llama por su nombre solo en sujetos carentes de lenguaje, como algunas de las características más evidentes en las personas con TEA. En general, las variables en interacción social están más estrechamente relacionadas entre sí que en el resto de los ámbitos evaluados.

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols.

Little is known about the reproductive biology of the Canada lynx; virtually no data are available describing seminal parameters in this species and sperm cryopreservation studies have not been performed. Our aims were to 1) evaluate effectiveness of two semen collection methods: urethral catheterization (UC) and electroejaculation (EEJ); 2) characterize basal seminal traits throughout the breeding season; 3) compare effectiveness of semen cryopreservation using TEST egg yolk (TEY) or soy lecithin-based (SOY) media; and, 4) evaluate the ability of preserved Canada lynx sperm to fertilize domestic cat in vitro matured oocytes by heterologous in vitro fertilization. Testicular volume averaged 4.5±1.0 cm3. A significant relationship was found between animal body weight and testes volume (P 0.05). Cleavage rates did not differ between TEY (29 ± 17 %) and SOY (27 ± 14 %) and mean numbers of sperm bound to the zona pellucida was similar (20 sperm, TEY vs. 18 sperm, SOY), indicating that both extenders equally preserved the function of Canada lynx sperm for semen banking purposes. Our findings provide zoos and population managers with valuable information about normative reproductive traits in this species, establishing comparative benchmarks for assessing the reproductive potential of specific males recommended for breeding.

Due to the success of artificial intelligence (AI) applications in the medical field over the past decade, concerns about the explainability of these systems have increased. The reliability requirements of black-box algorithms for making decisions affecting patients pose a challenge even beyond their accuracy. Recent advances in AI increasingly emphasize the necessity of integrating explainability into these systems. While most traditional AI methods and expert systems are inherently interpretable, the recent literature has focused primarily on explainability techniques for more complex models such as deep learning. This scoping review critically analyzes the existing literature regarding the explainability and interpretability of AI methods within the clinical domain. It offers a comprehensive overview of past and current research trends with the objective of identifying limitations that hinder the advancement of Explainable Artificial Intelligence (XAI) in the field of medicine. Such constraints encompass the diverse requirements of key stakeholders, including clinicians, patients, and developers, as well as cognitive barriers to knowledge acquisition, the absence of standardised evaluation criteria, the potential for mistaking explanations for causal relationships, and the apparent trade-off between model accuracy and interpretability. Furthermore, this review discusses possible research directions aimed at surmounting these challenges. These include alternative approaches to leveraging medical expertise to enhance interpretability within clinical settings, such as data fusion techniques and interdisciplinary assessments throughout the development process, emphasizing the relevance of taking into account the needs of final users to design trustable explainability methods.

Biogas is a promising and robust renewable energy that holds potential as clean energy in the context of the current climatic emergency. Biogas has the immense advantage of coupling waste management and clean energy production. In other words, it is not only a renewable energy source, but also a central tool in recycling a vast range of waste products from the agroindustry. Despite its potential, the process is microbiologically complex and is usually carried out in both industrial and pilot laboratories, utilizing a variety of reactors and systems. In this work, we present a very simple, Do It Yourself (DIY) biogas fermenter that we have designed, operated, and characterized. We propose this technology as both an inexpensive proxy for biogas reactors in academic and private laboratories and as an effective dissemination tool to foster the knowledge and potential of biogas as a key technology to contribute to the development of a global bioeconomy.

(1) Background: Treatment of male stress incontinence in patients with prostate cancer treated with radical prostatectomy and adjuvant pelvic radiation is a therapeutic challenge. The efficacy and safety of the adjustable trans-obturator male system (ATOMS) in these patients is not well established, despite the general belief that outcomes are worse than in patients without radiation. (2) Methods: Retrospective multicenter study evaluating patients treated with silicone-covered scrotal port (SSP) ATOMS implant after radical prostatectomy and radiotherapy in nine different institutions between 2016 and 2022. The primary endpoint was dry patient rate, defined as pad-test ≤ 20 mL/day. The secondary endpoints were complication rate (defined using Clavien–Dindo classification), device removal and self-perceived satisfaction using the Patient Global Impression of Improvement (PGI-I) scale. Wilcoxon rank-sum test, Fisher’s exact test and logistic regression were performed using stepwise method with a 0.15 entry and 0.1 stay criteria. (3) Results: 223 patients fulfilled the criteria for inclusion and 12 (5.4%) received salvage prostatectomy after radiation and 27 (12.1%) previous devices for stress incontinence. After ATOMS adjustment, 95 patients (42.6%) were dry and 36 (16.1%) had complications of any grade (grade I, n = 20; grade II, n = 11; grade III, n = 5) during the first 3 months postoperatively. At a mean of 36 ± 21 months follow-up, the device was explanted in 26 (11.7%) patients. Regarding self-perceived satisfaction with the implant, 105 of 125 patients (84%) considered themselves satisfied (PGI-I 1 to 3). In the univariate analysis, dryness was associated to younger age (p = 0.06), primary prostatectomy (p = 0.08), no previous incontinence surgery (p = 0.02), absence of overactive bladder symptoms (p = 0.04), absence of bladder neck stricture (p = 0.001), no need of surgical revision (p = 0.008) and lower baseline incontinence severity (p = 0.0003). Multivariate analysis identified absence of surgical revision (p = 0.018), absence of bladder neck stricture (p = 0.05), primary prostatectomy (p = 0.07) and lower baseline incontinence severity (p < 0.0001) were independent predictors of dryness. A logistic regression model was proposed and internally validated. (4) Conclusions: ATOMS is an efficacious and safe alternative to treat male incontinence after radical prostatectomy and adjuvant radiotherapy. Factors predictive of dryness are identified in this complex scenario to allow for better patient selection.

Introducción: la COVID-19 ha generado serias consecuencias en la salud mental de los seres humanos, y ha provocado reacciones psicológicas como el miedo y la ansiedad. Los estudiantes de Ciencias Médicas, como protagonistas de la pesquisa activa, pudieran ser proclives a presentar dichas manifestaciones.Objetivo: describir las reacciones de ansiedad y miedo a la COVID-19 en los estudiantes pesquisadores del poblado de Falcón, Villa Clara.Métodos: se desarrolló una investigación cuantitativa, transversal y descriptiva mediante cuestionarios, en enero de 2021. La muestra estuvo constituida por 27 pesquisadores, estudiantes de Ciencias Médicas residentes en Falcón. Los resultados se analizaron mediante pruebas estadísticas de tipo no paramétrico.Resultados: se encontraron bajos niveles de ansiedad, mientras que el miedo obtuvo resultados equilibrados entre bajos y altos niveles. Estas manifestaciones fueron encontradas, en su mayoría, en los participantes que no conocían personas diagnosticadas con la enfermedad. Se destacó una correlación inversa significativa entre las variables edad y ansiedad. Se encontró que los niveles de ansiedad y de miedo resultaron inversos a conocer a una persona diagnosticada con COVID-19. Se destacó una correlación positiva y directa entre el miedo y la ansiedad.Conclusiones: la presente investigación constituyó un acercamiento al estado de salud mental de los estudiantes de Ciencias Médicas vinculados a la pesquisa activa. Una fortaleza de la investigación radica en el empleo de instrumentos desarrollados para evaluar reacciones psicológicas vinculadas específicamente a la COVID-19. Convendría la realización de estudios similares en poblaciones mayores, los cuales permitiesen la generalización de los resultados.

When the COVID-19 pandemic struck in early 2020, it rapidly became apparent that older individuals were at greater risk of serious illness and death. The risk was even greater for residents in care homes, who live in close proximity and may be suffering other comorbidities. Such facilities also saw a high turnover of staff and visitors, meaning an increased risk of transmission. Data has suggested that care home residents may account for up to a half of all COVID-related deaths in Spain. As morbidity and mortality for COVID-19 was increasing in March 2020, MSF offered support to Spanish care homes during the first wave of infections. Our intervention included different axes: advocacy, knowledge sharing, training and implementation of measures for a reduction in transmission and for infection prevention and control (IPC). The situation for care home residents was dire, with many people dying alone, away from loved ones and without access to palliative care. Staff were overwhelmed and ill-equipped to deal with the scale and complexity of this tragedy. Although technical interventions to reduce transmission were crucial, it became clear that other people-centred activities that supported residents, their families and staff, were of equal importance, including facilitating contact between families, providing emotional support and offering adequate pain management and palliative care. Residents in care homes have the same rights as everyone else. In the event of future crises, the most vulnerable should not be neglected.

Viral infections represent a major health problem worldwide. Due to the wide variety of etiological agents and their increasing resistance to anti-virals and antibiotics treatments, new strategies for effective therapies need to be developed. Scientific evidence suggests that probiotics may have prophylactic and therapeutic effects in viral diseases. Indeed, these microorganisms interact harmoniously with the intestinal microbiota and protect the integrity of the intestinal barrier as well as modulate the host immune system. Currently, clinical trials with probiotics have been documented in respiratory tract infections, infections caused by human immunodeficiency viruses, herpes, human papillomavirus and hepatic encephalopathy. However, the benefits documented so far are difficult to extrapolate, due to the strain-dependent effect. In addition, the dose of the microorganism used as well as host characteristics are other parameters that should be consider when advocating the use of probiotics to treat viral infections. This review addresses the scientific evidence of the efficacy of probiotics in clinical strains perspective in viral infectious diseases in the last 10 years.

Sporadic Legionnaires’ disease is frequently detected in commercial truck drivers. We report 2 sporadic cases of this disease in Barcelona, Spain, that occurred during December 2019 and September 2020. Laboratory findings were consistent with windshield wiper fluid without added screen wash as a possible source of infection for both cases.

Tomato is one of the most common crops across the world, but it is also one of the types of food that generates the most losses across its life cycle. This paper addresses this issue by providing a Life Cycle Analysis of greenhouse grown tomato in southern Spain. The results confirm that tomatoes are a thirsty and frail crop. Most of its energy demands and carbon emissions go to packaging (35%) and transportation (42%) as well as supplying water for their growth. There seems to be room for improvement in the recovery of energy (54.6%) and CO2 emissions, mainly addressing the waste treatment of packaging and plastic as well as improving transportation. Despite being highly water demanding, irrigation processes are already efficient in industrial greenhouses, and most of the water recovery will need to take place in the waste recovery stage. Food losses at the consumption phases do not constitute a significant loss in energy or a significant amount of carbon emissions saved.

La terapia ocupacional supone un aspecto fundamental en la rehabilitación de cualquier paciente ingresado en una unidad hospitalaria; su uso ha demostrado aportar grandes beneficios en la recuperación de los pacientes y en su adaptación a la vida cotidiana. Entre estas actividades se encuentra la alimentación, por lo que el tratamiento de la disfagia supone un pilar fundamental en el restablecimiento de las actividades básicas de la vida diaria.

BackgroundMalaria is among the top causes of death in adolescent girls (10 to 19 years) globally. Adolescent motherhood is associated with increased risk of adverse maternal and neonatal outcomes. The interaction of malaria, adolescence, and pregnancy is especially relevant in malaria endemic areas, where rates of adolescent pregnancy are high. However, data on burden of malaria among adolescent girls are limited. This study aimed at investigating whether adolescent girls were at a greater risk of experiencing malaria-related outcomes in pregnancy-parasitaemia and clinical disease-than adult women.Methods and findingsAn individual secondary participant-level meta-analysis was conducted using data from 5,804 pregnant women participating in 2 malaria prevention clinical trials in Benin, Gabon, Kenya, Mozambique, and Tanzania between 2009 and 2014. Of the sample, 1,201 participants were adolescent girls with a mean age of 17.5 years (standard deviation (SD) 1.3) and 886 (73.8%) of them primigravidae. Among the 4,603 adult women with mean age of 27.0 years (SD 5.4), 595 (12.9%) were primigravidae. Mean gestational age at enrolment was 20.2 weeks (SD 5.2) and 1,069 (18.4%) participants were HIV-infected. Women were followed monthly until the postpartum visit (1 month to 6 weeks after delivery). This study considered outcomes including clinical episodes during pregnancy, peripheral parasitaemia at delivery, and placental malaria. A 2-stage meta-analysis approach was followed by pooling single multivariable regression results into standard DerSimonian-Laird random-effects models. Adolescent girls were more likely than adult women to present with clinical malaria during pregnancy (incidence risk ratio (IRR) 1.70, 95% confidence interval (CI) 1.20; 2.39, p-value = 0.003, I2 = 0.0%, N = 4,092), peripheral parasitaemia at delivery (odds ratio (OR) 2.28, 95% CI 1.46; 3.55, p-value < 0.001, I2 = 0.0%, N = 3,977), and placental infection (OR 1.97, 95% CI 1.31; 2.98, p-value = 0.001, I2 = 1.4%, N = 4,797). Similar associations were observed among the subgroup of HIV-uninfected participants: IRR 1.72 (95% CI 1.22; 2.45, p-value = 0.002, I2 = 0.0%, N = 3,531) for clinical malaria episodes, OR 2.39 (95% CI 1.49; 3.86, p-value < 0.001, I2 = 0.0%, N = 3,053) for peripheral parasitaemia, and OR 1.88 (95% CI 1.06 to 3.33, p-value = 0.03, I2 = 34.9%, N = 3,847) for placental malaria. Among HIV-infected subgroups statistically significant associations were not observed. Similar associations were found in the subgroup analysis by gravidity. The small sample size and outcome prevalence in specific countries limited the inclusion of some countries in the meta-analysis. Furthermore, peripheral parasitaemia and placental malaria presented a considerable level of missing data-12.6% and 18.2% of participants had missing data on those outcomes, respectively. Given the original scope of the clinical trials, asymptomatic malaria infection was only assessed at the end of pregnancy through peripheral and placental parasitaemia.ConclusionsIn this study, we observed that adolescent girls in sub-Saharan Africa (SSA) are more prone to experience clinical malaria episodes during pregnancy and have peripheral malaria and placental infection at delivery than adult women. Moreover, to the best of our knowledge, for the first time this study disaggregates figures and stratifies analyses by HIV infection. Similar associations were found for both HIV-infected and uninfected women, although those for HIV-infected participants were not statistically significant. Our finding suggests that adolescent girls may benefit from targeted malaria prevention strategies even before they become pregnant.

Bifidobacterium longum is considered a microorganism with probiotic potential, which has been extensively studied, but these probiotic effects are strain dependent. This work aims to characterize the probiotic potential, based on the biochemical and genomic functionality, of B. longum LBUX23, isolated from neonates’ feces. B. longum LBUX23 contains one circular genome of 2,287,838 bp with a G+C content of 60.05%, no plasmids, no CRISPR-Cas operon, possesses 56 tRNAs, 9 rRNAs, 1 tmRNA and 1776 coding sequences (CDSs). It has chromosomally encoded resistance genes to ampicillin and dicloxacillin, non-hemolytic activity, and moderate inhibition of Escherichia coli ATCC 25922 and to some emergent pathogen’s clinical strains. B. longum LBUX23 was able to utilize lactose, sucrose, fructooligosaccharides (FOS), and lactulose. The maximum peak of bacterial growth was observed in sucrose and FOS at 6 h; in lactose and lactulose, it was shown at 8 h. B. longum LBUX23 can survive in gastrointestinal conditions (pH 4 to 7). A decrease in survival (96.5 and 93.8%) was observed at pH 3 and 3.5 during 120 min. argC, argH, and dapA genes could be involved in this tolerance. B. longum LBUX23 can also survive under primary and secondary glyco- or tauro-conjugated bile salts, and a mixture of bile salts due to the high extracellular bile salt hydrolase (BSH) activity (67.3 %), in taurocholic acid followed by taurodeoxycholic acid (48.5%), glycocholic acid (47.1%), oxgall (44.3%), and glycodeoxycholic acid (29.7%) probably due to the presence of the cbh and gnlE genes which form an operon (start: 119573 and end: 123812). Low BSH activity was determined intracellularly (B. longum LBUX23 showed antioxidant effects in DPPH radical, mainly in intact cells (27.4%). In the case of hydroxyl radical scavenging capacity, cell debris showed the highest reduction (72.5%). In the cell-free extract, superoxide anion radical scavenging capacity was higher (90.5%). The genome of B. longum LBUX23 contains PNPOx, AhpC, Bcp, trxA, and trxB genes, which could be involved in this activity. Regarding adherence, it showed adherence up to 5% to Caco-2 cells. B. longum LBUX23 showed in vitro potential probiotic properties, mainly in BSH activity and antioxidant capacity, which indicates that it could be a good candidate for antioxidant or anti-cholesterol tests using in vivo models.

Global dispersion, hospital outbreaks, and lineage relationships between emerging antibiotic-resistant strains such as Klebsiella pneumoniae are of public health interest. This study aimed to isolate and identify K. pneumoniae clones from third-level healthcare hospitals in Mexico to establish their multidrug-resistant phenotype, phylogeny, and prevalence. Biological and abiotic surface samples were used to isolate K. pneumoniae strains and to test their antibiotic susceptibility to classify them. The housekeeping genes: gapA, InfB, mdh, pgi, phoE, ropB, and tonB were used for multilocus sequence typing (MLST). Phylogenetic networks were constructed with 48 strains. Isolated strains (93) were mainly from urine and blood, 96% were resistant to ampicillin as expected, 60% were extended-spectrum β-lactamases (ESBL), 98% were susceptible to ertapenem and meropenem and 99% were susceptible to imipenem, 46% were multi-drug resistant (MDR), 17% were extensively-drug resistant (XDR), 1% were pan-drug resistant (PDR), and 36% were not classified. The tonB, mdh, and phoE genes were the most variable, and the InfB gene showed positive selection. The most prevalent sequence types (STs) were ST551 (six clones), ST405 (six clones), ST1088 (four clones), ST25 (four clones), ST392 (three clones), and ST36 (two clones). ST706 was PDR, and ST1088 clones were MDR; neither of these STs has been reported in Mexico. The strains analyzed were from different hospitals and locations; thus, it is important to maintain antibiotic surveillance and avoid clone dissemination to prevent outbreaks, adaptation to antibiotics, and the transmission of antibiotic resistance.

Research related to food insecurity (FI) among European university student populations is currently limited, especially the studies carried out during the COVID-19 pandemic. The present study aimed to assess the prevalence and identify possible predictors of FI among students from a Spanish public university, the University of the Basque Country UPV/EHU, during the COVID-19 pandemic. A cross-sectional observational study design was used, in which a total of 422 students completed an online survey. Results were weighted according to age and field of education. Binary logistic regressions adjusted by sex, age, and campus were applied to identify FI predictors. FI in 19.6, 2.6, and 0.7% of the population was mild, moderate, and severe, respectively. The three main predictors of FI were a decrease in the main source of income (OR, 2.80; 95% IC, 2.57–3.06), not receiving scholarships during the pandemic (OR, 2.32; 95% IC, 2.18–2.47), and living arrangements before the pandemic (not living with parents/relatives) (OR, 2.03, 95% IC, 1.89–2.18). This study found a high prevalence of FI among the students surveyed, and the strongest predictors of this FI were related to socioeconomic status. A robust and comprehensive policy response is recommended to mitigate FI in this population.

Resumen: Introducción: El desarrollo normativo de la Ley 44/2003, a través del Real Decreto 639/2014, inició el proceso de reorganización de la Formación Sanitaria Especializada (FSE). El objetivo de este trabajo es elaborar una propuesta de competencias específicas para la especialidad de Medicina Preventiva y Salud Pública mediante un análisis comparado y proceso participativo. Métodos: Cuatro fases: 1) análisis y extracción de competencias de documentación de organismos oficiales; 2) consulta dirigida a personas clave; 3) consulta abierta a residentes y personas implicadas en la FSE, y 4) difusión a la Comisión Nacional de la Especialidad y público general. Resultados: 1) Se extrajeron 543 competencias y 67 categorías de 7 fuentes primarias (Austria, Canadá, ECDC, Estados Unidos, Francia, Reino Unido y OPS). Se produjeron 126 competencias en 12 categorías. 2) Participaron 10 personas clave, 64 competencias fueron modificadas, 10 eliminadas y 9 nuevas. 3) Hubo 32 respuestas: 132 competencias en 12 categorías. Propuesta final: 145 competencias en 21 categorías, organizadas en 3 bloques: competencias genéricas, técnicas y específicas. Conclusión: La propuesta final es producto de la participación de residentes y personas implicadas en la FSE, partiendo del actual marco y del análisis del desarrollo de la especialidad en el contexto internacional. Se han incorporado conceptos presentes en países de nuestro entorno y cercanos a la práctica. Abstract: Introduction: The Royal Decree 639/2014 (‘Core Curriculum’ Decree) has amongst its objectives to modify Specialist Training in Medicine Disciplines. The aim of this project is to elaborate a proposal of specific skills for the specialty of Preventive Medicine and Public Health using a comparative and participative approach. Methods: 1) Comparative analysis of documents published by official institutions; 2) consultation with key informants; 3) open consultation with residents and trainers, and 4) presentation to the National Commission of the Specialty and the general public. Results: 1) 126 competencies were found in 12 categories. 2) 10 key informants, 64 skills modified, 10 removed, and 9 added; 3) 32 responses the first draft contained 132 skills in 12 categories. The final proposal included 145 skills in 21 categories, classified into 3 areas: generic, technical, and specific skills. Conclusion: The final proposal is the product of participation of residents and individuals involved in specialised training, starting from the current framework and international context analysis. Concepts present in countries in this field and close to our professional activity have been included.

Introducción: El rendimiento en trabajadores de la construcción es un tema poco estudiado, más aún si se lo vincula con el cumplimiento de las normas de seguridad y salud laboral. Objetivo: Determinar la relación entre el grado de cumplimiento de las normas de Seguridad y Salud Ocupacional y el rendimiento de los trabajadores de cuatro empresas constructoras de la ciudad Quito. Métodos: Investigación no experimental, relacional, transversal aplicada a 167 trabajadores. Se aplicaron dos cuestionarios para la recolección de información sociodemográfica/laboral y para la evaluación del rendimiento. Se aplicó la lista de verificación del Ministerio de Trabajo para medir el grado de cumplimiento de las normas de seguridad y salud. Resultados: Muestran relación significativa el consumo de drogas con los comportamientos contraproducentes (p= 0.024); hábito de fumar y rendimiento contextual (p= 0.023); dormir y descansar por las noches con el rendimiento contextual; (p= 0.000); temperatura baja con el rendimiento contextual (p= 0.038); temperatura alta con rendimiento en la tarea (p= 0.042); duración de la jornada y rendimiento contextual (p= 0.015); poder realizar pausas y rendimiento contextual (p= 0.003); relación con los jefes y rendimiento en la tarea (p= 0.011); relación con los compañeros y comportamientos contraproducentes (p= 0.022) y rendimiento contextual (p= 0.007). Se obtuvo significación estadística en la correlación entre el grado de cumplimiento de las normas de SSO y Comportamientos contraproducentes (Rho(167) = 0.215; p= 0.003). Conclusión: La relación entre el grado de cumplimiento de las normas de SSO fue estadísticamente significativa con la dimensión de comportamientos contraproducentes.

Abstract Background Torture methods have traditionally been quantified using checklists. However, checklists fail to capture accurately both the almost infinite range of available methods of torture and the victims’ subjective experience. The Torturing Environment Scale (TES) was designed as a multidimensional alternative that groups torture methods according to the specific human function under attack. This study aims to do an exploratory assessment of the internal consistency reliability and discriminatory validity of the TES as part of a construct validity assessment in a sample of Basque torture survivors. Methods We applied the TES to a sample of 201 torture survivors from the Istanbul Protocol Project in the Basque Country Study (IPP-BC) to profile torturing environments in detention. To estimate the internal consistency reliability of the scale, categorical omega values were obtained for each subscale of the TES. To assess its discriminatory validity, the “known groups” method was used comparing mean scorings by gender, state security forces involved in the detention, and decade (the 1980s to the present) when the events took place. Results Men reported more physical pain, while women reported more attacks on self-identity and sexual integrity. The TES also showed significant differences as regards the security forces involved in the detention: Civil Guard (a militarised police) used more manipulation of the environment, threats, fear, pain and extreme pain, as compared to national and regional corps. Finally, although patterns of torture remained mostly unchanged across decades, more recent detentions included more emphasis on psychological attacks: context manipulation, humiliation linked to sexual identity, and attacks to meaning and identity. For all subscales of the TES, categorical omega values ranged from 0.44 to 0.72. Conclusion The TES may be a useful tool in profiling torturing environments. Its sensitivity to key contextual variables supports the discriminatory validity of the scale. While some of the subscales showed an acceptable degree of internal consistency, others require further analysis to improve reliability. The scale provides unique insights into the profile of contemporary torture. It will allow for future quantitative research on the relationship between different torturing environments and the medical and psychological consequences thereof.

The subtribe Ditaxinae in the plant family Euphorbiaceae is composed of five genera (Argythamnia, Caperonia, Chiropetalum, Ditaxis and Philyra) and approximately 120 species of perennial herbs (rarely annual) to treelets. The subtribe is distributed throughout the Americas, with the exception of Caperonia, which also occurs in tropical Africa and Madagascar. Under the current classification, Ditaxinae includes genera with a questionable morphology-based taxonomy, especially Argythamnia, Chiropetalum and Ditaxis. Moreover, phylogenetic relationships among genera are largely unexplored, with previous works sampling petD, trnLF, trnTL) DNA sequences and a wide taxon sampling (60%). We confirmed the paraphyly of Ditaxinae and Ditaxis, both with high support. Following our phylogenetic results, we combined Ditaxis in Argythamnia and upgraded Ditaxinae to the tribe level (Ditaxeae). We also established and described the tribe Caperonieae based on Caperonia, and transferred Philyra to the tribe Adelieae, along with Adelia, Garciadelia, Lasiocroton and Leucocroton. Finally, we discuss the main morphological synapomorphies for the genera and tribes and provide a taxonomic treatment, including all species recognized under each genus.

This paper studies the distributional restrictions that the approximative adverb casi (‘almost’) displays. From a descriptive point of view, it is shown that casi is incompatible with negation when this adverb modifies a numeral word and that it requires the presence of negation if it precedes countable nouns in plural or uncountable nouns. From a theoretical point of view, this paper offers an explanation of these restrictions based on the semantic properties of cassi and the environments with which this item is incompatible.

ObjectiveTo assess the impact of SARS-CoV-2 viral infection on the metataxonomic profile and its evolution during the first month of lactation.MethodsMilk samples from 37 women with full-term pregnancies and mild SARS-CoV-2 infection and from 63 controls, collected in the first and fifth postpartum weeks, have been analyzed. SARS-CoV-2 RNA was assessed by reverse transcription polymerase chain reaction (RT-PCR) both in cases and controls. After DNA extraction, the V3-V4 hypervariable region of the gene 16S rRNA was amplified and sequenced using the MiSeq system of Illumina. Data were submitted for statistical and bioinformatics analyses after quality control.ResultsAll the 1st week and 5th week postpartum milk samples were negative for SARS-CoV-2 RNA. Alpha diversity showed no differences between milk samples from the study and control group, and this condition was maintained along the observation time. Analysis of the beta-diversity also indicated that the study and control groups did not show distinct bacterial profiles. Staphyloccus and Streptococcus were the most abundant genera and the only ones that were detected in all the milk samples provided. Disease state (symptomatic or asymptomatic infection) did not affect the metataxonomic profile in breast milk.ConclusionThese results support that in the non-severe SARS-CoV-2 pregnant woman infection the structure of the bacterial population is preserved and does not negatively impact on the human milk microbiota.

Introduction. Breast cancer is the world’s most prevalent malignancy, with an increasing incidence and a predisposition for postpubertal females from all cultural and ethnic backgrounds. More recently, oral Fusobacterium nucleatum species have been observed in cancerous human breast tissue, drawing attention to the role of microbes in cancer pathogenesis. Objectives. Investigating oral Fusobacterium nucleatum species as potential biomarkers for female-specific breast cancer. Methods. A systematic search in The Central Register of Controlled Trials, EMBASE, EBSCO, NCBI, and MEDLINE databases was undertaken from the 1st January, 1983–31st March, 2022. Articles included were in English and based on women between the ages of 18–96 years with confirmed gingivitis/periodontal disease and breast cancer diagnoses from registered specialists. Authors extracted data independently, and a meta-analysis of risk estimations measuring associations between oral Fusobacterium nucleatum species and female-specific breast cancer was elucidated via calculated relative risks and 95% confidence intervals. Results. AXIS tool analysis revealed 78.70% of articles with a positive correlation between oral Fusobacterium nucleatum and female-specific breast cancer. The risk of breast cancer development increased with significant levels of oral Fusobacterium nucleatum due to gingivitis/periodontitis (relative risk = 1.78, 95% confidence interval = 1.63–1.91). Low-moderate statistical heterogeneity was found (I2 = 41.39%; P = 0.02), and the importance of periodontal status on breast cancer pathogenesis was determined (relative risk = 1.24, 95% confidence interval = 1.01–1.30). Conclusions. Oral Fusobacterium nucleatum species are a risk factor for breast cancer development, thus elevating their biomarker potentiality.