Background: Chronic kidney disease (CKD) is a significant cardiovascular (CV) risk factor, with dialysis-dependent CKD (DD-CKD) patients facing high mortality rates. Hypercholesterolemia is another crucial CV risk factor, typically managed with lipid-lowering therapy, though its efficacy in DD-CKD remains uncertain. Evidence shows mixed results regarding the benefits of statins in these patients. Citrate-based dialysates are known to reduce inflammatory biomarkers compared to acetate-based ones, potentially impacting lipid profiles and immune responses. This study aimed to determine the effects of citrate versus acetate dialysate on lipid profiles and immunophenotypes in DD-CKD patients. Methods: This unicentric, cross-over, prospective study included 21 hemodialysis patients (10 males, 11 females, average age 62.25 years). Each patient underwent 24 dialysis sessions (12 with each dialysate) and acted as their own control. Lipid profiles, immunological parameters, and nutritional and inflammatory markers were measured before the last session with each dialysate. Results: Compared to acetate dialysate (AD), citrate dialysate (CD) resulted in significantly higher LDL (75.71 vs. 67.05 mg/dL, p=0.042) and HDL (51.19 vs. 47.14 mg/dL, p=0.013), and lower TG (97.86 vs. 110.38 mg/dL, p=0.046). CD also led to higher NK cells (19.24 vs. 16.95%, p=0.035), higher complement C3 levels (115.14 vs. 107.81 mg/dL, p=0.009) and lower CD3+ CD8+ and CD16+56+ lymphocytes. Finally, total lymphocytes were lower with AD than with CD. We found no difference in predialysis nutritional nor inflammatory parameters (IL-6 and hs-CRP) except for ESR, which was higher when subjects used CD than AD. Conclusion: There are significant differences in lipid and immunophenotypic profiles that should increase the CV risk of patients who use CD. However, numerous studies have shown no differences, or even a benefit in mortality in certain HD subpopulations that use CD. Further studies are needed to understand if the observed changes may be counterbalanced by other mechanisms potentially provided by citrate (e.g., reducing vascular calcification).

When profit-driven renewal is difficult to implement, many historic districts are “frozen protected” in China. In the social context of “building cities for the people” in recent years, the public value-oriented renewal of urban historic areas plays an important role in the transformation of cities. This study investigates the strategies of historic district regeneration in China by integrating spatial form, urban governance, and public value. We propose a novel framework to analyze the regeneration of historic districts, using Taiyuan Bell Tower Street as a case study. The framework distinguishes between two dimensions: spatial and economic-social. In the spatial dimension, we focus on the transformation of spatial form to regenerate public value, emphasizing the attribute of "publicness" as central to urban regeneration efforts. This involves a tiered approach of excavating and upgrading historic districts at macro, meso, and micro levels. In the economic-social dimension, we explore urban governance to strengthen public value, involving government, market, and societal actors in a collaborative renewal process. The analysis highlights that a public value-oriented approach to heritage regeneration offers greater sustainability and could serve as a model for other cities seeking similar outcomes.

As a precious natural resource, forests are being destroyed. In previous studies, there is a lack of interactive assessment of its distribution that comprehensively considers multiple external disturbances. This paper takes the Barcelona Metropolitan Region as an example. Based on remote sensing, it analyzes the development process of the forest from 2006 to 2018 through multiple landscape indicators, and OLS models were established to analyze variables that have direct and indirect effects on forest distribution. In addition, the ecological structure of the forest was analyzed based on NDVI. It was found that the forest area is the largest but has been decreasing, becoming more complex in distribution structure. Much of the forest was converted to agricultural land and grassland. The green quality of forests was increasing, and the broad-leaved forest, the second largest area, contributes the most. NDVI is the most important positively correlated variable, and daytime surface temperature is an important inverse factor related to NDVI. In addition, NDBI is also a negative condition that inhibits forest development. In conclusion: The BMR forest area is decreasing and becoming more fragmented. NDVI and daytime LST are the two most significant factors. Climate warming may lead to worse forest development.

Visible-light photocatalysis, particularly in its application to organic synthesis, has experienced a big renaissance in the past decade. The rational design of new photocatalysts with designed and improved photocatalytic properties, that at the same time circumvents the necessity of using scarce and toxic transition metals, will predictably play a key role in photocatalysis in the next few years. Although free-base porphyrins were identified some years ago as a promising, easily accessible and easily tunable class of organic photoredox catalysts, a systematic study on the effect of the electronic nature and of the position of the substituents on both the ground-state and the excited-state redox potentials of these compounds is still lacking. We have prepared a set of known functionalized derivatives of meso-tetraphenyl porphyrin containing different substituents either in one of the meso-positions or at a beta-pyrrole carbon and we have determined their ground- and (singlet) excited-state redox potentials. This survey has led us to conclude that the introduction of a carbonyl group at the beta-pyrrolic position strongly increases the facility of the monoelectronic reduction of the porphyrin both in the ground state and in the singlet excited state. We have also prepared a second set of four previously unknown benzoyl derivatives of meso-tetraphenylporphyrin, and we have confirmed the validity of our conclusions.

Melanoma is the most aggressive and deadly form of skin cancer, and its incidence has been steadily increasing over the past few decades, particularly in the Caucasian population [1]. Current treatment strategies, the combination of BRAF and MEK inhibitors (BRAF/MEKi) in BRAFV600 mutant melanoma, and immune checkpoint inhibitors (ICI), have changed the clinical evolution of this disease [2]. However, a significant percentage of patients do not benefit from these therapies. Therefore, to improve patient selection, it is imperative to look for novel biomarkers. Immune subsets, particularly the quantification of lymphoid populations, could contribute to the identification of ICI responders. The aim of this review is to thoroughly examine significant published data on this topic in melanoma patients and to evaluate the potential role of lymphoid subsets as prognostic and predictive response biomarkers.

The choice of dialysate buffer in hemodialysis is crucial, with acetate being widely used despite complications. Citrate has emerged as an alternative due to its favorable effects, yet concerns persist about its impact on calcium and magnesium levels. This study investigates the influence of citrate dialysate (CD) with and without additional magnesium supplementation on CKD-MBD biomarkers and assesses their ability to chelate divalent metals compared to acetate dialysates (AD). A prospective crossover study was conducted in a single center, involving patients on thrice-weekly online hemodiafiltration (HDF). Four dialysates were compared: two acetate-based and two citrate-based. Various biochemical parameters were monitored before and after each dialysis session. Seventy-two HDF sessions were performed in eighteen patients. CD showed stability in iPTH levels and reduced post-dialysis total calcium, with no significant increase in adverse events. Magnesium supplementation with CD prevented hypomagnesemia. However, no significant differences among dialysates were observed in the chelation of other divalent metals. Citrate dialysates, particularly with higher magnesium concentrations, offer promising benefits, including prevention of hypomagnesemia and stabilization of CKD-MBD parameters, suggesting citrate as a viable alternative to acetate. Further studies are warranted to elucidate long-term outcomes and optimize dialysate formulations.

Background: Older adults with bipolar disorder (OABD) are individuals aged 50 years and older with bipolar disorder (BD). People with BD may have fewer coping strategies or resilience. A long course of the disease, such as in OABD, could impact the development of resilience strategies, but this remains under-researched in OABD. Therefore, this study aims to assess resilience levels within the OABD and explore associated factors, hypothesizing that resilience could improve psychosocial functioning, wellbeing and quality of life of OABD patients. Methods: This study sampled 33 OABD patients from the OABD cohort at the Bipolar and Depressive Disorders Unit of Hospital Clinic of Barcelona. This was an observational, descriptive and cross-sectional study. Demographic and clinical variables as well as psychosocial functioning, resilience and cognitive reserve were analyzed. Resilience was measured using the CD-RISC-10. Non-parametric tests were used for statistical analysis. Results: The average CD-RISC-10 score was 25.67 points (SD 7.87). Resilience negatively correlated with the total number of episodes (p = 0.034), depressive episodes (p = 0.001), and the FAST (p < 0.001). Participants with normal resilience had a lower FAST (p = 0.046), a higher CRASH (p = 0.026), and more EOBD (p = 0.037) compared to those with low resilience. Conclusions: OABD individuals may exhibit lower resilience levels which correlate with more psychiatric episodes, particularly the number of depressions and worse psychosocial functioning and cognitive reserve. Better understanding and characterization of resilience could aid in early identification of patients requiring additional support to foster resilience and enhance OABD management.

Introduction: Identifying the complexity of palliative care needs is a key aspect of referral to specialised multidisciplinary early palliative care (EPC) teams. The PALCOM scale is an instrument consisting of five multidimensional assessment domains, developed in 2018 and validated in 2023, to identify the level of complexity in patients with advanced cancer. Objectives: The main objective of this study was to determine the degree of instability (likelihood of level change or death), health resource consumption and survival of patients according to the level of palliative complexity assigned at the baseline visit during a 6-month follow-up. Method: An observational, prospective, multicentre study was conducted using pooled data from the development and validation cohort of the PALCOM scale. The main outcome variables were: a) instability ratio (IR), defined as the probability of level change or death; b) emergency department visits; c) days of hospitalisation; d) hospital death; e) survival. All variables were analysed monthly according to the level of complexity assigned at the baseline visit. Results: A total of 607 patients with advanced cancer were enrolled. According to the PALCOM scale, 20% of patients were classified as low complexity, 50% as medium and 30% as high complexity. The overall IR was 45% in the low complexity group, 68% in the medium complexity group and 78% in the high complexity group (p

Atopic dermatitis and psoriasis are prevalent inflammatory skin conditions with diverse treatment options. Despite advances in understanding their underlying mechanisms, recent research highlights the significance of interleukins IL-18 and IL-37 as potential therapeutic targets. This review synthesizes knowledge on these interleukins, their roles in atopic dermatitis and psoriasis, and emerging treatment strategies. Findings of a literature search up to May 30, 2024 underscore a research gap in IL-37-targeted therapies. Conversely, IL-18-focused treatments have demonstrated promise in adult-onset Still’s Disease, warranting further exploration for their potential efficacy in psoriasis and atopic dermatitis.

The Dual-Frequency Precipitation Radar (DPR) on the Core GPM satellite provides spaceborne 3-dimensional observations of the precipitation field and surface rainfall rate with quasi global coverage. The present study evaluates the behavior of liquid precipitation intensity, radar reflectivity factor (ZKu and ZKa) and Drop Size Distribution (DSD) parameters (weighted mean diameter Dm and intercept parameter Nw) of the GPM DPR derived products version 07 from 2014 to 2023. Observations from seven Parsivel disdrometers located in different topographic zones in the Western Mediterranean are taken as ground reference. Four matching techniques between satellite estimates and ground level observations were tested, and best results were found for the so-called optimal comparison approach. Overall, GPM DPR products capture well the variability of the observed DSD at different rainfall intensities. However, overestimation of the mean Dm and underestimation of the mean Nw are observed, being much more sensitive to errors in drop diameters larger than 1.5 mm. Moreover, lowest errors were found for radar reflectivity factor and Dm, and highest for Nw and rainfall rate. In addition, the GPM DPR convective and stratiform classification was tested and it was found a substantial overestimation of stratiform cases compared to disdrometer observations.

The cavitating wake behind a wedge has been simulated employing both incompressible and compressible solvers with the purpose of comparing their performance. To develop the compressible solver, the ZGB cavitation model for incompressible flows has been modified to consider the compressibility effects. First, the equations of state for the vapor and liquid phases have been implemented. Then, a pressure limit and absorbing boundary conditions have been set to prevent a non-physical pressure field. To test the developed compressible solver, a series of verification tests have been conducted comprising a 1D sod cavitating tube and the cavitating vortex shedding behind a circular body at laminar flow conditions. After that, the incompressible and the validated compressible solvers have been applied to simulate the cavitating wake behind a wedge. The obtained results show similar predictions with the two solvers in terms of pressure, vortex shedding frequency and instantaneous and average vapor volume fraction profiles. Moreover, it is interesting to note that the components of the fluid force fluctuations on the body at the lowest frequencies, as predicted by both solvers, are indistinguishable. However, the higher frequency fluctuations of the forces tend to be better resolved and amplified when the compressibility is considered. Overall, both flow solvers have provided comparable cavitation phenomena, yielding results well aligned with experimental observations.

Multiple sequence alignments and phylogenetic trees are rich in biological information and are fundamental to research in biology. PhyKIT is a tool for processing and analyzing the information content of multiple sequence alignments and phylogenetic trees. Here, we describe how to use PhyKIT for diverse analyses, including (i) constructing a phylogenomic supermatrix, (ii) detecting errors in orthology inference, (iii) quantifying biases in phylogenomic data sets, (iv) identifying radiation events or lack of resolution using gene support frequencies, and (v) conducting evolution-based screens to facilitate gene function prediction. Several PhyKIT functions that streamline multiple sequence alignment and phylogenetic processing—such as renaming FASTA entries or tree tips—are also discussed. These protocols demonstrate how simple command-line operations in the unified framework of PhyKIT facilitate diverse phylogenomic data analysis and processing, from supermatrix construction and diagnosis to gene function prediction.

Thermal analysis is widely employed for the characterization of nanomaterials. It encompasses a variety of techniques that allow the evaluation of the physicochemical properties of a material by monitoring its response under controlled temperature. In the case of carbon nanomaterials, such as carbon nanotubes and graphene derivatives, thermogravimetric analysis (TGA) is particularly useful to determine the quality and stability of the sample, presence of impurities and the degree of functionalization or doping after post-synthesis treatments. Furthermore, TGA is widely used to evaluate the thermal stability against oxidation by air, which can be for instance enhanced by the purification of the material and by nitrogen doping, finding application in areas where a retarded combustion of the material is required. Herein, we have evaluated key parameters that play a role in the data obtained from TGA. Within this study we show that the thermogravimetric curve of carbon nanomaterials is greatly influenced by these parameters. This is important in terms of data recording and their analysis, since a poor control of the conditions of measurement might lead to false conclusions. We highlight this by analyzing different samples of graphene and carbon nanotubes where both thermal stability and sample purity assessment are found to be dependent on the employed TGA parameters. Finally, a set of TGA parameters are recommended for the analysis of carbon nanomaterials to obtain reliable data.¡

Ustekinumab is a fully human IgG1k monoclonal antibody that binds with high affinity and specificity to the p40 subunit of interleukins (IL-) 12 and 23, inhibiting their activity by preventing binding to their receptors. The European extension of the patent (Supplementary Protection Certificate) of ustekinumab expired on July 20, 2024. Biosimilar alternatives to ustekinumab are now an additional option for treating patients. The efficacy data for this drug in moderate-to-severe psoriasis, obtained both from clinical trials and indirect comparisons through meta-analyses, are superior to those of etanercept and adalimumab, and its safety profile is more favorable than that of tumor necrosis factor (TNF) inhibitors. Several ustekinumab biosimilars have already been approved by regulatory agencies: between October 2023 and July 2024, Wezlana® (Amgen ABP 654), Uzpruvo® (Alvotech AVT04) and Pyzchiva® (Samsung/Bioepis SB17) have been approved by both the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). SteQeyma® (Celltrion Healthcare CT-P43) has been approved by the EMA in August 2024. Several other potential biosimilar candidates are under development, including FYB202 (Formycon), BAT2206 (Bio-Thera), DMB-3115 (Dong-A ST), QX001S (Qyuns Therapeutic), BFI-751 (BioFactura), NeuLara (Neuclone), ONS3040 (Oncobiologics), and BOW090 (Epirus Biopharmaceuticals). In most cases, these monoclonal antibodies are expressed in cell lines (e.g. Chinese Hamster Ovary, CHO) different from those used for the originator (Sp2/0 spleen cell murine myeloma); of note, the cell line of origin is not a requirement for biosimilarity in the totality-of-evidence comparison exercise and may facilitate the production and reduce the immunogenicity of biosimilars originated in CHO cultures. This narrative review will summarize the available data on characteristics of the full comparability exercises and comparative clinical trials of these drugs.

Linear polyamides, known as nylons, are a class of synthetic polymers with a wide range of applications due to their outstanding properties, such as chemical and thermal resistance or mechanical strength. These polymers have been used in various fields: from common and domestic applications, such as socks and fishing nets, to industrial gears or water purification membranes. By their durability, flexibility and wear resistance nylons have been started to be used in addictive manufacturing technology as a good material choice to get sophisticated devices with precise and complex geometric shapes. Furthermore, the emergence of triboelectric nanogenerators and the development of biomaterials have highlighted the versatility and utility of these materials. In order to enhance the triboelectric performance and the range of applications, nylons show a potential use as tribo-positive materials. Because of the easy control of their shape they can be subsequently integrated into nanogenerators. The use of nylons has also extended into the field of biomaterials, where their biocompatibility, mechanical strength and versatility have paved the way for groundbreaking advances in medical devices as dental implants, catheters and non-absorbable surgical sutures. By means 3D bioprinting nylons have been used to develop scaffolds, joint implants and drug carriers with tailored properties for various biomedical applications. The present paper aims to collect these recently specific applications of nylons by reviewing the literature produced in the last decades, with a special focus on the newer technologies in the field of energy harvesting and biomedicine.

Flash floods repeatedly threaten Barcelona, damaging the city infrastructure and endangering the safety of the population. The city’s urban planning and socioeconomic distribution, associated with the topography and other geographic factors, means that these flood events do not affect the entire city in the same way. This is a key point for surveillance and emergency tasks, which need some patterns and models to improve response capacity. This work aims to gain a better understanding of such events, to add valuable information on how to predict and manage these situations. For this purpose, both radar and ground observational data have been combined to identify the most important precipitation episodes in Barcelona between 2013 and 2018. To make the analysis easier, a new algorithm has been developed to determine the thunderstorm hotspots. Episodes with a higher impact have been analysed in depth. The final objective is to improve the actions taken by the organisation responsible for managing urban floods, which have seen Barcelona recognised as a model city for flood resilience by the United Nations.

Background: Penile squamous cell carcinoma (PSCC) is classified into two prognostically distinct types: human papillomavirus (HPV)-associated and HPV-independent. Conversely, the impact of p53 status on prognosis remains controversial. We correlated HPV and p53 status with prognosis in a large series of PSCC patients. p53 was analysed according to a recently described immunohistochemical (IHC) pattern-based framework that includes two normal (scattered, mid-epithelial) and four abnormal patterns (diffuse, basal overexpression, cytoplasmic and null) and closely correlates with TP53 mutational status. Methods: A total of 122 patients with surgically treated PSCC in three hospitals in Barcelona, Spain, were included. Based on HPV in situ hybridization and p16 and p53 IHC expression, the tumors were classified into three molecular types: HPV-associated, HPV-independent/p53 normal, and HPV-independent/p53 abnormal. All patients were followed for at least 22 months (median 56.9 months), and disease-specific survival (DSS) was analysed. Results: Thirty-six tumors (29%) were HPV-associated, 35 (29%) were HPV-independent/p53 normal, and 51 (42%) were HPV-independent/p53 abnormal. Disease-related deaths were observed in 3/36 (8%), 0/35 (0%) and 14/51 (27%) of the patients, respectively (p&lt;0.001). A total of 7/14 deaths in the latter group were patients with tumors showing p53 patterns not recognized in the classical p53 IHC interpretation (basal, null, cytoplasmic). According to our multivariate analysis, HPV-independent/p53 abnormal tumors and advanced stage were associated with impaired DSS (hazard ratio=23.4, 95% confidence interval [CI]= 2.7-3095.3; p=0.001 and 16.3, 95% CI=1.8-2151.5; p=0.008, respectively). CONCLUSION: Compared with patients with HPV-associated and HPV-independent/p53-normal PSCC, patients with HPV-independent/p53 abnormal PSCC have worse clinical outcomes. p53 IHC results define two prognostic categories in HPV-independent PSCC: HPV-independent/p53-normal tumors as low-risk tumors, whereas HPV-independent/p53-abnormal tumors as aggressive neoplasms.

Introduction: The association between epilepsy and myasthenia gravis has rarely been reported, and only in small case series. Objective: To report the frequency of epilepsy and myasthenia gravis and to describe a case series of patients with myasthenia gravis and epilepsy, focusing on their clinical characteristics and searching for a possible physiopathological mechanism. Methods: A retrospective, observational, adult center study was conducted in 2022. Patients were recruited from the database of the outpatient clinic of the Myasthenia Gravis unit and Epilepsy unit. Results: Five patients were included. Frequency of epilepsy in the myasthenia gravis cohort was 5/469 (1.1%), and of myasthenia gravis in the epilepsy cohort was 5/1432 (0.35%). All patients suffered focal epilepsy, mainly fronto-central, and drug-resistant in half of them. Myasthenia gravis was generalized and with exacerbations in half of them. Three patients were thymectomized. Other autoimmune diseases were found in 2 (40%). Epilepsy onset preceded myasthenia gravis onset in all patients. Both diseases were considered autoimmune-related in 3/5 (60%). Conclusion: Epilepsy and myasthenia gravis are only infrequently associated. In adult patients, epilepsy onset precedes myasthenia onset in most cases. In some cases, epilepsy has an autoimmune aetiology and coexists with other autoimmune conditions.

Background/Objectives: Bacterial infections (BI) are a major cause of mortality in patients with alcohol-associated hepatitis (AH); however, only a few studies have investigated BI in AH in the last decade. Therefore, we aimed to assess the features and outcomes of BI in patients with AH. Methods: This observational descriptive study included patients with AH admitted to a tertiary academic hospital between 2016–2021. Clinical and complete microbiological data were recorded and complications, including acute-on-chronic liver failure (ACLF), and mortality over 90-days were compared between infected and non-infected patients. Results: Overall, 115 patients with AH were recruited and 75 had severe AH; among them, 66 started corticosteroid treatment. We identified 69 cases of BI in 44 patients; the incidence of BI at hospital discharge was 32.2%, which reached 38.2% at 90 days. The predominant infection site was the chest (35%). Among the identified bacteria (52.1%), half were gram-positive and half gram-negative. A low rate of multidrug-resistant bacteria (14%) was also noted. Infected patients during hospitalization (n=37) exhibited higher rates of hepatic decompensation and ACLF p=0.001) and lower survival (81.8% vs. 95.8%, p=0.015) than did non-infected patients (n=78). In-hospital infected patients (n=22) exhibited worse survival (72.7%) than did those infected upon admission (93.3%) or non-infected patients (94.9%) (p=0.009). Corticosteroid-treated patients displayed a nonsignificant increase in the total number of BI; however, without greater mortality. Conclusions: BI were common in our cohort of patients with AH. Patients with in-hospital infections commonly experienced serious complications, including high ACLF and death rates. Infections diagnosed upon admission were treated without affecting survival.

Physical inactivity, highly dependent on community and environmental conditions, is the fourth leading cause of death worldwide. The objective of Every Walk You Take initiative was to co-design and test a mHealth intervention prototype (mobile app) to promote active living, and to identify barriers and facilitators for active living in individuals older than 55 years. Community stakeholders that included citizen scientists, teachers, researchers, health professionals and policy makers, familiar with the social and economic burden of aging in developed societies, codesigned the prototype. The app functionalities included recommendations on healthy routes in the city (parks, pedestrian lanes and streets) according to environmental variables (air quality and climate) and personal preferences (route difficulty, distance and geolocalization); and the collection of ecological momentary assessments (pictures and voice notes) to identify the barriers and facilitators to perform the routes. The prototype was tested in a pilot study in two deprived neighbourhoods of Barcelona. A total of 21 citizen scientists [mean age=67 (standard deviation=7)], 86% of them female collected, during two 7-day cycles, 112 comments and 48 pictures describing the barriers and facilitators for active living. The negative impact of dirty or damaged roads on citizen scientists’ motivation to engage in physical activity was highly reported as a barrier indicating that city infrastructure directly influences the public's inclination towards adopting active lifestyles. However, citizen scientists highlighted murals and urban green spaces they encountered, which made their walks more enjoyable and stimulating, as facilitators for active living. Every Walk You Take initiative constitutes the foundation for the development of novel models of health surveillance to address gaps in the current research landscape of active living. Moreover, the increased health literacy of the individuals ensures that they are more conscious about the role of physical activity in healthy ageing.

The Olympic Games are a sporting event and a catalyst for urban development in the host city. In this study, we utilized remote sensing and GIS techniques to examine the impact of the Olympic infrastructure on the surface temperature of urban areas. Using Landsat Series Collection 2 Tier 1 Level 2 data, cloud computing, and Google Earth Engine (GEE) methods, this study examines the effects of various Olympic Games facility urban planning in different historical moments and location typologies: monocentric, polycentric, peripheric and clustered Olympic ring. The GEE code applies to the Olympic Games from Paris’24 to Munich’72. However, this paper focuses specifically on the representative cases of Paris’24, Tokyo’20, Rio’16, Beijing’08, Sydney’00, Barcelona’92, Seoul’88, and Montreal’76. The study is not only concerned with obtaining absolute Land Surface Temperatures (LST), but rather the relative influence of mega-event infrastructures on mitigating or increasing the urban heat. As such, locally Normalized Land Surface Temperature (NLST) was utilized for this purpose. In some cities (Paris, Tokyo, Beijing, and Barcelona), it is identified that Olympic planning has resulted in the development of green spaces, creating "green spots" that contribute to lower-than-average temperatures. However, it should be noted that there is a significant variation in temperature within intensely built-up areas, such as Olympic villages and the surrounding areas of the Olympic stadium, which can become “hotspots”. Therefore, it is important to acknowledge that different planning typologies of Olympic infrastructure can have varying impacts on city heat islands, with the polycentric and clustered Olympic ring typologies displaying a mitigating effect. This research contributes to a cloud computing method that can be updated for future Olympic Games or adapted for other mega-events and utilizes a widely available remote sensing data source to study a specific urban planning context.

Background. Transcatheter edge-to-edge repair (TEER) is a safe and effective treatment in symptomatic patients with mitral regurgitation (MR). We aimed to investigate the short-term impact of mitral TEER on left ventricular (LV) performance and identify echocardiographic prognostic indicators. Methods. Seventy-eight patients with severe MR (organic and functional etiologies) were included retrospectively. All patients had a baseline and short-term echocardi-ography after TEER and were followed up for the primary composite endpoint (heart failure hos-pitalization and cardiovascular death) over a median period of 13 months. Results. A significant decrease in left ventricular ejection fraction (LVEF), all myocardial work indices (except global wasted work), and left atrial reservoir were observed after TEER. Additionally, there was an im-provement in the pulmonary artery systolic pressure and tricuspid annular plane systolic excur-sion/pulmonary artery systolic pressure (TAPSE/PASP) ratio. 34% of all patients presented the primary composite endpoint. A TAPSE/PASP ratio post-TEER < 0.47 (HR: 4.76, p-value = 0.039), and left atrial reservoir post-TEER < 9.0% (HR: 2.77, p-value = 0.047) were independently associ-ated with the primary endpoint. Conclusions. Echocardiography post-TEER reflects impairment in ventricular performance due to preload reduction and right ventricular to pulmonary artery coupling improvement. Short-term echocardiography after TEER identifies high-risk patients who could benefit from a close clinical follow-up.

Recent advancements in neural machine translation (NMT) offer promising potential for generating cross-language clinical natural language processing (NLP) resources. There is a pressing need to be able to foster the development of clinical NLP tools that extract key clinical entities in a comparable way for a multitude of medical application scenarios, hindered by lack of multilingual annotated data. This study explores the efficacy of using NMT and annotation projection techniques with expert in the loop validation to develop named entity recognition (NER) systems for an under resourced target language (Catalan) by leveraging Spanish clinical corpora annotated by domain experts. We employed a state-of-the-art NMT system to translate three clinical case corpora. The translated annotations were then projected onto the target language texts and subsequently validated and corrected by clinical domain experts. The efficacy of the resulting NER systems was evaluated against manually annotated test sets in the target language. Our findings indicate that this approach not only facilitates the generation of high-quality training data for the target language (Catalan) but also demonstrates the potential to extend this methodology to other languages, thereby enhancing multilingual clinical NLP resource development. The generated corpora and components are publicly accessible, providing potentially a valuable resource for further research and application in multilingual clinical settings: https://zenodo.org/doi/10.5281/zenodo.13133124.

We study the enhancement of the elastocaloric effect in natural rubber by using forced air convection in order to favour heat extraction during the elongation stage of an stretching-unstretching cycle. Elastocaloric performance is quantified by means of the adiabatic undercooling that occurs after a fast removal of the stress, measured by infrared thermography. To ensure accurate measurements, spatial averages on thermal maps of the sample surface are performed since undercooled samples display heterogeneities caused by various factors. The influence of the stretching velocity and the air velocity is analysed. The results show that, given the fact that the stretching velocities should be high enough to improve the cooling power, there is an optimal air velocity that provides maximum adiabatic undercooling. Our experiments have also allowed us to characterise the dependence of the Newton heat transfer coefficient on the air convection velocity. We have shown that this coefficient may show an enhancement up to 600% for air velocities around 4 m/s.

Transport systems are essential in the path towards sustainable urbanisation and the transition to more sustainable living. Recently, European cities have undergone substantial changes, owing to which suburbanisation is posing new challenges. Suburban areas are often more affordable in terms of housing, but their neighbourhoods tend to be car-oriented. This leads to higher commuter costs, immobility, transport and time poverty, pollution, and accident rates and a lack of social interaction. To offer sustainable mobility options to citizens, we must comprehensively understand their specific mobility practices, together with their personal characteristics, and the built environment. This study centred on the Barcelona Metropolitan Region, which has a public transport network that covers the entire area. The aim of this study was to examine the relationship between travel behaviour, transport mode use, individual characteristics, and place of residence, using detailed information sources. Herein, we used data from the annual travel survey conducted in the Barcelona region from 2018 to 2021, together with land-use and other information sources. Our findings suggest that transport policies have encouraged sustainable mobility practices, particularly in the centre of Barcelona. Despite the positive results, considerable disparities exist between the inner and outer city, with notably decreased sustainable mobility practices in the latter. Our results indicate that promoting sustainable mobility policies requires further changes in transport, city, and land-use planning that consider equity, the socioeconomic profile of citizens, and mixed urban planning.

Purpose: Inflammation and neutrophils play a central role in both Covid-19 disease and cancer. We aimed to assess the impact of pre-existing tumor-related inflammation on Covid-19 outcomes in patients with cancer and to elucidate the role of circulating neutrophil subpopulations. Methods: We conducted a multicenter retrospective analysis of 524 patients with cancer and SARS-CoV-2 infection, assessing the relationship between clinical outcomes and circulating inflammatory biomarkers collected before and during Covid-19 infection. Additionally, a unicenter prospective cohort provided data for an exploratory analysis, assessing the immunophenotype of circulating neutrophils and inflammatory cytokines. The primary endpoints were 30-day mortality and severity of Covid-19 disease. Results: Prior to Covid-19, 25% of patients with cancer exhibited elevated dNLR, which increase to 55% at the time of Covid-19 diagnosis. We developed the FLARE score, incorporating both tumor and infection-induced inflammation, which categorized patients into four prognostic groups. The poor prognostic group had a 30-day mortality rate of 68%, significantly higher than the 23% in the favorable group (p<0.0001). The score proved to be an independent predictor of early mortality. The prospective analysis revealed a shift towards immature forms of neutrophils and higher IL-6 levels in patients with cancer and severe Covid-19 infection. Conclusions: A pre-existing tumor-induced pro-inflammatory state significantly impacts Covid-19 outcomes in patients with cancer. The FLARE score serves as an easy-to-use and worldwide accessible effective tool to predict outcomes in this population, while circulating neutrophil subpopulations might provide additional information and could help refine outcome prediction.

Planar differential systems whose angular velocity is constant are called rigid differential systems. We characterize the existence and non-existence of limit cycles, and the finite and infinite singularities of the rigid polynomial differential systems with homogeneous nonlinearities of arbitrary degree in the Poincaré disc. Moreover, we classify the phase portraits in the Poincaré disc of the rigid polynomial differential systems of degree two, and of one class of rigid polynomial differential systems with cubic homogeneous nonlinearitie that can exhibit one limit cycle.

The aim of the study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual-task conditions. Design: Randomized clinical trial. Methods: 20 healthy and physically active older adults (73.255.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE), closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants’ ability to reposition their dominant knee at 45º. Finally, performance on the cognitive task was measured through a subscale of the Barcelona Test called “categorical evocation in associations.” The EG and the CG completed 8-week training programme with two sessions the 30 minutes per week of postural control and proprioception exercises. The EG additionally included music in each session. Results: The results showed significant differences in both group at the postural control tests (RBOE and RBCE) and proprioceptive test post intervention. Conclusion: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music.

The present article describes the synthesis of an isonicotinate-derived meso-arylporphyrin, that has been fully characterized by spectroscopic methods (including fluorescence spectroscopy), as well as by elemental analysis and by HR-MS. The structure of a n-hexane monosolvate has been determined by single crystal X-ray diffraction analysis. The radical scavenging activity of this new porphyrin against the 2,2-diphenyl-1-picrylhydrazyl (DDPH) radical has been measured. Its antifungal activity against three yeast strains (C. albicans ATCC 90028, C. glabrata ATCC 64677 and C. tropicalis ATCC 64677) has been tested, using the disk diffusion and the microdilution methods. Whereas the measured antioxidant activity was low, the porphyrin showed moderate but encouraging antifungal activity. Finally, a study of its effect on the germination of lentil seeds revealed interesting allelopathic properties.

Computational fluid dynamics (CFD) modeling has emerged as a valuable tool for investigating complex processes like microencapsulation. This paper aims to validate the ability of CFD simulations to predict particle size distribution in a polymer microencapsulation process. The CFD modeling approach employed an Eulerian multiphase framework, incorporating a discrete population balance model to track the evolution of the droplet population. A realizable k-ε turbulence model and a multiple reference frame strategy were utilized to capture the system’s flow dynamics. The results reveal that while the CFD simulations align well with experimental data at higher agitation speeds (>10000 rpm), discrepancies arise at lower speeds (<7500 rpm), indicating a challenge in accurately capturing turbulent viscous regimes. Despite these challenges, the CFD model demonstrates robust predictive capabilities for droplet formation and distribution in microencapsulation processes, validated by error margins within acceptable limits. The validated model can be used as a reliable tool to guide experimental efforts and optimize process parameters, contributing to an enhanced understanding and control of microencapsulation processes.

During the last years there has been a high interest in the development of new purely-organic single-component conductors. Very recently, we have reported a new neutral radical conductor based on the perchlorotriphenylmethyl (PTM) radical moiety linked to a monopyrrolo-tetrathiafulvalene (MPTTF) unit by a -conjugated bridge (1). Interestingly, this system behaves as a semiconductor with high conductivity and small energy gap under high pressure. With the aim of developing a new material with improved conducting properties, we have designed and synthesized the radical dyad 2 which was functionalized with an ethylenedithio (EDT) group in order to improve the intermolecular interactions of the TTF subunits. The physical properties of the new radical dyad 2 were studied in detail in solution to further analyze its electronic structure as well as its potential use as radical conductor in the solid state.

Background: Tuberculosis (TB) continues to be a serious public health threat that affects the most vulnerable population. Patients who are LTFU after TB diagnosis still represent one of the biggest challenges to TB control. Method: In this prospective observational study, we aimed to identify and analyse the risk factors associated with LTFU among TB patients who started first-line TB treatment in the Sanatorium Hospital in Luanda. Result: A total of 113 patients with TB were included between August 2018 and September 2019. Seventy-six (67.3%) patients were cured, 27 (23.9%) were LTFU, 5 (4.4%) died, 4 (3.5%) were transferred and 1 (0.9%) presented a treatment failure. After excluding those dead, transferred or who failed to treatment, we observed that severe TB at the time of diagnosis (OR 9.24, 95% CI 2.18-39.04) and food insecurity were significantly associated with LTFU (OR 5.96, 95% CI 1.66-21.41). Conclusion: The findings of our study are of enormous value to understand the reasons for the LTFU of patients with TB and can guide polices and facilitate designing measures to allow better adherence, and therefore, greater treatment success

Antimicrobial peptides (AMPs) are regarded as a promising alternative to traditional antibiotics in the face of ever-increasing resistance. Our research has focused on crotalicidin (Ctn), an AMP from a snake venom, and a fragment thereof, Ctn[15-34], with improved in vitro antimicrobial and anticancer activities and remarkable serum stability. As the retroenantio versions of both AMPs maintained favorable profiles, in this work we evaluate the in vivo efficacy of both the na-tive-sequence AMPs and their retroenantio counterparts in a murine infection model with Aci-netobacter baumannii. A significant reduction in bacterial levels is found in the mice treated with Ctn[15-34]. However, contrary to expectations, the retroenantio analogues either exhibit toxicity or lack efficacy when administered to mice.

This paper presents a novel CNN-based architecture, referred to as Q-Net, to learn local feature descriptors that are useful for matching image patches from two different spectral bands. Given correctly matched and non-matching cross-spectral image pairs, a quadruplet network is trained to map input image patches to a common Euclidean space, regardless of the input spectral band. Our approach is inspired by the recent success of triplet networks in the visible spectrum, but adapted for cross-spectral scenarios, where for each matching pair there are always two possible non-matching patches; one for each spectrum. Experimental evaluations on a public cross-spectral VIS-NIR dataset shows that the proposed approach improves the state-of-the-art. Moreover, the proposed technique can also be used in mono-spectral settings, obtaining a similar performance to triplet network descriptors, but requiring less training data.

Objectives: Teachers’ intention understanding ability reflects their professional insight, which is the basis for effective classroom teaching activities. However, the cognitive process and brain mechanism of how teachers understand students' action intention in class are still unclear; Methods: This study used event-related potential (ERP) technology to explore the cognitive neural differences in intention understanding ability among teachers with different levels of knowledge and experience. The experiment used the comic strips paradigm to examine the ability of expert and novice teachers to understand students’ normative and non-normative classroom actions under different text prompts (“how” and “why”); Results: The results revealed that in the late time window, expert teachers induced larger P300 and LPC amplitudes when they understood students' classroom action intentions, while the N250 amplitudes induced by novice teachers in the early time window were significantly larger. In addition, for both types of teachers, when understanding the intentions behind students’ normative actions, the N250 amplitude was the most significant, while the P300 and LPC amplitudes were more significant for non-normative actions.; Conclusions: This study found that teachers at varying professional development stages had different time processing processes in intention understanding ability, which supported teachers' brain electrophysiological activities related to social ability.

Background: Antimicrobial consumption data in Latin America is scarce and usually spread out within different sources for AMC calculations, making it difficult to both standardize and compare regions through similar time frames. The main objective was to analyze antimicrobial consumption trends in Social Security tertiary care hospitals in Costa Rica in the period spanning January 2017 to December 2021, using both defined daily doses (DDD)/100 bed days and DDD/100 discharges. Methods: Retrospective observational study of antimicrobial consumption. Global consumption trends were calculated and expressed in DDD/100 bed days and DDD/100 discharges. Trends in antimicrobial consumption were analyzed using a simple linear regression model to determine potential differences in antimicrobial usage throughout the study’s duration. Results: A statistically significant increase in the consumption expressed in DDD/100 discharges was observed in the following groups: carbapenems: 35.62% (p&lt;0.0001), trimethoprim-sulfamethoxazole: 62.50% (p&lt;0.0001), echinocandins: 20.73% (p=0.01) and azole antifungals: 61.58% (p&lt;0.0001). Additionally, a statistically significant increase of 40.43% in the consumption of azole antifungals expressed in DDD/100 bed days was observed (p=0.0008). In contrast, a statistically significant decrease in consumption expressed in DDD/100 discharges was identified for cephalosporins -21.97% (p&lt;0.0001) and macrolides -51.67% (p&lt;0.0001). Conclusions: This five-year analysis demonstrated trends over time in overall antimicrobial consumption measured in DDD/100 bed days do not correlate with trends in DDD/100 discharge rates. Continually, the comparison between DDD/100 bed days and DDD/100 discharges allows for complementary comparisons to be made regarding antimicrobial exposure in a clinical setting.

Extramammary Paget disease (EMPD) is an uncommon adenocarcinoma of apocrine gland-rich areas, presenting significant diagnostic challenges due to its nonspecific clinical appearance and frequent misidentification as benign, inflammatory skin conditions. Traditional diagnostic methods such as biopsy are invasive and uncomfortable, often required repeatedly due to high recurrence rates. Dermoscopy and non-invasive imaging techniques have been used but provide limited diagnostic accuracy due to their constraints in depth penetration and resolution. Recent advancements in imaging technologies, such as line-field confocal optical coherence tomography (LC-OCT), show promise in enhancing diagnostic precision while minimizing invasive procedures. LC-OCT merges high-resolution imaging with deep penetration capabilities, capturing detailed horizontal and vertical skin images akin to histopathology. This study evaluated the diagnostic performance of LC-OCT in detecting EMPD and its recurrence in 17 clinically suspicious anogenital regions, belonging to 6 patients. Data were collected prospectively at patient bedside by an LC-OCT expert with poor training for EMPD; and, then, reviewed retrospectively by an independent LC-OCT expert with adequate training for EMPD and no concerns about time. The prospective examination yielded 64.7%-accuracy, 71.4%-sensitivity, and 33.3%-specificity. The retrospective analysis achieved 94.1%-accuracy, 100%-sensitivity, and 66.7%-specificity, with the only false positive case being a difficult-to-diagnose concomitant presentation of a lichen sclerosus et atrophicus. Despite the need for specialized training, our results suggest that LC-OCT represents a valuable tool for accurately identifying EMPD and improve its management by reducing unnecessary biopsies. Further studies are needed to standardize its clinical application.

This paper addresses the critical issue of trust in Artificial Intelligence systems, especially when users might find it challenging to comprehend the internal decision-making processes of such systems. A relevant topic of research in this respect is Theory of Mind, which involves attempting to understand these systems as if they possessed beliefs, desires, and intentions. We focus on the latter: intentions, and we examine how producing explanations based on them can improve \emph{understandability} while allowing for a better interpretation of how they align with human values. We also review some existing methods for identifying intentions in AI systems and we conclude with a discussion on possible future directions in this line of research.

Although flow mixing and cooling can be greatly enhanced when considering the use of Fluidic Oscillators (FO), they are more commonly employed in Active Flow Control (AFC) applications where the injected pulsating flow interacts with the boundary layer in order to usually delay its separation. In fact, prior to any FO implementation in a given application, it is essential to study the range of frequencies and amplitudes it can generate as a function of the incoming mass flow and its dimensions. This point is what is being enlightened in the present manuscript for a rather novel FO configuration. We are numerically studding a standard FO configuration in three dimensions 3D and also using a two dimensional 2D approach. After comparing the 3D and the 2D results and analyzing the main differences, we modified some of the internal dimensions of the FO in order to evaluate the variation of its dynamic performance. The present results clarify which internal dimensional modifications are more effective in generating larger output frequencies and velocity field variations. Care is taken to analyze the origin of the self sustained oscillations. In fact, the present research needs to be seen as the continuation of a former one recently published , where the effect of several Reynolds numbers as well as some different internal dimensions was considered.

Neurobrucellosis in cetaceans, caused by Brucella ceti, is a relevant cause of death in striped dolphins (Stenella coeruleoalba) from the Mediterranean Sea. Serological tests are not used as a routinary technique for the diagnosis of this infection. We briefly describe the pathological findings of 10 free-ranging stranded cetaceans diagnosed with Brucella infection in our veterinary necropsy service from 2012 to 2023. Findings included focal diskospondylitis, non-suppurative meningitis, choroiditis and radiculitis. Additionally, an exploratory serological study was conducted in 66 frozen sera collected in the period 2012-2022 from 57 striped dolphins, 5 Risso’s dolphins (Grampus griseus), 2 common bottlenose dolphins (Tursiops truncatus), 1 common dolphin (Delphinus delphis) and 1 pilot whale (Globicephala melas), to compare antibody levels in Brucella-infected (n=8) and non-infected (n=58) animals, classified by cause of death, sex, age class and cetacean morbillivirus (CeMV) infection status. We performed a commercial competition ELISA (cELISA) using serial serum dilutions for each sample, considering a percentage of inhibition (PI) of ≥40% as positive. A titer of 1:160 was arbitrarily determined as the seropositivity threshold. Seropositive species included striped dolphins and Risso’s dolphins. Seroprevalence was higher in animals with neurobrucellosis (87.5%) compared to the overall prevalence (31.8%) and to other causes of death, indicating a high sensitivity but low specificity for neurobrucellosis. Animals with chronic CeMV seemed to have higher seroprevalences, as well as juveniles, which also had more disease prevalence. These results suggest that high antibody titers are not always protective against clinical brucellosis, although they may indicate a carrier state, and that CeMV may potentially condition Brucella epidemiology. More research is required to elucidate the epidemiology and pathogenesis and to disentangle the complicated host-pathogen interaction in Brucella species.

Coastal zones experience increasing climatic and human pressures, which lead to growing risks and tipping points (TPs) under future scenarios and natural resource scarcity. To avoid crossing TPs with irreversible coastal losses, this paper proposes the development of adaptation pathways based on advanced coastal oceanography and engineering knowledge that enables an objective assessment of evolving coastal risks. These pathways feature sequential interventions, combining conventional engineering works with nature-based solutions (NbS), steered by simulations and observations as a function of available coastal resources (space and sediment) and risks for infrastructure and socioeconomic assets. Such an adaptation has been developed for urban and peri-urban Mediterranean beaches, considering conventional coastal engineering together with NbS. Both types of interventions are assessed in terms of key physical variables, which serve to evaluate performance and estimate TPs. This analysis supports the new coastal protection and management plan promoted by the local government and the coastal adaptation plan of the central government. The approach and results illustrate the potential of adaptation pathways for beach sustainability, enhancing the compatibility between short/long-term coastal protection objectives under present/future climate and management scenarios. The adaptation pathways development underpins an increasing stakeholder cooperation to achieve shared decisions for coastal sustainability.

Creativity in virtual work environments and its influence on emotional exhaustion is a relationship with inconclusive results. Furthermore, autonomy, when it loses its original purpose of acting as a job resource, takes on an ambiguous role that needs further research. Objective: To analyze the relationship between creativity and emotional exhaustion, along with the role assumed by work autonomy in this link, in an online work context. Methodology: The sample is formed by 448 employees with university studies. The statistical analysis is done through a simple moderation process. Results: Creativity and work autonomy mitigate emotional exhaustion. Control over work surely reduces the impact of work related stressors, and this safety climate promotes adaptive and original responses that improve employees' emotional health. However, when creative demands coincide with an autonomy that extends working hours, instead of establishing limits, this supposed benefit becomes a demand that prevents employees from disconnecting until emotionally exhausting them. Conclusion: A virtual work environment is an ideal habitat for creativity and self-management to improve employees' emotional health, as long as work autonomy acts as a resource.

(1) Background Diabetic Retinopathy (DR) is the primary cause of poor vision in young adults. Screening for DR is important but many patients do not attend; (2) Methods: We validated an algorithm for predicting DR and its progression by conducting a retrospective study of 11 children in a population of 120,389 T2DM (3) Results: By applying the algorithm to the population showed an AUC of 0.93 (95% CI, 0.92–0.94) for any-DR and 0.90 (95% CI, 0.89–0.91) for referable-DR(4) Conclusions: The algorithm is useful for predicting patients who could develop referable forms of DR and also for any-DR. This would allow a personalized screening plan to be drawn up for each patient.

Solifenacin (SFC) is a potent muscarinic antagonist that effectively reduces bladder muscle contraction, thereby alleviating symptoms such as frequency of micturition and urgency. Oxidation of SFC leads to the formation of impurities like Impurity K. Effective analysis and control of this impurity is crucial for ensuring compliance with regulatory standards and safeguarding patient health. To address these challenges, we propose a novel one-step synthesis of Impurity K from SFC. Impurity K was synthesized using cerium ammonium (IV) nitrate (CAN) in water/acetonitrile as the solvent. Additionally, we describe a new HPLC-MS method for the detection of Impurity K in solifenacin succinate tablets.

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.

Ecuador is an important center of biodiversity of the plant family Amaryllidaceae, specially the subfamily Amaryllidoideae, known as a source of important bioactive molecules. The aim of this study was to assess the chemical and biological potential of four different species of Amaryllidoideae collected in Ecuador: Urceolina formosa, Urceolina ruthiana, Clinanthus incarnatus, and Stenomesson aurantiacum. Sixteen alkaloids were identified in the bulb extract of these species by GC-MS, which the extract of S. aurantiacum exhibiting the greatest structural diversity. The potential of these three genera against Alzheimer’s disease was evaluated by measuring their AChE and BuChE inhibitory activity, revealing that C. incarnatus and U. formosa (from Sucumbíos province) showed the best results with IC50 values of 1.73 ± 0.25 and 30.56 ± 1.56 g·ml-1, respectively. Molecular dynamic assays were conducted to elucidate the possible interactions that occurs among 2-hydroxyanhydrolycorine and AChE enzyme, suggesting some similarity with those observed for galanthamine. This study enhances our understanding of the biodiversity of Amaryllidoideae species from Ecuador, highlighting their potential as a source of chemical compounds with pharmaceutical potential.

Background: Although many studies analyse gender differences in the clinical expression of Attention Deficit Hyperactivity Disorder (ADHD) and prevalence studies show that girls with ADHD are underdiagnosed, there are no instruments that are sensitive to the detection of girls with ADHD. Objective: The objective of this study is to develop a self-report early detection instrument for ADHD for boys and girls aged 7 to 16, which includes the gender perspective and is sensitive to the detection of girls with ADHD. Methods: The development of the scale and the items that comprise it were created from the thematic analysis of ADHD and its evaluation in children, based on the diagnostic criteria of the DSM-5-TR. A modified e-Delphi method involving a three-round web survey was used to reach a consensus on the content of the scale. Ten experts were recruited into a professional panel. The panel members were asked to assess the differential symptomatology of ADHD in boys and girls, the dimensions to be evaluated, and the importance of the scale items to evaluate the content. Results: Consensus was reached regarding 13 total items distributed in three dimensions: Inattention, Hyperactivity/Impulsivity, and a third dimension, Internalisation, which includes symptoms most present in the expression of ADHD in girls. Conclusions: To the best of our knowledge, the development of this scale using the Delphi method is the first specific scale for identifying ADHD that addresses the gender perspective and the differential symptomatology between boys and girls. Although we must proceed to the analysis of the psychometric properties, we can anticipate that this scale will provide relevant and reliable information for the identification of ADHD in both boys and girls.

A multicenter retrospective analysis of 408 patients diagnosed with onychomycosis and attended at three tertiary care Spanish hospitals was conducted to assess the effectiveness and safety of a combined treatment with ciclopirox 8% hydroxypropyl chitosan (CPX 8% HPCH) nail lacquer and oral antifungal agents (terbinafine, itraconazole, and fluconazole). Data were extracted and analyzed using the EHRead® technology based on natural language processing and machine learning and using SNOMED CT terminology. The median age was 51 years with a ratio male: female close to 1. Repeated nail trauma was the most common risk factor (7.1%). More than half of patients (56.6%) underwent fungal culture. Terbinafine was used in 67.7% of patients, itraconazole in 20.8%, and fluconazole in 11.5%. Treatment synchronicity distribution revealed that 59.1% of patients started concomitant treatment with CPX 8% HPCH and oral antifungals, 27.9% had initial oral antifungals, and 13% had initial nail lacquer. The response to treatment (positive response 15.7%, presumed positive 59.8%) was unrelated to treatment synchronicity or type of antifungal agent. Erythema (5.6%), diarrhea (4.9%) and fever (4.2%) were the most frequently registered potential adverse events. The present findings provide valuable insights for physicians paving the way for better management of patients with onychomycosis.

Background The operator's ability in performing carotid stenting (CAS) has improved clinical outcomes. However, more than 3% of patients need to be treated again after CAS. Most of the cases requiring further intervention are affected by hyperplasia. The recommended procedure is the DEBalloon. On the other hand, the literature reports a small number of carotid neoatherosclerosis cases and is recommended to be treated using elective Micronet-covered stent. Discriminating between the two types of in-stent-restenosis ISR (hyperplasia or neoatherosclerosis) is critical for a positive outcome.Case summary We describe a case in which a patient treated with carotid stenting 8 years before, was diagnosed with ISR. Due to the development of neurological symptoms and progressive increases in Peak Systolic Velocity (PSV) eight years following carotid stenting, a DEBalloon was used in a carotid in-stent-restenosis (ISR) standard procedure. About ten minutes after the procedure, the patient developed hemiplegia consistent with the treated carotid territory. The implantation of a MicroNet-covered stent excluded the thrombus and reverted symptoms with a normal MR control at 24 h. Conclusion This case illustrates that when in-stent stenosis evolves years after the stent implantation, neoatherosclerosis should be assessed, and a MicroNet-covered stent should be considered.

Systemic AL amyloidosis is a challenging disease for which many patients are considered frail in daily clinical practice. However, no study has so far addressed frailty and its impact on the outcome of these patients. We built a simple score to predict mortality based on three frailty-associated variables: age, ECOG performance status (&lt;2 vs. 2) and NT-proBNP (&lt;8500 vs. 8500 ng/L). Four-hundred and sixteen consecutive newly diagnosed patients diagnosed at ten sites from the Spanish Myeloma Group were eligible for the study. The score was developed in a derivation cohort from a referral center, and it was externally validated in a multicenter cohort. On multivariate analysis the three variables were independent predictors of survival. The score was able to discriminate four groups of patients in terms of overall survival and early mortality in both cohorts. Comorbidity was also analyzed with the Charlson comorbidity index, but it did not reach statistical significance in the model. A nomogram was created to easily estimate the mortality risk of each patient at each time point. This score is a simple, robust, and efficient approach to dynamically assess frailty-dependent mortality both at diagnosis and throughout the follow-up. The optimal treatment for frail AL amyloidosis patients remains to be determined but we suggest that the estimation of frailty-associated risk could complement current staging systems, adding value in clinical decision-making in this complex scenario.

The entropy of the partition generated by an n-tone music scale is proposed to quantify its regularity. The normalized entropy relative to a regular partition, and its complementary, here referred to as the bias, allow to analyze various conditions of similarity between an arbitrary scale and a regular scale. Interesting particular cases are scales having limited bias because their tones are distributed along interval fractions of a regular partition. The most typical case in music concerns partitions associated with well-formed scales generated by a single tone h. These scales are maximal even sets that combine two elementary intervals. Then, the normalized entropy depends on the number of tones as well as the relative size of both elementary intervals. When well-formed scales are refined, several nested families stand out with increasing regularity. It is proven that a scale of minimal bias, i.e. with less bias than those with fewer tones, is always a best rational approximation of log2h.

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

Archaeometry can help archaeologists in multiple instances, one of the common archaeometric goals are the provenance analyses. Volcanic stones appear frequently in archaeological sites as materials used to build grinding tools like millstones and mortars or as building materials. Petrographic characterization is commonly applied to identify their main mineralogical components. However, provenance of volcanic stones is usually undertaken by comparison with geochemical data from reference outcrops using common descriptive statistical tools such as biplots of chemical elements, and unsupervised multivariate data analysis like principal component analysis (PCA). Recently, the use of supervised classification methods has shown a superior performance in assigning provenance to archaeological samples. However, these methods require the use of reference databases for every possibly provenance class to be able to train the used classification algorithms. The existence of comprehensive collections of published geochemical analyses of igneous rocks enables the use of the supervised approach for provenance determination of volcanic stones. In this paper, the provenance of volcanic grinding tools from two archaeological sites (Iulia Libica, Spain and Sidi Zahruni, Tunisia) is attempted using data from the GEOROC Database through unsupervised and supervised approaches.

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

In the field of construction, materials referred to as sustainable are currently undergoing a process of technological development. This study aims to contribute to the understanding of the behavior of the fundamental properties of concretes prepared with recycled coarse aggregates that incorporate in their matrix a polyethylene terephthalate-based additive in an attempt to reduce their high porosity. Techniques to measure the gas adsorption, water porosity and x-ray diffraction (XRD) were used to evaluate the effect of the additive on the physical, mechanical and microstructural properties of these concretes. Porosity reductions of up to 30.60% are achieved with the addition of 1, 3, 4, 5, 7 and 9% of the additive, defining a new state in the behavioral model of the additive (the overdosage point) in the concrete matrix; in addition, the porous network of these concretes and their correlation whit other physical and mechanical properties are also explained.

During the last 100 years the planet has increased its temperature rapidly, this climate change could bring catastrophic effects for organisms and natural systems. One of the most affected groups is the ectotherms, due to their direct dependence on the environmental temperature. In recent years several studies analyse the effects of temperature and the thermal tolerance on several species of ectotherms. However, there are species whose thermal tolerances are still unknown. Such is the case of critically endangered species the Montseny Brook Newt (Calotriton arnoldi), endemic from the Montseny massif in Spain and whose thermal biology is unknown. Its critical situation makes essential to know its tolerance to cooling, warming and thermopreferendum in water environment where the newt lives. Three experimental procedures were conducted from the western and eastern subpopulations of C. arnoldi considering four classes separately (males, females, juveniles and larvae). The results obtained showed that the CTmax of the species exceeded 31°C, with a significant difference between the two populations. We found that the species tolerates well low temperatures (&lt;1°C), because of the genera Calotriton is adapted to lives in cold waters with temperatures below 15º. Although the thermopreference of the species was expected to trend to cold temperatures, some individuals chose relatively high temperatures, obtaining a range of 11.7°C to 21.6°C. The results presented in this study are an advance in the knowledge of the thermal physiology of this species and support the importance of the temperature of the torrent on its survival. Knowing their thermal limits and their preferred temperature range will help to propose management measures that promote the conservation of streams and its riparian forest cover to mitigate the temperature increase due to climate change.

Introductory courses regarding radar technologies are very popular in undergraduate curriculum of many electrical and electronics engineering departments. Hands-on experience is an essential part for understanding the theoretical concepts given in lectures. In most cases, it is not affordable for universities to acquire experimental radar systems, especially those in developing countries. This paper presents a detailed description of a cost-effective easy-to-deploy radar system laboratory sessions and measures the educational effectiveness of the proposed material. The provided radar models can be used in teaching undergraduate students the working principles of frequency modulated continuous wave (FMCW) radar systems, as well as assisting graduate students in their research activities. The effectiveness of the laboratory sessions is measured thoroughly via qualitative and quantitative methods based on the proposed learning process and students’ success. The results show that the lab sessions have increased the students' understanding of the topics covered within the course, and the students' general perception is positive.

The paper analyses how between 1956 and 2009 the agrarian metabolism of the Barcelona Metropolitan Region (BMR) has become less functional, losing circularity in biomass flows and in relationship to its landscape. We do so by adopting a Multi-EROI and flow-fund (MuSIASEM) analyses and its nexus with landscape functional structure. The study of agricultural flows of Final Produce, Biomass Reused and External Inputs is integrated with that of land use, livestock, power capacity and population changes between 1956 (at the beginning of the Green Revolution) and 2009 (fully industrialized agriculture). A multi-scale analysis is conducted at the landscape scale (seven districts within the Barcelona metropolitan region) as well as for the functions deployed, within an agroecosystem, by the mutual interactions between its funds (land-uses, livestock and farming population). A complex nexus between land, livestock, dietary patterns and energy needs is shown; we conclude that from the perspective of the circular bioeconomy the agrarian sector has gone worse hand in hand with the landscape functional structure. Therefore, a novel perspective in landscape agroecology is opened

Objective: Several authors have analyzed the impact of the pandemic on the incidence rates of different conditions. Our aim was to analyze the impact of the COVID-19 pandemic on primary care new diagnoses of respiratory diseases. Methods: This was an observational retrospective study performed to describe the impact of COVID-19 pandemic on primary care new diagnosis of respiratory diseases other than lung cancer. Incidence rate ratio between pre-pandemic and pandemic period was calculated. Results: We found an decrease in the incidence of respiratory conditions (IRR 0.65) during the pandemic period. When we compared the different groups of diseases according to ICD-10, we found a significant decrease in the number of new cases during the pandemic period, except in the case of pulmonary tuberculosis, abscesses or necrosis of the lungs and other respiratory complications. Instead, we found increases in new diagnoses of flu and pneumonia (IRR 2.17) and respiratory interstitial diseases (IRR 1.41). Conclusion: There has been a decrease in new diagnosis of most respiratory diseases during the COVID-19 pandemic. The real clinical impact of this situation is still unknown. Large-scale real-life studies will make it possible to evaluate the long-term true impact of COVID-19 pandemic on the respiratory diseases management.

The city of Barcelona, ​​like other cities in the world, suffers strong internal socio-economic inequalities. Numerous works have sought to detect, quantify, characterize and / or map existing intra-urban differences, almost always based on quantitative methodologies. With this contribution, we intend to illuminate the complementary role that qualitative methodologies can play in studies on urban socio-environmental vulnerability. We consider aspects that are not quantifiable but that may be inherent to many such vulnerable spaces, both in the constructed environment and in the social ambit. These questions are considered through selected neighborhoods of Barcelona which have been shown (in prior works, mainly studies of quantitative manufacturing) to possess elements of vulnerability including a high presence of immigrants from less-developed countries, low per capita income, aging populations, or low educational levels. The results reveal the multidimensionality of vulnerability in the neighborhoods analyzed, as well as the essential complementarity among methodologies that detect and support possible public actions aimed at reducing or eliminating intra-urban inequalities.

This research examines the overtopping volumes associated with focused wave groups on smooth dikes with an emerged toe. Focused wave groups are employed to represent the highest waves of random sea states in a compact form, obviating the need to model the entire irregular wave train. The study investigates how overtopping volumes are affected by focus location and phase. Results from 418 experimental tests have been gathered and analyzed. The experiments employed first-order wave generation theory to analyse structural response. Subsequent studies will address the errors induced by this approximation and compare it with second-order wave generation. The experiments simulated extreme wave impacts on an idealised coastal layout, comprising a 1:6.3 foreshore slope and three different dike slopes, including vertical structures, with the initial still water level set below the dike toe. The study employed NewWave theory for generating focused wave groups, aiming to extend recent research on wave overtopping under varied conditions. The results, analysed in both dimensional and non-dimensional forms, indicate that overtopping volumes are significantly influenced by the focus phase. Critical focus locations were identified at a distance of one-third of the deep-water wavelength from the toe.

The difficult current environmental situation, caused by construction industry residues containing ceramic materials could be improved by using these materials as recycled aggregates in mortars, with their processing causing a reduction in their use in landfill, contributing to recycling and also minimizing the consumption of virgin materials. Although some research is currently being carried out into recycled mortars, little is known about their stress-strain (σ-ε); therefore this work will provide the experimental results obtained from recycled mortars with recycled ceramic aggregates (with contents of 0, 10, 20, 30, 50 and 100%), such as: the density, the compression strength, as well as the σ-ε curves representative of their behavior. The values obtained from the analysis process of the results are those of: σ (elastic ranges and failure maximum), ε (elastic ranges and failure maximum), and Resilience and Toughness; in order to finally obtain, through numerical analysis, the equations to predict their behavior (related to their recycled content). At the end of the investigation it is established that mortars with recycled ceramic aggregate contents of up to 20% could be assimilated just like mortars with the usual aggregates, and the prediction equations produced could be used in cases of similar applications.

Wang et al. (Nature 623, 340—350; 2023)¹ used satellite observations and phenological signatures to estimate the extent of planted rubber (Hevea brasiliensis Müll.Arg.) and associated deforestation for eight Southeast Asian countries. Their map implies that planted rubber has caused more than 4 Mha of deforestation since 1993 — a value greater than previously assumed. Unfortunately, their approach was flawed. Our assessment indicates that the actual extent of planted rubber is approximately half that reported by Wang et al., while the extent of associated deforestation is approximately one quarter.

Introduction: Pre-Exposure Prophylaxis (PrEP) for HIV prevention has been implemented in several countries. Previous literature has shown that its cost-effectiveness (and, under some specifications, cost-saving character) is dependent on the reduction in price due to generics, the time-horizon and its effectiveness. The intervention has never been studied in Catalonia, a territory with extensive implementation. Methods: Economic evaluation of the implementation of HIV pre-exposition prophylaxis using administrative data from Men who have Sex with Men (MSM) who receive the treatment (at the generic price). A deterministic compartmental model and a social perspective with a micro-costing approach over the time horizon 2022-2062 are used. A baseline 86% effectiveness of PrEP is assumed. Results: Daily oral PrEP is found to be cost-saving: discounted savings in costs are attained after 16 years, and after 40 years they reach 81 million euros. In terms of health indicators, 10,322 additional discounted QALYs are generated by the intervention. Results are sensitive to sexual behavioral patterns among MSM, the price of PrEP (reduced if offered on-demand), its effectiveness and the discount rate. Conclusions: The use and promotion of PrEP in Catalonia is predicted to result in substantial health and monetary benefits because of reductions in HIV infections. Short-term investments in the promotion of PrEP will result in important cost-savings in the long term.

The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures. Among these, mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to limit the spread of the virus. In this article, we aim to evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population through a Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. Excluding the value of monetized health, the Benefit-Cost ratio was estimated at approximately 0.45. However, if monetized health is included in the calculation, the ratio is close to 1.20. The monetization of health is the critical element that tips the scales in favour of the desirability of screening. Screenings with the highest return are those that maximize the percentage of positives detected.

Photocatalysis is a promising method for methylene blue (MB) degradation due to its effectiveness and environmental compatibility. Among photocatalysts, titanium dioxide (TiO2) has been widely used for MB degradation due to its exceptional photocatalytic activity. However, the wide bandgap limits the degradation efficiency of TiO2 under visible light. Herein, an interstitial nitrogen-doped TiO2 (5%NT/TiO2) used thiourea as the N source is fabricated for the visible light-derived MB degradation. 5%NT/TiO2 exhibits an extended visible light absorption range. Besides, photoelectrochemical measurement shows an improvement in photocurrent response and charge transfer behavior on N/TiO2. Thus, 5%NT/TiO2 has enhanced photocatalytic activity compared to pristine TiO2 and substitutive N-doped TiO2 (5%NAB/TiO2). The accelerated photocatalytic MB degradation process on N/TiO2 should be mainly attributed to the interstitial N doping, which causes the appearance of new energy states and extended optical properties.

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.

The recent availability of commercial platforms for behavioral analysis in zebrafish larvae based on video-tracking technologies has exponentially increased the number of studies analyzing different behaviors in this model organism to assess neurotoxicity. Among the most commonly used assays in zebrafish larvae are basal locomotor activity (BLA) and visual motor response (VMR). However, the effect of different intrinsic and extrinsic factors that can significantly alter the outcome of these assays is still not well understood. In this work we have analyzed in 143 larvae the influence of age (5-8 days post-fertilization), time of day (8:00, 10:00, 12:00, 14:00; 16:00, 18:00, and 20:00 h), and experiment (three experiments performed at different days) on BLA and VMR results (4,004 analyses for each behavior). Results from both behaviors were adjusted to a Random-Effects linear regression model using generalized least squares (GLS), including in the model the effect of the three variables, the second-way interactions between them and the three-way interaction. The results presented in this manuscript show a specific effect of all three intrinsic factors and their interactions on both behaviors, supporting the view that the most stable time period for performing these behavioral assays is from 10:00 am to 04:00 pm, with some differences depending on age of the larva and the behavioral test.

Petrochemicals and oil refineries are industrial processes that use compounds and polymers derived directly or indirectly from natural gas or crude oil for chemical purposes. They have posed a number of short- and long-term risks to the environment and the people who live nearby. The study aims to determine how the presence of industrial areas, such as oil refineries, affects the local population's perception of their surroundings. The investigation centers on the Tehran Oil Refinery, a major refinery hub, and its perceived environmental impact. For this purpose, a Geographic Information System for Public Participation (PPGIS) covering three basic sections has been designed: socio-demographic information of the participants; self-perceived health; and landscape valuation before and after an intervention. The main observations show a complex interaction between industrial presence and the perception of landscape values. Participants' reactions to the manipulated Photographs reveal important details about the psychological impact of visual elements on emotional perception. There is also a direct relationship between the level of stress and emotional perception in the manipulated and original photos.This research adds to the larger debate about the effects of industrialization on the environment and society. It emphasizes the importance of considering public perception when planning and developing industrial projects. The goal is to strike a balance between industrial operational needs and environmental quality preservation, resulting in long-term urban growth.

Mediterranean diet, featuring sourdough bread, shows promise in managing metabolic syndrome. This study explored the effects of two sourdough breads with differing fermentation times but similar nutritional profiles on inflammation, satiety, and gut microbiota composition in adults with metabolic syndrome. The double-blind clinical trial randomized participants to consume over two-months Elias Boulanger® long fermentation (48h) sourdough bread (EBLong) or Elias Boulanger® short fermentation (2h) sourdough bread (EBShort). We assessed clinical parameters, inflammatory- and satiety-related biomarkers; and richness and abundance of gut microbiota at baseline and follow-up. 31 individuals (mean age: 67, 55.7% female) participated. EBShort was associated with reduced soluble intercellular adhesion molecule (sICAM) levels, and irrespective of the adjudicated intervention, all participants had a decrease in sICAM and diastolic pressure relative to baseline (p&lt;0.017). At follow-up, plasminogen activator inhibitor-1 (PAI-1) levels were lower in EBShort (-744 pg/mL; 95%CI: -282 to -1210 pg/mL) compared to EBLong. High-quality sourdough bread may offer mild benefits in blood pressure and inflammation for those with metabolic syndrome, however, only EBLong was associated to reduced Enterobacteriaceae abundance. Further research is needed to understand potential benefits and mechanisms of sourdough bread in managing metabolic syndrome and improving cardiovascular health.

Sequence analysis is a robust methodological framework that has gained popularity in various fields, including transportation research. It provides a comprehensive approach to understanding the dynamics and patterns of individual behaviors over time. In the context of the Metropolitan Region of Barcelona, applying sequence analysis to the mobility surveys offers valuable insights into the sequencing and order of travel activities and modes, shedding light on the complex interrelationship between individuals, their travel choices, and the built environment. The Barcelona travel surveys collect detailed data on individuals' travel behavior, such as trip purpose, duration, mode of transportation, and origin-destination pairs. Sequence analysis allows for examining travel behaviors as dynamic processes, unveiling travel patterns' underlying structure and evolution in a day. A data analytics methodological approach is described; it enables the identification of common travel patterns and the exploration of variations across different demographic groups or geographical regions. Sequence analysis reveals insights into the factors influencing mode choice and potential opportunities for sustainable transport interventions. The paper proposes a methodological approach to discover homogeneous travel behavioral segments from diaries included in travel surveys in order to refine transport policies to selected segments by transportation planners and authorities

Background: Bariatric surgery (BS) has a significant impact on body composition (BC) and con-sequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study is to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evalua-tion of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aim to demonstrate how MUS of RFT correlates better with the quality of life (Qol) in this population, likely because it enables the detection of regional quadriceps muscle sarcopenia, in comparison to the other mentioned methods. Methods: This is a prospective pilot study including 77 subjects (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA and RFT was measured by MUS. Moreover, Homeostasis Model Assessment of Insulin Resintance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was as-sessed using the Moorehead-Ardelt questionnaire. Results: The mean BMI decreased by 12.95 ± 3.56 kg/m2 (p=0.001). Firstly, we observed positive correlation pre-surgery between HOMA and: RFT (r=0.27, p=0.02), iFFM (r=0.36, p=0.001), AMI (r=0.31, p=0.01) and dynamometer (r=0.26, p=0.02). In addition, we found correlation between RFT and iFFM (pre-surgical: r=0.31, p=0.01; post-surgical: r=0.25, p=0.05) and between RFT and lower extremities AMI post-surgical (r=0.27, p=0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT (p=0.001), but not with dynamometer (p=0.94). Finally, a tendency to a positive correlation between QoL question-naire and RFT post-surgery (r=0.23, p=0.079) was observed. Conclusions: Our results suggest that RFT measured by MUS for the evaluation of SO and the follow-up after BS of these patients. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.

The effect of doublet state metalloradical complex in a solar cell inside the common active layer poly(3-hexylthiophene)/ [6,6]-phenyl-C61-butyric acid methyl ester (P3HT/PC60BM) is explored. In this work is demonstrated that the role of the Bis-[1,3-Bis-(2,6-diisopropylphenyl)-4,5-dichloroimidazol-2-ylidene]palladium(I) hexafluoridophosphate dopant, [Pd(IPrCl)2][PF6], is crucial because, by having a stable unpaired electron in the molecule, it significantly improves the optoelectronic performance of the devices. We found the optimal concentration of this molecule in the active layer, and we demonstrated that the presence of this additive in the active layer helps to significantly improve the morphology of the device. The improvements in optoelectronic and morphological parameters are associated with a remarkable increase of photocurrent generation due to more favourable mechanisms of charge separation at the donor/acceptor (D/A) interfaces of the active layer and reduced recombinations. Moreover, the presence of this additive improves the stability of the unencapsulated solar cell against photochemical degradation produced by sunlight.

Our study focused on investigating the impact of Instagram use on body satisfaction and self-esteem among participants aged 20 to 40 years (N = 95) through a cross-sectional survey design in which the Rosenberg Self-Esteem Scale, the Body Shape Questionnaire (BSQ), and ad hoc designed questions were administered. The results highlight the influence of Instagram on body dissatisfaction (p = .005) but not on self-esteem (p = .211). Gender was not found to be an influential factor (p = .173). However, it was found that greater body satisfaction correlates with higher self-esteem and vice versa (p < .001). Finally, we concluded that the number of hours users in the sample spend on Instagram is related to greater body dissatisfaction but not to lower self-esteem.

Recently several papers have been published on the Liénard equation x'' +L x+m x^3+n x^5=0, where the authors studied their explicit solutions and their applications. Here we describe the complete dynamics of these differential equations in the Poincar\'e disc. The Poincar\'e disc is the closed disc centered at the origin of coordinates of radius one, the whole plane R^2 is identified with the interior of this disc, and its boundary, the circle $\sss^1$ is identified with the infinity of R^2.

ProAKAP4, a precursor of AKAP4 (A-kinase anchor protein) found in the flagellum of mammalian and non-mammalian spermatozoa, serves as a structural protein with established correlations to motility parameters across diverse species. This study aimed to determine the proAKAP4 levels evolution in thawed stallion semen over a 3-hour period, examining its correlation with motility descriptors and mitochondrial membrane potential. Utilizing sixteen ejaculates from four French warmblood stallions, the study involved maintaining thawed samples at 37°C for 3 hours, conducting proAKAP4 enzyme-linked immunosorbent assay (ELISA), computer-assisted sperm analysis (CASA), and mitochondrial membrane potential by JC-1 probe and flow cytometry at 0, 1, and 3 hours post-thawing. The findings indicate significant positive correlations (p≤0.05) between proAKAP4 levels and sperm total or progressive motility at all time points analyzed. Spermatozoa velocity descriptors (VAP, VCL, VSL) and spermatozoa lateral head displacement (ALH) display positive correlations (p≤0.05) with ProAKAP4 at the 0-hour post-thawing. ProAKAP4 concentration exhibits no discernible difference between batches with or without cryoprotectant. Notably, proAKAP4 consumption remains insignificant within the initial hour after thawing but becomes significant (p≤0.05) between 1 and 3 hours post-thawing. In summary, proAKAP4 demonstrates positive correlations with total and progressive motility in stallion semen for up to 3 hours after thawing, albeit showing a noticeable decrease starting from the first hour post-thawing, indicating a progressive consumption as a result of spermatozoa motile activity.

Aim: To evaluate the impact of applying alternative diagnostic criteria for gestational diabetes mellitus (GDM) during the COVID-19 pandemic on GDM prevalence, obstetrical and perinatal outcomes, and costs, as compared to the standard diagnostic method. Methods: A cohort of pregnant individuals undergoing GMD screening with the alternative GDM method, which uses plasma glucose (fasting or non-fasting) and HbA1c, was compared with a cohort of pregnant individuals undergoing the standard GDM screening method. Both cohorts were obtained from 6 hospitals across Catalonia, Spain, from April 2020 to April 2022. The primary outcome was large for gestational age rate at birth. Secondary outcomes were composite adverse outcomes including pregnancy complications, delivery complications, and neonatal complications. Cost differences between screening methods were also evaluated. A similar analysis was performed in the subgroup diagnosed with GDM. Results: Data were collected from 1,543 pregnant individuals in the standard screening group and 2,197 in the alternative screening group. The standard screening group had a higher GDM diagnostic rate than the alternative screening group (10.8% vs 6.9%, respectively; p

Waste glycerol can be subjected to various processing operations, including purification and re-fining, to obtain glycerol of appropriate purity. In addition, alternative methods of utilising waste glycerol are also being sought, e.g. by converting it into other valuable chemical products or biofuels. Therefore, various technologies are being developed to utilise this type of waste effectively and sustainably. The production of value-added products from waste glycerol is an important issue that determines the improvement of the economic viability of biofuel production and corresponds to the model of a waste-free and emission-free circular economy. This paper characterised the mechanisms and evaluated the efficiency of existing methods of microbiological utilisation of waste glycerol into liquid biofuels, including biodiesel, bioethanol and biobutanol, and identified further directions for the production of value-added products. In addition, a bibliographical analysis of publications re-lated to the production of liquid fuels and economically valuable products from glycerol was carried out, the progress of research and application work was assessed and directions for future research were identified.

The acoustic startle response (ASR) is an explosive motor response leaded by a sudden and intense acoustic stimulus. ASR has several clinically relevant forms of plasticity, including habituation and sensorimotor gating. Although ASR and its plasticity have been intensively studied in different animal models, including zebrafish (Danio rerio) larvae, information in adult zebrafish is still very scarce. In this manuscript we present Zebra_K, a new automated high-content kinematic analysis platform for assessing ASR, its habituation and prepulse inhibition (PPI), a quantitative measure of sensorimotor gating, in adult zebrafish. The analysis of the kinematic parameters in 1,875 ASR in adult zebrafish has shown a single response wave consistent with the short-latency C-bend described in zebrafish larvae. Moreover, protocols have been designed and validated in Zebra_K for the analysis of sensitivity, habituation and PPI of this response. Then, this platform has been used to determine the effect of pharmacological and physiological modulators of ASR plasticity. As described in other animal models, the NMDA-receptor antagonist ketamine increased the responsiveness to the acoustic stimuli, decreasing habituation and leading to complete abolition of PPI. Moreover, the effect of the gender on zebrafish ASR plasticity has been analyzed for the first time. Females exhibited higher responsiveness and a lower habituation and PPI than males, a result consistent with the gender effect described in other animal models and in humans. These results enhance the interest of using adult zebrafish to assess the potential effect of chemicals or genetic manipulations on ASR plasticity.

Background/Objectives Immune effector cell-associated hematotoxicity (ICAHT) is a frequent adverse event after chimeric antigen receptor (CAR)-T cell therapy. Grade ≥3 thrombocytopenia occurs in around one third of patients, many of whom become platelet transfusion-dependent. Without pharmacological support, platelet recovery may last for months. Eltrombopag is a thrombopoietin receptor agonist (TPO-RA) able to accelerate megakaryopoiesis, which has been used successfully in patients with bone marrow failure and immune thrombocytopenia (ITP.) Its role to manage thrombocytopenia, and other cytopenias, in CAR-T cell-treated patients has been scarcely addressed in the real-world setting. Our aim was to report the Feasibility of this approach and the outcome of patients included in the GETH-TC registry. Methods This is a retrospective, multicenter, observational study. Patients who developed platelet transfusion-dependence subsequently to CAR-T cell treatment were recruited in 10 Spanish hospitals and followed-up for at least 30 days after the first dose of eltrombopag was administered. Results Thirty-eight patients were enroled and followed-up for a median (interquartile range [IQR]) of 175 (99, 489) days since CAR-T cell infusion. At eltrombopag start, 18 patients had thrombocytopenia and another severe cytopenia, while 8 patients had severe pancytopenia. After 32 (14, 38) days on eltrombopag, 29 (76.3%) patients recovered platelet transfusion independence. The number of platelet units used correlated with the time needed to restore platelet counts to levels ³20x10⁹/L (Rho = 0.639, p <0.001). Non-responders to eltrombopag required more platelet units (58 [29, 69] vs. 12 [6, 26] in responders, p = 0.002). Nineteen out of 23 (82.6%) patients recovered from severe neutropenia after 22 (11, 31) days on eltrombopag. Twenty-nine out of 35 (82.9%) patients recovered red blood cell (RBC) transfusion independence after 29 (17, 44) days. Seven patients recovered all cell lineages while on treatment. No thromboembolic events were reported. Only 2 transient toxicities (cholestasis, hyperbilirubinemia) were reported during eltrombopag treatment, none of which compelled permanent drug withdrawal. Conclusions Eltrombopag can be safely used to manage thrombocytopenia and accelerate transfusion independence in CAR-T cell-treated patients.

The editorial explores the realm of emerging translational research in neurology and psychiatry, providing insights into various subjects, including neurodegenerative disorders and innovative therapeutic methods. The main objective is to study neurological and psychiatric disorders, such as Alzheimer's disease, with a particular emphasis on techniques for neural regeneration and repair. The editorial highlights the importance of taking a comprehensive approach to studying and treating complex neurological and psychiatric conditions. This involves thoroughly reviewing research papers on the causes, development, biomarkers, and treatment options for these conditions. The editorial emphasizes the necessity of using multidisciplinary and integrative methods to gain a deeper understanding and improve the treatment of these conditions. The development of an animal model for recurrent primary dysmenorrhea showcases the innovative techniques employed in the investigation of gynecological disorders, illustrating the capacity of translational research to connect fundamental scientific knowledge with practical medical applications. The cooperative endeavors of researchers and clinicians emphasized in this editorial lay the foundation for revolutionary advancements that hold the potential to enhance outcomes for individuals afflicted with neurological and psychiatric disorders globally.

OpenFOAM is a CFD software widely used in both industry and academia. The exaFOAM project aims at enhancing the HPC scalability of OpenFOAM, while identifying its current bottlenecks and proposing ways to overcome them. For the assessment of the software components and the code profiling during the code development, lightweight but significant benchmarks should be used. The answer was to develop microbenchmarks, with a small memory footprint and short runtime. The name microbenchmark does not mean that they have been prepared to be the smallest possible test cases, as they have been developed to fit in a compute node, which usually has dozens of compute cores. The microbenchmarks cover a broad band of applications: incompressible and compressible flow, combustion, viscoelastic flow and adjoint optimisation. All benchmarks are part of the OpenFOAM HPC Technical Committee repository and are fully accessible. The performance using HPC systems with Intel and AMD processors (x86_64 architecture) and Arm processors (aarch64 architecture) have been benchmarked. For the workloads in this study, the AMD processor seems particularly suited resulting in an overall shorter time-to-solution.

Pygeum africanum bark has been shown to inhibit the production of pro-inflammatory prostaglandins in the prostate and reduce the production of leukotrienes and other 5-lipoxygenase (5-LO) metabolites. It has been suggested that inflammation plays an important role in the pathophysiology of benign prostatic hyperplasia (BPH). In clinical trials, P. africanum improved the symptoms and objective measures of BPH. This in vitro study aimed to assess the anti-inflammatory potential of a proprietary Pygeum bark standardized extract (Prunera®) on cytokine release by lipopolysaccharide-simulated human peripheral blood mononuclear cells (PBMCs). PBMCs were obtained from four donors and a bead-based assay (ProcartaPlex™ panel) was used for the detection and quantitation of cytokines. Pygeum africanum bark standardized extract (PABE) showed the following effects: IL-2 was lowered in all donors in absence of a clear dose–response relationship; IL-4, IL-5, IL-6, IL-9, and IL-13 levels were decreased in most donors; IL-22 levels seemed to be suppressed only for donor 4 at lower and medium concentrations; and IL-27 and levels of TNF-α decreased at all PABE concentrations in all donors. The anti-inflammatory effect of PABE supports the potential use of this natural compound in the management of BPH and other conditions in which pro-inflammatory cytokines are involved in their underlying pathophysiological mechanisms.

Global climate change, particularly rising sea surface temperatures, profoundly impacts coral ecosystems, disrupting reproduction synchrony, symbiotic relationships with algae from the Symbiodiniceae family, and causing widespread bleaching and mortality among coral populations.  Oculina patagonica, a temperate scleractinian coral dominant in Mediterranean coastal waters, tolerates an annual temperature range of 10- 31°C. Moreover, in the past three decades, sea surface temperatures have rapidly risen in the Eastern Mediterranean Sea. O. patagonica offers insight into evolutionary adaptation to rapid environmental changes. This study investigated the effects of temperature changes on O. patagonica reproductive development, synchrony, and thermal sensitivity. Monthly monitoring of O. patagonica colonies for a year reveals no disruption in gonad development compared to previous studies, suggesting an unaffected sexual reproduction capacity. Thermal performance

Heart transplantation (HT) is the gold standard therapy for advanced heart failure (AHF) and LVAD as destination therapy are an option in non-HT candidates. Most patients with AHF never receive a HT or a LVAD, so alternative strategies are needed. Intermittent levosimendan can reduce HF hospitalizations in AHF patients in the short term. It is uncertain whether the results of the comparison of inotropes with older generation LVAD would have the same outcomes in the current era of less sick but older, AHF treated with levosimendan patients. In this paper we compare the use of two therapeutic strategies for end-stage HF in patients not candidates for HT: Repetitive intermittent Levosimendan vs. LVAD as destination therapy. To do so we compare two multicentre cohorts of real-life patients from Spain: the LEVO-D Registry and the REGALAD registry. 715 patients coming from the 2 registries where found, 403 from the LEVO-D and 312 from the REGALAD. Non-adjusted median survival was shorter for LEVO-D patients; with the benefit for the LVAD seen only after the first year of therapy. The survival advantage for the LVAD cohort was also true after analysis of the matched cohort but, as in the non-matched analysis, the survival benefit was mainly shown after one year of follow up. We conclude that in elderly AHF non-HT-candidates, LVAD therapy offers significantly better long-term outcomes when compared to intermittent levosimendan; thus, it should be considered in carefully selected candidates. On the other hand, in poor LVAD candidates or highly comorbid patients, intermit-tent inotropic support with levosimendan could be a reasonable alternative to LVAD as 1-year outcomes are similar.

Steroidogenic factor 1 (SF-1) is a nuclear receptor that regulates steroidogenesis and reproductive development. NR5A1/SF-1 variants are associated with a broad spectrum of phenotypes across individuals with disorders of sex development (DSD). Oligogenic inheritance has been suggested as an explanation. However, testing the impact of specific gene variants involved in a network remains difficult. To confirm the hypothesis that NR5A1/SF-1-related DSD follow an oligogenic mode of inheritance, we investigated a constellation of gene variants identified in a 46,XY severely undervirilized individual. Candidate genes were revealed by whole exome sequencing, and pathogenicity was predicted by different in silico tools. We found variants in NR1H2 and INHA associated with steroidogenesis, sex development, and reproduction. Functional testing was conducted in cell models. Novel SF-1 and NR1H2 binding sites in the AR and INHA gene promoters were found. Transactivation studies showed that wild-type NR5A1/SF-1 regulates INHA and AR gene expression, while the NR5A1/SF-1 variant had decreased transcriptional ac-tivity. NR1H2 was found to regulate AR gene transcription; however, the NR1H2 variant showed normal activity. This study expands the NR5A1/SF-1 network of interacting partners while strengthening the hypothesis that the broad phenotype observed in 46,XY DSD individuals may be caused by oligogenic pathogenicity.

Pigs are a social species and they stablish hierarchies for a better use of resources and to reduce conflicts. However, in pig production, the opportunities for growing can differ in dominant and subordinate animals. In the present study a system was tested to perform a Dominance versus Subordinate test in growing pigs to investigate how the hierarchy affects feeding behaviour, growth and gut microbiota assessed in faeces. 64 animals housed in eight different pens were used, with four castrated males and four females in each one, weighing 18kg at arrival and maintained during the whole growing period, until 140 kg. Three stool samplings were obtained from the animals directly from the anus to avoid contamination of the faeces on 58, 100 and 133 days after the start of the study to investigate the microbiota composition. The dominant animals had higher gains during the growing period that the subordinate. In addition, they were performing more visits to the feeder throughout the day. Differential abundance patterns were observed in five bacterial genera, Oliverpabstia, Peptococcus, and Faecalbacterium being more abundant in dominant animals and Holdemanella and Acetitomaculum being overrepresented in subordinate ones. This microbial biomarker accurately classified dominant versus subordinate groups of samples with an AUC of 0.92.

Background: Study to assess glucose levels of people with type 1 diabetes (T1D) overnight based on insulin type and timing. Methods: Real-world, retrospective study in T1D using multiple daily insulin injections. Contin-uous glucose monitoring and insulin injections data were collected for ten hours after dinner us-ing the Insulclock® connected cap. Meal events were identified using ROC detection methodology. The timing of rapid insulin, second injections, and the type of insulin analogs used were evaluat-ed. Results: Nocturnal profiles (n=775, 49 subjects) were analyzed. Higher glucose AUC over 180mg/dL was observed in delayed injections (number; %; mg/dL x h): -45-15min (n=136; 17.5%, 175.9 ±271.0); -15-0min (n= 231; 29.8%, 164.0 ±237.1); 0+45min (n= 408; 52.6%, 203.6 ±260.9), (p 0.049). The use of ultrarapid (FiAsp®) (URI) vs rapid insulin analogs (RI) was associated with less hypoglycemia events (7.1 vs 13.6%; p 0.005) and TBR70 (1.7 +6.9 vs 4.6 +13.9%; p 0.003). Us-ers of glargine U300 vs degludec had higher TIR (70.7 vs 58.5 %) (Adjusted R-squared: 0.22, p < 0.001). The use of a correction injection (n= 144, 18.6%) was associated with higher hypoglycemia events (18.1 vs 9.5%; p 0.003), TBR70 (5.5 +14.2 vs 3.0 +11.1%; p 0.003), glucose AUC over 180 mg/dL (226.1 +257.8 vs 178.0 +255.3 mg/dL x h; p 0.001), and lower TIR (56.0 +27.4 vs 62.7 +29.6 mg/dL x h; p 0.004). Conclusions: Dinner rapid insulin timing, insulin types and correction injections affect nocturnal glucose profile in T1D.

Detecting and evaluating pain in people with cognitive impairment, especially dementia, is a challenge. Their ability to accurately report pain and comprehend related questions decreases the reliability of their self-report. This has contributed to the fact that pain is underdiagnosed and undertreated in this population, which can lead to involuntary ageism. The design and assessment of this training capsule under the context of the European COST-Action TD1005 responds to the need for education and training in "Pain Assessment In Cognitive Impairment, especially dementia" and the development of the internationally agreed observational PAIC15 scale. The 3-hour capsule, intended for healthcare workers and caregivers, consists of theoretical-practical levels: 1) basic concepts and challenges in pain in aging, cognitive impairment/dementia, 2) available scales and PAIC15, 3) video presentation of clinical cases illustrating a 3×2 matrix of situations (rest, transfer and experimental pain) and stages of disease (mild and moderate). The objectives focused on training the ability to observe, detect, and assess the signs of pain using PAIC15 and its feasibility. The pre-post analysis in a Master educational setting showed agreement with the results obtained in the Spanish national survey on 1) scarce knowledge of observational tools and their use, and 2) uncertainty in the identification of signs of pain and feasibility in moderate/severe scenarios. The capsule improved the ability to identify and evaluate the pain items, especially facial expressions, and their confidence on observational tools. Debriefings highlighted the relevance of observational scales in dementia and the gain obtained using the new observational instrument.

Finite-time control theory has been widely used as a mathematical tool to design robust controllers. By manipulating the finite-time convergence proof of this theory, we developed a new control design appropriately tuned for the finite-time control of the chaotic logistics system. In our experimental setup, the logistic equation is programmed into a PIC microcontroller, and a part of the controller was conceived using analog electronics. Because the system to be controlled is in the discrete-time domain, and the finite-time stability proof is stated in the continuous-time representation, our finite-time control approach is a good example for designing control algorithms in both time domain schemes. Hence, our experimental results support our main contribution. Pulse Width Modulation (PWM) is the signal format used to translate digital signals into continuous-time fields.

This study compares the Melbourne Decision-Making Questionnaire (MDMQ) and the General Decision-Making Style (GDMS), two of the most widely used decision-making questionnaires in the literature, in a large age- and sex-weighted general population sample of 714 men (45.7%) and 848 women (54.3%) between 18 and 90 years old. The objective was to evaluate the convergent and construct validity between several aspects of decision-making styles questionnaires. The results indicate that the two questionnaires replicate the factorial structure of four and five factors reported in the original studies respectively, through exploratory and confirmatory procedures in our cross-cultural context. The domains of both questionnaires that represent a strong or large correlation are Vigilance with Rational (.50), Hypervigilance, Buck-passing, and Procrastination with Avoidant (.45, .52 and .60). A Structural Equations Model (SEM) between both questionnaires indicates that both latent factors formed by the domains of the MDMQ and the GDMS obtain a correlation of .96. It is concluded that the two questionnaires measure similar aspects of the decision-making construct.

Background. While selective use of antibiotics for infected pancreatic necrosis (IPN) in acute pan-creatitis (AP) is recommended, studies indicate a high rate of inadequate treatment. Methods. A search of PubMed, Scopus, and Cochrane databases was conducted, focusing on primary research and meta-analyses. Data were categorized based on core concepts, and a narra-tive synthesis was performed. Results. The searches yielded 1016 publications. After assessing 203 full texts and additional sources, 80 studies were included. The answers obtained were: (1) Preventive treatment does not decrease the incidence of IPN or mortality. Given the risks of bacteria resistance and fungal infec-tions, antibiotics should be reserved for highly suspected or confirmed IPN; (2) The diagnosis of IPN not always require microbiological samples, as clinical suspicion or CT signs can suffice. Early di-agnosis and treatment may be improved by using biomarkers such as procalcitonin and novel mi-crobiological methods; (3) When indicated, early initiation of antibiotics of IPN is a key determinant in reducing mortality; (4) Antibiotics with good penetration into pancreatic tissue covering Gram-negative and Gram-positive bacteria should be used. Routine antifungal therapy is not recommended; (5) The step-up approach, including antibiotics, is the standard for IPN manage-ment; (6) Antibiotic duration should be kept to a minimum and should be based on the quality of source control and patient condition. Conclusions. Early antibiotic therapy is essential for the treatment of IPN, but prophylactic anti-biotics are not recommended in AP. High-quality RCTs are required to better understand the role of antibiotics and antifungals in AP management.

Background: While the clinical factors of the post-COVID-19 condition (PCC) are becoming clearer, the economic implications remain uncertain, posing a challenge to healthcare professionals in terms of understanding and managing this emerging phenomenon. This article aims to investigate the demographic and clinical characteristics of PCC patients and quantify the economic impact of their healthcare resource utilisation. Methods: A retrospective and case-control observational study was conducted, comparing the case group of PCC population before and after diagnosis with a control group. Demographic and clinical variables were analysed with the objective of describing the population. Economic analysis was performed to evaluate the resource costs in procedures and primary, secondary (both outpatient and inpatient) and emergency care. Findings: PCC patients (N=341) exhibited older age and elevated cardiovascular risk factors compared to controls (N=49,078). There were differences in the socio-economic distribution between male and female patients in the PCC patients. Hypertension and diabetes mellitus type 2 were the most common chronic diseases observed among the case patients. Economic analysis revealed that PCC patients were approximately four times as costly as control patients, with increased utilisation of healthcare resources. However, post-diagnosis PCC patients showed a reduction in costs, primarily driven by decreased primary care visits and hospitalisations. Conclusion: Coordinated care management for PCC patients is associated with reduced costs and improved healthcare resource utilisation. Further research is warranted to investigate long-term health outcomes and establish causal relationships between COVID-19 sequelae and healthcare resource utilisation.

Background: Heart failure (HF) with preserved ejection fraction (pEF) has lacked effective 23 treatments for reducing mortality. However, previous studies have found an association between 24 statin use and decreased mortality in patients with HFpEF. The aim of this study was to analyze 25 whether statin therapy is associated with a reduction in mortality in these patients and whether the 26 effect differs according to presence or absence of ischemic heart disease (IHD). Methods: We ana- 27 lyzed data from the National Registry of Heart Failure, a prospective study including patients ad- 28 mitted for HF in Internal Medicine units nationwide. Patients with HFpEF were classified according 29 to the use of statins and differences between two groups were analyzed. A multivariate analysis 30 was performed using Cox regression to assess factors independently related to mortality. Results: 31 2788 patients with HFpEF were included, 63% of them were women with a mean age of 80.1(±7.8) 32 years. The statin-treated group (40.2%) was younger, with better functional status, and had a more 33 common diagnosis of vascular disease and lower frequency of atrial fibrillation. The most frequent 34 etiology of HF in both groups was the hypertensive one. Nevertheless, ischemic HF was more com- 35 mon in those who received statins (24.8% vs. 9.6%; p<0.001). Multivariate analysis showed lower 36 mortality at 1-year follow-up in statin-treated patients (OR:0.74; 95%CI:0.61-0.89; p=0.002). This as- 37 sociation was observed in patients without IHD (p<0.001), but not in those with IHD (p=0.11). Con- 38 clusion: Statins are associated with a decrease in total mortality in patients with HFpEF. This benefit 39 occurs mainly in those without IHD.

Whereas there is an increasing number of scientific publications investigating the optimal anti-biotic treatment for diabetic foot infections, we are lacking corresponding data in the adult non-diabetic (postsurgical) foot infection population. We therefore established one of the largest single-center databases on this topic and retrospectively investigate failures of a combined sur-gical and antibiotic therapy for surgical site foot infections. Overall, 17.4% of the episodes expe-rienced any therapeutic failures; especially among the infected ankle prostheses. In contrast, neither the age, the biological sex, pathogens, the duration of post-debridement antibiotic treatment, the number of surgical debridement, or the use of negative-pressure wound care could alter the failure risk. In multivariate logistic regression analyses, the duration of postsur-gical antibiotic use was completely indifferent (as a continuous variable with odds ratio 1.0, 95% confidence interval 0.96-1.03), or when stratified into inter-tertiary groups. Our results poten-tially enable shorter applications of systemic antibiotics in favor of a better stewardship in the non-diabetic adult population. Consecutive prospective-randomized trials are under way to identify eligible patient populations for a potentially shorter durations in surgical site infections after elective foot and ankle surgery.

Hybrid forecasting methods have emerged as a solution surpassing the limitations of both statistical and deep learning approaches. While the first emphasize the significance of variables, they often produce worse forecasting results when compared to newer techniques. In contrast, deep learning models remain enigmatic "black boxes" in terms of interpretability, although achieving better results in forecasting. This article introduces the Comprehensive Cross-Correlation and Lagged Linear Regression Deep Learning (CCLR-DL) framework, designed to harness the best of both approaches, enhancing forecasting accuracy while retaining model interpretability through a feature selection process. CCLR-DL blens cross-correlation analysis, lagged multiple linear regression and granger's causality procedures with deep learning architectures based on LSTM. In a practical demonstration, CCLR-DL was applied to a real database of clinical visits associated to diagnoses in Catalonia, Spain (tracking a population of 6.3 million patients during 10 years). Predicting visits enables the healthcare managers to be ready for future demand shifts. Results demonstrate a consistent and substantial improvement over standalone statistical and deep learning methods when predicting healthcare demand. This hybrid approach not only showcases its efficacy but also offers a promising solution to the challenge of balancing predictive accuracy with model explicability. In this context, this work aims to design and validate a method for feature selection and forecasting of multivariate high dimensional time series datasets not only to improve prediction accuracy but also to model transparency by identifying a subset of variables that improve predictions and G-cause the target variable.

Transcatheter Aortic Valve Implantation (TAVI) now represents the mainstay in the treatment of severe aortic stenosis. Owing to its exceptional procedural efficacy and safety, TAVI has been extended to include patients at lower surgical risk, thus now encompassing a diverse patient population receiving this treatment. Yet, long-term outcomes also depend on optimal medical therapy for secondary vascular prevention, with antithrombotic therapy serving as a cornerstone. Leveraging data from multiple randomized controlled trials, current guidelines generally recommend single antithrombotic therapy, with either single antiplatelet therapy (SAPT) or oral anticoagulation (OAC) alone in those patients without, or with atrial fibrillation respectively. Yet, individualization of this pattern, as well as specific case uses, may be needed based on individual-patient characteristics and concurrent procedures. This review aims to discuss the evidence supporting antithrombotic treatments in patients treated with TAVI, indications for a standardized treatment, as well as specific considerations for an individualized approach to treatment.

Background/Objectives: Congenital Radioulnar Synostosis (CRS) is a rare elbow joint disorder resulting from abnormal fusion of the radius and ulna during fetal development. Methods: Although predominantly sporadic, familial cases exist with autosomal dominant inheritance. Diagnosis relies on clinical evaluation and radiological findings, showcasing synostosis. Surgical decisions hinge on factors like age and symptom severity. Results: Multiple surgical treatments have been described but derotation osteotomy offers predictable results. Challenges include potential complications and cultural considerations influencing final forearm positioning. Conclusions: A nuanced approach is crucial for optimal management, highlighting the need for ongoing research to refine diagnostic and therapeutic strategies for improved outcomes in CRS patients.

This study compares the Melbourne Decision-Making Questionnaire (MDMQ) and the General Decision-Making Style (GDMS), two of the most widely used decision-making questionnaires in the literature, in a large age- and sex-weighted general population sample of 714 men (45.7%) and 848 women (54.3%) between 18 and 90 years old. The objective was to evaluate the convergent and construct validity between several aspects of decision-making styles questionnaires. The results indicate that the two questionnaires replicate the factorial structure of four and five factors reported in the original studies respectively, through exploratory and confirmatory procedures in our cross-cultural context. The domains of both questionnaires that represent a strong or large correlation are Vigilance with Rational (.50), Hypervigilance, Buck-passing, and Procrastination with Avoidant (.45, .52 and .60). A Structural Equations Model (SEM) between both questionnaires indicates that both latent factors formed by the domains of the MDMQ and the GDMS obtain a correlation of .96. It is concluded that the two questionnaires measure similar aspects of the decision-making construct.

Introduction: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European re-search consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis and linkage to specialty care for European PC settings. Aim: Based on the lessons from this project, the latest research evidence and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral and management of MASLD in PC. Methods: The Rand/UCLA modified Delphi panel method, with two rounds, was used to reach consensus on practice recommendations. The international panel consisted of experts from six countries, representing family medicine, gastroenterology, hepatology, cardiology and public health. Initially, fifteen statements were drafted based on a synthesis of evidence from the literature and earlier findings from our consortium. Prior to the consensus meeting, the statements were rated by the experts in a first round. Then, in a hybrid meeting, the experts discussed findings of round one, adjusted the statements and reassessed the updated recommendations in a second round. Results: In round one, there was already a high level of consensus on 10 out of 15 statements. After round 2, there were fourteen statements with a high agreement (>90%). One statement was not endorsed. The approved recommendations addressed the following practice areas: risk screening and diagnosis, management of MASLD – Lifestyle interventions, pharmacological treatment of MASLD/MASH, pharmacological treatment for co-morbidity, integrated care, surgical management and other referrals to specialists. Conclusion: The final set of 14 recommendations focuses on increasing comprehensive care for MASLD in PC. The recommendations provide practical evidence-based guidance tailored to PC practitioners. We expect that these recommendations will contribute to the ongoing discussion on systematic approaches to tackle MASLD and support European PC providers by integrating the latest evidence into practice.