Search

Research on topics related to educational leadership is evolving rapidly. A scoping review was conducted to investigate research on teacher leadership in Spain searching online databases (WoS, ÍnDICEs-CSIC, SCOPUS, Google Scholar) to identify papers published between 1990 and 2022, of which 39 were included. Through a thematic and contextual analysis, the review concludes that teacher leadership is an emerging topic in Spain; it has a much stronger empirical position and has expanded related to distributed leadership and leadership for social justice. Nevertheless, further research is needed to develop this area and make it more useful for academics, practitioners, and policymakers.

Diarrhoea is a serious cause of mortality worldwide that can lead to dehydration, gut barrier function impairment, nutrient malabsorption, and alterations of the gut microbiota (dysbiosis). The current solutions for its management, such as oral rehydration salts (ORS), inhibitors of gut motility, antibiotics, and living probiotics, only partially counteract the mechanisms of the disease and do not provide a full coverage of the problem. The potential risks of the use of living probiotic strains, particularly in immunocompromised patients, can be eliminated with the use of tyndallized (heat-killed) postbiotic bacteria and yeast. ABB C22® is a postbiotic combination of three tyndallized yeasts, namely Saccharomyces boulardii, Saccharomyces cerevisiae, and Kluyveromyces marxianus. To assess the action of the postbiotic combination on diarrhoea, immune and gut epithelial cell signalling assays, the gut barrier formation assay, and the rotavirus gene expression assay were performed. ABB C22® showed a strong anti-inflammatory effect, an induction of the build-up of the gut epithelium, and a degree of protection against rotavirus infection. These experimental studies support the use of the postbiotic ABB C22® as a solution for the management of diarrhoea and gastrointestinal conditions, alone or in combination with existing but incomplete treatments.

Because of its taste, texture, and aroma, chocolate is consumed as a way to generate pleasant sensations. Due to its high caloric density, moderate consumption is recommended. Seeking to offer the benefits of this product to a more selective public, the aim of this research was to determine the chemical composition and sensory properties of a sugar-free dark chocolate added with inulin and sweetened with stevia extract obtained by pressurized hot water, which was compared with a commercial dark chocolate and accompanied by a sensory analysis of the samples. A completely randomized statistical experimental design was used to compare the properties of the alternative and commercial chocolates. The treatments were carried out in triplicate and the results obtained were analyzed by descriptive statistics and one-way analysis of variance with 95 % confidence level. The results showed that the treatment of stevia leaves with hot pressurized water allowed an extraction of 41.51 g of steviol glycosides for rebaudioside A and 6.76 g for stevioside per 100 g of leaves subjected to processing. The chemical analysis of the alternative and commercial chocolates indicated that the fat and total dietary fiber contents showed no significant difference (p > 0.05) between the dark chocolates, unlike the other components. Moisture, ash, fat, and protein contents were slightly higher in the two types of chocolate, and carbohydrate content was 4.1 % lower than in the commercial chocolate. Both products had 0 % added sugars and high dietary fiber content (> 37 %), and there was a reduction of 100 kcal/100 g compared to the commercial brand. Consumer sensory evaluation showed a higher level of liking (p < 0.05) for the elaborated chocolate with respect to the commercial product in attributes such as appearance, color, and texture. These findings suggest the use of stevia extracts obtained by pressurized hot water as a non-caloric sweetener for healthy, alternative dark chocolates suitable for people with diabetes.

The Argo array of profiling floats has considerably increased the observing capability of the three-dimensional global ocean and the knowledge of the ocean response to climate change. In particular, the Argo sampling has allowed observing relevant ocean indicators over the whole Mediterranean Sea especially during the last decade. In this study, the Mediterranean Argo network is comprehensively described from its spatio-temporal coverage to its capability to observe ocean monitoring indicators at sub-regional scale. For this purpose, the Argo array, as a non-interpolated product of profiles, is used to estimate the ocean heat and salt contents integrated within the upper, intermediate and deep layers over the period 2013-2022 in the different sub-regions of the basin. The same computational method is also applied to a model reanalysis product to estimate the impact of sampling of the sole Argo array. The sampling error is defined at sub-regional scale by comparing estimations from the whole model grid (full-sampled model) and from the Argo-like sampled model grid (sub-sampled model). Warming and salinification trends are well captured by the Argo array over the period of study, warming trends being the highest in the sub-regions of the western Mediterranean Sea from surface to depth and salinification trends being higher in the eastern sub-basin for the upper layer and in the western sub-basin for the deeper layers. This study also demonstrates the capability of the Argo array to capture local ocean structures and dynamics (e.g. anticyclonic and cyclonic gyres, intermediate and deep convection events and Atlantic Water inflows) and to account for their impact in the sub-regional variability of ocean heat and salt contents in the upper, intermediate and deep layers from seasonal to interannual scales. Considering these structures is fundamental for the understanding of the thermohaline circulation and changes observed in the Mediterranean Sea, and thus for future climate studies.

Objetivo. Evaluar la composición fisicoquímica y el valor nutritivo de leche de cabra en tres diferentes sistemas de manejo productivo a pequeña escala en Mérida, Yucatán, México; con la finalidad de producir leche destinada a la alimentación humana con problemas de asimilación de lactosa. Materiales y métodos. Se recolectaron muestras de leche cada dos semanas durante cuatro meses y se les cuantificó sólidos totales, grasa, proteína, lactosa, cenizas, calcio y fósforo. Se determinó densidad, pH, acidez, ácidos grasos por cromatografía de gases y caseínas por electroforesis. Resultados. La composición promedio fue 2.69% grasa, 4.10% proteína, 4.12% lactosa, 12.96% sólidos totales, 0.83% cenizas, 139 mg/100g calcio y 105 mg/100g fósforo. La densidad, acidez como ácido láctico y pH obtenidos fueron 1.032 g/cm3, 1.36 g/L y 6.51, respectivamente. Las leches aportaron MUFAs como ácidos oleico y gadoleico, y PUFAs como ácido linoleico y araquidónico, implicados procesos metabólicos que reducen el riesgo del síndrome metabólico. El patrón electroforético de las caseínas mostró bandas más abundantes con pesos moleculares de 20 a 36 kDa. Conclusiones. La composición de la leche de cabra producida resultó ser superior, con ventajas nutricionales, y potenciales beneficios a la salud respecto a la leche de otras especies. El contenido de lactosa, el pH y la acidez de la leche de cabra fueron diferentes en función de las unidades de producción; y la densidad, grasa, proteína y cenizas no se vieron influenciadas. La ausencia αs1-caseína sería ventajoso para la reducción de alergias asociadas al consumo de leche.

The pitahaya Selenicereus undatus is a fruit widely consumed in the Yucatan Peninsula in Mexico, and its cultivation is promising due to its adaptability to adverse climatic conditions, its nutritional quality, and its bioactive compounds. The objective of this work was to determine the physical parameters of the fresh fruit (weights and diameters) and chemical parameters of the pulp (stored at -18 ºC) of pitahaya grown in two locations in the state of Yucatán, as well as to estimate the yield of fructooligosaccharides (FOS) present in freeze-dried pulp and peel flour, using the solid/liquid extraction method. Six physicochemical and six proximal descriptors (in freeze-dried pulp and peel), which were statistically compared using the t-student test, were quantified. The fruits had an average weight of 534.81 and 520.36 g for the pitahaya grown in Kinchil and Yobain, respectively. The peel weight of the fruit from Kinchil was significantly (p < 0.05) higher. The pulp represented between 67 – 72 % of the weight of the fruits. The physicochemical analysis of the fruit pulp indicated that the average total soluble solids/titratable acidity (TSS/TA) ratio was 20.5, and the pH was 3.29. The proximal analysis expressed on a dry basis (% d.b.) showed average values for the pulp of 4.80 % ash, 0.47 % crude fat, 10.42 % crude fiber, and 6.92 % protein; while for the peel 14.20 % ash, 1.39 % crude fat, 22.22 % crude fiber, and 5.31 % protein. The values of crude fiber and total carbohydrates in the peel, as well as the crude fat content in the pulp, were different (p < 0.05) between the locations. The estimated extraction yield of FOS with water was 86.49 g/kg for the freeze-dried pulp and 17.64 g/kg for the freeze-dried peel flour. This fruit exhibited good nutritional properties, and the freeze-dried flour from its peel could be used as supplement rich in dietary fiber and, together with the freeze-dried pulp, could be added to products such as juices, yogurt, and jams, among others, with a potential prebiotic effect due to its fructooligosaccharides content.

Recycling is a highly relevant issue in environmental behavior. To make it work, it is necessary to involve people. Many efforts have been made to increase people's participation in recycling. This study proposes an informal education to raise awareness among homemakers about recycling, especially aluminum packaging recycling, using workshops and compensating the factors that act as barriers to recycling in Spain. The results are the "Spaces for Dialogue" strategy to increase knowledge, awareness, and recycling intention. The findings present the main barriers to closing the gap between intention to action, and the study highlights the role that mentors play as teachers in facilitating communication and education for sustainable development.

Due to the crucial role principals have on school outcomes, investing in their training is a cost-effective approach for schools' improvement. Research shows that principals attribute pertinence to their ongoing professional development. However, little research has been conducted on principals' training needs from their viewpoint, particularly in Portugal. Through individual interviews (n = 19) and a questionnaire (n = 117) to principals, we collected data that enable us to understand principals' perceptions on their training needs, focusing on learning areas, skills to be developed and learning methods. Results show considerable variability, reinforcing the relevance of tailored and contextualised approaches to professional development. Globally, principals request management skills and training opportunities that enable them to develop leadership skills (e.g., personal, interpersonal/socioemotional). Moreover, principals need training on instructional and distributed leadership practices. Collaborative and reflective methods are the ones principals prefer. Practical implications for the design of systematic professional development practices, in a lifelong perspective, are also discussed.

Este artículo pretende describir y analizar cómo es posible potenciar el liderazgo educativo desde los niveles intermedios del sistema, así como el papel decisivo que pueden realizar estos niveles intermedios o middle tiers como agentes de cambio para la mejora. Se emplea una metodología de revisión narrativa de la literatura enfocada a sintetizar el conocimiento y la práctica existente sobre el tema a nivel internacional, a la vez que se examina crítica y subjetivamente. Como resultado se concluye lo siguiente: 1. El liderazgo de los niveles intermedios del sistema importa y establece una relación positiva con los resultados y la mejora de la calidad de la educación; 2. Hay que potenciar la conexión de los agentes y de las instituciones intermedios entre sí y con los niveles inferiores y superiores para conseguir un liderazgo sistémico; 3. El liderazgo desde los niveles intermedios tiene en cuenta el contexto, pero se han identificado algunas características comunes; 4. Es preciso realizar un esfuerzo de conceptualización y nomenclatura, y 5. Las investigaciones están concentradas en el área anglosajona y sería necesario introducir esta línea crucial de análisis en otros lugares.

Candida albicans cell wall component β-glucan has been extensively studied for its ability to induce epigenetic and functional reprogramming of innate immune cells, a process termed trained immunity. We show that a high-complexity blend of two individual β-glucans from Saccharomyces cerevisiae possesses strong bioactivity, resulting in an enhanced trained innate immune response by human primary monocytes. The training required the Dectin-1/CR3, TLR4, and MMR receptors, as well as the Raf-1, Syk, and PI3K downstream signaling molecules. By activating multiple receptors and downstream signaling pathways, the components of this β-glucan preparation are able to act synergistically, causing a robust secondary response upon an unrelated challenge. In in-vivo murine models of melanoma and bladder cell carcinoma, pre-treatment of mice with the β-glucan preparation led to a significant reduction in tumor growth. These insights may aid in the development of future therapies based on β-glucan structures that induce an effective trained immunity response.

The purpose of this scoping review is to analyse the literature concerning principals' problems and challenges, beginning in 2003 and ending in 2019. The research team conducted an extensive search to locate relevant academic literature, comprising 17 years of research, and a total of 153 documents were analysed. According to the findings, most of the documents (71%) correspond to the last six years (2014-2019), and most are studies from Anglo-Saxon countries (55%). The results point to eight main categories related to the complex nature of the job (the management challenge, the complexity challenge and the learning challenge), and interactions with different stakeholders (problems with educational authorities and educational policy; the staff and teaching process; the students; the families and the school community; and the society). Although the importance given to each category varies from one context to another, problems concerning the complex nature of the job and with the educational authorities and the educational policy are the most recurrent. A significant increase in the number and complexity of problems and challenges throughout the times was noticed, which seems to enhance the need for changes in educational policies and the careful design and implementation of leadership training programmes.

Abstract Systematic and sustained high quality measurements of nearshore waves and beach morphology are crucial to understand morphodynamic processes that determine beach evolution, to unravel the effects of global warming on sandy coasts and thus improve forecasting models. In 2011 a comprehensive beach monitoring program, the first in the Mediterranean Sea, started at Cala Millor Beach on the island of Mallorca (Spain). The aim was to provide long-term datasets of near-shore morphodynamics in a carbonate sandy micro-tidal and semi-embayed beach fronted by a Posidonia oceanica seagrass meadow. We present our morphological and hydrodynamical dataset of Cala Millor covering more than a decade. The dataset includes topobathymetries, shoreline positions obtained from video cameras, meteorological parameters from a weather station, currents, as well as waves and sea level from ADCP measurements and sediment size. This free and unrestricted archived dataset can be used to support the modelling of erosion-deposition patterns, calibrate beach evolution models, and as a result to propose adaptation and mitigation actions under different global change scenarios.

This study evaluated the anti-inflammatory effects, the protection of gut barrier integrity, and the stimulation of phagocytosis in peripheral cells of a nutritional supplement based on a synergistic combination of yeast-based ingredients with a unique 1,3/1,6-glucan complex and a consortium of postbiotic Saccharomyces cerevisiae rich in selenium and zinc. The anti-inflammatory effect in caco-2 cells in the presence and absence of a pro-inflammatory challenge (tumour necrosis factor alpha [TNF-α]/interferon gamma [IFN-ɣ]) showed statistically significant reductions in IFN-ɣ induced protein-10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) levels vs. controls (p < 0.001). Disruption of the gut integrity in the presence or absence of Escherichia coli (ETEC H10407) showed transepithelial electrical resistance (TEER) values higher in the ABB C1® group after 6 h of testing. Spontaneous build-up of the gut epithelium monolayer over 22 days was also greater in the ABB C1® condition vs. a negative control. ABB C1® showed a significantly higher capacity to stimulate phagocytosis as compared with controls of algae β-1,3-glucan and yeast β-1,3/1,6 glucan (p < 0.001). This study supports the mechanism of action by which ABB C1® may improve the immune response and be useful to prevent infection and allergy in clinical practice.

The organisation of K-18 schools and the management function are similar in Portugal and Spain, although, in recent years, Portugal has surpassed Spain's educational results. Based on the last international reports, this article compares the educational systems of both countries considering some variables related to the management model: (i) the general organisation of education in these stages, (ii) the characteristics of the teaching profession, including the process of recruitment and selection of teachers and principals, and (iii) the level of school autonomy and the type of management and leadership. Findings corroborated the existence of structural proximity in the governance of schools within the framework of a management model that is both centralized and participatory. However, there are differences in the permanency of educational laws, the duration of compulsory education, the grouping of schools, and the requirements to be a teacher. We conclude that the policies undertaken by Portugal to improve education (such as the extension of compulsory schooling, legislative stability, or the rethinking of the internal organization of schools) are succeeding and can serve as an example for Spain. Both countries could help principals become leaders for learning and improve their autonomy to favour changes in education.

Resumen: Introducción: Alemtuzumab es un fármaco de alta eficacia aprobado por la Agencia Europea de Medicamentos como tratamiento modificador de la enfermedad en pacientes con esclerosis múltiple remitente recurrente. Objetivo: Elaborar un documento de consenso sobre el manejo de alemtuzumab en la práctica clínica habitual, que sea de aplicación en el ámbito español. Desarrollo: Un grupo de expertos en esclerosis múltiple revisó las publicaciones disponibles hasta diciembre de 2017, de tratamiento con alemtuzumab y esclerosis múltiple. Se incluyeron trabajos sobre eficacia, efectividad y seguridad, despistaje de infecciones y vacunación, administración y monitorización. La propuesta inicial de recomendaciones fue desarrollada por un grupo coordinador con base en la evidencia disponible y en su experiencia clínica. El proceso de consenso se llevó a cabo en 2 etapas; se estableció como porcentaje inicial de acuerdo grupal el 80%. El documento final con todas las recomendaciones acordadas por el grupo de trabajo se sometió a revisión externa y los comentarios recibidos fueron considerados por el grupo coordinador. Conclusiones: El documento aportado pretende ser una herramienta útil para facilitar el manejo del fármaco en condiciones de práctica clínica habitual. Abstract: Introduction: Alemtuzumab is a highly effective drug approved by the European Medicines Agency as a disease-modifying drug for the treatment of relapsing-remitting multiple sclerosis. Objective: A consensus document was drafted on the management of alemtuzumab in routine clinical practice in Spain. Development: A group of multiple sclerosis specialists reviewed articles addressing treatment with alemtuzumab in patients with multiple sclerosis and published before December 2017. The included studies assessed the drug's efficacy, effectiveness, and safety; screening for infections and vaccination; and administration and monitoring aspects. The initial proposed recommendations were developed by a coordinating group and based on the available evidence and their clinical experience. The consensus process was carried out in 2 stages, with the initial threshold percentage for group agreement established at 80%. The final document with all the recommendations agreed by the working group was submitted for external review and the comments received were considered by the coordinating group. Conclusion: The present document is intended to be used as a tool for optimising the management of alemtuzumab in routine clinical practice.

Introduction: Alemtuzumab is a highly effective drug approved by the European Medicines Agency as a disease-modifying drug for the treatment of relapsing-remitting multiple sclerosis. Objective: A consensus document was drafted on the management of alemtuzumab in routine clinical practice in Spain. Development: A group of multiple sclerosis specialists reviewed articles addressing treatment with alemtuzumab in patients with multiple sclerosis and published before December 2017. The included studies assessed the drug's efficacy, effectiveness, and safety; screening for infections and vaccination; and administration and monitoring aspects. The initial proposed recommendations were developed by a coordinating group and based on the available evidence and their clinical experience. The consensus process was carried out in 2 stages, with the initial threshold percentage for group agreement established at 80%. The final document with all the recommendations agreed by the working group was submitted for external review and the comments received were considered by the coordinating group. Conclusion: The present document is intended to be used as a tool for optimising the management of alemtuzumab in routine clinical practice. Resumen: Introducción: Alemtuzumab es un fármaco de alta eficacia aprobado por la Agencia Europea de Medicamentos como tratamiento modificador de la enfermedad en pacientes con esclerosis múltiple remitente recurrente. Objetivo: Elaborar un documento de consenso sobre el manejo de alemtuzumab en la práctica clínica habitual, que sea de aplicación en el ámbito español. Desarrollo: Un grupo de expertos en esclerosis múltiple revisó las publicaciones disponibles hasta diciembre de 2017, de tratamiento con alemtuzumab y esclerosis múltiple. Se incluyeron trabajos sobre eficacia, efectividad y seguridad, despistaje de infecciones y vacunación, administración y monitorización. La propuesta inicial de recomendaciones fue desarrollada por un grupo coordinador con base en la evidencia disponible y en su experiencia clínica. El proceso de consenso se llevó a cabo en 2 etapas; se estableció como porcentaje inicial de acuerdo grupal el 80%. El documento final con todas las recomendaciones acordadas por el grupo de trabajo se sometió a revisión externa y los comentarios recibidos fueron considerados por el grupo coordinador. Conclusiones: El documento aportado pretende ser una herramienta útil para facilitar el manejo del fármaco en condiciones de práctica clínica habitual.

Objective: To study the clinico-radiological paradox in multiple sclerosis (MS) relapse by analyzing the number and location of gadolinium-enhanced (Gd+) lesions on brain MRI before methylprednisolone (MP) treatment. Methods: We analyzed brain MRI from 90 relapsed MS patients in two Phase IV multicenter double-blind randomized clinical trials that showed the noninferiority of different routes and doses of MP administration. A 1.5- or 3-T brain MRI was performed at baseline before MP treatment and within 15 days of symptom onset. The number and location of Gd+ lesions were analyzed. Associations were studied using univariate analysis. Results: Sixty-two percent of patients had at least 1 Gd+ brain lesion; the median number was 1 (interquartile range 0–4), and 41% of patients had 2 or more lesions. The most frequent location of Gd+ lesions was subcortical (41.4%). Gd+ brain lesions were found in 71.4% of patients with brainstem-cerebellum symptoms, 57.1% with spinal cord symptoms and 55.5% with optic neuritis (ON). Thirty percent of patients with brain symptoms did not have Gd+ lesions, and only 43.6% of patients had symptomatic Gd+ lesions. The univariate analysis showed a negative correlation between age and the number of Gd+ lesions (p = 0.002). Conclusion: Most patients with relapse showed several Gd+ lesions on brain MRI, even when the clinical manifestation was outside of the brain. Our findings illustrate the clinico-radiological paradox in MS relapse and support the value of brain MRI in this scenario. Resumen: Objetivo: Estudiar la paradoja clínico-radiológica en el brote de la esclerosis múltiple (EM) mediante el análisis de lesiones captantes de gadolinio (Gd+) en la RM cerebral antes del tratamiento con metilprednisolona (MP). Métodos: Analizamos la RM cerebral basal de 90 pacientes con EM en brote de 2 ensayos clínicos aleatorizados multicéntricos fase IV que demostraron la no inferioridad de diferentes vías y dosis de MP, realizadas antes del tratamiento con MP y en los 15 días siguientes a la aparición de los síntomas. Se analizaron el número y la localización de las lesiones Gd+. Se estudiaron las asociaciones mediante análisis univariado. Resultados: El 62% de los pacientes tenía al menos una lesión Gd+ cerebral y el 41% de los pacientes tenía 2 o más lesiones. La localización más frecuente fue la subcortical (41,4%). Se encontraron lesiones Gd+ cerebrales en el 71,4% de los pacientes con síntomas de tronco cerebral o cerebelo, en el 57,1% con síntomas medulares y en el 55,5% con neuritis óptica. El 30% de los pacientes con síntomas cerebrales no tenían lesiones Gd+ y sólo el 4,.6% de los pacientes tenían lesiones Gd+ sintomáticas. El análisis univariante mostró una correlación negativa entre la edad y el número de lesiones Gd+ (p = 0,002). Conclusiones: La mayoría de los pacientes en brote mostraron varias lesiones Gd+ en la RM cerebral, incluso cuando la manifestación clínica fue medular u óptica. Nuestros hallazgos ilustran la paradoja clínico-radiológica en el brote de la EM y apoyan el valor de la RM cerebral en este escenario.

The clinical-radiological and biological overlap of the spectrum of pediatric demyelinating disorders makes the diagnostic process of a child with an acquired demyelinating syndrome truly challenging. We present a 9-year-old girl with subacute symptoms of severe decrease in bilateral visual acuity and gait ataxia. An urgent MRI showed inflammatory-demyelinating lesions affecting the periaqueductal gray matter, the cerebellar hemispheres, the area postrema as well as both optic nerves and chiasm. Likewise, multisegmental involvement of the cervical and dorsal spinal cord was found, with short and peripheral lesions. Anti myelin oligodendrocyte glycoprotein (MOG) antibodies (Abs) were positive in cerebrospinal fluid (CSF) and weakly in serum. Oligoclonal bands (OB) were positive in CSF. Based on all this, the diagnosis of MOG antibody disease (MOGAD) with a neuromyelitis optica spectrum disorder (NMOSD)-like picture was made. Given the good clinical and radiological recovery after the acute phase treatment, and that anti MOG Abs became negative, it was decided to keep the patient without specific treatment. However, during follow-up, while the patient was asymptomatic, a control brain MRI showed the appearance of new lesions with morphology and topography suggestive of multiple sclerosis (MS). This, added to the presence of OB, made the diagnosis of pediatric-onset MS (POMS) likely. Immunosuppressive treatment was restarted with a good response since then. Unlike adult-onset MS, children with POMS may usually not have entirely typical clinical and radiological features at presentation. In many cases, the time factor and close clinical and radiological monitoring could be critical to make an accurate diagnosis.

Dimethyl fumarate (DMF) is a widely used oral disease-modifying therapy for multiple sclerosis (MS). Its efficacy and safety profiles are supported by over a decade of experience. Differences exist between Asia and Europe/United States in the prevalence and characteristics of MS; most data for DMF are derived from populations outside Asia. DMF was recently (2021) approved for use in China. The objectives of this review were to evaluate the evidence for DMF’s profile, to provide an update to healthcare providers on current knowledge surrounding its use and to assess the relevance of existing data to use in China. This study used a modified Delphi method based on the insights of a scientific Steering Committee (SC), with a structured literature review conducted to assess the data of DMF. The literature review covered all papers in English (from 01 January 2011 to 21 February 2022) that include ‘dimethyl fumarate’ and ‘multiple sclerosis’, and their MeSH terms, on PubMed, supplemented by EMBASE and Citeline searches. Papers were categorized by topic and assessed for relevance and quality, before being used to formulate statements summarizing the literature on each subject. SC members voted on/revised statements, requiring ⩾80% agreement and ⩽10% disagreement for inclusion. Statements not reaching this level were discussed further until agreement was reached or until there was agreement to remove the statement. A total of 1030 papers were retrieved and used to formulate the statements and evidence summaries considered by the SC members. A total of 45 statements were agreed by the SC members. The findings support the positive efficacy and safety profile of DMF in treating patients with MS. Limited Chinese patient data are an ongoing consideration; however, based on current evidence, the statements are considered applicable to both the global and Chinese populations. DMF is a valuable addition to address unmet MS treatment needs in China. Registration: Not applicable

Abstract The decreasing seawater pH trend associated with increasing atmospheric carbon dioxide levels is an issue of concern due to possible negative consequences for marine organisms, especially calcifiers. Globally, coastal areas represent important transitional land-ocean zones with complex interactions between biological, physical and chemical processes. Here, we evaluated the pH variability at two sites in the coastal area of the Balearic Sea (Western Mediterranean). High resolution pH data along with temperature, salinity, and also dissolved oxygen were obtained with autonomous sensors from 2018 to 2021 in order to determine the temporal pH variability and the principal drivers involved. By using environmental datasets of temperature, salinity and dissolved oxygen, Recurrent Neural Networks were trained to predict pH and fill data gaps. Longer environmental time series (2012–2021) were used to obtain the pH trend using reconstructed data. The best predictions show a rate of $$-\,0.0020\pm 0.00054$$ - 0.0020 ± 0.00054 pH units year $$^{-1}$$ - 1 , which is in good agreement with other observations of pH rates in coastal areas. The methodology presented here opens the possibility to obtain pH trends when only limited pH observations are available, if other variables are accessible. Potentially, this could be a way to reliably fill the unavoidable gaps present in time series data provided by sensors.

Employed for over a century, the traditional way of monitoring sea level variability by tide gauges – in combination with modern observational techniques like satellite altimetry – is an inevitable ingredient in sea level studies over the climate scales and in coastal seas. The development of the instrumentation, remote data acquisition, processing, and archiving in the last decades has allowed the extension of the applications to a variety of users and coastal hazard managers. The Mediterranean and Black seas are examples of such a transition – while having a long tradition of sea level observations with several records spanning over a century, the number of modern tide gauge stations is growing rapidly, with data available both in real time and as a research product at different time resolutions. As no comprehensive survey of the tide gauge networks has been carried out recently in these basins, the aim of this paper is to map the existing coastal sea level monitoring infrastructures and the respective data availability. The survey encompasses a description of major monitoring networks in the Mediterranean and Black seas and their characteristics, including the type of sea level sensors, measuring resolutions, data availability, and existence of ancillary measurements, altogether collecting information about 240 presently operational tide gauge stations. The availability of the Mediterranean and Black seas sea level data in the global and European sea level repositories has been also screened and classified following their sampling interval and level of quality check, pointing to the necessity of harmonization of the data available with different metadata and series in different repositories. Finally, an assessment of the networks' capabilities for their use in different sea level applications has been done, with recommendations that might mitigate the bottlenecks and ensure further development of the networks in a coordinated way, a critical need in the era of human-induced climate changes and sea level rise.

The Mediterranean Sea is a prominent climate-change hot spot, with many socioeconomically vital coastal areas being the most vulnerable targets for maritime safety, diverse met-ocean hazards and marine pollution. Providing an unprecedented spatial and temporal resolution at wide coastal areas, high-frequency radars (HFRs) have been steadily gaining recognition as an effective land-based remote sensing technology for continuous monitoring of the surface circulation, increasingly waves and occasionally winds. HFR measurements have boosted the thorough scientific knowledge of coastal processes, also fostering a broad range of applications, which has promoted their integration in coastal ocean observing systems worldwide, with more than half of the European sites located in the Mediterranean coastal areas. In this work, we present a review of existing HFR data multidisciplinary science-based applications in the Mediterranean Sea, primarily focused on meeting end-user and science-driven requirements, addressing regional challenges in three main topics: (i) maritime safety, (ii) extreme hazards and (iii) environmental transport process. Additionally, the HFR observing and monitoring regional capabilities in the Mediterranean coastal areas required to underpin the underlying science and the further development of applications are also analyzed. The outcome of this assessment has allowed us to provide a set of recommendations for future improvement prospects to maximize the contribution to extending science-based HFR products into societally relevant downstream services to support blue growth in the Mediterranean coastal areas, helping to meet the UN's Decade of Ocean Science for Sustainable Development and the EU's Green Deal goals.

Due to the semi-enclosed nature of the Mediterranean Sea, natural disasters and anthropogenic activities impose stronger pressures on its coastal ecosystems than in any other sea of the world. With the aim of responding adequately to science priorities and societal challenges, littoral waters must be effectively monitored with high-frequency radar (HFR) systems. This land-based remote sensing technology can provide, in near-real time, fine-resolution maps of the surface circulation over broad coastal areas, along with reliable directional wave and wind information. The main goal of this work is to showcase the current status of the Mediterranean HFR network and the future roadmap for orchestrated actions. Ongoing collaborative efforts and recent progress of this regional alliance are not only described but also connected with other European initiatives and global frameworks, highlighting the advantages of this cost-effective instrument for the multi-parameter monitoring of the sea state. Coordinated endeavors between HFR operators from different multi-disciplinary institutions are mandatory to reach a mature stage at both national and regional levels, striving to do the following: (i) harmonize deployment and maintenance practices; (ii) standardize data, metadata, and quality control procedures; (iii) centralize data management, visualization, and access platforms; and (iv) develop practical applications of societal benefit that can be used for strategic planning and informed decision-making in the Mediterranean marine environment. Such fit-for-purpose applications can serve for search and rescue operations, safe vessel navigation, tracking of marine pollutants, the monitoring of extreme events, the investigation of transport processes, and the connectivity between offshore waters and coastal ecosystems. Finally, future prospects within the Mediterranean framework are discussed along with a wealth of socioeconomic, technical, and scientific challenges to be faced during the implementation of this integrated HFR regional network.

Three galaxy clusters selected from the XXL X-ray survey at high redshift and low mass (z ~ 1 and M500 ~ 1 – 2 × 1014 M⊙) were observed with NIKA2 to image their Sunyaev-Zel'dovich effect (SZ) signal. They all present an SZ morphology, together with the comparison with X-ray and optical data, that indicates dynamical activity related to merging events. Despite their disturbed intracluster medium, their high redshifts, and their low masses, the three clusters follow remarkably well the pressure profile and the SZ flux-mass relation expected from standard evolution. This suggests that the physics that drives cluster formation is already in place at z ~ 1 down to M500 ~ 1014 M⊙.

Long-chain dextrans are α-glucans that can be produced by lactic acid bacteria. NextDextTM, a specific long-chain dextran with a high degree of polymerisation, produced using Weissella cibaria, was recently shown to exert prebiotic potential in vitro. In this study, the ex vivo SIFR® technology, recently validated to provide predictive insights into gut microbiome modulation down to the species level, was used to investigate the effects of this long-chain dextran on the gut microbiota of six human adults that altogether covered different enterotypes. A novel community modulation score (CMS) was introduced based on the strength of quantitative 16S rRNA gene sequencing and the highly controlled ex vivo conditions. This CMS overcomes the limitations of traditional α-diversity indices and its application in the current study revealed that dextran is a potent booster of microbial diversity compared to the reference prebiotic inulin (IN). Long-chain dextran not only exerted bifidogenic effects but also consistently promoted Bacteroides spp., Parabacteroides distasonis and butyrate-producing species like Faecalibacterium prausnitzii and Anaerobutyricum hallii. Further, long-chain dextran treatment resulted in lower gas production compared to IN, suggesting that long-chain dextran could be better tolerated. The additional increase in Bacteroides for dextran compared to IN is likely related to the higher propionate:acetate ratio, attributing potential to long-chain dextran for improving metabolic health and weight management. Moreover, the stimulation of butyrate by dextran suggests its potential for improving gut barrier function and inflammation. Overall, this study provides a novel tool for assessing gut microbial diversity ex vivo and positions long-chain dextran as a substrate that has unique microbial diversity enhancing properties.

BackgroundThere is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis.ObjectiveBuild a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient's course.MethodsSerially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women's Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d'Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)).Results and conclusionWe provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.

The application of convolutional neural networks (CNNs) to MRI data has emerged as a promising approach to achieving unprecedented levels of accuracy when predicting the course of neurological conditions, including multiple sclerosis, by means of extracting image features not detectable through conventional methods. Additionally, the study of CNN-derived attention maps, which indicate the most relevant anatomical features for CNN-based decisions, has the potential to uncover key disease mechanisms leading to disability accumulation.From a cohort of patients prospectively followed up after a first demyelinating attack, we selected those with T1-weighted and T2-FLAIR brain MRI sequences available for image analysis and a clinical assessment performed within the following six months (N = 319). Patients were divided into two groups according to expanded disability status scale (EDSS) score: ≥3.0 and

The organisation of K-18 schools and the management function are similar in Portugal and Spain, although, in recent years, Portugal has surpassed Spain’s educational results. Based on the last international reports, this article compares the educational systems of both countries considering some variables related to the management model: (i) the general organisation of education in these stages, (ii) the characteristics of the teaching profession, including the process of recruitment and selection of teachers and principals, and (iii) the level of school autonomy and the type of management and leadership. Findings corroborated the existence of structural proximity in the governance of schools within the framework of a management model that is both centralized and participatory. However, there are differences in the permanency of educational laws, the duration of compulsory education, the grouping of schools, and the requirements to be a teacher. We conclude that the policies undertaken by Portugal to improve education (such as the extension of compulsory schooling, legislative stability, or the rethinking of the internal organization of schools) are succeeding and can serve as an example for Spain. Both countries could help principals become leaders for learning and improve their autonomy to favour changes in education.

Introducción. Las proteínas y polisacáridos con frecuencia son utilizados simultáneamente en la industria de alimentos. Las interacciones entre ambos biopolímeros juegan un papel importante en la estructura y estabilidad de muchos alimentos procesados ya que pueden resultar en un sistema con propiedades bioactivas diferentes como ocurre en el caso de las funcionales. Objetivo. Evaluar los cambios en la capacidad antioxidante de un sistema hidrocoloide mixto formado por un hidrolizado enzimático proteico de frijol endurecido (P. vulgaris) y goma modificada de flamboyán (Delonix regia) (SHM). Materiales y métodos. El estudio se hizo entre febrero-octubre, 2014, en Mérida, México. Se modificó enzimáticamente el concentrado proteico de P. vulgaris con Pepsina-Pancreatina® y la goma extraída del flamboyán mediante carboximetilación, preparando dispersiones al 1% de cada uno de los biopolímeros, determinado la fluorescencia intrínseca de Trp (FIT) como indicador de la interacción entre ambos biopolímeros y la actividad antioxidante y quelante del sistema resultante. Resultados. Se obtuvo un hidrolizado proteico extensivo con 28,8% de grado de hidrólisis y una goma de flamboyán con grado de sustitución de 0,91. La mayor interacción entre ambos biopolímeros, se obtuvo empleando una relación 5:1 del SHM a pH 4 de acuerdo con el valor de FIT. Conclusiones. Los sistemas hidrocoloides mixtos preparados con hidrolizado extensivo de las proteínas Phaseolus vulgaris y goma modificada de flamboyán presentaron un incremento en la actividad antioxidante, respecto del hidrolizado dependiendo del mecanismo de oxidación, así como de las condiciones de pH en que se encuentra el sistema y la interacción entre ambos componentes.