A new genus of scutigerid centipede from southern South America with the description of two new species and an updated molecular phylogeny of the myriapod order Scutigeromorpha (Myriapoda: Chilopoda).

Scutigeromorph centipedes are conspicuous, yet often ignored myriapods for which little work has been conducted in southern South America. After examining recent and museum collections from Chile and Argentina, two new species of generic uncertainty were identified. A new genus of scutigerid centipede, Edgethreua , is therefore described with two new species, E. chilensis from Central Chile (type species of the genus) and E. goloboffi from Argentinian Patagonia. The new genus is characterised by the presence of scattered setiform bristles with short paired spines and the absence of simple spinulae and spines on all stomatotergites, the presence of a single spine-bristle in the prefemur of the second maxilla, a patch of cuticular ridges and pores surrounding the sensilla of the proximal labral portion of the epipharynx, the morphology of the sensilla of the distal patch of the hypopharynx and the morphology of the female gonopods. A phylogenetic analysis of the new species using two nuclear ribosomal RNA genes (18S and 28S rRNA), two mitochondrial ribosomal RNA genes (12S and 16S rRNA) and the mitochondrial protein-encoding gene cytochrome c oxidase subunit I show that the new genus does not cluster with any other described genus of scutigeromorph represented in molecular phylogenies. The data indicate that the new genus is probably sister group to a clade including the genera Lassophora , Ballonema and the subfamily Thereuoneminae, although one analysis suggests a position as sister group to Scutigerinae. ZooBank: urn:lsid:zoobank.org:pub:A4D453F3-9031-4E21-84C7-87F16C07AD51.

Implementation and the effects of a Parkinson Network Therapy (PaNTher) on activities of daily living and health-related quality of life in Parkinson's disease patients: study protocol of an mixed-method observational cohort study in outpatient care.

INTRODUCTION: Parkinson's disease (PD) represents the fastest growing neurodegenerative disease with an increasing prevalence worldwide. It is characterised by complex motor and non-motor symptoms that lead to considerable disability. Specialised physiotherapy has been shown to benefit patients with PD. The Parkinson Netzwerk Therapie (PaNTher) was created to improve access to specialised physiotherapy tailored to care priorities of PD patients. This study aims to evaluate the effectiveness, acceptability and needs of the PaNTher network by neurologists and physiotherapists involved in the network in outpatient care. METHODS AND ANALYSIS: This is a mixed-method, prospective, pragmatic non-randomised cohort study of parallel groups, with data collection taking place in Bavaria, Germany, between 2020 and 2024. Patients with PD insured by the Allgemeine Ortskrankenkasse Bayern (AOK Bayern) living in Bavaria will be recruited for study participation by network partners. Patients in the intervention group must reside in Munich or the surrounding area to ensure provision of specialised physiotherapy in close proximity to their place of residence. Controls receive care as usual. Six and 12 months after baseline, all patients receive a follow-up questionnaire. Mixed-effect regression models will be used to examine changes in impairment of activities of daily living and quality of life of patients with PD enrolled in the programme over time compared with usual care. Qualitative interviews will investigate the implementation processes and acceptability of the PaNTher network among neurologists and physiotherapists. The study is expected to show that the PaNTher network with an integrative care approach will improve the quality and effectiveness of the management and treatment of patients with PD. ETHICS AND DISSEMINATION: The study has been approved by the ethics committee at the medical faculty of the Ludwig-Maximilians-University Munich (20-318). Results will be published in scientific, peer-reviewed journals and presented at national and international conferences.

Activities of Daily Living Are Improved by Inpatient Multimodal Complex Treatment for PD-a Real-World Cohort Study.

Background: The multimodal complex treatment for Parkinson's disease (MCT) provides inpatient care by a multi-disciplinary team for people with Parkinson's disease (PwP) in Germany. Objectives: We conducted a 5-year real-world mono-center cohort study to describe the effectiveness of MCT in the full cohort and various subgroups and outcome predictors. Methods: We collected an anonymized dataset between Jan 2015 and Dec 2019, involving N = 1773. The self-reported MDS-UPDRS part II was used as primary outcome, and clinical routine data for explanatory variables. PwP were categorized as responders or non-responders according to a response of at least 3 points 4 weeks after discharge. Results: N = 591 complete data records were available for statistical analyses. The full group improved by -2.4 points on the MDS-UPDRS II (P = <0.0001). 47.7% (n = 282) and 52.3% (n = 309) were coded as responders and non-responders, respectively. A clinically meaningful response was positively associated to age (χ2 = 11.07, P = 0.018), as well as baseline-severity of the MDS-UPDRS II (χ2 = 6.05, P = 0.048) and negatively associated to the presence of psychiatric disorder (χ2 = 3.9, P = 0.048) and cognitive dysfunction (χ2 = 7.29, P = 0.007). Logistic regression showed that baseline severity of the MDS-UPDRS II predicted therapy success. PwP with moderate baseline-severity had an about 2fold chance (OR 2.08; 95% CI 1.20-3.61; P = 0.009) and with severe an about 6fold chance (OR 5.92; 95% CI 2.76-12.68; P < 0.0001) to benefit clinically meaningful. Discussion: In a naturalistic setting of a specialized Parkinson's center, MCT improved ADL disability of PwP at least 4 weeks after discharge. Moderately and severely impaired patients were more likely to achieve clinically meaningful responses.

The role of the basal ganglia and cerebellum in adaptation to others' speech rate and rhythm: A study of patients with Parkinson's disease and cerebellar degeneration.

BACKGROUND: Spoken language is constantly undergoing change: Speakers within and across social and regional groups influence each other's speech, leading to the emergence and drifts of accents in a language. These processes are driven by mutual unintentional imitation of the phonetic details of others' speech in conversational interactions, suggesting that continuous auditory-motor adaptation takes place in interactive language use and plasticity of auditory-motor representations of speech persists across the lifespan. The brain mechanisms underlying this large-scale social-linguistic behavior are still poorly understood. RESEARCH AIM: To investigate the role of cerebellar and basal ganglia dysfunctions in unintended adaptation to the speech rhythm and articulation rate of a second speaker. METHODS: Twelve patients with spinocerebellar ataxia type 6 (SCA6), 15 patients with Parkinson's disease (PD), and 27 neurologically healthy controls (CTRL) participated in two interactive speech tasks, i.e., sentence repetition and "turn-taking" (i.e., dyadic interaction with sentences produced by a model speaker). Production of scripted sentences was used as a control task. Two types of sentence rhythm were distinguished, i.e., regular and irregular, and model speech rate was manipulated in 12 steps between 2.9 and 4.0 syllables per second. Acoustic analyses of the participants' utterances were performed to determine the extent to which participants adapted their speech rate and rhythm to the model. RESULTS: Neurologically healthy speakers showed significant adaptation of rate in all conditions, and of rhythm in the repetition task and partly also the turn-taking task. Patients with PD showed a stronger propensity to adapt than the controls. In contrast, the patients with cerebellar degeneration were largely insensitive to the model speaker's rate and rhythm. Contrary to expectations, sentences with an irregular speech rhythm exerted a stronger adaptive attraction than regular sentences in the two patient groups. CONCLUSIONS: Cerebellar degeneration inhibits the propensity to covertly adapt to others' speech. Striatal dysfunction in Parkinson's disease spares or even promotes the tendency to accommodate to other speakers' speech rate and rhythm.

Enhancing Part-to-Part Repeatability of Force-Sensing Resistors Using a Lean Six Sigma Approach.

Polymer nanocomposites have found wide acceptance in research applications as pressure sensors under the designation of force-sensing resistors (FSRs). However, given the random dispersion of conductive nanoparticles in the polymer matrix, the sensitivity of FSRs notably differs from one specimen to another; this condition has precluded the use of FSRs in industrial applications that require large part-to-part repeatability. Six Sigma methodology provides a standard framework to reduce the process variability regarding a critical variable. The Six Sigma core is the DMAIC cycle (Define, Measure, Analyze, Improve, and Control). In this study, we have deployed the DMAIC cycle to reduce the process variability of sensor sensitivity, where sensitivity was defined by the rate of change in the output voltage in response to the applied force. It was found that sensor sensitivity could be trimmed by changing their input (driving) voltage. The whole process comprised: characterization of FSR sensitivity, followed by physical modeling that let us identify the underlying physics of FSR variability, and ultimately, a mechanism to reduce it; this process let us enhance the sensors' part-to-part repeatability from an industrial standpoint. Two mechanisms were explored to reduce the variability in FSR sensitivity. (i) It was found that the output voltage at null force can be used to discard noncompliant sensors that exhibit either too high or too low sensitivity; this observation is a novel contribution from this research. (ii) An alternative method was also proposed and validated that let us trim the sensitivity of FSRs by means of changing the input voltage. This study was carried out from 64 specimens of Interlink FSR402 sensors.

Point-of-care ultrasound in cardiorespiratory arrest (POCUS-CA): narrative review article.

The POCUS-CA (Point-of-care ultrasound in cardiac arrest) is a diagnostic tool in the Intensive Care Unit and Emergency Department setting. The literature indicates that in the patient in a cardiorespiratory arrest it can provide information of the etiology of the arrest in patients with non-defibrillable rhythms, assess the quality of compressions during cardiopulmonary resuscitation (CPR), and define prognosis of survival according to specific findings and, thus, assist the clinician in decision-making during resuscitation. This narrative review of the literature aims to expose the usefulness of ultrasound in the setting of cardiorespiratory arrest as a tool that allows making a rapid diagnosis and making decisions about reversible causes of this entity. More studies are needed to support the evidence to make ultrasound part of the resuscitation algorithms. Teamwork during cardiopulmonary resuscitation and the inclusion of ultrasound in a multidisciplinary approach is important to achieve a favorable clinical outcome.

Is the development of desalination compatible with sustainable development of the Arabian Gulf?

The development of desalination has been essential to the rapid economic development of the countries bordering the Arabian Gulf. The current production capacity of sea water desalination plants drawing water from Gulf is over 20 million m3 day-1, which may rise to 80 million m3 day-1 by 2050. Whilst supporting aspects of sustainable development related to water and sanitation, desalination impacts the marine environment through impingement and entrainment of organisms in intakes, and through thermal, brine and chemical discharges. This may compromise other objectives for sustainable development related to sustainable use of the oceans. Under business as usual scenarios, by 2050, the impact of individual desalination plants will combine causing a regional scale impact. Without mitigating actions to avoid the business as usual scenario, by 2050, desalination in combination with climate change, will elevate coastal water temperatures across more than 50% of the Gulf by at least 3 °C, and a volume of water equivalent to more than a third of the total volume of water between 0 and 10 m deep will pass through desalination plants each year. This will adversely impact the coastal ecosystem of the Gulf, with impacts on biodiversity, fisheries and coastal communities and may cause potential loss of species and habitats from the Gulf. Given the significant implications of these preliminary findings, and in light of the precautionary approach to management, it is recommended that mitigating options addressing behavioural, regulatory and technological change are rapidly evaluated and implemented to avoid the development of desalination in the region along a business as usual pathway, and multidisciplinary research studies should be conducted to reduce uncertainty in predictions of future impacts.

Revision and phylogeny of the genus Andocaeculus (Acari: Caeculidae) I: the A. weyrauchi species group.

Two new caeculid mite species, Andocaeculus beatrizrosso sp. nov. and Andocaeculus burmeisteri sp. nov., are described and A. weyrauchi (Franz, 1964) is redescribed based on material collected at the type locality. All post-larval stages are described for A. weyrauchi and Andocaeculus beatrizrosso sp. nov. and stochastic variation in the idiosomal and appendages chaetotaxy is considered. A clade of Andocaeculus containing the three species (the A. weyrauchi group) is established based on morphological characters, and confirmed with a Bayesian phylogenetic analysis of sequences from the CO1 marker. As result of the same analysis, the absence of the (st) pair of setae on leg II is proposed as a derived condition for the genus Andocaeculus, and the presence of the φ solenidion on leg IV is a derived condition for some Andocaeculus species of the A. weyrauchi species group.

Ramucirumab in Combination with Pembrolizumab in Treatment-Naïve Advanced Gastric or GEJ Adenocarcinoma: Safety and Antitumor Activity from the Phase 1a/b JVDF Trial.

Ramucirumab (anti-VEGFR2) plus pembrolizumab (anti-PD1) demonstrated promising antitumor activity and tolerability among patients with previously treated advanced cancers, supporting growing evidence that combination therapies modulating the tumor microenvironment may expand the spectrum of patients who respond to checkpoint inhibitors. Here we present the results of this combination in first-line patients with metastatic G/GEJ cancer. Twenty-eight patients (≥18 years) with no prior systemic chemotherapy in the advanced/metastatic setting received ramucirumab (8 mg/kg days 1 and 8) plus pembrolizumab (200 mg day 1) every 3 weeks as part of JVDF phase 1a/b study. The primary endpoint was safety. Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), and overall survival (OS). Tumors were PD-L1-positive (combined positive score ≥ 1) in 19 and -negative in 6 patients. Eighteen patients experienced grade 3 treatment-related adverse events, most commonly hypertension (14%) and elevated alanine/aspartate aminotransferase (11% each), with no grade 4 or 5 reported. The ORR was 25% (PD-L1-positive, 32%; PD-L1-negative, 17%) with duration of response not reached. PFS was 5.6 months (PD-L1-positive, 8.6 months; PD-L1-negative, 4.3 months), and OS 14.6 months (PD-L1-positive, 17.3 months; PD-L1-negative, 11.3 months). Acknowledging study design limitations, ramucirumab plus pembrolizumab had encouraging durable clinical activity with no unexpected toxicities in treatment-naïve biomarker-unselected metastatic G/GEJ cancer, and improved outcomes in patients with PD-L1-positive tumors.

The first fossil pycnocheiridiine pseudoscorpion (Pseudoscorpiones: Cheiridiidae: Procheiridium gen. nov.) from Cretaceous Burmese amber.

Procheiridium judsoni n. gen. et n. sp. is described from Burmese cretaceous amber. This species represents the earliest record of the pseudoscorpion subfamily Pycnocheiridiinae and the first fossil taxon of the subfamily to be recorded. The phylogenetic position of the new genus in the superfamily Cheiridioidea is discussed.

Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2 / Clinical Consensus Recommendations Regarding Non-Invasive Respiratory Support in the Adult Patient with Acute Respiratory Failure Secondary to SARS-CoV-2 infection

La enfermedad por coronavirus 2019 (COVID-19) es una infección del tracto respiratorio causada por un nuevo coronavirus emergente que se reconoció por primera vez en Wuhan, China, en diciembre de 2019. Actualmente la Organización Mundial de la Salud (OMS) ha definido la infección como pandemia y existe una situación de emergencia sanitaria y social para el manejo de esta nueva infección. Mientras que la mayoría de las personas con COVID-19 desarrollan solo una enfermedad leve o no complicada, aproximadamente el 14% desarrollan una enfermedad grave que requiere hospitalización y oxígeno, y el 5% pueden requerir ingreso en una Unidad de Cuidados Intensivos. En casos severos, COVID-19 puede complicarse por el síndrome de dificultad respiratoria aguda (SDRA), sepsis y shock séptico y fracaso multiorgánico. Este documento de consenso se ha preparado sobre directrices basadas en evidencia desarrolladas por un panel multidisciplinario de profesionales médicos de cuatro sociedades científicas españolas (Sociedad Española de Medicina Intensiva y Unidades Coronarias [SEMICYUC], Sociedad Española de Neumología y Cirugía Torácica [SEPAR], Sociedad Española de Urgencias y Emergencias [SEMES], Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor [SEDAR]) con experiencia en el manejo clínico de pacientes con COVID-19 y otras infecciones virales, incluido el SARS, así como en sepsis y SDRA. El documento proporciona recomendaciones clínicas para el soporte respiratorio no invasivo (ventilación no invasiva, oxigenoterapia de alto flujo con cánula nasal) en cualquier paciente con presentación sospechada o confirmada de COVID-19 con insuficiencia respiratoria aguda. Esta guía de consenso debe servir como base para una atención optimizada y garantizar la mejor posibilidad de supervivencia, así como permitir una comparación fiable de las futuras intervenciones terapéuticas de investigación que formen parte de futuros estudios observacionales o de ensayos clínicos

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the management of this new infection. While most people with COVID-19 develop only mild or uncomplicated illness, approximately 14% develop severe disease that requires hospitalization and oxygen support, and 5% require admission to an intensive care unit. In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure. This consensus document has been prepared on evidence-informed guidelines developed by a multidisciplinary panel of health care providers from four Spanish scientific societies (Spanish Society of Intensive Care Medicine [SEMICYUC], Spanish Society of Pulmonologists [SEPAR], Spanish Society of Emergency [SEMES], Spanish Society of Anesthesiology, Reanimation, and Pain [SEDAR]) with experience in the clinical management of patients with COVID-19 and other viral infections, including SARS, as well as sepsis and ARDS. The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. This consensus guidance should serve as a foundation for optimized supportive care to ensure the best possible chance for survival and to allow for reliable comparison of investigational therapeutic interventions as part of randomized controlled trials

Importancia semiológica del dolor durante etapas de un proceso inflamatorio pulpar / Semiological importance of pain during the stages of a pulpal inflammation process

RESUMEN Introducción: Existe la tentativa de realizar un diagnóstico del proceso inflamatorio pulpar, basado en el aspecto histopatológico, el cual es irreal pues no se puede comparar estos hallazgos con los clínicos. Resulta más objetivo y confiable, analizar las características del dolor que expresa la evolución pulpar en cada etapa y establecer un diagnóstico certero que permita precisar el tipo de tratamiento. Objetivo: Interpretar el curso de un proceso inflamatorio pulpar a través de las variables asociadas a estímulos nociceptivos. Métodos: Se realizó una revisión bibliográfica sobre las variables en relación con el dolor y su asociación con un estado inflamatorio pulpar. Se analizaron 24 artículos científicos en relación con el dolor pulpar, se escogieron 15 por ser los más afines al propósito perseguido, y todos corresponden a los últimos 5 años, publicados en revistas internacionales y nacionales. PubMed se utilizó como fuente fundamental de búsqueda; otras bases de datos también consultadas fueron Lilacs, Hinari y Medline. Análisis e integración de la información: Las condiciones pulpares se clasifican como: pulpitis reversible, transicional, irreversible y pulpa necrótica. La semiología del dolor se sustenta en cuatro variables básicas asociadas a los estímulos nociceptivos que son: cualidad del dolor pulpar puede ser punzante o continuo, su curso intermitente o continuo, su localización limitado a una región de la boca, irradiado y referido, y su intensidad considerada como leve, moderado o severo. Conclusiones: Las variables asociadas a los estímulos nociceptivos revisten importancia semiológica, pues permiten valorar las manifestaciones dolorosas por las que transita un proceso inflamatorio pulpar(AU)

ABSTRACT Introduction: Attempts have been made to diagnose the pulpal inflammatory process based on its histopathological features, but to no avail, for these findings cannot be compared with clinical results. It would be more objective and reliable to analyze the characteristics of the pain expressing the pulpal evolution at each stage and establish an accurate diagnosis allowing the choice of the type of treatment to be indicated. Objective: Interpret the course of a pulpal inflammatory process through variables associated to nociceptive stimuli. Methods: A bibliographic review was conducted about the study variables with respect to pain and its association to a pulpal inflammatory state. A total 24 scientific papers were analyzed which dealt with pulpal pain, of which 15 were selected for being the most closely related to the goal pursued and having been published in international and national journals in the last five years. PubMed was the main source searched, while other databases such as Lilacs, Hinari and Medline were also consulted. Data analysis and integration: Pulpal conditions are classified into reversible, transitional, irreversible pulpitis and necrotic pulp. Pain semiology is based on the following four basic variables associated to nociceptive stimuli: pulpal pain quality (sharp or continuous), course (intermittent or continuous), location (limited to a region in the mouth, radiating or referred) and intensity (mild, moderate or severe). Conclusions: The variables associated to nociceptive stimuli are semiologically important, for they make it possible to evaluate the painful manifestations gone through by a pulpal inflammatory process(AU)

Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2 / Clinical Consensus Recommendations Regarding Non-Invasive Respiratory Support in the Adult Patient with Acute Respiratory Failure Secondary to SARS-CoV-2 infection

La enfermedad por coronavirus 2019 (COVID-19) es una infección del tracto respiratorio causada por un nuevo coronavirus emergente que se reconoció por primera vez en Wuhan, China, en diciembre de 2019. Actualmente la Organización Mundial de la Salud (OMS) ha definido la infección como pandemia y existe una situación de emergencia sanitaria y social para el manejo de esta nueva infección. Mientras que la mayoría de las personas con COVID-19 desarrollan solo una enfermedad leve o no complicada, aproximadamente el 14% desarrollan una enfermedad grave que requiere hospitalización y oxígeno, y el 5% pueden requerir ingreso en una Unidad de Cuidados Intensivos. En casos severos, COVID-19 puede complicarse por el síndrome de dificultad respiratoria aguda (SDRA), sepsis y shock séptico y fracaso multiorgánico. Este documento de consenso se ha preparado sobre directrices basadas en evidencia desarrolladas por un panel multidisciplinario de profesionales médicos de cuatro sociedades científicas españolas (Sociedad Española de Medicina Intensiva y Unidades Coronarias [SEMICYUC], Sociedad Española de Neumología y Cirugía Torácica [SEPAR], Sociedad Española de Urgencias y Emergencias [SEMES], Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor [SEDAR]) con experiencia en el manejo clínico de pacientes con COVID-19 y otras infecciones virales, incluido el SARS, así como en sepsis y SDRA. El documento proporciona recomendaciones clínicas para el soporte respiratorio no invasivo (ventilación no invasiva, oxigenoterapia de alto flujo con cánula nasal) en cualquier paciente con presentación sospechada o confirmada de COVID-19 con insuficiencia respiratoria aguda. Esta guía de consenso debe servir como base para una atención optimizada y garantizar la mejor posibilidad de supervivencia, así como permitir una comparación fiable de las futuras intervenciones terapéuticas de investigación que formen parte de futuros estudios observacionales o de ensayos clínicos

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the management of this new infection. While most people with COVID-19 develop only mild or uncomplicated illness, approximately 14% develop severe disease that requires hospitalization and oxygen support, and 5% require admission to an intensive care unit. In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure. This consensus document has been prepared on evidence-informed guidelines developed by a multidisciplinary panel of health care providers from four Spanish scientific societies (Spanish Society of Intensive Care Medicine [SEMICYUC], Spanish Society of Pulmonologists [SEPAR], Spanish Society of Emergency [SEMES], Spanish Society of Anesthesiology, Reanimation, and Pain [SEDAR]) with experience in the clinical management of patients with COVID-19 and other viral infections, including SARS, as well as sepsis and ARDS. The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. This consensus guidance should serve as a foundation for optimized supportive care to ensure the best possible chance for survival and to allow for reliable comparison of investigational therapeutic interventions as part of randomized controlled trials

Clinical Consensus Recommendations Regarding Non-Invasive Respiratory Support in the Adult Patient with Acute Respiratory Failure Secondary to SARS-CoV-2 infection. / Recomendaciones de consenso respecto al soporte respiratorio no invasivo en el paciente adulto con insuficiencia respiratoria aguda secundaria a infección por SARS-CoV-2.

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus, that was first recognized in Wuhan, China, in December 2019. Currently, the World Health Organization (WHO) has defined the infection as a global pandemic and there is a health and social emergency for the management of this new infection. While most people with COVID-19 develop only mild or uncomplicated illness, approximately 14% develop severe disease that requires hospitalization and oxygen support, and 5% require admission to an intensive care unit. In severe cases, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS), sepsis and septic shock, and multiorgan failure. This consensus document has been prepared on evidence-informed guidelines developed by a multidisciplinary panel of health care providers from four Spanish scientific societies (Spanish Society of Intensive Care Medicine [SEMICYUC], Spanish Society of Pulmonologists [SEPAR], Spanish Society of Emergency [SEMES], Spanish Society of Anesthesiology, Reanimation, and Pain [SEDAR]) with experience in the clinical management of patients with COVID-19 and other viral infections, including SARS, as well as sepsis and ARDS. The document provides clinical recommendations for the noninvasive respiratory support (noninvasive ventilation, high flow oxygen therapy with nasal cannula) in any patient with suspected or confirmed presentation of COVID-19 with acute respiratory failure. This consensus guidance should serve as a foundation for optimized supportive care to ensure the best possible chance for survival and to allow for reliable comparison of investigational therapeutic interventions as part of randomized controlled trials.

High-Resolution Motor State Detection in Parkinson's Disease Using Convolutional Neural Networks.

Patients with advanced Parkinson's disease regularly experience unstable motor states. Objective and reliable monitoring of these fluctuations is an unmet need. We used deep learning to classify motion data from a single wrist-worn IMU sensor recording in unscripted environments. For validation purposes, patients were accompanied by a movement disorder expert, and their motor state was passively evaluated every minute. We acquired a dataset of 8,661 minutes of IMU data from 30 patients, with annotations about the motor state (OFF,ON, DYSKINETIC) based on MDS-UPDRS global bradykinesia item and the AIMS upper limb dyskinesia item. Using a 1-minute window size as an input for a convolutional neural network trained on data from a subset of patients, we achieved a three-class balanced accuracy of 0.654 on data from previously unseen subjects. This corresponds to detecting the OFF, ON, or DYSKINETIC motor state at a sensitivity/specificity of 0.64/0.89, 0.67/0.67 and 0.64/0.89, respectively. On average, the model outputs were highly correlated with the annotation on a per subject scale (r = 0.83/0.84; p < 0.0001), and sustained so for the highly resolved time windows of 1 minute (r = 0.64/0.70; p < 0.0001). Thus, we demonstrate the feasibility of long-term motor-state detection in a free-living setting with deep learning using motion data from a single IMU.

The Minimal Clinically Relevant Change of the FOG Score.

BACKGROUND: Freezing of gait is a highly disabling symptom in persons with Parkinson's disease (PwP). Despite its episodic character, freezing can be reliably evaluated using the FOG score. The description of the minimal clinically relevant change is a requirement for a meaningful interpretation of its results. OBJECTIVE: To determine the minimal clinically relevant change of the FOG score. METHODS: We evaluated video recordings of a standardized freezing-evoking gait parkour, i.e., the FOG score just before and 30 minutes after the intake of a regular levodopa dose in a randomized blinded fashion. The minimal clinically relevant response was considered a value of one or more on a 7-step Likert-type response scale [-3; +3] that served as the anchor. The minimal clinically relevant change was determined by ROC analysis. RESULTS: 37 PwP (Hoehn & Yahr stages 2.5-4, 27 male, 10 female) were aged 68.2 years on average (range 45-80). Mean disease duration was 12.9 years (2-29 years). Minimum FOG score was 0 and Maximum FOG score was 29. Mean FOG scores before medication were 10.6, and 11.1 after medication intake, with changes ranging from -14.7 to +16.7. The minimal clinically relevant change (MCRC) for improvement based on expert clinician rating was three scale points with a sensitivity of 0.67 and a specificity of 0.96. CONCLUSIONS: The FOG score is recognized as a useful clinical instrument for the evaluation of freezing in the clinical setting. Knowledge of the MCRC should help to define responses to interventions that are discernible and meaningful to the expert physician and to the patient.

The first record of caeculid mites from the Cretaceous amber of Myanmar with notes on the phylogeny of the family.

Procaeculus coineaui sp. nov. from Cretaceous Burmese amber is described and its phylogenetic position discussed. This fossil taxon is the first caeculid mite known from Burmese amber and constitutes the earliest record of the family. The genus Procaeculus is redefined to include the new fossil species and internal relationships between genera of the family are discussed based on a phylogenetic hypothesis.

Study of Flow Rate Measurements Derived from Temperature Profiles of an Emulated Well by a Laboratory Prototype.

The objective of this work is the study of the procedure for flow rate measurement derived from temperature profiles. This method is deemed appropriate because of the inability to mount conventional flow meters in multiple-zone oil wells. In this work, a reduced-scale prototype well with horizontal geometry was developed to study and validate a method of flow profiling by temperature measurements in the well column based on a heat transfer mathematical model studied by Ramey in 1962. Flow sensors were installed at key points to provide validation data for the flow measurements derived from the temperature. The plant was automated and all the tests were managed from a workstation. It was possible to test different situations to provide a variability of evaluation scenarios. The initial experiments used injected fluid flow rates of 15 and 18 L/min in the well inlet. The results of the calculated flow values in different work conditions were compared with a relatively low error reference meter.