Background: There have been few reports of cutaneous skin lesions in severe COVID-19 hospitalized patients which exhibit different behavior compared to outpatients. Furthermore, a notable lack of rigorous studies exits. In this study we included patients with generalized rash during the first wave of the pandemic for characterization.Methods: Hospitalized patients with severe confirmed pulmonary COVID-19 infection and a generalized cutaneous rash during the first wave in March-May 2020 were included. The study received approval from the ethics committee. Clinical presentation, histo-logical examination, blood test, and complete blood interleukin profile were assessed. Special immunohistochemical investigations were conducted. Long term follow-up of the patient was performed throuhg a phone call 24 months later. Results: A total 28 patients were studied and classified by histological examination into three groups: G1: perivascular dermatitis (18/28, 64%); G2: Drug reaction (7/28, 25%); and G3: Generalized exanthema and chilblain (3/28, 11%). The virus was not detected in the skin, by PCR and by immunohistochemical analysis, and the interleukin expression in the skin were undetectable results. Vascular cell adhesion molecule 1 (VCAM1), E-selectine, and IT Galpha 5 were unspecific. G1 exhibited the least inflammation, G2 the most in-flammatory, and G3 had previous inflammation. Discussion: Our data suggest that generalized exanthemas during severe SARS-Cov-2 infection exhibit unspecific finding and are similar to other rashes caused by inflammation. Drug reaction should be considered, as they accounted for 25% of the rashes. Further studies including higher number of patients are necessary.

Purpose To analyse diagnostic and therapeutic impact of molecular imaging TNM (miTNM) stage obtained with 18F-DCFPyL versus 18F-Fluorocholine in head to head comparison in biochemical recurrence (BCR) prostate cancer (PCa). Material and methods Patients with BCR PCa after radical treatment with previous 18F-Fluorocholine-PET/CT (negative or oligometastatic disease) were derived to 18F-DCFPyL-PET/CT. Patients were classified attending to: grade group, EAU classification, PSA, PSA doubling time (PSAdt) and PSA velocity (PSAvel). The overall detection rate (DR) and miTNM stage according to PROMISE criteria were assessed for both radiotracers and also correlation (Kappa). The influence of PSA and kinetics on both PET/CT (DR and miTNM) and predictive value of unfavourable kinetics on miTNM were determined. Cut-off PSA, PSAdt and PSAvel values able to predict PET/CT results were determined. Change in miTNM and treatment derived of 18F-DCFPyL information with respect to 18F-Fluorocholine was also evaluated. Results We studied 138 patients. 18F-DCFPyL showed a higher DR than 18F-Fluorocholine (64.5% vs 33.3%). 18F-DCFPyL and 18F-Fluorocholine detected T in 33.3% versus 19.6%, N in 27.5% versus 13.8%, M in 30.4% versus 8.7%. Both tracers DR showed significant associations with PSA and PSAvel. Significant association was only found between miTNM and PSA on 18F-Fluorocholine-PET/CT (p=0.033). For 18F-Fluorocholine and 18F-DCFPyL PET/CT a PSAdt cut-off of 4.09 and 5.59 months, respectively, were able to predict M stage. 18F-DCFPyL changed therapeutic management in 40/138 patients. Conclusion 18F-DCFPyL provides a higher DR and superior miTNM staging than 18F-Fluorocholine in restaging BCR, especially with high PSA and unfavourable PSA kinetics, showing a fair agreement to 18F-Fluorocholine.

Plant male sterility refers to the failure in the production of fertile pollen. It occurs spontaneously in natural populations and may be caused by genes encoded in the nuclear (genic male sterility; GMS) or mitochondrial (cytoplasmic male sterility; CMS) genomes. This feature has great agronomic value for the production of hybrid seeds and has been widely used in crops, such as corn, rice, wheat, citrus, and several species of the family Solanaceae. Mitochondrial genes determining CMS have been uncovered in a wide range of plant species. The modes of action of CMS have been classified in terms of the effect they produce in the cell, which ultimately leads to a failure in the production of pollen. Male fertility can be restored by nuclear-encoded genes, termed restorer-of-fertility (Rf) factors. CMS from wild plants has been transferred to species of agronomic interest through somatic hybridization. Somatic hybrids have also been produced to generate CMS de novo upon recombination of the mitochondrial genomes of two parental plants or by separating the CMS cytoplasm from the nuclear Rf alleles

In recent years information and communication technologies (ICT) play a significant role in all aspects of modern society and impact socioeconomic development in sectors as education, administration, business, medical care and agriculture. The benefits of such technologies in agriculture can be appreciated only if farmers use them. In order to predict and evaluate the adoption of these new technological tools, the technology acceptance model (TAM) can be a valid aid. The paper measures the potential acceptance of an e-learning tool designed for EU farmers and agricultural entrepreneurs. Starting from a literature review of the technology acceptance model, by analyzing the most commonly used external variables in the fields of e-learning, Agriculture, and Virtual reality, the analysis shows that computer self-efficacy, individual innovativeness, computer anxiety, perceived enjoyment, social norm, content and system quality, experience and facilitating conditions are the most common determinants addressing technology acceptance. Furthermore, findings evidenced that the external variables have a different impact on the two main beliefs of the TAM Model, Perceived Usefulness (PU) and Perceived Ease of Use (PEOU). This study is expected to bring theoretical support for academics when determining the variables to be included in TAM extensions.

Toxin/antitoxin (TA) systems are used primarily to inhibit phage, reduce metabolic activity during stress, and maintain genetic elements. Given the extreme toxicity of some of the toxins of these TA systems, we were curious how the cell silences toxins, if the antitoxin is inactivated or when toxins are obtained without antitoxins via horizontal gene transfer. Here we find that the RalR (type I), MqsR (type II), GhoT (type V), and Hha (type VII) toxins are inactivated primarily by a mutation that inactivates the toxin promoter or via the chromosomal mutations iraM and mhpR.

The ciguatera is a food poisoning caused by the consumption of primarily coral fish; these species exist in large numbers in the seas that bathe the Colombian territory. The underreported diagnosis of this clinical entity has been widely highlighted due to multiple factors, as are among others, ignorance by the primary care practitioner consulted for this condition, clinical similarity with secondary gastroenteric symptoms, to common food poisonings of bacterial, parasitic or viral etiology. Eventually people affected by ciguatotoxin are related to trips to coastal areas hours before the onset of symptoms. Thanks to multiple studies over the years it has been possible to identify the relation of the dinoflagellates in the assembly of said toxin and its introduction into the food chain, starting by fish primarily inhabiting reef ecosystems and culminating in the intake of these by humans. Identifying the epidemiological link, its cardinal symptoms and affected systems such as gastrointestinal, peripheral nervous system and fortunately with a low frequency, the cardiovascular system, leads to a purely clinical diagnostic impression without further complementary studies, performing an adequate treatment primarily symptomatic without underestimating or overlooking any associated complications.

In this study, the physical properties of briquettes produced from two different biomass feedstocks (sawdust and date palm trunk) and different plastic wastes were investigated, without using any external binding agent. The biomass feedstocks were blended with different ratios of two WEEE plastics (halogen-free wire and print circuit boards (PCB)) and automotive shredder residues (ASR). The briquettes production is studied at different waste proportions (10-30%), pressures (22-67 MPa) and temperatures (room-130 ˚C). Physical properties as density and durability rating were measured, usually increasing with temperature. Palm trunk gave better results than sawdust in most cases, due to its moisture content and the extremely fine particles that are easily obtained.

HIV infection is well-known to be associated with the development of Hodgkin's lymphoma (HL) with extranodal involvement being exclusive bone marrow involvement is less common. Co-infection by other viruses such as the esptein Baar virus (EBV) increases the incidence of a frequent complication denominated hemophagocytic lymphohistocytosis (HLH). We present the case of a 50-year-old patient with the above clinical spectrum who develops several serious complications during treatment.

Antibiotic failure is one of the most worrying health problems worldwide. Nowadays we are facing an international crisis where several issues are involved: new antibiotics are not being discovered any longer, resistance mechanisms become spread in nearly every clinical isolate of bacteria and the appearance of recurrent infections caused by persistent bacteria complicates the overcoming of infections. In this context, it has been explored new anti-infectious strategies against MDR and persistent bacteria as well as the rescue of FDA-approved compounds (drug repurposing). Among the highlighted new anti-infectious strategies we find anti-microbial peptides, anti-virulence compounds, phage therapy and new molecules. On the other hand, as drugs of repurposing that have been described, we have anti-inflammatory compounds, anti-psychotics, anti-helmintic drugs, anti-cancerous and statins.

This study delves into the foundational aspects of electrocardiographic (ECG) lead systems, specifically focusing on Einthoven’s Triangle and Wilson’s Central Terminal. We introduce the innovative concept of a Precordial Central Terminal, a strategic arrangement of thoracic electrodes that establishes two Einthoven’s triangles within the horizontal plane, in accordance with physical-mathematical principles. Furthermore, we meticulously scrutinize Goldberger’s contributions to the field of ECG, particularly augmented leads, which shed light on the development of our theory. Additionally, we propose the implementation of a novel standardized electrocardiograph, characterized by its use of exclusively “precordial” electrodes, yet capable of providing a comprehensive three-dimensional perspective of cardiac electrical activity. By amalgamating theoretical underpinnings with empirical experimentation, our study lays the groundwork for future investigations, including the experimental validation of our innovative Precordial Terminal. This validation holds the promise of yielding substantial advancements in the realm of clinical electrocardiography.

We have studied the very large amount of literary works written by the Italian mystic Maria Valtorta to assess similarities and differences in her writings because she claims that most of them are due to mystical visions. We have used mathematical and statistical tools developed for specifically studying deep linguistic aspects of texts. The general trend indicates that the literary works explicitly attributable to Maria Valtorta differ significantly from her other literary works, that she claims are attributable to the alleged characters Jesus and Mary. Mathematically, they seem to have been written by different authors. The comparison with the Italian literature is very striking. A single author, namely Maria Valtorta, seems to be able to write texts so diverse to cover the entire mathematical range (suitable defined) of the Italian literature of seven centuries.

"Hidden hunger", the deficiency of important mineral micronutrients, affects more than 2 billion people globally. Adolescence is unquestionably a period of nutritional risk, given the high nutritional requirements for growth and development, erratic or capricious diets and the increased consumption of snacks. This study applied the rational food design approach to obtain micronutrient-dense biscuits by combining chickpea and rice flours to achieve an optimal nutritional profile, crunchy texture and appealing flavour. The perception of 33 adolescents of the suitability of such biscuits as a mid-morning snack was examined. Four biscuits were formulated, with different ratios of chickpea and rice flours (CF:RF): G100:0, G75:25, G50:50 and G25:75. Nutritional content, baking loss, acoustic-texture and sensory analyses were carried out. On average, the mineral content of biscuits with the CF:RF ratio of 100:0 doubled compared with the 25:75 formula. The dietary reference values for iron, potassium and zinc reached 100% in the biscuits with CF:RF ratios of 50:50, 75:25 and 100:0, respectively. The analysis of mechanical properties revealed that samples G100:0 and G75:25 were harder than the others. Sample G100:0 showed the highest sound pressure level (Smax). Sensory analysis showed that increasing the proportion of CF in the formulation augments the grittiness, hardness, chewiness and crunchiness. Most of the adolescents (72.7%) were habitual snack consumers; 52% awarded scores ≥ 6 to biscuit G50:50 for its overall quality, 24% described its flavour as "biscuit" and 12% as "nutty". However, 55% of the participants could not pinpoint any dominant flavour. In conclusion, it is possible to design nutrient-dense snacks that meet the micronutrient requirements and sensory expectations of adolescents by combining flours naturally rich in micronutrients.

We conducted a topological analysis of the novel, non-associative, and unital algebraic structure known as Bermejo Algebras, developed by Alejandro Bermejo, which includes the Algebra B and Treon Algebra. This algebras can define Lie and Malcev algebras when their product operations are derived from the Bermejo Algebras product. Central to this study are treons, complex entities that arise as isomorphisms of Algebra B when the field is real. We define the vector spaces associated with Bermejo Algebras to establish equivalence classes and a quotient topology, resulting in Hausdorff spaces that do not depend on traditional norms, inner products, or metrics. Our findings lay the groundwork for constructing new types of differential manifolds, opening new avenues for advanced mathematical research.

We introduce a novel algebraic structure, termed algebra B, which generalizes Lie algebras through the definition of a non-associative and unital algebra. We demonstrate that algebra B retains essential properties such as bilinearity and antisymmetry, and satisfies both the Jacobi and Malcev identities; this occurs when the product operations of Lie and Malcev algebras are derived from the product operation defined in our algebra. By examining the connections between algebra B, Malcev algebras, and Lie algebras, we establish that algebra B effectively generalizes these structures. Furthermore, we show that algebra B can generate complex entities with a novel structure distinct from those currently known. Our findings lay the groundwork for future investigations into the practical applications and further theoretical development of this new algebraic framework.

Background. Implementing mammogram screening means that clinicians are seeing many breast cancers that will never develop metastases. The purpose of this study was to identify subgroups of breast cancer patients who did not present events related to long-term breast cancer mortality, taking into account diagnosis at breast screening, absence of palpability and axillary involvement, and genomic analysis with PAM50. Patients and Methods. To identify them, a retrospective observational study was carried out selecting patients without palpable tumour, without axillary involvement, and a genomic analysis was performed with PAM50. Results. The probability of distant metastasis-free interval (DMFI) of 337 patients was 0.92 (95% CI, 0.90-0.93) at 20 years and 0.96 (95% CI, 0.92-1.00) in 95 patients (28%) with available PAM50 tests. In 22 (23.15%) luminal A tumours and in 9 (9.47%) luminal B tumours smaller than 1 cm and in HER2 and basal type tumours there were no metastatic events (20-year DMFI of 1.00). Conclusion. Patients with nonpalpable breast cancer found at screening with negative nodes are at very low risk. It is possible to identify subgroups without metastatic events by determining the intrinsic subtype and tumour size less than 1 cm. De-escalation of treatment should be considered.

Primary Health Care is crucial in the healthcare system, being the first level of contact with health services for users and patients to take action using the available resources. Patient care units are created to facilitate direct user participation through the circuit of complaints, grievances, and suggestions, allowing the analysis of the population's unmet expectations and needs. To study complaints and grievances regarding the treatment and information received by users in the Santiago and Barbanza healthcare area during the year 2022. A descriptive cross-sectional study was conducted, in which complaints filed by patients in the year 2022 in the Santiago and Barbanza healthcare area were analyzed. A total of 326 users who filed a total of 512 complaints were studied in the year 2022, with 358 (70.0%) related to treatment/information. The mean age was 33.5±16.2 years. 72.4% were women (n=236). A Pearson correlation was performed to establish whether there was a dependence between the number of healthcare visits in both primary care and hospital settings in 2022 and the number of complaints filed in the same year. Pearson correlation coefficient was 0.14; 95% CI (0.02 - 0.27), p=0.012. There is a correlation between the number of consultations and the number of complaints filed. Frequent users are more likely to file a complaint. However, there is no correlation between the number of consultations and the likelihood of filing a complaint regarding treatment/information. Therefore, there seems to be a good relationship between healthcare personnel and users, which impacts patient satisfaction.

A nanostructured electrochemical bi-sensor system for analysis of milks has been developed using the Layer by Layer technique. The non-enzymatic sensor [CHI+IL/CuPcS]2, is a layered material containing a negative film of the anionic sulfonated copper phthalocyanine (CuPcS) acting as electrocatalytic material, and a cationic layer containing a mixture of an ionic liquid (IL) (1-butyl-3-methylimidazolium tetrafluoroborate) that enhances the conductivity and chitosan (CHI) that facilitates the enzyme immobilization. The biosensor ([CHI+IL/CuPcS]2-GAO) results from the immobilization of galactose oxidase on the top of the LbL layers. FTIR, UV-vis and AFM have confirmed the proposed structure and cyclic voltammetry has demonstrated the amplification caused by the combination of materials in the film. Sensors have been combined to form an electronic tongue for milk analysis. Principal Component Analysis has revealed the ability of the sensor system to discriminate between milk samples with different lactose content. Using PLS-1 calibration models, correlations have been found between the voltammetric signals and chemical parameters measured by classical methods. PLS-1 models provide excellent correlations with lactose content. Additional information about other components such as fats, proteins and acidity can also be obtained. The method developed is simple and the short response time permits its use in assaying milk samples on-line.

Ever since pharmacy has become a profession, pharmacist's role has been continuously subjected to changes due to specific influences from historical, socio-economic, political, and scientific context. Nowadays the classic perception of pharmaceutical profession in Community Pharmacy is facing worldwide extinction due to many factors. Modern services, such as online, mail-order, and telephone-order pharmacies are increasingly gaining ground thanks to their ability to facilitate customer demand. However, at the same time, they are endangering “face-to-face” contact, affecting the building of customer loyalty based on direct “human” interaction, and consequently reducing pharmacists to mere commercial figures. Communication is in fact emphasized as the essential element to build a solid and appropriate interpersonal relationship with the client, to make the consultancy process effective, and to strengthen pharmacist's professionalism in community pharmacy. The aim of this work is to analyze pharmacist’s role in modern society by pinpointing the factors affecting pharmacy profession practice. Specific purpose will be improving both the academic training of future professionals and their capacity to approach public relations through a deepened study and practice of behavioral, communication, educational, and sociological methodologies and techniques that would allow the development of more effective communication skills useful for providing an efficient consultancy service.

As a result of the growing demand for foods with reduced animal protein content, many new alternative diets are now emerging. Nevertheless, recent studies have shown that the Western population is unprepared for drastic changes and is disinclined to accept foods based on alternative proteins. However, hybrid products might become a good transitional offer. This study used a desirability-based mixture design to model hybrid spreadable cheese analogues (SCAs). The design combined the dairy protein (MPC), Tenebrio molitor (IF) and faba bean (FBP) flours. Nine SCAs with different MPC/FBP/IF ratios were formulated, representing 0, 50 and 100% MPC replacement (7.1% of the formula). Incorporating the IF negatively impacted the desirable texture properties. The FBP flour improved the texture (achieving increased firmness and stickiness and decreased spreadability), but only when combined with MPC. Changing the MPC/FBP/IF ratio affected the colour of SCAs. Sensory analysis showed that hybrid SCAs (≤ 50% MPC) had a more characteristic cheesy flavour than the commercial plant-based reference, and sample C2 had a texture profile similar to the dairy reference. Samples containing IF showed a better flavour profile than the products without IF. The SCAs had higher protein and lower saturated fat, starch and sugar con-tent than commercial analogues.This study demonstrates that the inclusion of alternative proteins can be effective as a strategy to reduce dairy protein content in hybrid product formulations.

We explore the concept of Euclidean locality within treonic topological spaces. Our study establishes a foundational theoretical framework, elucidating the properties of continuity, homeomorphisms, and compactness in these spaces. We assess the Euclidean locality of treonic spaces through the analysis of specific homeomorphisms, which enables us to define manifolds in treonic spaces and extend recent research on Bermejo Algebras. For the first time, we characterize treonic manifolds by incorporating the property of Euclidean locality alongside previously studied properties such as Hausdorff spaces and second countable spaces. Our findings advance the understanding of the topological and geometric properties of treonic spaces, providing significant insights for advanced mathematical research.

Bermejo Algebras, which consist of Algebra B and Treon Algebra, are non-associative and unital algebraic structures that introduce new complex entities. Recently, a Hausdorff space associated with the space where these algebras act was defined. We constructed a second-countable treon space utilizing a novel metric derived from these algebras. We defined topological spaces and established a metric to prove the second-countable property within Bermejo Algebras. Our findings contribute to the construction of manifolds in treon spaces by defining a countable base using the density of rationals in the real numbers.

We explored an extension of the Cauchy-Riemann equations to the algebra of treons, recently described by Alejandro Bermejo, whose elements are ordered 3-tuples. We leveraged the isomorphism between the algebra of treons and algebra B, and deduced the Cauchy-Riemann equations for the algebra of treons, establishing the necessary conditions for analyticity in this algebraic structure. This work significantly broadened our horizons in complex analysis and introduced new possibilities for applications across various fields of advanced mathematics.

We present an exploration of algebra B, a recently published unital and non-associative algebra. Unique complex entities emerged from this algebra, distinct from both quaternion and complex number systems, which we termed treons. We defined the treonic number system and established an isomorphism between this system and the real vector space. Our findings revealed that the treonic representation maintained structural integrity under the defined operations. Based on this foundation, we proceed to determine Euler identity for algebra B within the treonic system. By presenting the fundamental definitions and properties of algebra B, we derived a generalized version of Euler identity applicable within this algebra. This formula revealed the emergence of hyperbolic trigonometric entities, extending the applicability of Euler identity beyond traditional complex numbers. Our results provide a theoretical foundation for a deeper understanding of the properties and behaviors of complex entities within this expanded algebraic framework, thus enabling new theoretical developments and practical applications in the realms of advanced mathematics and theoretical physics.

Although the failure of antibiotic treatment is normally attributed to resistance, tolerance and persistence display a significant role in the lack of response to antibiotics. Due to the fact that several nosocomial pathogens show a high level of tolerance and/or resistance to chlorhexidine, in this study we analyzed the molecular mechanisms associated with chlorhexidine adaptation in two clinical strains of Klebsiella pneumoniae by phenotypic and transcriptomic studies. These two strains belong to ST258-KPC3 (high-risk clone carrying β-lactamase KPC3) and ST846-OXA48 (low-risk clone carrying β-lactamase OXA48). Our results showed that K. pneumoniae ST258-KPC3CA and ST846-OXA48CA strains exhibited a different behavior under CHLX pressure, adapting to this biocide through resistance and tolerance mechanisms, respectively. Furthermore, the appearance of cross-resistance to colistin was observed in the ST846-OXA48CA strain (tolerant to CHLX), using the broth microdilution method. Interestingly, this ST846-OXA48CA isolate contained a plasmid that encodes a novel type II toxin/antitoxin (TA) system, PemK/PemI. We characterized this PemK/PemI TA system by cloning both genes into the IPTG-inducible pCA24N plasmid, and found their role in persistence and biofilm formation. Accordingly, the ST846-OXA48CA strain showed a persistence biphasic curve in the presence of a chlorhexidine-imipenem combination, and these results were confirmed by the enzymatic assay (WST-1).

Background: Little is known about risk and prognostic factors in very old patients developing sepsis secondary to community-acquired pneumonia (CAP). Methods: We conducted a retrospective observational study of data prospectively collected at the Hospital Clinic of Barcelona over a 13-year period. Consecutive patients hospitalized with CAP were included if they were very old (≥80 years) and divided into those with and without sepsis for comparison. Sepsis was diagnosed based on the Sepsis-3 criteria. The main clinical outcome was 30-day mortality. Results: Among the 4,219 patients hospitalized with CAP during the study period, 1,238 (29%) were very old. The prevalence of sepsis in this aged group was 71%. Male sex, chronic renal disease, and diabetes mellitus were independent risk factors for sepsis, while antibiotic therapy before admission was independently associated with a lower risk of sepsis. Thirty-day and intensive care unit (ICU) mortality did not differ between patients with and without sepsis. In CAP-sepsis group, chronic renal disease and neurological disease were independent risk factors for 30-day mortality. Conclusion: In very old patients hospitalized with CAP, in-hospital and 1-year mortality rates were increased if they developed sepsis. Antibiotic therapy before hospital admission was associated with a lower risk of sepsis.

A major parameter controlling the extent and rate of oral drug absorption is permeability through the lipid bilayer of intestinal epithelial cells. Here, a biomimetic artificial membrane permeability assay (Franz-Bampa) was validated using Franz cells apparatus. Both high and low permeability drugs (metoprolol and mannitol, respectively) were used as external standards. Biomimetic properties of Franz-Bampa were also characterized by electron paramagnetic resonance spectroscopy (EPR). Moreover, the permeation profile for the 14 BCS class I-IV drugs cited in the FDA guidance (including other drugs as acyclovir, cimetidine, diclofenac, ibuprofen, piroxicam, and trimethoprim) were measured across Franz-Bampa. Apparent permeability (Papp) was compared to literature fraction dose absorbed in humans (Fa%). Papp in Caco-2 cells and Corti artificial membrane were likewise compared to Fa% to assess Franz-Bampa performance. Mannitol and metoprolol Papp values across Franz-Bampa were lower (3.20 x 10-7 and 1.61 x 10-5 cm/s, respectively) than those obtained across non-impregnated membrane (2.27 x 10-5 and 2.55 x 10-5 cm/s, respectively), confirming lipidic barrier resistivity. Performance of the Franz cell permeation apparatus using an artificial membrane showed similar log linear correlation (R2 = 0.664) with Fa%, as seen for Papp in Caco-2 cells (R2 = 0.805). Data support the validation of the Franz-Bampa method for use during drug discovery process.

Rheumatoid arthritis (RA) occurs more frequently in women than in men, and the studies that have addressed clinical and prognostic differences between sexes are scarce and have contradictory results and methodological problems. The present work aims to evaluate sex and gender-related differences in the clinical expression and prognosis of RA as well as the impact on psychosocial variables, coping behavior, and healthcare use and access. By identifying between-sex differences and gender-related outcomes in RA, it may be possible to design tailored therapeutic strategies that consider the differences and unmet needs. Being sex, together with age, the most relevant biomarker and health determinant, a so-called personalized medicine approach to RA must include clear guidance on what to do in case of differences.

This paper uses the numerical results of surveys sent to Huelva’s (Andalusia, Spain) households to determine the degree of knowledge they have about the urban water cycle, needs, values, and attitudes regarding water in an intermediary city with low water stress. In previous research, we achieved three different households’ clusters. The first one grouped households with high knowledge of the integral water cycle and a positive attitude to smart devices at home. The second cluster described households with low knowledge of the integral water cycle and high sensitivity to price. The third one showed average knowledge and predisposition to have a closer relationship with the water company. This paper continues with this research line, applying Classification and Regression Trees (CART) to determine which hierarchy of variables/factors/ independent components obtained from the surveys are the decisive ones to predict the range of household water consumption in Huelva. Positive attitudes towards improved cleaning habits for personal or household purposes are the highest hierarchy component to predict the water consumption range. Second in the hierarchy, the variable Knowledge Global Score about the integral urban water cycle, associated with water literacy, also contributes to predicting the water consumption range. Together with the three clusters obtained previously, these results will allow us to design water demand management strategies (WDM) fit for purpose that enable Huelva’s households to use water more efficiently.

The COVID-19 pandemic has raised questions about the possible cross immunity resulting from common vaccination programs and SARS-CoV-2 infection. Therefore, the Spanish Obstetric Emergency group performed a multicenter prospective study on the vaccination status of Influenza and Tdap (diphtheria, tetanus and pertussis vaccine boost administered in adulthood) in consecutive cases of SARS-CoV-2 infection in a pregnancy cohort, in order to assess its possible association with the clinical presentation and severity of symptoms of SARS-CoV-2 infection, as well as to determine the factors that may affect vaccination adherence. 1,150 SARS-CoV-2 positive pregnant women from 78 Spanish hospitals were analyzed: 183 had not received either vaccine, 23 had been vaccinated for Influenza only, 529 for Tdap only and 415 received both vaccines. No association was observed between the vaccination status and the clinical presentation of SARS-CoV-2 infection and/or the severity of symptoms. However, a lower adherence to the administration of both vaccines was observed in the Latin-American subgroup. Based on the results above, we reinforce the importance of maternal vaccination programs in the actual pandemic. Health education campaigns should be specially targeted to groups less likely to participate in these programs, as well as for a future SARS-CoV-2 vaccination campaign.

Optical properties of the cornea are responsible for correct vision, ultrastructure allows optical transparency and biomechanical properties governs the shape, elasticity or stiffness of the cor-nea affecting ocular integrity and intraocular pressure. Therefore, optical aberrations, corneal transparency, structure and biomechanics play a fundamental role in the optical quality of hu-man vision, ocular health and refractive surgery outcomes. However, the convergence of those properties is not yet reported at macroscopic scale within the hierarchical structure of the cornea. This work explores the relationships between biomechanics, structure and optical properties (corneal aberrations and optical density) at macrostructural level of the cornea through dual Placido-Scheimpflug imaging and air-puff tonometry systems in a healthy young adult popula-tion. Results showed convergence between optical transparency, corneal macrostructure and biomechanics.

This article shows the numerical results and the analysis of households' degree of knowledge in an intermediary city such as Huelva (Andalusia, Spain) about the sustainable use of urban water. It analyzes the needs and values regarding water and the attitudes that households maintain regarding the acceptance of reclaimed water and the use of new technologies to achieve more efficient and sustainable consumption. These results are part of the stages of needfinding and synthesis of Design Thinking methodology, adopted as a framework to improve the efficiency and sustainability of urban water among households in this city. Different statistical analysis techniques of surveys sent to households and the use of clustering are the mathematical tools used to draw conclusions and recommendations that allow the design of a web-based prototype grounded on Product Service Systems methodology, as a tool to improve the engagement of households concerning water and align citizens with the sustainability of their city. Strategies of customization and technological facilitators will be the means to improve the hydrosocial contract among households in Huelva in future later stages of the project.

The cornea is the optical window to the brain. Its optical and structural properties are responsible for optical transparency and vision. The shape, elasticity, rigidity or stiffness are given by its biomechanical properties, whose stability results in ocular integrity and intraocular pressure dynamics. Here, we report in vivo observation of structural changes and biomechanical alterations of the human cornea induced by acoustic wave pressure within the frequency range of 50-350 Hz and 90 dB of sound pressure level. Central corneal thickness (CCT) and eccentricity (e2) were measured using Scheimpflug imaging and biomechanical properties [corneal hysteresis (CH) and intraocular pressure (IOP] were assessed with air-puff tonometry in 6 young healthy subjects. At the specific 150 Hz acoustic frequency, the variation in CCT and e2 were of 0.058 and 7.33 µm, respectively. Biomechanical alterations were also observed in both IOP (decrease of 3.60 mmHg) and CH that showed an increase of 0.40 mmHg.

Taking advantage of tourists’ intensive flow, the SARS-CoV-2 virus rapidly spread causing thousands of deaths globally. Trying to contain the already pandemic virus, government travel restrictions were suddenly imposed. Consequently, the tourism industry, which at that moment employed one in ten workers globally, suddenly collapsed. Hundreds of thousands of workers immediately lost their income. Flights were cancelled, and thousands of tourists were stuck abroad with no means to return to their home countries. The gravity of the situation raised the question of whether there was scholarly knowledge that could have helped manage tourism during the current pandemic. To answer this question, a methodical literature review was performed, allowing for up to 900 publications to be analysed. Keywords used were pandemic, tourism, tourist and travel. Based on this process, 63 publications were selected for further analysis. Among these, less than 5% were focused on the tourism side of the problem. As such, this research concludes that, by the time the novel coronavirus emerged, there was, virtually, no scholarly knowledge on how to manage tourism during pandemic times so as to avoid chaos, and that the scholarly community studying related issues is very small. Moving forward, this article recommends that research funding agencies and universities encourage the sound development of this area of knowledge. Aspects that should be investigated include when, how and by whom should tourism be halted, as well as the feasibility of a Tourism World Fund for supporting related costs.

In this paper, we introduce a computational procedure that enables autonomous LEO laser trackers endowed with INSs to increase the current accuracy when shooting at middle distant medium-size LEO debris targets. The code is designed for the trackers to throw the targets into the Atmosphere by means of ablations. In case that the targets are eclipsed to the trackers by the Earth, the motions of the trackers and targets are modeled by equations that contain post-Newtonian terms accounting for the curvature of space. Otherwise, when the approaching targets become visible for the trackers, we additionally use more accurate equations, which allow to account for the local bending of the laser beams aimed at the targets. We observe that under certain circumstances the correct shooting configurations that allow to safely and efficiently shoot down the targets, differ from the current estimations by distances that may be larger than the size of many targets. In short, this procedure enables to estimate the optimal shooting instants for any middle distant medium-size LEO debris target.

The 3D/3D+ multidimensional geriatric assessment tool provides an optimal model of emergency care for patients aged 75 and over who attend the Emergency Department (ED). The baseline, or static, component (3D) stratifies the degree of frailty prior to the acute illness, while the current, or dynamic, component (3D+) assesses the multidimensional impact caused by the acute illness and helps to guide the choice of care facility for patients upon their discharge from the ED. The objective of this study was to evaluate the prognostic value of the 3D/3D+ to predict short- and long-term adverse outcomes in ED patients aged 75 years and older. Multivariable logistic regression models were used to identify the predictors of mortality 30 days after 3D/3D+ assessment. Two hundred and seventy-eight patients (59.7% women) with a median age of 86 years (interquartile range: 83-90) were analysed. According to the baseline component (3D), 83.1% (95%CI: 78.2-87.3) presented some degree of frailty. The current component (3D+) presented alterations in 60.1% (95%CI: 54.1-65.9). The choice of care facility at ED discharge indicated by the 3D/3D+ was considered appropriate in 96.4% (95%CI: 93.0-98.0). Thirty-day all-cause mortality was 19.4%. Delirium and functional decline were the dimensions on the 3D/3D+ that were independently associated with 30-day mortality. These two dimensions had an area under receiver operating characteristic of 0.80 (95%CI: 0.73-0.86) for predicting 30-day mortality. 3D/3D+ enhances the provision of comprehensive care by ED professionals, guides them in the choice of patients’ discharge destination, and has a prognostic validity that serves to establish future therapeutic objectives.

Maria Valtorta (MV) (1897–1961) – an Italian mystic who claimed to have visions of Jesus’s life – describes Jesus’ crucifixion with many details from which significant data can be retrieved. My investigation based on these data and the topography of northwest Jerusalem in the I century AD, shows that Jesus’ crucifixion place, Golgotha (the “skull”), is neither at the Holy Sepulchre nor in the Garden Tomb area. The paved road to Golgotha she accurately describes arrives at its top with the minimum mean route gradient; its half way defines two distinct tracts with same height and same walking time but different mean route gradient; at half way Jesus is allowed to walk to the top in a spiral country road less steep than the second tract. The paved road leads to a place where few years after Jesus’ crucifixion the Psephinus Tower, described by Flavius Josephus, was erected, in the area known today as the Russian Compound. In conclusion, the Golgotha reveiled by MV’s writings was located at the same site of the Psephinus Tower.

Black-purple carrots possess, apart from carotenoids, high content of other bioactive pigments such as anthocyanins. However, both carotenoids and anthocyanins are modified over cold storage due to their lability. In this work, we investigated the effect of the postharvest elicitation on nutritional and organoleptic quality of purple carrots over storage at 5°C for 21 days. Based on our experience, we considered methyl jasmonate and abscisic acid as elicitors. The values obtained were compared with those provided by the fresh-untreated sample on the treatment day (ie, day 0) and after three-week storage (ie, on day 21), which were used as a reference. As a result, carotenoid content increased naturally in untreated samples over storage whereas anthocyanins maintained invariable. Also, physicochemical parameters reflected apparent organoleptic quality loss. However, the postharvest treatment of purple carrot samples with elicitors resulted in similar carotenoid content in elicited samples to fresh carrots on day 0 as well as lower concentration of anthocyanins and antioxidant activity. Besides, elicitation, particularly with abscisic acid, enabled purple carrot deterioration to be slowed down and, therefore, the organoleptic quality to be preserved. This suggests delaying effect of both elicitors on the spoilage rate of purple carrots over the storage time. These findings indicate that the postharvest application of elicitors may be an interesting conservation method, alternative to traditional procedures, to decelerate decomposition and extend shelf-life of purple carrots.

This study presents a strategic approach to developing applications focused on implementing Large Language Models using the Langchain framework in Python. Three language models are highlighted: GPT-3.5 (turbo mode), LLaMA 2, and Vicuna 7B, each with their distinctive features and capabilities. The methodology used is described in detail, including data extraction from medical reports using zero-shot prompting data extraction techniques, interaction with language models, and structured storage of results. The performance of the models in data extraction is evaluated, presenting metrics such as precision, recall, and F1 score. The results demonstrate high model capability in extracting information, although areas for improvement are identified, particularly in data extraction precision. In conclusion, the efficacy of the models in extracting information from medical histories is not considerably acknowledged, with an emphasis on the importance of improving precision and increasing the volume of trained data for future research in healthcare digitalization.

Flowering time is a critical stage for crop development as it regulates the ability of plants to adapt to an environment. To understand the genetic control of flowering time, a genome wide association study (GWAS) was conducted to identify the genomic regions associated with the control of this trait in durum wheat (Triticum durum Desf.). A total of 96 landraces and 288 modern lines were evaluated for days to heading, growing degree days, and accumulated day length at flowering across 13 environments spread across Morocco, Lebanon, Mauritania, and Senegal. These environments were grouped into four pheno-environments based on temperatures, day length and other climatic variables. Genotyping with 35K Axiom array generated 7,652 polymorphic SNPs in addition to 3 KASP markers associated to known flowering genes. In total, 34 significant QTLs were identified in both landraces and modern lines. Some QTLs had strong association with already known regulatory photoperiod genes, Ppd-A and Ppd-B and vernalization genes Vrn-A1, and Vrn3. However, these loci explained only 5 to 20% of variance for days to heading. Seven QTLs overlapped between the two germplasm groups in which Q.ICD.Eps-03 and Q.ICD.Vrn-17 consistently affected flowering time in all the pheno-environments, while Q.ICD.Eps-11 and Q.ICD.Ppd-12 were significant only in two pheno-environments and the combined analysis across all environments. These results help clarify the genetic mechanism controlling flowering time in durum wheat and show some clear distinctions to what is known for common wheat (Triticum aestivum L.)

One of the current challenges in Higher Education is the development of students’ emotional competencies, and consequently, how these competencies can be trained. Moreover, this must be addressed within the UN framework of inclusive, equitable, quality education (United Nations Agenda 2030) (SDG 4). To address this challenge, the present study set the following objectives: (1) to analyze pre-service teachers’ level of interest in EI and their perceived level of general EI knowledge, (2) to examine their self-perception of certain variables of emotional knowledge, according to their degree program and year of studies, (3) to analyze the relationship between these emotional knowledge variables and perceived emotional intelligence (EI); and (4) to study the predictive capacity of the study variables on future teachers' emotional knowledge variables. The study sample contained a total of 434 university students from three degree programs at two universities in Spain, of which 82.70% were women, and the mean age was 20.91 years. Two instruments were used: an ad hoc questionnaire, which assessed perceived emotional knowledge according to three variables (General knowledge of EI, where level of training in EI is considered; Intrapersonal knowledge of EI; and Theoretical-practical knowledge related to teaching), and the Trait Meta-Mood Scale (TMMS-24), which assesses metaknowledge of emotional states across three variables (Attention, Clarity, and Repair). Results of the study suggest that there are differences in perceived EI knowledge according to students' year of studies and according to their degree, and indicate that students present high interest, while their perceived level of knowledge is low. In addition, emotional clarity is the EI variable that was identified as being important in the emotional knowledge of future teachers. This study shows evidence of the importance of social-emotional competencies in initial teacher training.

Brugada Syndrome is a cardiac channelopathy closely related to lethal arrhythmias and sudden death in people without underlying structural pathology. The diagnosis is usually assumed with electrocardiographic patterns strictly limited to the right precordial leads, V1 or V2; but this is not so at all. In our article, we describe the clinical case of a patient with a novel and different electrocardiographic presentation: the typical diagnostic pattern was presented in a lower lead of the electrocardiogram, and next to it, another pattern was presented in a contiguous lead. In addition, we propose the possible association of a structural pathology (non-compaction cardiomyopathy) with Brugada Syndrome, since both share a possible common genetic origin in the SCN5A gene.

We propose a new binary formulation of the Travelling Salesman Problem (TSP), with which we overcame the best formulation of the Vehicle Routing Problem (VRP) in terms of the minimum number of necessary variables. Furthermore, we present a detailed study of the constraints used and compare our model (GPS) with other frequent formulations (MTZ and native formulation). Finally, we have carried out a coherence and efficiency check of the proposed formulation by running it on a quantum annealing computer, D-Wave\_2000Q6.

The global health emergency caused by multi-drug resistant bacteria has led to the search for and development of new antimicrobial agents. Phage therapy is an abandoned antimicrobial therapy that has been resumed in recent years. In this study, we mutated a lysogenic phage from Acinetobacter baumannii into a lytic phage (Ab105-2phiΔCI) showing antimicrobial activity against A.baumannii clinical strains (such as Ab177_GEIH-2000 which showed MICs to meropenem and imipenem of 32 µg/ml and 16 µg/ml, respectively as well as belonging to GEIH-REIPI Spanish Multicenter A. baumannii Study II 2000/2010, Umbrella Genbank Bioproject PRJNA422585). We then enhanced the time kill curves (in vitro) and in Galleria mellonella survival assays (in vivo) antimicrobial activity of the new lytic phage by combining it with carbapenem antibiotics (meropenem and imipenem). We observed in vitro, an antimicrobial synergistic effect (from 4 log to 7 log CFU/ml) with meropenem plus lytic phage in all combinations analysed (0.1, 1 and 10 MOI of Ab105-2phiΔCI mutant as well as 1/4 and 1/8 MIC of meropenem). Moreover, we had a decrease in bacterial growth of 8 log CFU/ml for the combination of imipenem at 1/4 MIC plus lytic phage (Ab105-2phiΔCI mutant) and of 4 log CFU/ml for the combination of imipenem at 1/8 MIC plus lytic phage (Ab105-2phiΔCI mutant) in both MOI 1 and 10. These results were confirmed in in vivo (G. mellonella) obtaining a higher effectiveness in the combination of imipenem and Ab105-2phiΔCI mutant (P<0.05 by Log Rank-Matel Cox test). This approach could help to reduce the emergence of phage resistant bacteria and restore sensitivity to the antibiotics when used to combat multiresistant strains of Acinetobacter baumannii.

An evaluation of image contrast in a controlled foggy environment has been made by comparison between intensity imaging and different modes of polarimetric imaging. A small-scale fog chamber has been designed and constructed to create the necessary controlled foggy environment. A linear polarimetric camera of division of focal plane and a linearly polarized light source has been used for performing the experiments with polarized light. In order to evaluate the image contrast of the different imaging modes, the Michelson’s contrast of samples of different materials relative to their background has been calculated. The higher the image contrast, the easier is to detect and segment the targets of interest that are surrounded by fog. It has been proved quantitatively that in the studied situations polarimetric images present an improvement in contrast when compared to conventional intensity images.

Indoleamine 2,3-dioxygenase 1 (IDO1) and IDO2, originated from gene duplication before vertebrate diver-gence. While IDO1 has a well-defined role in immune regulation, the biological role of IDO2 remains unclear. Discovered in 2007, IDO2 is located near the IDO1 gene. Because of their high sequence similarity, IDO2 was initially thought to be a tryptophan (Trp)-degrading enzyme like IDO1. Differently from what expected, IDO2 displays extremely low catalytic activity toward Trp. Nevertheless, many studies, often contradictory, tried to demonstrate that IDO2 modulates immune responses by catabolizing Trp into kynurenine, a hypothesis un-convincing and, let’s say, linked to the first life of IDO2. Here, we review its “new life”, the one in which IDO2 has a functional role beyond Trp metabolism. The IDO2’s evolutionary persistence across species, despite be-ing almost inactive as an enzyme, suggests it has some relevant biological importance. IDO2 expression in human normal cells is poor, but significant in various cancers, with two prevalent SNPs. Overall, the com-parison of IDO2 to IDO1 as a Trp-degrading enzyme may have led to misunderstandings about IDO2’s true physiological and pathological roles. New insights suggest that IDO2 might function more as a signaling molecule, particularly in cancer contexts, and further studies could reveal its potential as a target for cancer therapy.

Coronavirus Disease-2019 (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). There is sufficient experimental evidence to confirm that SARS-CoV-2 infection produces states of ciliary and flagellar dysfunction. However, these studies are unable to explain the observed effects molecularly, because they lack a sufficient understanding of the interaction between human proteins and virus proteins. Using the physical-chemical study of the human interactome in interaction with the SARS-CoV-2 proteome, we found evidence of interactions to explain the experimental effects from a molecular perspective. We found that ten viral proteins interact with key components in the maintenance of the molecular structure of axoneme. Additionally, we evaluated the pulmonary and extrapulmonary pathogenesis of COVID-19 from the point of view of ciliary dysfunction, and warned about other possible complications such as episodes of transient infertility that, due to the limitations of our work, would need verification.

Despite gender equality being present in the social and political sphere, we still encounter aspects that are characteristic of sexism. Such aspects impact upon gender inequality and different types of violence towards women. The present article aims to examine the behaviour of adolescents from Huelva with regards to ambivalent sexism towards women on social networks and their influence on health. Further, we seek to uncover adolescent’s perceptions with regards to gender differences in the use of social networks, the relationship between sexism and women's emotional well-being was observed. The study sample was formed by young people aged between 14 and 16 years who were residing in rural and urban zones in the south of Spain. A mixed methods approach was taken. At a quantitative level, a sample of 400 young people was recruited. These were administered a questionnaire about sexism which was composed of two scales and has been validated at a national and international level. At a qualitative level, the study counted on 33 young people who participated in in-depth discussions via interviews and discussion groups. The results showed that sexism emerges in adolescence in the analysed sample from the south of Spain. This favoured a digital gender gap and was reinforced through social networks such as Instagram and Snapchat. Rising awareness and a critical view of the aforementioned sexism was shown on the behalf of females, particularly those from urban backgrounds.

Tongue mobility is an obstructive sleep apnoea (OSA) marker and myofunctional therapy (MFT) target. For this reason, all patients with sleep-disordered breathing should require a combined functional assessment from an ear, nose, and throat (ENT) specialist and a phonoaudiologist to confirm or rule out the presence of tongue-tie. To our knowledge, this is the first case of a 13-year-old girl diagnosed with severe OSA and a significant decrease of 94% in her apnoea index (AI), requiring frenotomy with immediate postoperative change in the tongue position. A drug-induced sleep en-doscopy (DISE) was performed before and immediately post-frenotomy, and the anatomical changes provoked by this surgery during sleep were confirmed for the first time.

Aging involves several changes depending on genetic and behavioural factors, such as lifestyle and number and quality of social relationships, which in turn can be influenced by empathy. Here, the change in the perceived social support across the life span as a function of empathy was investigated, considering the mediating role of the empathy, after controlling for gender and education. 441 people (18-91 years old) filled in the Italian short version of the Interpersonal Support Evaluation List (ISEL-12) and the Social Support Questionnaire (SSQ6) as well as the Empathy Questionnaire (EQ) and the Reading the Mind in the Eyes test (RMET). The mediation analyses with ISEL-12 showed that age and the EQ fully mediated the relationship between age and Appraisal, Belonging and Tangible scores. Further, the EQ fully mediated only the relationship between age and SSQ6-People. These results showed that empathic skills play a key role in the relationships between age and social support. This suggests: empathy can trigger social support and ultimately well-being if stimulated across the lifespan, especially since young age; this would help to form the socio-emotional competence across the years, as a sort of cushion that can be useful in the elderly to fulfil active aging.

Oral mucosa is a key player in the cancer patient and during cancer treatment. The increasing prevalence of cancer and cancer therapy associated side effects are behind the major role that oral mucosa plays in the oncological patient. Oral mucositis is a debilitating severe complication caused by early toxicity of chemo and/or radiotherapy that can restrict treatment outcome possibilities, even challenging patient’s survival. It has been referred to as the most feared cancer treatment complication. Predictive variables as to who and to what extent will be affected are still unclear. Additionally, oral mucositis is one of the sources of the increasing economic burden of cancer, not only for patients and their families but also for institutions and governments. All efforts should be implemented in the search for new approaches to minimize the apparently ineluctable outburst of oral mucositis along the cancer treatment. New perspectives derived from different approaches in explaining the interrelation between oral mucositis and oral microbiome or the similarities with genitourinary mucosa may help elucidate the biomolecular pathways and mechanisms behind oral mucosa cancer-therapy related toxicity and what is more important its management in order to minimize treatment side effects and to provide enhanced cancer support.

In the last years, different biotechnological approaches were developed to reduce the indiscriminate use of chemical fertilizers and pesticides and enhance plant growth and health. The most attractive, safe, and environmentally mild alternatives include those based on plant beneficial microorganisms. After a long period of studies on isolation, selection, and characterisation of plant-beneficial microorganisms, the main lines of research have been oriented to optimising the fermentation processes to produce high-quality and large volumes of biomass/spores and their further formulation. However, further well-structured schemes for improvement of all main steps of the production of bio-formulates should be developed following the ideas based on “healthy soil-healthy plants-healthy humans”.

Background: Protein CCDC186 is involved in the maturation of dense core vesicles in the trans-Golgi network in neurons and endocrine cells. To date, only one patient, within a large sequencing study of 1000 cases, and a single case report with variants in CCDC186 had previously been described. However, no functional studies in any of these two cases had been performed. Methods: Exome sequencing from one affected individual of each family was performed. In addition, Sanger sequencing of the parents and one of the affected siblings was also performed. CCDC186 protein was assessed in cultured fibroblasts or muscle tissue by western blot. Transcriptomic analysis was done by means of RNA sequencing. Results. We identified three patients from two gypsy families, unrelated to each other, with the same homozygous mutations in CCDC186 gene. Clinically, all patients presented with seizures, frontotemporal atrophy, hypomyelination, recurrent infections, and endocrine disturbances such as severe non ketotic hypoglycemia. Low levels of cortisol, insulin or growth hormone could only be verified in one patient. All of them had a neonatal onset and died between 7 months and 4 years of age. WES identified a homozygous variant in CCDC186 gene (c.2215C>T, p.Arg739Ter) in the index patients of both families. Protein expression studies demonstrated that the CCDC186 was practically undetectable in fibroblasts and muscle tissue. These observations correlated perfectly with the transcriptomic analysis performed in fibroblasts in one of the patients, which showed a significant reduction of CCDC186 mRNA levels. Conclusion. Our study provides functional evidence that mutations in this gene have a pathogenic effect on the protein and reinforces CCDC186 as a new disease-associated gene. In addition, mutations in CCDC186 could explain the combined endocrine and neurologic alterations detected in our patients

The variety of risks due to climate change with a potential impact on Cultural Heritage CH requires a multidisciplinary approach and a preliminary overview of the existing methods for risk analysis and assessment in different fields. Thus, the starting point of the research conducted by the Sapienza PNRR working group consists in a systematic literature review of risk assessment approaches, methods and indicators. As a first outcome, the research has designed a multidisciplinary comprehensive framework consisting of the definition of risk categorization, the framework represented by a measurable index and the main target, according to the classification of Cultural Heritage based on the harmonization of European vocabularies definitions and protocols. The risk assessment framework sets the methodological core of a future multi criteria matrix and digital platform for decision focused on the historic built environment and it is functional to the definition of specific operational guidelines connected to each risk for elaborating descriptive/predictive Architectural Heritage’s transformation scenarios to support the development of mitigation and adaptation strategies.

Glioblastoma (GBM) is the most common primitive tumor in adult central nervous system (CNS), classified as grade IV according to WHO 2016 classification. GBM shows a poor prognosis with an average survival of approximately 15 months, representing an extreme therapeutic challenge. One of its distinctive and aggressive features is aberrant angiogenesis, which drives tumor neovascularization, representing a promising candidate for molecular target therapy. Although several pre-clinical studies and clinical trials have shown promising results, anti-angiogenic drugs have not led to a significant improvement in overall survival (OS), suggesting the necessity of identifying novel therapeutic strategies. Metformin, an anti-hyperglycemic drug of the Biguanides family, used as first line treatment in Type 2 Diabetes Mellitus (T2DM), demonstrated in vitro and in vivo antitumoral efficacy in many different tumors, including GBM. From this evidence, a process of repurposing of the drug has begun, leading to the demonstration of the inhibition of various oncopromoter mechanisms and, consequently, to the identification of the molecular pathways involved. Here, we review and discuss the potential metformin’s antitumoral effects on GBM, inspecting if it could properly act as an anti-angiogenic compound to be considered as a safely add-on therapy in the treatment and management of GBM patients.

Background: Ceftobiprole is a fifth-generation cephalosporin that has been approved in Europe solely for the treatment of community-acquired and nosocomial pneumonia. The objective was to analyze the use of ceftobiprole medocaril (Cefto-M) in Spanish clinical practice in patients with infection in hospital or outpatient parenteral antimicrobial therapy (OPAT). Methods: This retrospective, observational, multicenter study included patients treated from September 1, 2021 to December 31, 2022. Results: 249 individuals were enrolled, aged 66.6±15.4 years, 59.4% male, with Charlson index of 4 (IQR 2-6); 13.7% had COVID-19, and 4.8% were in intensive care unit (ICU). The most frequent type of infection was respiratory (55.8%), followed by skin and soft tissue infection (21.7%). Cefto-M was administered to 67.9% as empirical treatment, being in monotherapy for 7 days (5-10) in 53.8% of cases. The infection-related mortality was 11.2%.The highest mortality rates were for ventilator-associated pneumonia [40%], and infections due to methicillin-resistant S. aureus (20.8%) and Pseudomonas aeruginosa (16.1%). Mortality-related factors were age (OR: 1.1, 95%CI [1.04-1.16]), ICU admission (OR:42.02, 95%CI[4.49-393.4]), and sepsis/septic shock (OR:2.94, 95%CI [1.01-8.54]).Conclusions: In real life, Cefto-M is a safe antibiotic, with only half of prescriptions in respiratory infections, mainly administered as rescue therapy in pluripathological patients with severe infectious diseases.

Career guidance needs new perspectives considering challenges that characterized our future, and it can not exist without solidarity, inclusion, and attention to the environmental challenges. It also should be able to positively influence stakeholders to invest in the values of the 2030 Agenda recently proposed by the United Nations and their encouragement to think about some emergencies that the new generations will have to face in the future. Based on these premises, we designed and validated a sustainable career guidance intervention for high school students. Participants (N = 75) were assigned to an experimental or a control group. All participants responded pre- and post-intervention to measure career adaptability, training, and future investment, and wishes about the feature. The students from the sustainable career intervention group increased in post-intervention scores on control, curiosity, confidence, and training and future investment. They also indicated future wishes that take into more account attention to relationships and social challenges.

Introduction: The HIV/AIDS pandemic in Spanish prison institutions has led to a series of necessary changes to adapt and provide an effective response. Materials and Methods: This research was conducted from an interpretative paradigm with a phenomenological perspective, interpreting the experiences of nursing professionals in Spanish prison institutions. Focus groups were conducted with professionals who worked before and after the emergence of antiretroviral treatments through the Microsoft Teams platform, using the ATLAS Ti v.9 software. The project received approval from the Ethics Committee of the UJI university. Results: Limited dissemination of news in the press regarding HIV/AIDS and Spanish prisons was observed. Changes occurred in organizational, material, and personnel resources, requiring adaptation among nursing professionals. The available resources and difficulties are described, along with patient perspectives, the role of professionals, their environment, and their experiences, both positive and negative. Discussion and Conclusions: There is minimal visibility of the problem, and a description is provided of an adaptation process to the environment compatible with the Callista Roy´s model.

In this study, we aimed to identify the features of indeterminate choroidal melanocytic lesions visualized on optical coherence tomography angiography (OCTA) and to identify predictors of growth. We retrospectively evaluated 86 patients with indeterminate lesions treated at our cen-tre from 2016 to 2021. Clinical management involved active surveillance followed by brachy-therapy if growth was detected. The lesions were classified into two groups according to wheth-er they grew (small melanomas) or remained stable (choroidal nevi). Growth was detected in 19 (22.1%) lesions. All patients underwent OCTA at baseline. These images were compared to iden-tify possible predictors of growth. Significant between-group differences were observed in thickness (p=0.00), greatest basal diameter (p=0.00), number of risk factors (p=0.00), symptoms (p=0.001; relative risk [RR]: 4.3), orange pigment (p=0.00; RR: 6.02), and ultrasonographic hol-lowness (Kappa sign); p=0.000; RR: 5.3). The melanomas had significantly more vessels with a diameter ≥ 76.3 µm (p=0.02; RR: 2.46). The time to growth in these lesions was significantly shorter (p=0.05) than in lesions with smaller vessels. These findings show that vessel diameter quantified by OCTA can differentiate between choroidal nevi and small melanomas, especially when considered together with clinical risk factors.

We present a case report of a young patient with pectus carinatum who experienced a small right apex pneumothorax and exhibited Brugada patterns on electrocardiogram tracing. This is the first clinical case reporting Brugada pattern presentation in both a patient with pectus carinatum and a small pneumothorax. We conducted a clinical, anatomical, and electrocardiographic analysis to explore a physiopathological explanation for these findings, considering our patient had no history or clinical signs of Brugada Syndrome. We conclude that: 1. Pectus carinatum may create a window that facilitates the less resistive measurement of cardiac action potentials; 2. Small pneumothoraces can induce modifications in the cardiac electrical signal detected by surface electrodes, and pectus carinatum could unmask these modifications; and 3. Surface electrodes may measure subepicardial potentials that include and are modified by adjacent pericardial tissues, potentially resulting in alterations in transmural potential differences, thus producing fictitious Brugada patterns. Similarly, there is a possibility that the right ventricular outflow tract may be included within the subendocardial potentials.

Two antimicrobial agents such as silver nanoparticles (AgNPs) and titanium dioxide (TiO2) have been formulated with natural polysaccharides (chitosan or alginate) to develop innovative inks for the rapid, customizable, and extremely accurate manufacturing of 3D printed scaffolds useful as dressings in the treatment of infected skin wounds. Suitable chemical-physical properties for the applicability of these innovative devices were demonstrated through the evaluation of water content (88-93%), mechanical strength (Young’s modulus 0.23-0.6 MPa), elasticity, and morphology. The antimicrobial tests performed against Staphylococcus Aureus and Pseudomonas Aeruginosa demonstrated the antimicrobial activities against Gram+ and Gram– bacteria of AgNPs and TiO2 agents embedded in the CH or ALG macroporous 3D hydrogels (AgNPs MIC starting from 5 µg/ml). The biocompatibility of chitosan was widely demonstrated by cell viability tests and was higher than that observed for alginate. Constructs containing AgNPs at 10 µg/ml concentration level did not significantly alter cell viability as well as the presence of titanium dioxide; cytotoxicity towards human fibroblasts was observed starting with AgNPs concentration of 100 µg/ml. In conclusions, the 3D printed dressings here developed own the features to be cheap, highly defined, easy to be manufactured and further applied in personalized antimicrobial medicine applications.

The patellofemoral joint (PFJ) is a complex articulation between the patella and the femur, in-volved in the extensor mechanism of the knee. Patellofemoral disorders can be classified into ob-jective patellar instability, potential patellar instability, and patellofemoral pain syndrome. An-atomical factors such as trochlear dysplasia, patella alta, and tibial tuberosity-trochlear groove (TT-TG) distance contribute to instability. Patellofemoral instability can result in various types of dislocations, and the frequency of dislocation can be categorized as recurrent, habitual, or per-manent. Primary patellar dislocation requires diagnostic framing, including physical examina-tion and imaging. Magnetic resonance imaging (MRI) is essential for assessing the extent of damage, such as bone bruises, osteochondral fractures, and medial patellofemoral ligament (MPFL) rupture. Treatment options for primary dislocation include urgent surgery for oste-ochondral fragments or conservative treatment for cases without lesions. Follow-up after treat-ment involves imaging screening and assessing principal and secondary factors of instability. Detecting and addressing these factors is crucial for preventing recurrent dislocations and opti-mizing patient outcomes.

Vitamin D receptor (VDR) is an important candidate gene in musculoskeletal phenotypes. Polymorphisms in VDR have been previously associated with several pathologies and muscular strength in athletes and elderly people, however literature reported contradictory results. The object of this research is to verify the association between the most studied VDR variants (rs2228570, rs7975232, and rs1544410) and the increase of muscle mass in elite young soccer players. A sample of 55 soccer players (15-18 years old) form a professional team was selected for this study. DNA was extracted by salting out method and polymorphisms were genotyped by PCR-RFLP, followed by 2% agarose gel electrophoresis. To test the effect of the three SNPs, logistic regression analysis was applied. Body composition was carried out through skinfold thickness method, and muscular area of arm and lower limb were calculated using Frisancho formulas. All three polymorphisms met Hardy-Weinberg equilibrium (p &gt; 0.05) and their frequencies fell within the worldwide variability. A significant correlation between rs1544410 and increase of calf muscle mass was observed. Individuals carrying A allele showed higher calf muscular mass than those carrying the G allele (p = 0.034). Moreover, haplotype analysis applied to the two SNPs in linkage disequilibrium (rs7975232 and rs1544410), showed that AG haplotype resulted negatively correlated to calf muscle area. In conclusion, we confirm an association between VDR polymorphisms and muscular mass that could encourage the genetic screening of VDR gene to identify a potential risk of injury and for individual nutritional interventions.

Cardiovascular disease (CVD), a group of disorders affecting the heart or blood vessels, are the primary cause of death worldwide, with an immense impact on patient quality of life and disa-bility. According to the World Health Organization, CVD takes an estimated 17.9 million lives each year, where more than four out of five CVD deaths are due to heart attacks and strokes. In the decades to come, increased prevalence of age-related CVD, such as atherosclerosis, coronary artery stenosis, myocardial infarction (MI), valvular heart disease, and heart failure (HF) will contribute to even greater health and economic burden as the global average life expectancy increases and consequently the world’s population continues to age. Considering this, it is important to focus our research efforts on understanding the fundamental mechanisms underlying CVD. In this review, we focus on cellular senescence and mitochondrial dysfunction, which have long been established to contribute to CVD. We also assess the recent advances in targeting mitochondrial dysfunction and senescence with a focus on therapies that influence both and therefore perhaps represent strategies with the most clinical potential, range, and utility.

Labyrinth seals are commonly used in turbomachinery in order to control leakage flows. Flutter is one of the most dangerous potential issues for them, leading to High Cycle Fatigue (HCF) life considerations or even mechanical failure. This phenomenon depends on the interaction between aerodynamics and structural dynamics; mainly due to the very high uncertainties regarding the details of the fluid flow through the component, it is very hard to predict accurately. In 2014, as part of the E-Break research project funded by the European Union (EU), an experimental campaign regarding the flutter behaviour of labyrinth seals was conducted at Centro de Tecnologias Aeronauticas (CTA). During this campaign, three realistic seals were tested at different rotational speeds, and the pressure ratio where the flutter onset appeared was determined. The test was reproduced using a linearized uncoupled structural-fluid methodology of analysis based on Computational Fluid Dynamics (CFD) simulations, with results only in moderate agreement with experimental data. A procedure to adjust the CFD simulations to the steady flow measurements was developed. Once this method was applied, the matching between flutter predictions and the measured data improved, but still some discrepancies could be found. Finally, a set of simulations to retain the influence of the external cavities was run, what further improved the agreement with testing data.

The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back-squat exercise. Methods: Twenty-four university students participated in this study. In two randomized 72-hours apart sessions, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back-squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity [MPV], peak concentric velocity [Vmax] and the effort index [EI]). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs. Results: BFR condition showed higher (p&lt;0.05) EI, peak and rooted mean square normalized EMG in set 1 compared to set 2. Similar MPV and Vmax were observed at each set for both BFR and control conditions. No significant differences were observed between conditions at any set. Conclusions: BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less activation of the muscles involved.

Atrial fibrillation (AF) is an increasingly recognized comorbidity in patients with can-cer. Indeed, cancer patients have a significantly higher incidence of AF than that ob-served in the general population. A reciprocal relationship between these two diseases has been observed, as much as some assume AF as a marker for occult cancer screen-ing, especially in older adults. The pathophysiological mechanisms are many and var-ied, including the underlying pro-inflammatory state, specific treatments (chemo and radiotherapy) and surgery. The therapeutic management of patients with cancer and AF involves the same rhythm and frequency control strategies as the general popula-tion; however, the numerous interactions with chemotherapeutics, which lead to a sig-nificant increase in side effects, as well as the extreme fragility of the patient should be considered. Anticoagulant therapy is also a complex challenge to address, as bleeding and stroke risk scores have not been fully assessed in this subpopulation. Furthermore, in large studies establishing the efficacy of direct oral anticoagulants (DOACs), cancer patients have been underrepresented. In this review, we elaborate on mechanisms linking AF to cancer patients with a particular focus on therapeutic challenges in this population.

Copper-nitride (Cu3N) semiconductor material is attracting much attention as a potential, next-generation thin-film solar-light absorber in solar cells. In this communication, polycrystalline Cu3N thin films were prepared using reactive-RF-magnetron-sputtering deposition, at room temperature, onto glass and silicon substrates. The very-broadband optical properties of the Cu3N thin film layers were studied by UV-MIR (0.2-40 μm) ellipsometry and optical transmission, to be able to achieve the goal of a low-cost absorber material to replace the conventional silicon. The reactive-RF-sputtered Cu3N films were also investigated by focused ion beam scanning electron microscopy, and both FTIR and Raman spectroscopies.

Critical sized bone defects and articular cartilage injuries resulting from trauma, osteonecrosis or age-related degeneration are often nonhealing by the physiological repairing mechanisms, thus representing a clinic issue due to the relevant epidemiological incidence. Current treatment approaches consist of autologous or allogenic grafting, which are associated with painfulness, morbidity, risk of infections and rejection. Novel tissue-engineering approaches, aiming at the reconstruction of damaged tissues, have been proposed as alternative solutions to these conven-tional methods. These approaches are based on the combination of three fundamental compo-nents: autologous or allogenic cells, a scaffold and growth-stimulating signals, which are gener-ally referred to as the tissue engineering triad. Three-dimensional polymer networks are fre-quently used as scaffolds to allow cell proliferation and tissue regeneration. In this scenario, cryogels are giving promising results as cell scaffolds over other polymer networks, thanks to their peculiar properties. In particular, cryogels possess an interconnected porous structure and a typical sponge-like behaviour, which facilitate the cellular infiltration and ingrowth. Their properties can be appropriately adjusted to match the requirements of the specific tissue or or-gan that it is intended to regenerate. In this review it is reported the state of the art on the fabri-cation and employment of cryogels in supporting osteo or chondro-genic differentiation for the re-building of more organized tissues. Moreover, it will highlight current progress and future perspectives in the implementation of this technology in the clinical practice.

The alcoholic fermentation process with agitation/static, followed by the acetic fermentation submerged in banana was evaluated. Kinetics parameters of alcoholic fermentation for the maximum ethanol/glycerol metabolites in agitated process was 29 and 27 h, and in static 47 and 45 h, respectively. For acetic fermentation, the kinetics parameters were medium time of 39.9 h, acetic acid yield of 53.1% and acetic acid productivity of 0.216 g/Lh. Wines from agitated/static process presented 5.73 and 6.81% (v/v) of alcohol content, respectively. Wine obtained by the static process presented higher concentrations of volatile compounds. The vinegar showed 49.2 g/L of acetic acid and the esters concentrations were higher than in wine. The wine and vinegar minerals were consistent with amount observed in the pulp, with an increase in sulphur concentration after alcoholic fermentation and decrease after acetic fermentation. Products showed chemical and composition of sensory and nutritional interest.

The unstable international economic situation is reflected in the supply chain stress, lack or increased cost of some raw materials, fuel or semi-finished products is forcing organizations to perform new optimization initiatives in the utilization of their equipment and assets pointed to obtain the maximum value from them, while maintaining and even improving the quality of their products. The achievement of these objectives involves the reduction or minimization of equipment downtime to maintain the advantage over their competitors and ensure the organization's competitiveness. The intelligent maintenance system (IMS) provides adequate support for decision-making related to equipment maintenance, since poor maintenance results in unplanned stoppages, with the consequent additional cost and increased customer dissatisfaction, and an over-maintenance can result in an additional labor cost, time and the replacement of parts that are in good conditions. The utilization of new tools and technologies introduced by Industry 4.0 offers multiple opportunities for enhancement through communication and computerized data processing, aiming to improve the maintainability of a hydrogen compressor using neural networks based on attention mechanisms combined with linear regression.

Individual response to drugs is highly variable and largely influenced by genetic variants and gene-expression profiles. Also, it has been shown that response to drugs is strongly sex-dependent, both in terms of efficacy and toxicity. To expand current knowledge on sex differences in the expression of genes relevant for drug response, we generated a catalogue of differentially expressed human transcripts encoded by 289 genes in 41 human tissues from 838 adult individuals of the Genotype-Tissue Expression project (GTEx, v8 release) and focused our analysis on relevant transcripts implicated in drug response. We have detected significant sex-differentiated expression of 99 transcripts encoded by 59 genes in the tissues most relevant for human pharmacology (Liver, Lung, Kidney, Small intestine terminal ileum, Skin not sun-exposed, and Whole Blood). Among them, as expected, we observed significant differences in the expression of transcripts encoded by the cytochromes in the liver, CYP2B6, CYP3A7, CYP3A5, and CYP1A1. Our systematic investigation on differences between male and female in the expression of drug response related genes, reinforce the need to overcome the sex bias of clinical trials.

Bacteria can colonize and develop biofilm on a large variety of biotic and abiotic materials, it is accountable for nosocomial infections and chronic illness and consequently, it is a serious economic and public health problem. Staphylococcus epidermidis, thanks to its ability to form biofilm and colonize biomaterials, represents the most frequent causative agent involved in bio-film-associated infections of medical devices. Due to the biofilm presence, S. epidermidis infections are extremely difficult to treat and the research of new molecules able to interfere with its biofilm formation has a remarkable interest. In the present work, the attention was focused on Pseudomonas sp. TAE6080, an Antarctic marine bacterium able to produce and secrete an effective antibiofilm compound. The molecule responsible for this activity was purified by an activity-guided approach and it resulted to be a periplasmic protein, named Cold-Azurin. The Cold-Azurin was recombinantly produced in E. coli and purified. The recombinant protein was able to impair S. epidermidis attachment to the polystyrene surface and effectively prevent biofilm formation.

Abstract: Panfacial fractures are complex injuries involving multiple regions of the facial skele-ton simultaneously, which may necessitate multiple surgeries over a relatively short period. They are often associated with polytrauma and other injuries including brain trauma, which re-quire either immediate airway management, prolonged intubation, or repeated intubations for staged surgeries. Given the frequent need for intermaxillary fixation and the potential involve-ment of the central nasal complex or skull base, conventional oro-tracheal or nasotracheal intu-bation often presents challenges. Submental intubation is the most reported method of airway management with the aim to avoid tracheostomy and its related complications. A review of the different techniques of airway management in the elective treatment of panfacial fractures was performed focusing on the advantages and disadvantages of each method. Most of the literature consisted of retrospective studies, with only one prospective study comparing submental intu-bation to tracheostomy in panfacial fractures. There is abundant literature that favours the sub-mental intubation for its rapid establishment and low complication rate. Other techniques less reported were retromolar intubation, nasotracheal to orotracheal switch, tracheostomy or crico-thyroidotomy. An algorithm for the management of the airway in panfacial fractures is pre-sented.

The review of previous works shows this study is the first attempt to analyse the lockdown effect using Natural Language Processing Techniques, particularly sentiment analysis methods applied at large scale. On the other hand, it is also the first of its kind to analyse the impact of COVID 19 on the university community jointly on staff and students and with a multi-country perspective. The main overall findings of this work show that the most often related words were family, anxiety, house and life. On another front, it has also been shown that staff have a slightly less negative perception of the consequences of COVID in their daily life. We have used artificial intelligence models like swivel embedding and the Multilayer Perceptron, as classification algorithms. The performance reached in terms of accuracy metric are 88.8% and 88.5%, for student and staff respectively. The main conclusion of our study is that higher education institutions and policymakers around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.

Keywords: standing water bodies, glacial lakes, freshwater biodiversity, eutrophication; nature conservation network

In this paper we use the Mellin convolution theorem, which is related to Perron's formula. Also we introduce new explicit formulae for arithmetic function which generalize the explicit formulae of Weil for other arithmetic functions different from the Von-Mangoldt function.

Salmon aquaculture generates a substantial volume of waste material, offering potential for biomaterial production. This industry produces significant waste, which can be repurposed for various biological applications, particularly in biomaterial production for tissue engineering with pertinent applications in osteo-conduction, osteo-induction, and clinical/surgical bone regeneration and repair. The process involves a standardized pre-treatment stage aimed at minimizing biological waste content. Subsequently, the treatment stage, contingent on the chosen methodology, facilitates the removal of proteins, lipids, molecules, and other compounds, leaving the mineral phase as a valuable substrate. The selection of the optimal method, whether alkaline hydrolysis, calcination, or NaOH hydrolysis, for obtaining this substrate necessitates thorough examination through chemical, physical, and biological assessments, including Raman Spectroscopy and X-Ray Diffraction. This study aims to identify the most efficient laboratory process for biofunctional nano-sized hydroxyapatite mineral production derived from Chilean salmon fish backbone waste.

This paper presents a) the novel hybrid learning method to train the type-1 non-singleton interval type-3 (IT3) fuzzy logic systems (IT3 NSFLS-1) and b) the novel method named enhanced Wagner-Hagras (EWH) IT3 NSFLS-1 fuzzy systems which includes the level alpha 0 output to calculate the output y alpha using the average of the outputs y alpha k instead of their weighted average. The development of the proposed methodology uses the orthogonal least square (OLS) method to train the consequent parameters and the back propagation (BP) method to train the antecedent parameters. This proposal dynamically changes the parameters of only the level alpha 0 minimizing some criterion function as new information becomes available to each level alpha k. The antecedent sets are type-2 fuzzy sets, the consequent sets are fuzzy centroids, the inputs are type-1 non-singleton fuzzy numbers with uncertain standard deviations, and the secondary membership functions are modeled as two Gaussians with uncertain standard deviation and the same mean. Based on the firing set of the level alpha 0, the proposed methodology calculates each firing set of each level alpha k to dynamically construct and update the EWH IT3 NSFLS-1 (OLS-BP) system. The algorithm was tested in a hot strip mill facility to predict the transfer bar surface temperature showing its superior capability to obtain the industrial pyrometer’s knowledge uncertainty for tuning and its better performance when compared with IT2 SFLS, IT2 NSFLS-1, GT2 SFLS, GT2 NSFLS-1, IT3 SFLS, and IT3 NSFLS-1 trained with the BP-BP algorithm.

Development of biomarkers of analytes with interest in clinic is an important field of study. In this work, we synthesized and analyzed the new fluorescent acetate-biomarker, Iso-PG. The mechanism of detection is the acetate buffer mediated proton transfer reaction. The rate constants involved were obtained, and we measured the change in the fluorescence lifetime produced as a consequence of the presence of acetate in the medium. Finally, we checked its potential use as acetate biomarker in synthetic serum

One of the IRDiRC goals for 2017-2027 is to achieve definitive diagnosis for rare undiagnosed diseases within one year, as diagnosis delay remains one of the pending issues in the rare diseases field. The Spanish Undiagnosed Rare Diseases Program (SpainUDP) was created in response to this challenging scenario to cover patients’ needs and after seeing the success of the UDP in USA. SpainUDP offers a multidisciplinary approach to those patients who have long sought a diagnosis without any success. During a first phase of the protocol, undiagnosed cases are sent to SpainUDP by individual patients, patient organizations or hospitals. After a carefully analysis of phenotype, data from sequencing experiments (WES) is processed with a standard pipeline and a detailed standardized phenotypic information (mapped to HPO) is connected to genetic data. In addition, the participation of SpainUDP in international initiatives such as the European projects RD-Connect and Solve RD, the Undiagnosed Diseases Network International (UDNI), and the MatchMaker Exchange platform, allows the establishment of a global data sharing strategy across multiple projects submitting data to these international initiatives. From the official beginning of the program (at the end of 2015) until early 2018, 147 cases were accepted in SpainUDP. During this time, 37 cases (25 %) dropped out the program due to several reasons. The remaining 110 cases are distributed as follows: phenotypic and genotypic (WES) characterization was finished in 30 cases, of which 20 (67 %) were diagnosed; 21 cases are pending on variants validation by Sanger; in 25 cases, WES is ongoing and 34 cases are in a deep phenotypic characterization. As a conclusion, SpainUDP aims to achieve a diagnosis following two recommendations of the IRDiRC: the patients’ diagnosis in a period of time as short as possible and the promotion of data sharing (especially genomic) at the international level.

One of the biggest threats we face globally is the emergence of antimicrobial resistant (AMR) bacteria, which runs in parallel with a lack in the development of new antimicrobials. Among these AMR bacteria, pathogens belonging to the ESKAPE group can be highlighted (Enterococcus spp, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp) due to their profile of drug resistance and virulence. Therefore, innovative lines of treatment must be developed for these bacteria. In this review, we summarize the different strategies for the treatment and study of molecular mechanisms of AMR in the ESKAPE pathogens based on the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and CRISPR-associated (Cas) proteins' technologies: loss of plasmid or cellular viability, random mutation or gene deletion as well directed mutations that lead to a gene's loss of function.

The international literature shows a polarised debate on the impacts of climate change on migration. Some studies find a positive linkage, whereas others find a negative one. It is, without a doubt, a complex process better considered case-specific. There is no available information on the relationship between climate change and migration in Colombia, despite past research exploring each of these subjects independently. This study intends explicitly to investigate this linkage gap. Consequently, this paper's essential contribution is that it builds a bridge between climate change scenarios and migratory science for the first time in Colombia. Despite their limitations, the theoretical and methodological framework suggested by IOM (2009b pp. 86, Section B, Chapter II) is demonstrated in this study to be very valid since it provides a methodology to predict where future flows will occur (based on past evidence). The methodological approaches of SLA and NELM explained in section A in the IV Chapter are also valuable for analysing and approaching this study's conclusions. The primary conclusions of this study indicate that the "Coffee Region," Valle, and Atlantic (or Caribbean Coast) provinces that mainly send emigrants to Spain and the US are the key internal regions responsible for most of the international migration from Colombians. The same areas are especially vulnerable to the impacts of upcoming climate change in the A1B scenario produced by the IDEAM (2010) for 2040 and 2100. Thus, future flows of migrants are expected from these regions (2040-2100). However, issues such as visa requirements or the costs associated with migration constitute international barriers to this flow. The sensitivity of these regions can also be associated with internal migration flows, more armed conflict, and forced displacement in a cyclical process. Theoretically, a resurgence of Colombia's armed conflict and displacement due to climate change can be expected. However, the need for empirical studies in Colombia to support this analysis is imperative and is the most crucial recommendation arising from this study.

In this work, an embroidered textile moisture sensor is presented. The sensor is based on a capacitive interdigitated structure embroidered on a cotton substrate with an embroidery conductor yarn composed by 99% pure silver plated nylon yarn 140/17 dtex. In order to evaluate the sensor sensitivity, the impedance of the sensor has been measured by means of a LCR meter from 20 Hz to 20 kHz on a climatic chamber with a sweep of the relative humidity from 25% to 65% at 20 ºC. The experimental results show a clear and controllable dependence of the sensor impedance with the relative humidity. Moreover, the reproducibility of the sensor performance subject to the manufacturing process variability and washing process is also evaluated. The results show that the manufacturing variability introduce a moisture measurement error up to 4%. The washing process impact on the sensor behavior after applying the first washing cycle implies a sensitivity reduction higher than 14%. Despite these effect, the textile sensor keeps its functionality and can be reused in standard conditions. Therefore, these properties point out the usefulness of the proposed sensor to develop wearable applications on health and fitness scope including the user needs to have a life cycle longer than one-time use

Primary congenital glaucoma (PCG) is a heterogeneous, inherited, and severe optical neuropathy caused by apoptotic degeneration of the retinal ganglion cell layer. Whole-exome sequencing analysis of one PCG family identified two affected siblings who carried a low-frequency homozygous nonsense GUCA1C variant (c.52G>T/p.Glu18Ter/rs143174402). This gene encodes GCAP3, a member of the guanylate cyclase activating protein family, involved in phototransduction and with a potential role in intraocular pressure regulation. Segregation analysis supported the notion that the variant was coinherited with the disease in an autosomal recessive fashion. GCAP3 was detected immunohistochemically in the adult human ocular ciliary epithelium and retina. To evaluate the ocular effect of GUCA1C loss-of-function, a guca1c knockout zebrafish line was generated by CRISPR/Cas9 genome editing. Immunohistochemistry demonstrated the presence of GCAP3 in the non-pigmented ciliary epithelium and retina of adult wild-type fishes. Knockout animals presented up-regulation of the glial fibrillary acidic protein in Müller cells and evidence of retinal ganglion cell apoptosis, indicating the existence of gliosis and glaucoma-like retinal damage. In summary, our data provide evidence for the role of GUCA1C as a candidate gene in PCG and offer new insights into the function of this gene in the ocular anterior segment and the retina.

Polyarteritis nodosa (PAN), also known as panarteritis nodosa, represents a form of necrotizing vasculitis that predominantly affects medium-sized vessels, although it is not restricted to them and can also involve smaller vessels. The clinical presentation is heterogeneous and characterized by a significant number of patients exhibiting general symptoms including asthenia, fever, and unintended weight loss. Although PAN can involve virtually any organ, it preferentially affects the skin, nervous system, and the gastrointestinal tract. Orchitis is a rare but specific manifestation of PAN. The absence of granulomas, glomerulonephritis and ANCA serves to distinguish PAN from other type of vasculitis. Major complications consist of hemorrhagic and thrombotic events occurring in mesenteric, cardiac, cerebral, and renal systems. Historically, PAN was frequently linked to hepatitis B virus (HBV) infection, but this association has dramatically changed in recent years due to declining HBV prevalence. Current epidemiological research often identifies connection between PAN and genetic syndromes as well as neoplasia. This article provides a comprehensive review of PAN, specifically focusing on the progression of its clinical manifestations over time.

GDF5 gene is involved in the development of skeletal elements, synovial joint formation, tendons, ligaments, and cartilage. Several polymorphisms are present within the gene and two of them, rs143384 and 143383, have been reported as correlated with osteoarticular disease or muscle flexibility. The aim of this research is to verify if the worldwide distribution among human populations of rs143384 polymorphism has been shaped by selective pressure, or if it’s the result of random genetic drift events. Ninety-four individuals of both sexes, 18-28 years old, from Sardinia were analyzed. We observed the following genotype frequencies: 28.72% of homozygotes AA, 13.83% of homozygotes GG, and 57.45% of heterozygotes AG. Allele frequencies were 0.574 for allele A and 0.426 for alle G. Relationships between populations were verified by Multidimensional Scaling (MDS). Our data show: i) a clear heterogeneity within the African populations; ii) a strong differentiation between Africans and the other populations: iii) the Sardinian population is placed withing the European cluster. To reveal possible traces of selective pressure, Population Branch Statistic (PBS) was calculated; both SNPs rs143384 and 143383 have low PBS values, suggesting that there are no signals of selective pressure in those areas of the gene.

21-hydroxylase deficiency (21OHD), the most common form of congenital adrenal hyperplasia (CAH), is associated with pathogenic variants in CYP21A2 gene. The clinical form of the disease ranges from classic or severe to non-classic (NC) or mild late onset. The CYP21A2 gene is located on the long arm of chromosome 6, within the RCCX region, one of the most complex loci in the human genome. The 3’untranslated sequence of CYP21A2 exon 10 overlap the last exon of TNXB gene (these genes lie on the opposite strands of DNA and have the opposite transcriptional direction) that encodes an extracellular matrix glycoprotein tenascin-X (TNX). A recombination event between TNXB and its pseudogene TNXA causes a 30-kb deletion producing a chimeric TNXA/TNXB gene (CAH-X chimera) where both CYP21A2 and TNXB genes are impaired. This genetic condition characterizes a subset of patients with 21OHD who display the hypermobility phenotype of Ehlers Danlos Syndrome (hEDS) (CAH-X Syndrome). The aim of this study was to assess the prevalence of CAH-X syndrome in an Italian cohort of patients with 21OHD. At this purpose, 196 probands were recruited. Multiplex ligation-dependent probe amplification (MLPA) and Sanger sequencing were used to identify the CAH-X genotype. Twenty-one individuals showed the heterozygous continuous deletion involving the CYP21A2 and part of the TNXB gene. EDS-related clinical manifestations were identified in most patients carrying the CAH-X chimera. A CAH-X prevalence of 10.7% was estimated in our population.

The removal of metal ions by biosorption on inexpensive materials is still a challenge for environmental engineering research. In this study, marine green algae biomass (Ulva lactuca sp.) and the biochars obtained from this biomass, at 320 C (BC-320) and 550 C (BC-550), were used as biosorbents for the removal of Cu(II) ions from aqueous solution. In addition to comparing the biosorption capacities, the determination of the thermodynamic parameters allows the choice of the most suitable material for the biosorption processes. The experimental results, obtained for Cu(II) ions biosorption on each biosorbent (algae biomass (AB), BC-320 and BC-550), at three different temperatures (10, 30 and 50 C) were analyzed using Langmuir and Freundlich isotherm models, while pseudo-first order, pseudo-second order and intra-particle diffusions models were used to model the kinetic data. The biosorption of Cu(II) ions is best described by the Langmuir model and the pseudo-second kinetic model, regardless of the type of biosorbent. The maximum biosorption capacity (qmax, mg/g) depends on the temperature, but also on the type of biosorbent, and follow the order: BC-320 &lt; AB &lt; BC-550. Using the experimental isotherms, the thermodynamic parameters (G0, H0 and S0) for the biosorption of Cu(II) ions on each biosorbent were calculated. The analysis of the obtained values constitutes the main arguments in choosing BC-550 as the most effective biosorbent for the removal of Cu(II) ions from aqueous media.

COVID-19 was a terrible worldwide pandemic that caused a global public health crisis, with numerous deaths and a severe economic depression. To suppress the spread of COVID-19 and initiate patient isolation and contact tracing to reduce its effect, early diagnosis was required, with real-time reverse transcriptase polymerase chain reaction (RT-PCR) swab test being the most widely used. However, the RT-PCR test was sometimes found to be lengthy and inaccurate and; for that reason, in many cases of severe complications of COVID-19 pneumonia, chest screening with radiography imaging was preferred. In this paper, we carried out a study for COVID-19 detection from computed tomography images, and compared the obtained results using deep learning (DL) and support vector machine (SVM). The findings showed that, despite the excellent results shown by deep learning, the accuracy in predicting COVID-19 using SVM, in the presence of small databases, was slightly higher than DL. The execution time using SVM was also shorter

Background: Exercise is an accepted intervention to improve the quality of life (QoL) of breast cancer patients. Exercise programs have been developed and all have shown satisfactory results in improving QoL. There is a lack of research comparing different prescription modalities. The aim of this study is to evaluate the effectiveness of physical exercise (in-person, home-based, prescription) on QoL in breast cancer patients actively undergoing treatment; Methods Quasi-experimental study with randomized assignment to three groups (in-person: guided and supervised in-person exercise program; home-based exercise: guided and supervised exercise program with streaming monitoring; recommendation: exercise recommendation). Quality of life was measured using the QLQ-C30 questionnaire. Baseline and 24-week analysis. Results: The total sample analyzed was n=80. QoL improved significantly at 24 weeks in the face-to-face and home-based exercise groups, but not in the advice group. Exercise in all modalities improved fatigue, nausea, vomiting, appetite, and constipation. QoL at 24 weeks depended on active chemotherapy, tumor type, and assigned exercise group (r2 = 0.503; p &lt; 0.001). Conclusions: QoL in breast cancer patients undergoing active treatment improves after a 24-week exercise program, especially in face-to-face and home-based exercise. Home-based exercise, streaming-based recommendation is a viable option for exercise recommendation.

Background: Immunologic and neuro-inflammatory pathways have been found to play a major role in the pathogenesis of many neurological disorders such as epilepsy, proposing the use of novel therapeutic strategies. In the era of personalized medicine and in the face of the exhaustion of anti-seizure therapeutic resources it is worth looking at the current or future possibilities that neuroimmunomodulator or anti-inflammatory therapy can offer us in the management of patients with epilepsy. Methods: We performed a narrative review on the recent advances on the basic epileptogenic mechanisms related to the activation of immunity or neuroinflammation with special attention to current and future opportunities for novel treatments in epilepsy. Results: Neuroinflammation can be considered a universal phenomenon and occurs in structural, infectious, post-traumatic, autoimmune, or even genetically based epilepsies. The emerging research developed in recent years has allowed us to identify the main molecular pathways in-volved in these processes. These molecular pathways could constitute future therapeutic targets for epilepsy. Conclusions: Different drugs current or in development have demonstrated their capacity to inhibit or modulate molecular pathways involved in the immunologic or neuroinflammatory mechanisms described in epilepsy. Some of them should be tested in the future as possible antiepileptic drugs.

Glycosylation, the most significant modification of proteins, plays an essential role in cellular processes. Congenital disorders of glycosylation (CDG) are multisystemic diseases resulting from mutations affecting glycosylation steps. Diagnosis of CDG relies on biochemical assays, such as isoelectric focusing. Despite its significance, CDG cases remain unreported in Cuba due to the lack of implemented diagnostic methods. This study aimed to evaluate transferrin glycoforms for diagnosing congenital N-glycosylation defects. We conducted a cross-sectional descriptive study using serum samples from 17 patients stored at the National Center for Medical Genetics of Cuba for suspected CDG. Results revealed abnormal glycosylation patterns in 7 patients, suggesting congenital N-glycosylation defects. We conclude that the implementation of transferrin glycoform analysis could pioneer a preliminary diagnosis of CDG in Cuba.

Intense physical efforts performed at maximal or near-maximal speeds and the ability to recover among sprint are important characteristics of soccer player. Considering that women's soccer is a markedly growing sport, the aim of the study was to analyse the performance (total time –TT-; fatigue index percentage -IF%) and physiological (aerobic and anaerobic) responses to Repeated Sprint Ability Test (RSA, 7×30 m sprints with 25 s of active recovery among sprints) in an elite female player (age: 30 yrs; BMI: 20.3 kg/m²). A repeated measure MANOVA over the 7 sprints time series was applied (p < 0.05). Results showed that TT was 58.71 s (Ideal Time: 56.98 s) with IF% of 3.0%. Energy contributions were given for 80.3% by aerobic, 19.2% by anaerobic lactid, and 0.5% by anaerobic alactid sources. Considering that 1) we have different kinetics in heart rate (HR) and maximum oxygen uptake with oxygen uptake that reach the peak when HR is still rising, and 2) the energy consumption during intermittent exercises requires different metabolism as a result of physiological stimuli proposed, the present findings substantiate the need to choose specific and adequate training methods for female soccer players that aim at increasing their RSA performances.

Disease, trauma, and aging account for a significant number of clinical disorders. Regenerative medicine is emerging as a very promising therapeutic option. The design and development of new cell-customized biomaterials able to mimic ECM functionalities represent one of the major strategy to control the cell fate and stimulate tissue regeneration. Recently, hydrogels have received a considerable interest for their use in the modulation and control of cell fate during regeneration processes. Several synthetic bioresponsive hydrogels are being developed in order to facilitate cell-matrix and cell-cell interactions. In this review new strategies and future perspectives of such synthetic cell microenvironment will be highlighted.

Despite the recent approval of novel immunotherapies, as immunomodulatory drug, proteasome inhibitors and anti-CD38 monoclonal antibodies, Multiple Myeloma (MM) remains incurable and the acquisition of triple-refractoriness leads to really dismal outcomes, in even earlier lines of therapy. More recently, innovative therapeutic strategies targeting B cell maturation antigen (BCMA), highly expressed on the plasma cell surface, are drawing different future landscapes in terms of effectiveness and outcomes. Belantamab Mafodotin, a first-in-class anti-BCMA antibody drug conjugates, demonstrated good efficacy and safety profile in triple-refractory patients in the phase 2 DREAMM-2 trial and it was approved for the treatment of MM triple-exposed patients with >4 prior lines of therapy. Here, starting from Belantamab Mafodotin clinical trials also exploring combination studies and different schedules in order to improve its efficacy and toxicity, we focused on real life experiences all over the world, which have confirmed clinical trial data and encourage further Belantamab Mafodotin investigations

Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites.This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician's hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private Clinical Analysis Laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly (p&lt;0.05) to 27.5%. Gram-positive cocci and rods were the most common microbes, followed by gram-negative bacilli species. The effectiveness of hand antisepsis was 72.5%. The ideal would be 100% efficacy, that is, 0% microorganisms in all surgeons. It is logical that the presence of any organism, no matter how infrequent it may be, will always represent a great risk of postoperative infection for any patient.

This lack of information is due to the primary role of HSTs in fungal pathogenesis, which often masks the functions of NSTs and CWDEs. So, the toxic effects of A. alternata metabolites due to NSTs and CWDEs have received minor attention than those reported for HSTs mycotoxins [11]. A wider study of the activity of isolated fungal metabolites can allow the identification of compounds directly related to the pathogenic activity of the fungus, making it possible to create chemo libraries that facilitate the linking of the structure of the compounds with the species that produce it and its effect on host and non-host crops, as well as with biosynthetic features [12]. In this context, our work reports a study focused on NSTs and CWDEs used by an A. alternata strain isolated from infected pears in Italy. To this aim, the characterization of hydrolytic enzyme activities of A. alternata and the identification of the metabolites produced in vitro were performed. Furthermore, the phytotoxic activity of the isolated compounds was evaluated on pear (host and non-host varieties) and lemon fruits [13]. Finally, the competition of A. alternata with other pathogens was evaluated to investigate the role of NSTs on co-infections.

Low-cost miniature hyperspectral and thermal cameras onboard lightweight unmanned aerial vehicles (UAV) bring new opportunities for monitoring land surface variables at unprecedented fine spatial resolution with acceptable accuracy. This research applies hyperspectral and thermal imagery from a drone to quantify upland rice growth and water use efficiency (WUE) after biochar application in a Costa Rican dry region. The field flights were conducted over two experimental groups with bamboo biochar and sugarcane biochar amendments and one control group without biochar application. Rice canopy biophysical variables were estimated by inversion of a canopy radiative transfer model on hyperspectral reflectance. Variations in gross primary production (GPP) and WUE across treatments were estimated from the normalized difference vegetation index (NDVI), canopy chlorophyll content (CCC), and evapotranspiration. We found that GPP was increased by 41.9±3.4 % when using bamboo biochar and 17.5±3.4 % when using sugarcane biochar, which was probably due to higher soil moisture in the biochar-amended plots and led to significantly higher WUE by 40.8±3.5 % in bamboo biochar and 13.4±3.5 % in sugarcane biochar. This study demonstrated the use of hyperspectral and thermal imagery from drone to provide indicators for quantifying biochar effects on tropical dry cropland by integrating with ground point samples and physical models.

Recently Palle has investigated the chiral vorticity and Cartan torsion in neutrino asymmetries. In his case he addressed this problem in Goedel s like anisotropic Einstein-Catan cosmology. In this paper we discusse how these ideas applied to sheared Bianchi types I Einstein-Cartan (EC) neutrino amisotropic cosmology, affect the handness of neutrinos in the universe. Actually here a novel concept of the chiral metric is introduced where metric functions also possess two distinct signs as in neutrino flipping or helicity. The axial anomaly equation for neutrinos in the presence of torsion and metric chirality is shown to produce left-handed neutrinos from right-handed torsion. Metric chirality is shown to be able to define how the metric would behave far away of neutrino density. Chiral flipping of the chiral neutrinos in the presence of torsion is also investigated. It is shown that when the chiral torsion is left-handed the chemical chiral potential vanishes as the universe expands.

Antimicrobial resistance (AMR) has become a worldwide health problem. Consequently, there is a global interest in the study of the antimicrobial activity of natural compounds as an alternative to antibiotics. One of the possibilities studied during the last years is the use of bacteriophages and their derived proteins. More specifically, phage lytic proteins or endolysins are specific enzymes that cause cell lysis and can be easily produced and purified after overexpression in bacteria. However, one of the major disadvantages of these proteins is their sensitivity to some environmental conditions that can reduce their efficiency. The use of vesicles for endolysin encapsulation could help overcome this disadvantage, offering an additional protection to the protein and allowing its controlled release and long-term stability.