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Abstract Background The efficacy and safety of upadacitinib in patients with ankylosing spondylitis (AS) and inadequate response/intolerance to biologic disease-modifying antirheumatic drugs (bDMARD-IR) were evaluated through 1 year in the SELECT-AXIS 2 study. Here, we assess 2-year efficacy, safety, and imaging outcomes in SELECT-AXIS 2. Methods Patients who received continuous upadacitinib, and those who switched from placebo to upadacitinib at week 14, could enter the open-label extension (OLE). Efficacy endpoints included Assessment of SpondyloArthritis international Society (ASAS) and Axial Spondyloarthritis Disease Activity Score (ASDAS) responses, and changes from baseline in measures of disease activity, back pain, function, and quality of life. Radiographic progression was evaluated using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). As observed (AO) and AO with non-responder imputation (AO-NRI) analyses were used for binary endpoints; AO with mixed-effects model for repeated measures (AO-MMRM) for continuous endpoints; and AO-analysis of covariance for mSASSS. Treatment-emergent adverse events (TEAEs) in patients receiving ≥ 1 upadacitinib dose through week 104 are presented as events (E)/100 patient-years (PY). Subgroup analyses were performed by prior tumor necrosis factor/interleukin-17 inhibitor exposure and bDMARD lack of efficacy/intolerance. Results Of 420 patients who entered the bDMARD-IR AS study, 409 entered the OLE, and 331 (continuous upadacitinib, n = 163; placebo to upadacitinib, n = 168) completed week 104. Improvements in efficacy measures were sustained through the OLE, with similar response rates between the continuous upadacitinib and placebo to upadacitinib groups at week 104. At week 104, 64.9% and 61.7% of patients, respectively, had achieved ASAS 40% response (AO-NRI). Mean changes from baseline were similar between the two groups at week 104 across measures (ASDAS: -2.1 and -2.0; total back pain: -4.9 and -4.6, respectively; AO-MMRM). Over 93.0% of patients showed no radiographic progression (mSASSS mean change from baseline

Abstract We describe the geographical variation in tree species composition across Amazonian forests and show how environmental conditions are associated with species turnover. Our analyses are based on 2023 forest inventory plots (1 ha) that provide abundance data for a total of 5188 tree species. Within-plot species composition reflected both local environmental conditions (especially soil nutrients and hydrology) and geographical regions. A broader-scale view of species turnover was obtained by interpolating the relative tree species abundances over Amazonia into 47,441 0.1-degree grid cells. Two main dimensions of spatial change in tree species composition were identified. The first was a gradient between western Amazonia at the Andean forelands (with young geology and relatively nutrient-rich soils) and central–eastern Amazonia associated with the Guiana and Brazilian Shields (with more ancient geology and poor soils). The second gradient was between the wet forests of the northwest and the drier forests in southern Amazonia. Isolines linking cells of similar composition crossed major Amazonian rivers, suggesting that tree species distributions are not limited by rivers. Even though some areas of relatively sharp species turnover were identified, mostly the tree species composition changed gradually over large extents, which does not support delimiting clear discrete biogeographic regions within Amazonia.

Abstract Background Safety remains a significant concern for biologic drugs, and studies are needed to ensure a comparable safety profile for biosimilars and their legacy treatments. Using Canadian administrative health data from 2015–2019, we compared the incidence of serious infection between biosimilars and bio-originators initiators for etanercept and infliximab, two of the most commonly used biologics during this time. Methods We performed a retrospective cohort study using pan-Canadian data (except Quebec) from the National Prescription Drug Utilization Information System linked to hospitalization data. We studied new users of infliximab or etanercept (January/2015-December/2019) and compared incidence rates of serious infection, defined as those which required hospitalization, by using Cox regression models adjusted by biological sex, age at treatment initiation, prior corticosteroid or biologic, province, and calendar year. Results We studied 6,583 etanercept users (mean age 62) and 7,202 infliximab users (mean age 45). Hospitalization with infections occurred in 7% of infliximab and 2% of etanercept users. Comparing the risk of infection between biosimilar to bio-originator, the adjusted hazard ratio (95% confidence interval) was 1.33 (0.77, 2.30) for etanercept and 0.93 (0.72, 1.18) for infliximab. Conclusions Our study found no clear difference between etanercept and infliximab biosimilars and their bio-originators for infection incidence, suggesting a similar safety profile.

Abstract Background Along bacteria, yeasts are common in forages and forage fermentations as spoilage microbes or as additives, yet few studies exist with species-level data on these fungi’s occurrence in feedstuff. Active dry yeast and other yeast-based products are also common feed additives in animal husbandry. Here, we aimed to characterize both fermented and non-fermented milking cow feedstuff samples from Hungary to assess their microbial diversity in the first such study from Central Europe. Results We applied long-read bacterial metabarcoding to 10 fermented and 25 non-fermented types of samples to assess bacterial communities and their characteristics, surveyed culturable mold and yeast abundance, and identified culturable yeast species. Fermented forages showed the abundance of Aerococcaceae, Bacillaceae, Brucellaceae, Lactobacillaceae, Staphylococcaceae, and Thermoactinomycetaceae, non-fermented ones had Cyanothecaceae, Enterobacteriaceae, Erwiniaceae, Gomontiellaceae, Oxalobacteraceae, Rhodobiaceae, Rickettsiaceae, and Staphylococcaceae. Abundances of bacterial families showed mostly weak correlation with yeast CFU numbers, only Microcoleaceae (positive) and Enterococcaceae and Alcaligenaceae (negative correlation) showed moderate correlation. We identified 14 yeast species, most commonly Diutina rugosa, Pichia fermentans, P. kudriavzevii, and Wickerhahomyces anomalus. We recorded S. cerevisiae isolates only from animal feed mixes with added active dry yeast, while the species was completely absent from fermented forages. The S. cerevisiae isolates showed high genetic uniformity. Conclusion Our results show that both fermented and non-fermented forages harbor diverse bacterial microbiota, with higher alpha diversity in the latter. The bacterial microbiome had an overall weak correlation with yeast abundance, but yeasts were present in the majority of the samples, including four new records for forages as a habitat for yeasts. Yeasts in forages mostly represented common species including opportunistic pathogens, along with a single strain of Saccharomyces used as a feed mix additive.

Objective Upadacitinib improved the signs and symptoms of non‐radiographic axial spondyloarthritis (nr‐axSpA) versus placebo over 14 weeks in the primary analysis of the SELECT‐AXIS 2 nr‐axSpA study. Here, we evaluated the efficacy and safety of upadacitinib through 1 year in patients with nr‐axSpA in SELECT‐AXIS 2. Methods Patients aged at least 18 years diagnosed with nr‐axSpA who fulfilled the 2009 Assessment of SpondyloArthritis International Society (ASAS) classification criteria and were receiving stable background therapy were randomized to upadacitinib 15 mg once daily or placebo for the 52‐week double‐blind period. Efficacy was assessed using non‐responder imputation incorporating multiple imputation (NRI‐MI) and as‐observed analyses for binary endpoints, and mixed‐effects model repeated measures for continuous endpoints. Results Of 314 randomized patients, 259 (upadacitinib, n = 129; placebo, n = 130) completed 52 weeks of treatment. More patients receiving upadacitinib versus placebo achieved ≥40% improvement in ASAS at week 52 (63% vs 43%, NRI‐MI; nominal P < 0.001). Similar treatment effects were observed for the achievement of axSpA Disease Activity Score inactive disease (33% v 11%, NRI‐MI; nominal P < 0.001). Overall, patients receiving upadacitinib versus placebo showed greater improvement in disease activity, inflammation, pain, function, enthesitis, and quality of life through 52 weeks. Adverse events were generally comparable between the treatment groups. No opportunistic infections, malignancies, major adverse cardiovascular events, venous thromboembolic events, inflammatory bowel disease, or deaths were reported in those receiving upadacitinib. Conclusion Treatment with upadacitinib showed sustained efficacy versus placebo with no new safety findings identified through 1 year. These results support the continued favorable benefit–risk profile of upadacitinib treatment for nr‐axSpA.

Abstract Chiral multiferroics offer remarkable capabilities for controlling quantum devices at multiple levels. However, these materials are rare due to the competing requirements of long-range orders and strict symmetry constraints. In this study, we present experimental evidence that the coexistence of ferroelectric, magnetic orders, and crystallographic chirality is achievable in hybrid organic-inorganic perovskites [(R/S)-β-methylphenethylamine]2CuCl4. By employing Landau symmetry mode analysis, we investigate the interplay between chirality and ferroic orders and propose a novel mechanism for chirality transfer in hybrid systems. This mechanism involves the coupling of non-chiral distortions, characterized by defining a pseudo-scalar quantity, $$\xi={{{{{\bf{p}}}}}}{{\cdot }}{{{{{\bf{r}}}}}}$$ ξ = p ⋅ r ( $${{{{{\bf{p}}}}}}$$ p represents the ferroelectric displacement vector and $${{{{{\bf{r}}}}}}$$ r denotes the ferro-rotational vector), which distinguishes between (R)- and (S)-chirality based on its sign. Moreover, the reversal of this descriptor’s sign can be associated with coordinated transitions in ferroelectric distortions, Jahn-Teller antiferro-distortions, and Dzyaloshinskii-Moriya vectors, indicating the mediating role of crystallographic chirality in magnetoelectric correlations.

Abstract Introduction A previous network meta-analysis established 16-week relative efficacy with bimekizumab, an inhibitor of interleukin (IL)-17F in addition to IL-17A, versus other treatments for patients with radiographic axial spondyloarthritis (r-axSpA; i.e., ankylosing spondylitis), including the IL-17A inhibitors secukinumab and ixekizumab. This matching-adjusted indirect comparison (MAIC) assessed 52-week relative efficacy of bimekizumab versus secukinumab and ixekizumab. Methods Individual patient data from BE MOBILE 2 (bimekizumab 160 mg; N = 220) were matched to pooled summary data from MEASURE 1/2/3/4 (secukinumab 150 mg), MEASURE 3 (secukinumab 300 mg; escalated dose for inadequate responders), COAST-V (ixekizumab) and COAST-V/-W (ixekizumab). BE MOBILE 2 patients were reweighted using propensity score weights based on age, sex, ethnicity, tumor necrosis factor inhibitor (TNFi) exposure, weight, baseline ASDAS and BASFI (secukinumab) and baseline BASDAI (ixekizumab), and 52-week efficacy outcomes from the trial recalculated. Odds ratios (OR) or mean difference for unanchored comparisons are reported with 95% confidence intervals (CI). Results At week 52, MAIC demonstrated that patients may have higher likelihood of improvement in key efficacy outcomes with bimekizumab versus secukinumab 150 mg (e.g., ASAS40: [OR (95% CI): 1.48 (1.05, 2.10); p = 0.026]; effective sample size [ESS] = 177). Differences in 52-week efficacy outcomes between bimekizumab and secukinumab 300 mg dose escalation were non-significant (ESS = 120). Bimekizumab versus ixekizumab 80 mg comparisons (COAST-V only; ESS = 84) also suggested that differences were non-significant for most key efficacy outcomes. Other ixekizumab comparisons (COAST-V/-W; ESS = 45) suggested bimekizumab may have higher comparative efficacy for many of the same efficacy outcomes, however ixekizumab analyses were limited by poor population overlap, likely due to the greater proportion of patients with previous TNFi exposure. Conclusions Patients treated with bimekizumab may have a higher likelihood of achieving improved longer-term efficacy versus secukinumab 150 mg, suggesting bimekizumab may be a favorable therapeutic option for r-axSpA. Differences in efficacy outcomes with bimekizumab versus ixekizumab 80 mg were mostly non-significant, depending on the populations considered.

Food system sustainability, and ways of measuring it, are widely explored and discussed in academic literature. Measurement efforts are challenging because food systems are inherently complex and multifaceted, spanning diverse components, indus­tries, sectors, and scales. Several systems of indica­tors and metrics have been proposed to measure sustainability; however, most existing research focuses either on narrow scales (e.g., farm level or within a single supply chain), expansive scales that can gloss over complexity (e.g., national or global assessments), or limited scopes (e.g., only consider­ing environmental factors). A gap in the literature is a holistic local or regional approach to food sys­tem sustainability that integrates components across the system at a regional scale. In this reflec­tive essay, we describe our development of a framework to measure and track sustainability in such systems. We use a tiered framework that includes five sustainability dimensions and a system of indices, indicators, and metrics that allows for the measurement of important food system charac­teristics in a feasible and reproducible way. We employ a collaborative, transdisciplinary, facilitated team science process to first propose, and then refine, a sustainability assessment framework, using the U.S. state of Vermont as a case study. This paper details our process and progress, as well as reflections on challenges and recommendations for other team scientists. We further propose a plan to implement the framework, collect data, and engage with community members. The experiences and findings described here serve as a foundation for our own team’s continued work, as well as a springboard for other similar research efforts.

During a survey of plant-parasitic nematodes in Costa Rica, Quinisulcius capitatus was isolated and identified for the first time in three locations: Barva and Santa Bárbara in the Heredia province, and Vázquez de Coronado in the San José province. The nematodes were extracted from soil samples by the sugar solution centrifugation-flotation method, and the specimens described and characterized based on integrative taxonomy. The adult nematodes of Q. capitatus are in accordance with the type population, but displayed slight morphometric variations in relation to those originally described: body length of 649.5-875.7 vs. 630-850, style length of 13.7-17 vs. 16-18 and percentage of vulva of 52.7-59.9 vs. 51-58. The D2-D3 expansion segments of the 28S rDNA from the recovered populations were sequenced and used in the phylogenetic analysis. The Costa Rican populations showed a high similarity and formed a separate clade with the Pakistani and Ethiopian populations deposited in the GenBank® database. This study expands the species geographic distribution and provides the first morphometric and molecular characterization of Q. capitatus from Costa Rica.

Goat breeding in Peru is one of the main activities of smallholders. Goats are distributed in different agroecological zones and regions of the country, developing under heterogeneity of production systems, making it difficult to understand goat breeders’ socioeconomic, technological, and productive situations. This study aimed to characterize and typify the goat production systems in the highlands of southeast Peru. A survey was conducted with 91 goat farmers from five districts of Ayacucho, Peru, using a structured and individualized questionnaire administered on their farms. The socio-economic, productive, and commercial characteristics of the goat production systems were recorded. A multiple correspondence analysis (MCA) and hierarchical classification analysis (HCA) were performed to establish a typology of the smallholders. The results reveal that the breeding system is extensive, where there is no breeding program, with natural pastures and crop stubble being the source of food for the herds. Only slightly more than half (54%) carry out a deworming program. Farmers were categorized into three different groups, corresponding to three different farming systems: Group 1 farmers raised goats solely for home consumption; Group 2 breeders raised goats for both consumption and marketing of surplus products (cheese, milk, and meat), and Group 3 farmed focused on producing cheese and goat kids and selling to local markets. The study provides valuable insights that will help design effective breeding strategies to develop sustainable goat farming in the region, considering different production systems and their respective socio-economic and trade dynamics. This classification will be essential for tailoring development programs to the specific needs of each group, promoting better use of resources, improving productivity, and enhancing the livelihoods of smallholder goat producers in Peru.

Introduction A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs).Methods A prospective, observational study in 17 countries in Africa, Asia, Europe and South America, including adults with confirmed COVID-19 assessed at 2 to

Background Inflammation is increasingly recognised as a fundamental component of the pathophysiology of major depressive disorder (MDD), with a variety of inflammatory biomarkers playing pivotal roles. These markers are closely linked to both the severity of symptoms and the responsiveness to treatments in MDD. Aims This scoping review aims to explore the scientific literature investigating the complex relationships between inflammatory biomarkers and depression, by identifying new studies and critical issues in current research. Method Following the PRISMA Extension for Scoping Reviews guidelines, we systematically searched databases including PubMed, Scopus, PsycINFO, Open Grey and Cochrane Library. Our search focused on articles published from 1 January 2020 to 1 May 2024. We included studies evaluating inflammatory biomarkers in adult patients with MDD, utilising observational and randomised controlled trial designs, and review studies. Results Our analysis examined 44 studies on the complex interplay between inflammation and its multiple effects on MDD. Significant associations between specific inflammatory biomarkers and depression severity were found, requiring cautious interpretation. We also highlight several methodological limitations in the current studies, which warrant caution in directly applying these findings to clinical practice. However, identified methodologies show potential for using these biomarkers as diagnostic tools or therapeutic targets, including anti-inflammatory interventions. Conclusions The findings emphasise the need for sophisticated, integrative research to understand inflammation's role in MDD. Future studies should identify specific biomarker panels for diagnosing depression and bridging peripheral biomarker measurements with central neuroinflammatory processes, leading to better diagnostic and treatment strategies.

Objective This study sought to understand the current experiences and subsequent needs of digital maternal health application users based on an interdisciplinary analysis of features currently available in the digital marketplace (including mobile applications and mobile-friendly websites). Methods Following secondary analysis of previously collected interview and focus group data, we used qualitative thematic analysis to observe recurring themes within current maternal health applications and prospective augmentation of related technology for future development. Results Study findings suggested tailored features would best serve the target population, and eleven unique themes comprising additions and improvements to maternal health applications emerged. These included seven major areas: improved mental health support, need for forums and support groups, lack of lactation and breastfeeding support, lack of quality food and nutrition access and product finders, minimal financial literacy information, tailored culturally competent information, and need for localized information and resources. Findings also suggested four main improvements for digital offerings in the current maternal health space: increased emphasis on resources available for postpartum care, importance of minimizing the number of hubs used, need for making information more digestible by ensuring it is written, edited, and provided at appropriate reading levels by more coordinated interaction of words and graphics, and ensuring the trust and credibility of such applications. Conclusions Maternal health applications are improving; however, more features can be added in a localized manner. Additional improvements could be made to current offerings, maximizing the utility of applications, especially in hard-to-reach areas such as maternity care deserts. With the advent of artificial intelligence, developers are poised with the ability to make platforms more focused and tailored for their users.

Abstract Background Mortality rate estimation in small areas can be difficult due the low number of events/exposure (i.e. stochastic error). If the death records are not completed, it adds a systematic uncertainty on the mortality estimates. Previous studies in Brazil have combined demographic and statistical methods to partially overcome these issues. We estimated age- and sex-specific mortality rates for all 5,565 Brazilian municipalities in 2010 and forecasted probabilistic mortality rates and life expectancy between 2010 and 2030. Methods We used a combination of the Tool for Projecting Age-Specific Rates Using Linear Splines (TOPALS), Bayesian Model, Spatial Smoothing Model and an ad-hoc procedure to estimate age- and sex-specific mortality rates for all Brazilian municipalities for 2010. Then we adapted the Lee-Carter model to forecast mortality rates by age and sex in all municipalities between 2010 and 2030. Results The adjusted sex- and age-specific mortality rates for all Brazilian municipalities in 2010 reveal a distinct regional pattern, showcasing a decrease in life expectancy in less socioeconomically developed municipalities when compared to estimates without adjustments. The forecasted mortality rates indicate varying regional improvements, leading to a convergence in life expectancy at birth among small areas in Brazil. Consequently, a reduction in the variability of age at death across Brazil’s municipalities was observed, with a persistent sex differential. Conclusion Mortality rates at a small-area level were successfully estimated and forecasted, with associated uncertainty estimates also generated for future life tables. Our approach could be applied across countries with data quality issues to improve public policy planning.

Objective: The purpose of this study is to evaluate the phenotypic characteristics and typification of Creole goats in five localities of the Ayacucho region in south-central Peru. Materials and Methods: Data from 149 goats (25 males and 124 females) were collected, excluding animals under 2 years of age, pregnant, and sick. Seven qualitative characteristics and 11 zometric measurements were evaluated, and then 9 zometric indices were estimated. Results: In the region, goats with composite colors predominated (76.50%). Additionally, supernumerary (24.20%) and divergent teats (22.60%) were observed in females, while males exhibited a scrotal bifurcation (32.00%). The origin of the flock had a significant effect (p < 0.05) on body measurements, as well as on pelvic index, transverse pelvic index, longitudinal pelvic index, compactness index, and load cannon bone index, except for body index (BOI), proportionality index, dactyl thorax index (DTI), and relative cannon bone thickness index (p > 0.05). In the Ayacucho region, there is a predominance of light animals (57.72%) with a significant DTI (p < 0.05) among the populations, including goats with good balance and capable of walking long distances. Furthermore, there are compact animals (47.65%) with a significant BOI (p < 0.05) among the flock populations, which animals are of the biotype of meat. Conversely, the strongest positive correlation (r = 0.89) was discovered between chest girth and body weight. Conclusion: In the Ayacucho region, there are various creole goat biotypes range from light to very compact heavy goats, with a predominance of meat biotype animals, as well as a marked size dimorphism between localities of origin. [J Adv Vet Anim Res 2024; 11(2.000): 494-502]

Abstract Introduction The objective of this analysis is to evaluate the improvement in spinal pain with ixekizumab, placebo, and adalimumab based on objective measures of inflammation response in patients with ankylosing spondylitis (AS). Methods The COAST-V 52-week, double-blind, placebo-controlled, randomized phase III trial examined the efficacy of ixekizumab in patients with active AS; adalimumab was used as an active reference arm. Treatment effects on reduction in pain were assessed by objective measures of controlled and persisting inflammation (defined by magnetic resonance imaging [MRI], C-reactive protein [CRP], or MRI + CRP status). Pathway analysis was used to analyze treatment effect that was not attributable to reduction in inflammation biomarkers. Results In patients with AS, when inflammation was controlled as assessed by MRI, patients treated with ixekizumab experienced a reduction in spinal pain at night (SP-N, numeric rating scale, ixekizumab mean = − 3.9, p

Abstract Bi-allelic pathogenic variants in PRKN are the most common cause of autosomal recessive Parkinson’s disease (PD). 647 patients with PRKN-PD were included in this international study. The pathogenic variants present were characterised and investigated for their effect on phenotype. Clinical features and progression of PRKN-PD was also assessed. Among 133 variants in index cases (n = 582), there were 58 (43.6%) structural variants, 34 (25.6%) missense, 20 (15%) frameshift, 10 splice site (7.5%%), 9 (6.8%) nonsense and 2 (1.5%) indels. The most frequent variant overall was an exon 3 deletion (n = 145, 12.3%), followed by the p.R275W substitution (n = 117, 10%). Exon3, RING0 protein domain and the ubiquitin-like protein domain were mutational hotspots with 31%, 35.4% and 31.7% of index cases presenting mutations in these regions respectively. The presence of a frameshift or structural variant was associated with a 3.4 ± 1.6 years or a 4.7 ± 1.6 years earlier age at onset of PRKN-PD respectively (p

In this study, we introduce a novel and robust approach for computing Generalizability Theory (GT) absolute error and related dependability indices using indicator intercepts that represent observed means within structural equation models (SEMs). We demonstrate the applicability of our method using one-, two-, and three-facet designs with self-report measures having varying numbers of scale points. Results for the indicator mean-based method align well with those obtained from the GENOVA and R gtheory packages for doing conventional GT analyses and improve upon previously suggested methods for deriving absolute error and corresponding dependability indices from SEMs when analyzing three-facet designs. We further extend our approach to derive Monte Carlo confidence intervals for all key indices and to incorporate estimation procedures that correct for scale coarseness effects commonly observed when analyzing binary or ordinal data.

IntroductionSeasonal influenza generally represents an underestimated public health problem with significant socioeconomic implications. Monitoring and detecting influenza epidemics are important tasks that require integrated strategies. Wastewater-based epidemiology (WBE) is an emerging field that uses wastewater data to monitor the spread of disease and assess the health of a community. It can represent an integrative surveillance tool for better understanding the epidemiology of influenza and prevention strategies in public health.MethodsWe conducted a study that detected the presence of Influenza virus RNA using a wastewater-based approach. Samples were collected from five wastewater treatment plants in five different municipalities, serving a cumulative population of 555,673 Sicilian inhabitants in Italy. We used the RT-qPCR test to compare the combined weekly average of Influenza A and B viral RNA in wastewater samples with the average weekly incidence of Influenza-like illness (ILI) obtained from the Italian national Influenza surveillance system. We also compared the number of positive Influenza swabs with the viral RNA loads detected from wastewater. Our study investigated 189 wastewater samples.ResultsCumulative ILI cases substantially overlapped with the Influenza RNA load from wastewater samples. Influenza viral RNA trends in wastewater samples were similar to the rise of ILI cases in the population. Therefore, wastewater surveillance confirmed the co-circulation of Influenza A and B viruses during the season 2022/2023, with a similar trend to that reported for the weekly clinically confirmed cases.ConclusionWastewater-based epidemiology does not replace traditional epidemiological surveillance methods, such as laboratory testing of samples from infected individuals. However, it can be a valuable complement to obtaining additional information on the incidence of influenza in the population and preventing its spread.

Background: Stress and trauma significantly contribute to various psychiatric disorders, including schizophrenia. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, particularly abnormal cortisol secretion, is implicated in schizophrenia's pathophysiology. Salivary cortisol, a convenient measure, provides insights into HPA axis activity. This systematic review and meta-analysis assess salivary cortisol levels in individuals with schizophrenia compared to healthy controls, evaluating its potential as a biomarker for schizophrenia. Aim: To assess the differences in salivary cortisol levels at baseline and in response to stress between patients with schizophrenia and healthy controls, determining the reliability of salivary cortisol as a biomarker for schizophrenia. Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. We searched MEDLINE/PubMed, Cochrane Central, and EMBASE for human studies on schizophrenia and controls published from January 1, 2013, to July 1, 2023, reporting baseline or post-stress salivary cortisol levels. Exclusions were non-human studies, non-specific schizophrenia diagnoses, or missing cortisol data. Two reviewers independently extracted data and appraised quality, resolving discrepancies by consensus. Due to significant heterogeneity (I² = 94 % for baseline, 75 % for stress response), a random effects model was used. Results: Nineteen studies were initially selected, with twelve excluded due to non-specific schizophrenia diagnoses and missing cortisol data. The final meta-analysis included seven studies with 507 schizophrenia patients and 175 healthy controls. Key findings include: Baseline cortisol levels: No significant difference in baseline salivary cortisol levels between schizophrenia patients and healthy controls (pooled estimate: −0.02, 95 % CI: −0.47–0.42). Cortisol response to stress: No significant difference in post-stress cortisol levels between the two groups (pooled estimate: 0.03, 95 % CI: −1.84–1.79). Study variability: High variability across studies due to differences in design, patient characteristics, and cortisol measurement techniques. Despite some evidence of altered cortisol dynamics in schizophrenia, high variability in methodologies and confounding factors like medication use and psychosocial stressors complicate definitive conclusions. Conclusion: The review underscores the potential of cortisol as a biomarker for stress response; however, its use in diagnosing schizophrenia remains inconclusive. Individual variability and methodological differences limit the diagnostic accuracy of salivary cortisol. Future research with larger sample sizes, uniform methodologies, and comprehensive control for confounding variables is essential to elucidate the role of salivary cortisol in schizophrenia and its potential clinical applications.

O quadro teórico proposto por Pierre Bourdieu para analisar o campo econômico foi mobilizado neste artigo como um “programa de pesquisa” para estabelecermos algumas homologias com as estratégias tecnológicas, comerciais e políticas do Google, uma empresa que atua em um campo econômico composto por outras grandes empresas tecnológicas digitais. Realizado a partir de uma revisão bibliográfica, o objetivo deste artigo é apresentar uma discussão crítica sobre o poder e a capacidade de que dispõem a empresa Google/Alphabet, bem como outros agentes do mesmo campo econômico, para o estabelecimento de relações sociais entre si, com agentes governamentais e com os usuários da Internet, por meio de uma “infraestrutura material” e de processos tecnológicos baseados em inteligência artificial, buscando a concentração dos capitais tecnológico, financeiro e político.

Abstract Cedrela odorata is considered the second most invasive tree species of the Galapagos Islands. Although it is listed in CITES Appendix II and there are population losses in mainland Ecuador, in Galapagos it is paradoxically a species of concern due to its invasive potential. Genetic studies can shed light on the invasion history of introduced species causing effects on unique ecosystems like the Galapagos. We analyzed nine microsatellite markers in C. odorata individuals from Galapagos and mainland Ecuador to describe the genetic diversity and population structure of C. odorata in the Galapagos and to explore the origin and invasion history of this species. The genetic diversity found for C. odorata in Galapagos (He = 0.55) was lower than reported in the mainland (He = 0.81), but higher than other invasive insular plant species, which could indicate multiple introductions. Our results suggest that Ecuador's northern Coastal region is the most likely origin of the Galapagos C. odorata, although further genomic studies, like Whole Genome Sequencing, Rad‐Seq, and/or Whole Genome SNP analyses, are needed to confirm this finding. Moreover, according to our proposed pathway scenarios, C. odorata was first introduced to San Cristobal and/or Santa Cruz from mainland Ecuador. After these initial introductions, C. odorata appears to have arrived to Isabela and Floreana from either San Cristobal or Santa Cruz. Here, we report the first genetic study of C. odorata in the Galapagos and the first attempt to unravel the invasion history of this species. The information obtained in this research could support management and control strategies to lessen the impact that C. odorata has on the islands' local flora and fauna.

BackgroundTo address the global challenge of vaccine hesitancy, the Strategic Advisory Group of Experts on Immunization strongly promotes vaccination reminder and recall interventions. Coupled with the new opportunities presented by scientific advancements, these measures are crucial for successfully immunizing target population groups. ObjectiveThis systematic review and meta-analysis aims to assess the effectiveness of various interventions in increasing vaccination coverage compared with standard or usual care. The review will cover all vaccinations recommended for different age groups. MethodsIn February 2022, 2 databases were consulted, retrieving 1850 studies. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 79 manuscripts were included after the assessment phase. These comprised 46 trials/randomized controlled trials (RCTs) and 33 before-after studies. A meta-analysis using a random-effects model was performed with STATA software (version 14.1.2). The selected outcome was the risk ratio (RR) of vaccination coverage improvement effectiveness. Additionally, meta-regression analyses were conducted for the included manuscripts. ResultsThe analyses showed an overall efficacy of RR 1.22 (95% CI 1.19-1.26) for RCTs and RR 1.70 (95% CI 1.54-1.87) for before-after studies when considering all interventions cumulatively. Subgroup analyses identified multicomponent interventions (RR 1.58, 95% CI 1.36-1.85) and recall clinical interventions (RR 1.24, 95% CI 1.17-1.32) as the most effective in increasing vaccination coverage for RCTs. By contrast, educational interventions (RR 2.13, 95% CI 1.60-2.83) and multicomponent interventions (RR 1.61, 95% CI 1.43-1.82) achieved the highest increases for before-after studies. Meta-regression analyses indicated that the middle-aged adult population was associated with a higher increase in vaccination coverage (RCT: coefficient 0.54, 95% CI 0.12-0.95; before-after: coefficient 1.27, 95% CI 0.70-1.84). ConclusionsCommunity, family, and health care–based multidimensional interventions, as well as education-based catch-up strategies, effectively improve vaccination coverage. Therefore, their systematic implementation is highly relevant for targeting undervaccinated population groups. This approach aligns with national vaccination schedules and aims to eliminate or eradicate vaccine-preventable diseases.

Perder las piezas dentarias hace que un hábito tan cotidiano y tan habitual como sonreír se convierta en un dilema y un impedimento para relacionarse con las personas que nos rodean, representa un gran problema psicológico para los pacientes, debido a las implicaciones estéticas, fonéticas y funcionales que esto conlleva; sin embargo, gran cantidad de la población está completamente desdentada o parcialmente dentada en el mundo. Objetivo: analizar la conducta de pacientes adultos ante la pérdida dentaria. Metodología: Investigación de tipo descriptivo, con enfoque cualitativo, por medio de recopilación de fuentes bibliográficas en revistas científicas indexadas en bases de datos regionales. Resultados: La falta de dientes se soluciona con la aplicación de una prótesis dental: es una estructura diseñada a medida, para sustituir una o varias piezas dentarias perdidas, restableciendo la función del sistema estomatognático. Esto afecta directamente a la autoestima, insatisfacción del aspecto físico, intentan hablar lo mínimo posible. Y otros portadores de prótesis tienen dificultad para hablar Algunos pacientes solo utilizan una prótesis, normalmente la maxilar, mientras que un 7% son incapaces de llevar nunca sus dentaduras y se vuelven “inválidos orales”. Conclusiones: El bajo nivel de ingresos no permite invertir en tratamientos dentales privados, se establece que el mayor número de edentulismo lo presentan las personas de bajos estratos sociales y poco nivel de instrucción.

Despite the importance of demonstrating and evaluating how structural equation modeling (SEM), exploratory structural equation modeling (ESEM), and Bayesian structural equation modeling (BSEM) work simultaneously, research comparing these analytic techniques is limited with few studies conducted to systematically compare them to each other using correlated-factor, hierarchical, and bifactor models of personality. In this study, we evaluate the performance of SEM, ESEM, and BSEM across correlated-factor, hierarchical, and bifactor structures and multiple estimation techniques (maximum likelihood, robust weighted least squares, and Bayesian estimation) to test the internal structure of personality. Results across correlated-factor, hierarchical, and bifactor models highlighted the importance of controlling for scale coarseness and allowing small off-target loadings when using maximum likelihood (ML) and robust weighted least squares estimation (WLSMV) and including informative priors (IP) when using Bayesian estimation. In general, Bayesian-IP and WLSMV ESEM models provided noticeably best model fits. This study is expected to serve as a guide for professionals and applied researchers, identify the most appropriate ways to represent the structure of personality, and provide templates for future research into personality and other multidimensional representations of psychological constructs. We provide Mplus code for conducting the demonstrated analyses in the online supplement.

ABSTRACTGenetically modified (GM) crops offer significant advantages in our crop improvement programs because they are created using a more targeted approach which is not possible in traditional breeding methods. Human benefit is one of the main objectives of crop improvement but the legal framework for the introduction of GM crops and the depiction and portrayal of GM crops in the media create barriers to these benefits. This article attempts to highlight the barriers to GM crop adoption particularly focusing on the idea of “framing” and the way GM technology is framed in the media. The resulting public health, economic, and ecological concerns about genetically modified plants, along with the reality of these misconceptions, are discussed with specific examples. Finally, we propose potential routes toward increased acceptance of GM crops.

Abstract Rheumatic joints have an altered cartilage turnover. Cartilage intermediate layer protein 1 (CILP-1) is secreted from articular chondrocytes and deposited into the cartilage extracellular matrix. We developed an immunoassay targeting a Matrix Metalloproteinase (MMP)-generated neo-epitope of CILP-1, named CILP-M. Human articular cartilage was cleaved with proteolytic enzymes and CILP-M levels were measured. We also quantified CILP-M in two studies from patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and osteoarthritis (OA) and explored the monitoring and prognostic potential of CILP-M in TNF-α inhibitory treatment and modified Stoke AS Spine Score (mSASSS) progression. CILP-M was generated by MMP-1, -8 and -12. In the discovery study, CILP-M was significantly higher in patients with RA, AS and OA than healthy donors (p 0.95 (p 0.90 (p

This study examines the wettability behaviour of 304 stainless steel (304SS) and Ti-6Al-4V (Ti64) surfaces after sequential nanosecond (ns) and picosecond (ps) laser texturing; in particular, how the multi-scale surface structures created influence the lifecycle of surface hydrophobicity. The effect of different post-process treatments is also examined. Surfaces were analysed using Scanning Electron Microscopy (SEM), a white light interferometer optical profiler, and Energy Dispersive X-ray (EDX) spectroscopy. Wettability was assessed through sessile drop contact angle (CA) measurements, conducted at regular intervals over periods of up to 12 months, while EDX scans monitored elemental chemical changes. The results show that sequential (ns + ps) laser processing produced multi-scale surface texture with laser-induced periodic surface structures (LIPSS). Compared to the ns laser case, the (ns + ps) laser processed surfaces transitioned more rapidly to a hydrophobic state and maintained this property for much longer, especially when the single post-process treatment was ultrasonic cleaning. Some interesting features in CA development over these extended timescales are revealed. For 304SS, hydrophobicity was reached in 1–2 days, with the CA then remaining in the range of 120 to 140° for up to 180 days; whereas the ns laser-processed surfaces took longer to reach hydrophobicity and only maintained the condition for up to 30 days. Similar results were found for the case of Ti64. The findings show that such multi-scale structured metal surfaces can offer relatively stable hydrophobic properties, the lifetime of which can be extended significantly through the appropriate selection of laser process parameters and post-process treatment. The addition of LIPSS appears to help extend the longevity of the hydrophobic property. In seeking to identify other factors influencing wettability, from our EDX results, we observed a significant and steady rate of increase in the carbon content at the surface over the study period.

Este artigo apresenta uma discussão sociológica sobre o campo da inteligência artificial. Com o apoio de uma pesquisa de revisão bibliográfica abordamos os limites da inteligência artificial, atualmente baseada nas redes neurais de aprendizado profundo, em comparação com a inteligência humana. Discutimos a dimensão política da inteligência artificial no mundo contemporâneo, o seu uso para fins nocivos aos direitos humanos nas guerras que se travam atualmente, na vigilância, espionagem e manipulação do comportamento humano para fins políticos, comerciais e de controle social. O objetivo deste trabalho é demonstrar como a crítica sociológica à inteligência artificial pode se constituir em um recurso fundamental para que os seres humanos não percam o controle sobre o desenvolvimento dessa tecnologia.

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.

Environmental pollution from chemicals utilized in manufacturing, pharmaceuticals, and chemical process industries is of serious concern nowadays due to the contamination that ensues when these chemicals are discharged into water bodies. Activated carbon adsorption provides an efficient and economically viable means for mitigation of toxic chemicals (i.e., heavy metals, dyes, pharmaceutics, and antibiotics). However, the exorbitant cost of commercial activated carbons has resulted in the search for low-cost alternatives for the treatment of contaminated effluents. An exhaustive literature survey in this area is necessary to know the extent of work done in this area and seek out the gaps that future research will provide answers to. In this review, various works on activated carbon utilization, batch adsorption, fixed-bed adsorption (experimental and numerical studies) are summarized. This review elucidates the different kinetic and isotherm models of agrowastes-derived activated carbon materials in context with pollutants (dyes, heavy metals, pharmaceuticals, miscellaneous adsorbates) removal through batch and column methods. In addition, fixed-bed column adsorption/regeneration methods using various activated carbons derived from agrowastes are discussed. Among these methods, heavy metal adsorption from aqueous solutions by the activated carbons is the most efficient. The deployment of mathematical and machine learning approaches (ANN and novel GMDH algorithms) in optimization of batch and continuous adsorption processes are also highlighted. Numerical simulation of fixed-column adsorption systems for more improved industrial-scale column designs is described. Conclusions and future challenges of chemicals removal from polluted wastewater utilizing agrowaste-derived activated carbons are also presented.

Background Due to the accumulation of information generated by the information society, it is necessary to establish scientific criteria for its systematization. The objective of the research was to understand the implicit theories on the use of bibliographic managers in the organization of scientific information in university teachers in Latin American university teachers (Colombia, Ecuador and Peru). Methods The interpretative paradigm, phenomenological method and qualitative approach were used. The key informants were defined by fifteen teachers with research experience. The technique was the semi-structured interview, and the instrument was the interview script. The study was based on four cyclical-recursive moments, the first was the natural attitude, where information was obtained from the key informants as a result of the interviews. The second moment allowed the epoche-eidetic reduction, consisting of the analysis of each interview. The third moment originated the transcendental epoche-reduction, analyzing each attribute and their consistency. The fourth moment revealed the constitution of the study, integrating in a semantic network the categories, subcategories, and attributes that emerged. Results Even when it is recognized from the cognitive conception about the concept of bibliographic managers, its applicability or use, it seems not to be so effective in scientific academic spaces and activities, because teachers are still anchored to the traditionalist vision of organizing information through “drive, folder or excel”, reflecting the resistance to change. Conclusions The imperative need for continuous training in the use of bibliographic managers in both students and teachers is asserted, reflected as a transversal strategy throughout all academic cycles and semesters and internalized as a research policy that leads to generate a new change in the conception of researching reliable scientific sources, optimizing time, organizing information and guaranteeing quality research.

ABSTRACT A 22-year-old female researcher was bitten by a Leptodeira annulata on the index finger of the left hand during a contention activity. After removing the snake, a little bleeding and redness was observed in the bite region, accompanied by fang marks. Thirty minutes later, edema had progressed to the dorsum of the hand. After four hours, edema persisted, but the bitten area was slightly whitened. Treatment consisted of antibiotics and anti-inflammatory drugs. The edema resolved completely and disappeared after 48 hours. Overall, this report presents the first case of envenomation in humans caused by Leptodeira annulata in Brazil.

Las conductas alimentarias de riesgo son el resultado de los tipos de hábitos alimentarios de una persona. Estas conductas ponen en peligro las condiciones físicas, emocionales e incluso su entorno social debido a las prácticas erróneas del control del peso que, en efecto, al no ser detectadas y abordadas a tiempo, pueden manifestarse e incluso acumularse hasta el punto de convertirse en una patología alimentaria. Por tanto, por medio de esta investigación se pretende analizar las conductas alimentarias de riesgo y su relación con el índice de masa corporal de los adolescentes, debido a que, por los cambios que experimentan en esta etapa de la vida, son más vulnerables a la insatisfacción de su imagen corporal, por lo que representa un motivo de preocupación al momento de establecer relaciones interpersonales con la sociedad, por el deseo de conseguir o mantener un cuerpo delgado.

Introduction Calcium channel blockers (CCB), a commonly prescribed antihypertensive (AHT) medicine, may be associated with increased risk of breast cancer. The proposed study aims to examine whether long-term CCB use is associated with the development of breast cancer and to characterise the dose–response nature of any identified association, to inform future hypertension management.Methods and analysis The study will use data from 2 of Australia’s largest cohort studies; the Australian Longitudinal Study on Women’s Health, and the 45 and Up Study, combined with the Rotterdam Study. Eligible women will be those with diagnosed hypertension, no history of breast cancer and no prior CCB use at start of follow-up (2004–2009). Cumulative dose-duration exposure to CCB and other AHT medicines will be captured at the earliest date of: the outcome (a diagnosis of invasive breast cancer); a competing risk event (eg, bilateral mastectomy without a diagnosis of breast cancer, death prior to any diagnosis of breast cancer) or end of follow-up (censoring event). Fine and Gray competing risks regression will be used to assess the association between CCB use and development of breast cancer using a generalised propensity score to adjust for baseline covariates. Time-varying covariates related to interaction with health services will also be included in the model. Data will be harmonised across cohorts to achieve identical protocols and a two-step random effects individual patient-level meta-analysis will be used.Ethics and dissemination Ethical approval was obtained from the following Human research Ethics Committees: Curtin University (ref No. HRE2022-0335), NSW Population and Health Services Research Ethics Committee (2022/ETH01392/2022.31), ACT Research Ethics and Governance Office approval under National Mutual Acceptance for multijurisdictional data linkage research (2022.STE.00208). Results of the proposed study will be published in high-impact journals and presented at key scientific meetings.Trial registration number NCT05972785.

BackgroundChronic abdominal pain is the hallmark symptom of chronic pancreatitis (CP), with 50% to 80% of patients seeking medical attention for pain control. Although several management options are available, outcomes are often disappointing, and opioids remain a mainstay of therapy. Opioid-induced hyperalgesia is a phenomenon resulting in dose escalation, which may occur partly because of the effects of opioids on voltage-gated sodium channels associated with pain. Preclinical observations demonstrate that the combination of an opioid and the antiseizure drug lacosamide diminishes opioid-induced hyperalgesia and improves pain control. ObjectiveIn this phase 1 trial, we aim to determine the safety, tolerability, and dose-limiting toxicity of adding lacosamide to opioids for the treatment of painful CP and assess the feasibility of performance of a pilot study of adding lacosamide to opioid therapy in patients with CP. As an exploratory aim, we will assess the efficacy of adding lacosamide to opioid therapy in patients with painful CP. MethodsUsing the Bayesian optimal interval design, we will conduct a dose-escalation trial of adding lacosamide to opioid therapy in patients with painful CP enrolled in cohorts of size 3. The initial dose will be 50 mg taken orally twice a day, followed by incremental increases to a maximum dose of 400 mg/day, with lacosamide administered for 7 days at each dose level. Adverse events will be documented according to Common Terminology Criteria for Adverse Events (version 5.0). ResultsAs of December 2023, we have currently enrolled 6 participants. The minimum number of participants to be enrolled is 12 with a maximum of 24. We expect to publish the results by March 2025. ConclusionsThis trial will test the feasibility of the study design and provide reassurance regarding the tolerability and safety of opioids in treating painful CP. It is anticipated that lacosamide will prove to be safe and well tolerated, supporting a subsequent phase 2 trial assessing the efficacy of lacosamide+opioid therapy in patients with painful CP, and that lacosamide combined with opiates will lower the opioid dose necessary for pain relief and improve the safety profile of opioid use in treating painful CP. Trial RegistrationClinicaltrials.gov NCT05603702; https://clinicaltrials.gov/study/NCT05603702 International Registered Report Identifier (IRRID)PRR1-10.2196/50513

Este artigo é um convite para pensarmos a respeito das redes sociais digitais com a perspectiva sociológica. A partir de uma pesquisa de revisão bibliográfica, mobilizamos diferentes teorias e pesquisas sociais sobre as relações sociais contemporâneas, estabelecidas com o suporte tecnológico da informática baseada na operacionalização de algoritmos de inteligência artificial e através dos dispositivos concetados à internet. O objetivo deste trabalho é contribuirmos para uma discussão reflexiva e crítica sobre o impacto das redes sociais e das tecnologias digitais no mundo social contemporâneo.

Abstract Using 2.046 botanically-inventoried tree plots across the largest tropical forest on Earth, we mapped tree species-diversity and tree species-richness at 0.1-degree resolution, and investigated drivers for diversity and richness. Using only location, stratified by forest type, as predictor, our spatial model, to the best of our knowledge, provides the most accurate map of tree diversity in Amazonia to date, explaining approximately 70% of the tree diversity and species-richness. Large soil-forest combinations determine a significant percentage of the variation in tree species-richness and tree alpha-diversity in Amazonian forest-plots. We suggest that the size and fragmentation of these systems drive their large-scale diversity patterns and hence local diversity. A model not using location but cumulative water deficit, tree density, and temperature seasonality explains 47% of the tree species-richness in the terra-firme forest in Amazonia. Over large areas across Amazonia, residuals of this relationship are small and poorly spatially structured, suggesting that much of the residual variation may be local. The Guyana Shield area has consistently negative residuals, showing that this area has lower tree species-richness than expected by our models. We provide extensive plot meta-data, including tree density, tree alpha-diversity and tree species-richness results and gridded maps at 0.1-degree resolution.

We compared three methods for scoring the Balanced Inventory of Desirable Responding (BIDR) to detect faked responses on self-report measures: (1) polytomous, (2) dichotomous emphasizing exaggerating endorsement of socially desirable behaviors, and (3) dichotomous emphasizing exaggerating denial of such behaviors. The results revealed that respondents on average were able to fake good or fake bad and that faking markedly affected score distributions, subscale score intercorrelations, and overall model fits. When using the Impression Management scale, polytomous and dichotomous exaggerated endorsement scoring were best for detecting faking good, whereas polytomous and dichotomous exaggerated denial scoring were best for detecting faking bad. When using the Self-Deceptive Enhancement scale, polytomous and dichotomous exaggerated endorsement scoring again were best for detecting faking good, but dichotomous exaggerated denial scoring was best for detecting faking bad. Percentages of correct classification of honest and faked responses for the most effective methods for any given scale ranged from 85% to 93%, with accuracy on average in detecting faking bad greater than in detecting faking good and greater when using the Impression Management than using the Self-Deceptive Enhancement scale for both types of faking. Overall, these results best support polytomous scoring of the BIDR Impression Management scale as the single most practical and efficient means to detect faking. Cut scores that maximized classification accuracy for all scales and scoring methods are provided for future use in screening for possible faking within situations in which relevant local data are unavailable.

Objetivo. Identifcar la relación entre la sobrecarga y la presencia de estrés, ansiedad y depresión en los cuidadores de personas con discapacidad. Métodos. El estudio fue cuantitativo, de alcance correlacional y diseño transversal. Un total de 384 cuidadores de personas con discapacidad formaron parte de la muestra de estudio, seleccionada a partir de un muestreo por conveniencia. Se aplicó una encuesta con 47 preguntas. Los análisis estadísticos fueron desarrollados en Statistical Package for Social Sciences 24, calculando tanto la normalidad de los datos como las correlacionales de las variables. Resultados. Existía relación entre la sobrecarga del cuidador y la presencia de estrés, ansiedad y depresión en los cuidadores de personas con discapacidad. puesto que el exceso de actividades generadas a raíz del cuidado de personas con discapacidad se relacionó fuertemente con la presencia de estrés y de manera moderada con la ansiedad y la depresión. Conclusión. Se identifcó que la sobrecarga del cuidador influye en la presencia de ansiedad, depresión y estrés.

Objetivo. El objetivo del estudio consistió en determinar la influencia de los estados emocionales negativos (estrés, ansiedad y depresión) en la salud mental de los servidores de la salud en tiempos de pandemia. Métodos. Se trata de un estudio cuantitativo de alcance descriptivo y diseño transversal. El cuestionario estuvo conformado por 21 preguntas que fueron tomadas de la escala del DASS 21 propuesta por Lovibond y Lovibond (1995), y fue aplicado a 229 servidores de la salud de Santo Domingo de los Tsáchilas (Ecuador). Los análisis estadísticos fueron desarrollados a través de Excel y SPSS 21. Resultados. El estrés y la ansiedad fueron severos en los servidores de la salud mayores a 31 años que laboran en hospitales públicos y privados; mientras que la ansiedad afectó de manera extremadamente severa a todos los participantes del estudio. Conclusiones. El estudio es el primero en exponer los resultados respecto a la influencia de los estados emocionales negativos en los servidores de la salud de Santo Domingo de los Tsáchilas y pone en evidencia que el estrés, la ansiedad y la depresión fueron factores que influyeron considerablemente en tiempos de pandemia. COMENTARIOS SOBRE EL ARTÍCULO

Abstract Background Within the Learning Health System (LHS) model, learning routines, including evaluation, allow for continuous incremental change to take place. Within these learning routines, evaluation assists in problem identification, data collection, and data transformation into contextualized information, which is then re-applied to the LHS environment. Evaluation that catalyzes learning and improvement may also contribute to health innovation sustainability. However, there is little consensus as to why certain evaluations seem to support learning and sustainability, while others impede it. This realist synthesis seeks to understand the contextual factors and underlying mechanisms or drivers that best support health systems learning and sustainable innovation. Methods This synthesis will be guided by Pawson and colleagues’ 2005 and Emmel and colleagues’ 2018 guidelines for conducting realist syntheses. The review process will encompass five steps: (1) scoping the review, (2) building theories, (3) identifying the evidence, (4) evidence selection and appraisal, and (5) data extraction and synthesis. An Expert Committee comprised of leaders in evaluation, innovation, sustainability, and realist methodology will guide this synthesis. Review findings will be reported using the RAMESES guidelines. Discussion The use of a realist review will allow for exploration and theorizing about the contextual factors and underlying mechanisms that make evaluations ‘work’ (or ‘not work’) to support learning and sustainability. Depending on results, we will attempt to synthesize findings into a series of recommendations for evaluations with the intention to support health systems learning and sustainability. Finalized results will be presented at national and international conferences, as well as disseminated via a peer-reviewed publication. Systematic review registration This realist synthesis protocol has been registered with PROSPERO ( https://www.crd.york.ac.uk/prospero/ ID 382690).

Investigations of an Lower Carnian Wettersteinkalk ammonoid fauna found in the Hochobir massif (Carinthia/Austria) gave rise to problems in the taxonomic relationship within the Triassic ammonoid Family Pinacoceratidae. The morphological parameters of the ammonoid genus Pompeckjites are rather unclear. Morphological variation of at least two ammonoid species as Pompeckjites layeri Hauer on one end, Placites urlichsi Bizzarini on the other end have to be take into account. Numerous field surveys, studies and excavations on upper Wettersteinkalk sites within the Karavank Mountains and Hallstatt-facies sites in the Northern Calcareous Alps were implemented and compared with the reference sites in the Dolomites. As a consequence of our investigations, the Hochobir Wettersteinkalk ammonite assemblage is thought to be equivalent in time to the ammonoid fauna of the Upper San Cassian Formation. The frequent occurrence of the Julian (Lower Carnian) ammonoid Placites urlichsi Bizzarini may be a powerful tool in field investigations for a refined correlation of the upper Wettersteinkalk reef limestone to the coeval basinal facies of the Upper San Cassian Formation (Lower Carnian/upper Trachyceras aonoides Zone). As a result of this study Placites urlichsi was included in the genus Pompeckjites. This paper could be an attempt to recognize the differences in juvenile forms of Pompeckjites layeri and Placites urlichsi and other similar disciform ammonoid genera like Carnites floridus and Sageceras sp. based on suture lines, polished transversal-sections and morphological features.

Among the challenges in delivering integrated health and social care services is the need to attend to the coordination of tasks, roles, activities, and operations, while considering how these efforts are experienced by patients, carers and communities. The literature has noted an important disconnect between how providers and leaders view their efforts to coordinate service delivery, and how patients perceive these efforts on the receiving end. Our team has provided guidance to integrated care efforts in Ontario, Canada by drawing on Goffman’s theory of Dramaturgy to help classify the actions of integrated care delivery as linked to the roles individuals play in the delivery of care. Using this framing helps to uncover how “backstage” processes (such as team-functioning, funding models, and digital infrastructures) create a necessary foundation on which “frontstage” actions (or performances) can be effectively delivered.

This study evaluated the significance and predictive value of ultrasonographic and physical examination on arrival at an Austrian fattening farm. Treatment frequency and average daily weight gain (ADG) were related to physical and ultrasonographic examination results. Additionally, the effect of an intranasal vaccination in half of the examined calves was studied. The clinical and ultrasonographic health status 600 calves was recorded at the beginning and end of fattening. Half of the calves received an intranasal vaccination (Bovalto® Respi Intranasal). Overall, 44.5% showed an abnormal respiratory scoring (RS) and 56.0% showed signs of respiratory diseases in transthoracic ultrasonography (TUS) at arrival on the farm. For both RS and TUS, a categorization between ILL and HEALTHY was conducted. Results showed lower ADG in ILL calves (RS median: 0.93 kg/d; TUS median: 0.96 kg/d) compared to HEALTHY calves (RS median: 1.01 kg/d; TUS median: 1.01 kg/d). The median ADG was lower in not treated and ILL calves (RS median 0.90 kg/d; TUS: 0.93 kg/d) compared to treated and ILL calves (RS median 1.01 kg/d; TUS: 1.02 kg/d). Vaccination did not affect growth performance or occurrence of ILL, though treatment frequency was lower in VAC calves (17.0% in NVAC; 11.3% in VAC). The implementation of examination protocols for respiratory diseases may have a positive impact on production parameters (e.g., treatment frequency and ADG).

Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of “Holiday Heart Syndrome”, linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.