Search

STUDY DESIGN: Multicenter, international prospective study. OBJECTIVE: This study investigated the clinical outcome up to 2 years after multi-level spinal deformity surgery in the elderly by reporting the minimal clinically important difference (MCID) of EuroQol 5-dimensions (EQ-5D), EQ-VAS, and residential status. METHODS: As an ancillary study of 219 patients ≥60 years with spinal deformity undergoing primary instrumented fusion surgery of ≥5 levels, this study focuses on EQ-5D (3-L) as the primary outcome and EQ-VAS and residential status as secondary outcomes. Data on EQ-5D were compared between pre-operatively and postoperatively at 10 weeks, 12 months, and 24 months. An anchor-based approach was used to calculate the MCID. RESULTS: The EQ-5D index and EQ-VAS, respectively, improved significantly at each time point compared to pre-operatively (from .53 (SD .21) and 55.6 (SD 23.0) pre-operatively to .64 (SD .18) and 65.8 (SD 18.7) at 10 weeks, .74 (SD .18) and 72.7 (SD 18.1) at 12 months, and .73 (SD .20) and 70.4 (SD 20.4) at 24 months). 217 (99.1%) patients lived at home pre-operatively, while 186 (88.6%), 184 (98.4%), and 172 (100%) did so at 10 weeks, 12 months, and 24 months, respectively. Our calculated MCID for the EQ-5D index at 1 year was .22 (95% CI .15-.29). CONCLUSIONS: The EQ-5D index significantly increased at each time point over 24 months after ≥5 level spinal deformity surgery in elderly patients. The MCID of the EQ-5D-3 L was .22. Patients living at home pre-operatively can expect to be able to live at home 2 years postoperatively.

Maternal educational attainment (MEA) shapes offspring health through multiple potential pathways. Differential DNA methylation may provide a mechanistic understanding of these long-term associations. We aimed to quantify the associations of MEA with offspring DNA methylation levels at birth, in childhood and in adolescence. Using 37 studies from high-income countries, we performed meta-analysis of epigenome-wide association studies (EWAS) to quantify the associations of completed years of MEA at the time of pregnancy with offspring DNA methylation levels at birth (n = 9 881), in childhood (n = 2 017), and adolescence (n = 2 740), adjusting for relevant covariates. MEA was found to be associated with DNA methylation at 473 cytosine-phosphate-guanine sites at birth, one in childhood, and four in adolescence. We observed enrichment for findings from previous EWAS on maternal folate, vitamin-B12 concentrations, maternal smoking, and pre-pregnancy BMI. The associations were directionally consistent with MEA being inversely associated with behaviours including smoking and BMI. Our findings form a bridge between socio-economic factors and biology and highlight potential pathways underlying effects of maternal education. The results broaden our understanding of bio-social associations linked to differential DNA methylation in multiple early stages of life. The data generated also offers an important resource to help a more precise understanding of the social determinants of health.

La Serpiente y el Arco Iris (1988) de Wes Craven supone un modelo docente atractivo que combina la farmacología y las alteraciones fisiológicas en muchos sistemas funcionales. Basada en un hecho real, este clásico del terror convertido en una película de culto analiza como el método científico es capaz de dar respuestas al mito del muerto viviente, a través del vudú en la población de Haití, por la inhalación de una potente droga en polvo que contiene altas dosis de tetrodotoxina. Este filme simula el estado agudo de catalepsia de los pacientes y las pruebas sometidas para certificar la aparente defunción tras la confirmación del cese irreversible de las funciones cardiorrespiratorias o encefálica, debido a la ausencia de reflejos troncoencefálicos a causa de los efectos a largo plazo que presenta la droga. Además, a pesar de que el paciente no fallece y es enterrado siendo consciente de todo el proceso, el filme permite reflexionar en los estudiantes la alta carga psicológica, tanto del propio paciente como de la población, que profundiza en los estados de terror al suponer que es un esclavo retornado de la muerte sin alma y sin voluntad.

ABSTRACTScientific advances and technological requirements to develop carbon fibre-reinforced polymers (CFRP) with excellent strength-to-weight ratios led to the high consumption of CFRP composites. The mechanical recycling of CFRP is a simpler, more economical, and environmentally responsible solution for effectively recovering this structural material that contains epoxy resin and carbon fibre. CFRP laminates were placed on a Computer Numerical Control (CNC) and milling cutting at 1100, 1800, and 2500 rpm. The recovered CFRP particles were mixed with acrylonitrile butadiene styrene (ABS) using the melt intercalation approach. Recovered CFRP particles increased the molecular mobility and reduced the thermal stability of ABS. The main differences between the ABS and the composites were a more pronounced necking region in the ABS than in the composites and a notable reduction in strain. The strain of the ABS was 27.58%, while in the composites, it was 4.29, 4.02, and 3.51%, depending on the cutting speed. Thus, ductility decreased up to 87% in the composites. This work’s successful CFRP mechanical recycling method provides epoxy powder, individual carbon fibres, and CFRP particles, opening a research field of great economic and environmental relevance in developing new materials.

Abstract The QUANT study represents the most extensive open-access evaluation of commercial air quality sensor systems to date. This comprehensive study assessed 49 systems from 14 manufacturers across three urban sites in the UK over a three-year period. The resulting open-access dataset captures high time-resolution measurements of a variety of gasses (NO, NO2, O3, CO, CO2), particulate matter (PM1, PM2.5, PM10), and key meteorological parameters (humidity, temperature, atmospheric pressure). The quality and scope of the dataset is enhanced by reference monitors’ data and calibrated products from sensor manufacturers across the three sites. This publicly accessible dataset serves as a robust and transparent resource that details the methods used for data collection and procedures to ensure dataset integrity. It provides a valuable tool for a wide range of stakeholders to analyze the performance of air quality sensors in real-world settings. Policymakers can leverage this data to refine sensor deployment guidelines and develop standardized protocols, while manufacturers can utilize it as a benchmark for technological innovation and product certification. Moreover, the dataset has supported the development of a UK code of practice, and the certification of one of the participating companies, underscoring the dataset’s utility and reliability.

Geopolymers are cementitious materials with exceptional mechanical and physical properties, making them suitable for aerospace applications. Considering their excellent performance, the present investigation aims to develop geopolymers with designed physical properties to address some issues in the aerospace industry. In this sense, the influence of the alkaline activator on the final properties was evaluated. For the development of the geopolymers, sodium hydroxide and sodium metasilicate solutions were preparedto obtain the alkaline activator. The synthesis process also consisted of a mixing stage using a mixer to obtain a homogenous paste. After mixing, the curing process consisted of a first thermal treatment at 60 °C for 4 h to evaporate the excess water, avoid excessive contraction, and promote strength at early ages. Subsequently, the geopolymers were left at rest for 28 days until the final properties were achieved. The influence of the solid-to-liquidratio (S/L) on the microstructure of the geopolymers was evaluated. For this purpose, X-ray fluorescence spectrometry, X-ray diffraction, and infrared spectrometry analyses were performed. The results show that the content of the alkaline activator promotes variations inthe presence of different crystalline phases, which is more noticeable as the S/L ratio increases. Likewise, the infrared spectra display peaks at different wavelengths regarding the variations in elemental composition, which are more evident with the changes in the S/L ratio. In addition, physical studies, such as thermal conductivity and resistance to gamma radiation were conducted for different geopolymer compositions. The results indicate that changes in properties are not too sensitive to compositional variations, although slight modifications exist. Finally, these studies are significant as aerospace-focused materials are directly exposed to this kind of phenomena. The designed geopolymers have to be able to resist and maintain their properties through exposure to any energy.

O presente artigo apresenta a universidade enquanto um território contemporâneo e multifacetado, propício para a inserção dos coletivos indígenas como sujeitos acadêmicos. O objetivo é abordar de forma qualitativa o epistemicídio como uma das manifestações de racismo contra os povos originários presentes na educação superior e que impacta no caráter social universitário, reforçando seu papel eurocêntrico e menos plural – “monocromática”. Além da experiência dos autores com a temática, a revisão de literatura é o procedimento utilizado para se alcançar o objetivo pretendido. Brevemente, discute-se sobre a universidade pública brasileira no século XXI e seus desafios em face de grupos excluídos anteriormente do corpus acadêmico, realidade que vem mudando após a conhecida Lei de Cotas (Lei n. 12.711/2012), revista pelo congresso em 2023. O recorte deste artigo exclui as Licenciaturas Específicas e recai sobre os cursos de graduação regulares, bacharelados e demais licenciaturas, acessíveis via sistema de cotas. Verifica-se que atitudes de preconceito, discriminação e racismo, no seio universitário, perante os discentes indígenas, são práticas rotineiras, mas pouco se discute, o epistemicídio como sendo uma dessas atitudes, qual seja, a de desconsiderar as experiências, conhecimentos e contribuições culturais dos estudantes indígenas. O mesmo ocorre reiterada e sutilmente na vivência acadêmica em decorrência da organização curricular, da condução da pesquisa e extensão e da postura docente. Apresenta-se no artigo uma lista de indicativos para o enfrentamento ao epistemicídio e sua superação no território universitário brasileiro

Abstract Spaceflight presents significant challenges to the physiological state of living organisms. This can be due to the microgravity environment experienced during long-term space missions, resulting in alterations in muscle structure and function, such as atrophy. However, a comprehensive understanding of the adaptive mechanisms of biological systems is required to devise potential solutions and therapeutic approaches for adapting to spaceflight conditions. This review examines the current understanding of the challenges posed by spaceflight on physiological changes, alterations in metabolism, dysregulation of pathways and the suitability and advantages of using the model organism Caenorhabditis elegans nematodes to study the effects of spaceflight. Research has shown that changes in the gene and protein composition of nematodes significantly occur across various larval stages and rearing environments, including both microgravity and Earth gravity settings, often mirroring changes observed in astronauts. Additionally, the review explores significant insights into the fundamental metabolic changes associated with muscle atrophy and growth, which could lead to the development of diagnostic biomarkers and innovative techniques to prevent and counteract muscle atrophy. These insights not only advance our understanding of microgravity-induced muscle atrophy but also lay the groundwork for the development of targeted interventions to mitigate its effects in the future.

In times of growing concern about the impacts of air pollution across the globe, lower-cost sensor technology is giving the first steps in helping to enhance our understanding and ability to manage air quality issues, particularly in regions without established monitoring networks. While the benefits of greater spatial coverage and real-time measurements that these systems offer are evident, challenges still need to be addressed regarding sensor reliability and data quality. Given the limitations imposed by intellectual property, commercial implementations are often “black boxes”, which represents an extra challenge as it limits end users' understanding of the data production process. In this paper we present an overview of the QUANT (Quantification of Utility of Atmospheric Network Technologies) study, a comprehensive 3-year assessment across a range of urban environments in the United Kingdom, evaluating 43 sensor devices, including 119 gas sensors and 118 particulate matter (PM) sensors, from multiple companies. QUANT stands out as one of the most comprehensive studies of commercial air quality sensor systems carried out to date, encompassing a wide variety of companies in a single evaluation and including two generations of sensor technologies. Integrated into an extensive dataset open to the public, it was designed to provide a long-term evaluation of the precision, accuracy and stability of commercially available sensor systems. To attain a nuanced understanding of sensor performance, we have complemented commonly used single-value metrics (e.g. coefficient of determination, R2; root mean square error, RMSE; mean absolute error, MAE) with visual tools. These include regression plots, relative expanded uncertainty (REU) plots and target plots, enhancing our analysis beyond traditional metrics. This overview discusses the assessment methodology and key findings showcasing the significance of the study. While more comprehensive analyses are reserved for future detailed publications, the results shown here highlight the significant variation between systems, the incidence of corrections made by manufacturers, the effects of relocation to different environments and the long-term behaviour of the systems. Additionally, the importance of accounting for uncertainties associated with reference instruments in sensor evaluations is emphasised. Practical considerations in the application of these sensors in real-world scenarios are also discussed, and potential solutions to end-user data challenges are presented. Offering key information about the sensor systems' capabilities, the QUANT study will serve as a valuable resource for those seeking to implement commercial solutions as complementary tools to tackle air pollution.

Amazonian swamp forests remove large amounts of carbon dioxide (CO2) but produce methane (CH4). Both are important greenhouse gases (GHG). Drought and cultivation cut the CH4 emissions but may release CO2. Varying oxygen content in nitrogen-rich soil produces nitrous oxide (N2O), which is the third most important GHG. Despite the potentially tremendous changes, GHG emissions from wetland soils under different land uses and environmental conditions have rarely been compared in the Amazon. We measured environmental characteristics, and CO2, CH4 and N2O emissions from the soil surface with manual opaque chambers in three sites near Iquitos, Peru from September 2019 to March 2020: a pristine peat swamp forest, a young forest and a slash-and-burn manioc field. The manioc field showed moderate soil respiration and N2O emission. The peat swamp forests under slight water table drawdown emitted large amounts of CO2 and CH4. A heavy post-drought shower created a hot moment of N2O in the pristine swamp forest, likely produced by nitrifiers. All in all, even small changes in soil moisture can create hot moments of GHG emissions from Amazonian wetland soils, and should therefore be carefully monitored.

In the face of a pressing global issue-the escalating threat of antibiotic resistance-the development of new antimicrobial agents is urgent. Nanotechnology, with its innovative approach, emerges as a promising solution to enhance the efficacy of these agents and combat the challenge of microbial resistance. Chitosan nanoparticles (CSNPs) stand out in biomedical applications, particularly in the controlled release of antibiotics, with their unique properties such as biocompatibility, stability, biodegradability, non-toxicity, and simple synthesis processes suitable for sensitive molecules. This study synthesized CSNPs using the ionotropic gelation method, with tripolyphosphate (TPP) as the crosslinking agent. Various CS: TPP ratios (6:1, 5:1, 4:1, 3:1, 2:1) were tested, and the resulting nanoparticles were evaluated using dynamic light scattering (DLS). The CS: TPP ratio of 4:1, with an average hydrodynamic diameter (DHP) of (195 ± 10) nm and a zeta potential of (51 ± 1) mV, was identified as the most suitable for further analysis. The characterization of NPs by Transmission Electron Microscope (TEM) and atomic force microscopy (AFM) revealed diameters of (65 ± 14) nm and (102 ± 18) nm, respectively. Notably, CSNPs exhibited significant aggregation during centrifugation and lyophilization, leading to diameter increases of up to 285% as measured by AFM. The antibacterial activity of CSNPs against Staphylococcus aureus and Escherichia coli was assessed using the resazurin assay. It was found that CSNPs not subjected to centrifugation, freezing, and lyophilization retained their antimicrobial activity. In contrast, those that underwent these processes lost their efficacy, likely due to aggregation and destabilization of the system. This study presents a straightforward and effective protocol for encapsulating sensitive active agents and synthesizing chitosan nanoparticles, a potential system with significant implications in the fight against antibiotic resistance.

This research developed a bio-based polymer composite using polylactic acid (PLA) and agro-industrial residues from coffee by-products (without chemical modification and the use of coupling agents or stabilizers). Agro-industrial residues, such as spent coffee ground (SCG) and coffee silver skin (CSS) as filler, were added into the PLA matrix in different percentages by weight, from 0.5 to 10 wt%. The bio-composites were prepared using solvent-cast films and were characterized by various techniques, including FT-IR, TGA, DSC, XRD, SEM and mechanical tests. Bio-composites' formation was verified using FT-IR and SEM; the material showed good interfacial interaction, with percentages between 3 and 5 wt%. XRD and DSC determined the percentage crystallinity in the bio-composites. SEM found that the bio-composites form crystals, showing their limits after mechanical testing. The bio-composites exhibited enhanced thermal and mechanical properties compared to neat PLA.These bio-based composites show great potential for a wide range of applications in the food industry, including disposable and single-use materials, as well as food packaging. Moreover, their use can significantly contribute to the global demand for eco-friendly materials.

El objetivo del presente texto es contribuir a la reflexión sobre la inserción de las artes y la educación artística en las discusiones de gestión pública en el contexto de las transformaciones del siglo XXI en México. Se propone una estrategia multidisciplinaria desde las humanidades y las ciencias políticas, correlacionando temas como democracia, regímenes de bienestar y educación artística desde una perspectiva histórico-documental. Se estima importante revisarlos de manera conjunta, y en esto recae su relevancia académica, con el fin de profundizar en las problemáticas relacionadas con la educación artística y, de esta manera, señalar áreas de oportunidad en el debate público para encaminarse hacia transformaciones deseables de manera justa y humanista; en términos políticos: el reto es exigir una política social redistributiva en el tema de la educación artística-estética. Se parte de la pregunta general ¿qué se necesita para garantizar, en perspectiva actual, el derecho a la educación artística? Para responder a ésta se recurre a fuentes documentales e históricas en México, aunque idealmente se requiere obtener más información respecto a la organización interna de la SEP, lo mismo que comprender cómo se está organizando interinstitucionalmente con otras instancias estatales, pues también ha faltado comprender cómo cada grupo político está interviniendo para legislar en torno al tema de la educación artística, datos que se espera recopilar para futuras investigaciones. Se considera un hallazgo importante, aunque parece mínimo, encontrar claves concretas para exigir la garantía de la puesta en práctica de políticas en el tema.

This article explores how a re-interpretation of the socio-technical, socio-ecological and transition design approaches to transition from the point of view of Niklas Luhmann’s general systems theory of society. The need to understand and promote changes that include a technological and ecological dimension has led to different approaches, such as socio-technical or socio-environmental approaches, to incorporate links with society. While these approaches often include sociological insights, they rarely offer a general understanding of how these are embedded into society. We need a new environmental sociology that helps catalyze change processes with a collectively reorganized society, empowering more radically transformative actions to change the current structures and processes that have led us to where we are today. The article offers a cross-sectional look at the socio-ecological and socio-technical systems literature, specifically for what concerns their understanding of the ‘systems’ in transition and how they can be governed, and re-interpret it from the theoretical lens of the deep sociological knowledge, which refers to the profound understanding of social systems and their dynamics, embedded in Luhmann’s theory of social systems. From here, we suggest the second-order coupling for a sociologically grounded understanding of the interactions that comprise socio-ecological and socio-technical systems, heterogeneous and almost self-organizing assemblies of social, technical, and natural elements and processes. At the same time, third-order couplings are analyzed, focused on governance, relationships between operations, and structures mediated by a deliberate attempt to ensure coherence and coordination against the autonomy and heterogeneity of socio-techno-ecological systems. Therefore, this manuscript offers a deeper conceptual and methodological understanding of socio-techno-ecological couplings and systems in the context of sustainability transformation and gives insights into its governance.

Bacterivore nematodes are the most abundant animals in the biosphere, largely contributing to global biogeochemistry. Thus, the effects of environmental microbes on the nematodes' life-history traits are likely to contribute to the general health of the biosphere. Caenorhabditis elegans is an excellent model to study the behavioral and physiological outputs of microbial diets. However, the effects of complex natural bacterial assemblies have only recently been reported, as most studies have been carried out with monoxenic cultures of laboratory-reared bacteria. Here, we quantified the physiological, phenotypic, and behavioral traits of C. elegans feeding on two bacteria that were coisolated with wild nematodes from a soil sample. These bacteria were identified as a putative novel species of Stenotrophomonas named Stenotrophomonas sp. strain Iso1 and a strain of Bacillus pumilus designated Iso2. The distinctive behaviors and developmental patterns observed in animals fed with individual isolates changed when bacteria were mixed. We studied in more depth the degeneration rate of the touch circuit of C. elegans and show that B. pumilus alone is protective, while the mix with Stenotrophomonas sp. is degenerative. The analysis of the metabolite contents of each isolate and their combination identified NAD+ as being potentially neuroprotective. In vivo supplementation shows that NAD+ restores neuroprotection to the mixes and also to individual nonprotective bacteria. Our results highlight the distinctive physiological effects of bacteria resembling native diets in a multicomponent scenario rather than using single isolates on nematodes. IMPORTANCE Do behavioral choices depend on animals' microbiota? To answer this question, we studied how different bacterial assemblies impact the life-history traits of the bacterivore nematode C. elegans using isolated bacteria found in association with wild nematodes in Chilean soil. We identified the first isolate, Iso1, as a novel species of Stenotrophomonas and isolate Iso2 as Bacillus pumilus. We find that worm traits such as food choice, pharyngeal pumping, and neuroprotection, among others, are dependent on the biota composition. For example, the neurodegeneration of the touch circuit needed to sense and escape from predators in the wild decreases when nematodes are fed on B. pumilus, while its coculture with Stenotrophomonas sp. eliminates neuroprotection. Using metabolomics analysis, we identify metabolites such as NAD+, present in B. pumilus yet lost in the mix, as being neuroprotective and validated their protective effects using in vivo experiments.

Abstract Background Early life environmental stressors play an important role in the development of multiple chronic disorders. Previous studies that used environmental risk scores (ERS) to assess the cumulative impact of environmental exposures on health are limited by the diversity of exposures included, especially for early life determinants. We used machine learning methods to build early life exposome risk scores for three health outcomes using environmental, molecular, and clinical data. Methods In this study, we analyzed data from 1622 mother-child pairs from the HELIX European birth cohorts, using over 300 environmental, 100 child peripheral, and 18 mother-child clinical markers to compute environmental-clinical risk scores (ECRS) for child behavioral difficulties, metabolic syndrome, and lung function. ECRS were computed using LASSO, Random Forest and XGBoost. XGBoost ECRS were selected to extract local feature contributions using Shapley values and derive feature importance and interactions. Results ECRS captured 13%, 50% and 4% of the variance in mental, cardiometabolic, and respiratory health, respectively. We observed no significant differences in predictive performances between the above-mentioned methods.The most important predictive features were maternal stress, noise, and lifestyle exposures for mental health; proteome (mainly IL1B) and metabolome features for cardiometabolic health; child BMI and urine metabolites for respiratory health. Conclusions Besides their usefulness for epidemiological research, our risk scores show great potential to capture holistic individual level non-hereditary risk associations that can inform practitioners about actionable factors of high-risk children. As in the post-genetic era personalized prevention medicine will focus more and more on modifiable factors, we believe that such integrative approaches will be instrumental in shaping future healthcare paradigms.

La formación ciudadana es un tema de interés ético y político, con notable presencia dentro de las discusiones universitarias, que tienen como fin hacer frente a escenarios asimétricos presentes en el siglo XXI. Partiendo de estas premisas, el artículo fija como objetivo analizar la dimensión ético-política de la formación ciudadana en la educación superior, considerando los siguientes aspectos: Una breve síntesis sobre el significado conceptual de ciudadanía; señalar la dimensión ético-política de la educación superior, lo que incide en la formación del ser humano integral, que incluye la capacitación axiológica, deontológica y el carácter político de la acción participativa dentro de la colectividad; e indicar la relevancia de la formación ciudadana en la educación superior, reconociendo la importancia que tiene para el progreso material de los pueblos. El diseño de la investigación es de tipo cualitativo, aplicando el método hermenéutico-documental. Entre los principales resultados, se distingue que la formación ciudadana impulsa los encuentros comunitarios, fomenta la inclusión, el respeto, activismo político, teniendo en miras la transformación de la sociedad. Se concluye en la urgencia de replantear la dirección de la educación superior, encaminándole hacia la lucha contra contextos sociales adversos, homogeneización del saber, velando por la formación de ciudadanos libres.

Cuba por su condición de isla y los excelentes atractivos turísticos, constituye un potencial importante para el desarrollo de la actividad de cruceros; sin dudas, el impulso de esta actividad provocará un impacto significativo en el desarrollo sostenible de la economía nacional. En tal sentido, el presente artículo muestra los primeros resultados devenidos de una investigación cuyo objetivo principal es perfeccionar la gestión de la calidad y los niveles de satisfacción de los clientes de la Terminal de Cruceros de la Habana. En este estudio se realiza un análisis desde el punto de vista histórico-lógico y a través de métodos participativos, encuestas y entrevistas con los clientes internos y externos relacionados con la actividad de cruceros, se obtienen las limitaciones que afectan esta actividad en la isla. Se concluye que el accionar consciente e intencionado por parte de las diferentes organizaciones involucradas en el crucerismo, harán posible la optimización y satisfacción de los clientes que visitan la isla por esta modalidad, propiciándose sin dudas el perfeccionamiento y posicionamiento de la imagen Cuba como destino turístico seguro, atractivo y con estándares internacionales de calidad. Palabras clave: crucerismo, turismo, gestión de calidad. ABSTRACT Cuba, due to its status as an island and its excellent tourist attractions, constitutes an important potential for the development of cruise activity; without a doubt, the promotion of this activity will cause a significant impact on the sustainable development of the national economy. In this sense, this article shows the first results from a research whose main objective is to improve quality management and customer satisfaction levels at the Havana Cruise Terminal. In this study, an analysis is carried out from a historical-logical point of view and through participatory methods, surveys and interviews with internal and external clients related to the cruise activity, the limitations that affect this activity on the island are obtained. It is concluded that the conscious and intentional actions on the part of the different organizations involved in cruise tourism will make possible the optimization and satisfaction of clients who visit the island through this modality, undoubtedly promoting the improvement and positioning of Cuba's image as a tourist destination safe, attractive and with international quality standards. Keywords: cruise ship, tourism, quality management.

Trauma exposure and post-traumatic stress disorder (PTSD) impact emotional and physical well-being, social functioning, and parent-child relationship quality. The effect of parental trauma on parenting and child maltreatment is often overlooked by current child welfare (CW) services. The novel intervention, Parenting-STAIR, was created to address maternal mental health, parenting skills, and child well-being outcomes. Parenting-STAIR is a combination of Skills Training in Affective and Interpersonal Regulation (STAIR) Narrative Therapy and Parent-Child Care (PC-CARE). This open pilot study aimed to examine the feasibility and preliminary impact of Parenting-STAIR in reducing maternal PTSD and increasing positive parenting skills for mothers and families involved in the child welfare system. Parenting-STAIR was delivered to 111 mothers receiving family preservation services in New York City. Of these, 70 completed treatment; statistical and clinically significant changes were observed for maternal PTSD and depression as well as in parenting stress, parenting skills, and child behaviors. These findings provide encouraging initial evidence for the feasibility and impact of this novel PTSD intervention. An evaluation of maltreatment recidivism is needed, as well as implementation of a randomized controlled trial to establish efficacy of the intervention.

Research shows that parenting interventions struggle with keeping clients in treatment. The purpose of this study was to compare attrition and rates of improvement in caregiver-child dyads participating in either Parent-Child Care (PC-CARE), a brief, 7-session parenting intervention or Parent-Child Interaction Therapy (PCIT) over a 7-week period. Participants were 204 caregiver-child dyads referred to either PC-CARE (N = 69) or PCIT (N = 135) between 2016 and 2019. Children were aged 2-7 years, referred for treatment by county Behavioral Health Services, and Medicaid funded. Findings showed that PC-CARE participants were 2.5 times more likely than PCIT participants to complete 7 sessions, all other things being equal, and showed significantly greater rates of improvement during this timeframe in reported child behavior problems and parenting stress. In conclusion, compared with PCIT, PC-CARE showed greater retention and rate of improvement in child and parent outcomes over a comparable time period.

Windthrows (trees uprooted and broken by winds) are common across the Amazon. They range in size from single trees to large gaps that lead to changes in forest dynamics, composition, structure, and carbon balance. Yet, the current understanding of the spatial variability of windthrows is limited. By integrating remote sensing data and geospatial analysis, we present the first study to examine the occurrence, area, and direction of windthrows and the control that environmental variables exert on them across the whole Amazon. Windthrows are more frequent and larger in the northwestern Amazon (Peru and Colombia), with the central Amazon (Brazil) being another hot spot of windthrows. The predominant direction of windthrows is westward. Rainfall, surface elevation, and soil characteristics explain the variability (20%-50%) of windthrows but their effects vary regionally. A better understanding of the spatial dynamics of windthrows will improve understanding of the functioning of Amazon forests.

BackgroundChild maltreatment recidivism substantially increases the likelihood of adverse life outcomes, but there is little evidence that family preservation services are effective at reducing recidivism. Mothers in child welfare have very high rates of trauma exposure; maternal post-traumatic stress disorder (PTSD) is an intervention target that has the potential to reduce abuse and neglect. The Safe Mothers, Safe Children (SMSC) intervention program involves the delivery of an innovative combination of interventions, including Skills Training in Affective and Interpersonal Regulation (STAIR) and Parent-Child Interaction Therapy (PCIT). The combined intervention, Parenting-STAIR (P-STAIR), targets maternal PTSD and comorbid depression symptoms to reduce the adverse effects of PTSD on parenting, improve positive parenting skills, and prevent maltreatment recidivism.MethodsThis study is a two-arm randomized controlled trial: P-STAIR (23 sessions) versus supportive counseling (23 sessions). Participants are mothers receiving child welfare family preservation services (FPS), with a child in the age range of 1-8 years old and meeting diagnostic criteria for PTSD (with/without depression). Clinical assessment occurs at pre-treatment (baseline), two in-treatment assessments (mid-assessment #1 after module 9 and mid-assessment #2 after module 15), post-treatment, and at a 6-month follow-up. Recidivism will be measured using the New York State Child Welfare Registry (NYSCWR). We will enroll a total of 220 participants over 4 years: half (N = 110) randomly assigned to the P-STAIR condition and half (N = 110) to the supportive counseling condition.DiscussionThis is the first RCT to investigate the efficacy of P-STAIR. The findings for the trial have the potential to contribute to the expansion of evidence-based practices for maternal PTSD, maltreatment, and child welfare.

Background: Bisphenol A (BPA; or 4,4′-isopropylidenediphenol) is an endocrine disrupting chemical. It was widely used in a variety of plastic-based manufactured products for several years. The European Food Safety Authority (EFSA) recently reduced the Tolerable Daily Intake (TDI) for BPA by 20,000 times due to concerns about immune-toxicity. Objective: We used human biomonitoring (HBM) data to investigate the general level of BPA exposure from 2007 to 2014 of European women aged 18–73 years (n = 4,226) and its determinants. Methods: Fifteen studies from 12 countries (Austria, Belgium, Denmark, France, Germany, Greece, Israel, Luxembourg, Slovenia, Spain, Sweden, and the United Kingdom) were included in the BPA Study protocol developed within the European Joint Programme HBM4EU. Seventy variables related to the BPA exposure were collected through a rigorous post-harmonization process. Linear mixed regression models were used to investigate the determinants of total urine BPA in the combined population. Results: Total BPA was quantified in 85–100 % of women in 14 out of 15 contributing studies. Only the Austrian PBAT study (Western Europe), which had a limit of quantification 2.5 to 25-fold higher than the other studies (LOQ=2.5 µg/L), found total BPA in less than 5 % of the urine samples analyzed. The geometric mean (GM) of total urine BPA ranged from 0.77 to 2.47 µg/L among the contributing studies. The lowest GM of total BPA was observed in France (Western Europe) from the ELFE subset (GM=0.77 µg/L (0.98 µg/g creatinine), n = 1741), and the highest levels were found in Belgium (Western Europe) and Greece (Southern Europe), from DEMOCOPHES (GM=2.47 µg/L (2.26 µg/g creatinine), n = 129) and HELIX-RHEA (GM=2.47 µg/L (2.44 µg/g creatinine), n = 194) subsets, respectively. One hundred percent of women in 14 out of 15 data collections in this study exceeded the health-based human biomonitoring guidance value for the general population (HBM-GVGenPop) of 0.0115 µg total BPA/L urine derived from the updated EFSA’s BPA TDI. Variables related to the measurement of total urine BPA and those related to the main socio-demographic characteristics (age, height, weight, education, smoking status) were collected in almost all studies, while several variables related to BPA exposure factors were not gathered in most of the original studies (consumption of beverages contained in plastic bottles, consumption of canned food or beverages, consumption of food in contact with plastic packaging, use of plastic film or plastic containers for food, having a plastic floor covering in the house, use of thermal paper…). No clear determinants of total urine BPA concentrations among European women were found. A broader range of data planned for collection in the original questionnaires of the contributing studies would have resulted in a more thorough investigation of the determinants of BPA exposure in European women. Conclusion: This study highlights the urgent need for action to further reduce exposure to BPA to protect the population, as is already the case in the European Union. The study also underscores the importance of pre-harmonizing HBM design and data for producing comparable data and interpretable results at a European-wide level, and to increase HBM uptake by regulatory agencies.