Causes and attributable fraction of death from ARDS in inflammatory phenotypes of sepsis.

BACKGROUND: Hypoinflammatory and hyperinflammatory phenotypes have been identified in both Acute Respiratory Distress Syndrome (ARDS) and sepsis. Attributable mortality of ARDS in each phenotype of sepsis is yet to be determined. We aimed to estimate the population attributable fraction of death from ARDS (PAFARDS) in hypoinflammatory and hyperinflammatory sepsis, and to determine the primary cause of death within each phenotype. METHODS: We studied 1737 patients with sepsis from two prospective cohorts. Patients were previously assigned to the hyperinflammatory or hypoinflammatory phenotype using latent class analysis. The PAFARDS in patients with sepsis was estimated separately in the hypo and hyperinflammatory phenotypes. Organ dysfunction, severe comorbidities, and withdrawal of life support were abstracted from the medical record in a subset of patients from the EARLI cohort who died (n = 130/179). Primary cause of death was defined as the organ system that most directly contributed to death or withdrawal of life support. RESULTS: The PAFARDS was 19% (95%CI 10,28%) in hypoinflammatory sepsis and, 14% (95%CI 6,20%) in hyperinflammatory sepsis. Cause of death differed between the two phenotypes (p < 0.001). Respiratory failure was the most common cause of death in hypoinflammatory sepsis, whereas circulatory shock was the most common cause in hyperinflammatory sepsis. Death with severe underlying comorbidities was more frequent in hypoinflammatory sepsis (81% vs. 67%, p = 0.004). CONCLUSIONS: The PAFARDS is modest in both phenotypes whereas primary cause of death among patients with sepsis differed substantially by phenotype. This study identifies challenges in powering future clinical trials to detect changes in mortality outcomes among patients with sepsis and ARDS.

Navigating the Link Between Non-alcoholic Fatty Liver Disease/Non-alcoholic Steatohepatitis and Cardiometabolic Syndrome.

The global prevalence of non-alcoholic fatty liver disease (NAFLD) is nearly 25% and is increasing rapidly. The spectrum of liver damage in NAFLD ranges from simple steatosis to non-alcoholic steatohepatitis, characterised by the presence of lobular inflammation and hepatocyte ballooning degeneration, with or without fibrosis, which can further develop into cirrhosis and hepatocellular carcinoma. Not only is NAFLD a progressive liver disease, but numerous pieces of evidence also point to extrahepatic consequences. Accumulating evidence suggests that patients with NAFLD are also at increased risk of cardiovascular disease (CVD); in fact, CVDs are the most common cause of mortality in patients with NAFLD. Obesity, type 2 diabetes and higher levels of LDL are common risk factors in both NAFLD and CVD; however, how NAFLD affects the development and progression of CVD remains elusive. In this review, we comprehensively summarise current data on the key extrahepatic manifestations of NAFLD, emphasising the possible link between NAFLD and CVD, including the role of proprotein convertase substilisin/kenin type 9, extracellular vesicles, microbiota, and genetic factors.

Redescription of the enigmatic myriapod Hanseniellachilensis (Hansen, 1903) (Symphyla, Scutigerellidae) based on scanning electron microscope images of Chilean specimens.

Hanseniellachilensis is the only myriapod of the class Symphyla known from Chile. This garden centipede, or pseudocentipede, was described more than 120 years ago based on morphologically incomplete specimens collected in central Chile, a well-known biodiversity hotspot. In this study, we redescribe this species based on morphologically complete specimens collected near the type locality using scanning electron microscope images. Our study provides the description of diagnostic characters hitherto unknown in this species such as macrochaetae of the tergites and spinnerets of the cerci. We also include a new record from central Chile and discuss the presumed presence of this species in Argentina and Madagascar.

Rapidly improving ARDS differs clinically and biologically from persistent ARDS.

BACKGROUND: Rapidly improving acute respiratory distress syndrome (RIARDS) is an increasingly appreciated subgroup of ARDS in which hypoxemia improves within 24 h after initiation of mechanical ventilation. Detailed clinical and biological features of RIARDS have not been clearly defined, and it is unknown whether RIARDS is associated with the hypoinflammatory or hyperinflammatory phenotype of ARDS. The purpose of this study was to define the clinical and biological features of RIARDS and its association with inflammatory subphenotypes. METHODS: We analyzed data from 215 patients who met Berlin criteria for ARDS (endotracheally intubated) and were enrolled in a prospective observational cohort conducted at two sites, one tertiary care center and one urban safety net hospital. RIARDS was defined according to previous studies as improvement of hypoxemia defined as (i) PaO2:FiO2 > 300 or (ii) SpO2: FiO2 > 315 on the day following diagnosis of ARDS (day 2) or (iii) unassisted breathing by day 2 and for the next 48 h (defined as absence of endotracheal intubation on day 2 through day 4). Plasma biomarkers were measured on samples collected on the day of study enrollment, and ARDS phenotypes were allocated as previously described. RESULTS: RIARDS accounted for 21% of all ARDS participants. Patients with RIARDS had better clinical outcomes compared to those with persistent ARDS, with lower hospital mortality (13% vs. 57%; p value < 0.001) and more ICU-free days (median 24 vs. 0; p value < 0.001). Plasma levels of interleukin-6, interleukin-8, and plasminogen activator inhibitor-1 were significantly lower among patients with RIARDS. The hypoinflammatory phenotype of ARDS was more common among patients with RIARDS (78% vs. 51% in persistent ARDS; p value = 0.001). CONCLUSIONS: This study identifies a high prevalence of RIARDS in a multicenter observational cohort and confirms the more benign clinical course of these patients. We report the novel finding that RIARDS is characterized by lower concentrations of plasma biomarkers of inflammation compared to persistent ARDS, and that hypoinflammatory ARDS is more prevalent among patients with RIARDS. Identification and exclusion of RIARDS could potentially improve prognostic and predictive enrichment in clinical trials.

Dysfunctional mitochondria, disrupted levels of reactive oxygen species, and autophagy in B cells from common variable immunodeficiency patients.

Introduction: Common Variable Immunodeficiency (CVID) patients are characterized by hypogammaglobulinemia and poor response to vaccination due to deficient generation of memory and antibody-secreting B cells. B lymphocytes are essential for the development of humoral immune responses, and mitochondrial function, hreactive oxygen species (ROS) production and autophagy are crucial for determining B-cell fate. However, the role of those basic cell functions in the differentiation of human B cells remains poorly investigated. Methods: We used flow cytometry to evaluate mitochondrial function, ROS production and autophagy processes in human naïve and memory B-cell subpopulations in unstimulated and stimulated PBMCs cultures. We aimed to determine whether any alterations in these processes could impact B-cell fate and contribute to the lack of B-cell differentiation observed in CVID patients. Results: We described that naïve CD19+CD27- and memory CD19+CD27+ B cells subpopulations from healthy controls differ in terms of their dependence on these processes for their homeostasis, and demonstrated that different stimuli exert a preferential cell type dependent effect. The evaluation of mitochondrial function, ROS production and autophagy in naïve and memory B cells from CVID patients disclosed subpopulation specific alterations. Dysfunctional mitochondria and autophagy were more prominent in unstimulated CVID CD19+CD27- and CD19+CD27+ B cells than in their healthy counterparts. Although naïve CD19+CD27- B cells from CVID patients had higher basal ROS levels than controls, their ROS increase after stimulation was lower, suggesting a disruption in ROS homeostasis. On the other hand, memory CD19+CD27+ B cells from CVID patients had both lower ROS basal levels and a diminished ROS production after stimulation with anti-B cell receptor (BCR) and IL-21. Conclusion: The failure in ROS cell signalling could impair CVID naïve B cell activation and differentiation to memory B cells. Decreased levels of ROS in CVID memory CD19+CD27+ B cells, which negatively correlate with their in vitro cell death and autophagy, could be detrimental and lead to their previously demonstrated premature death. The final consequence would be the failure to generate a functional B cell compartment in CVID patients.

Biological basis of extensive pleiotropy between blood traits and cancer risk.

BACKGROUND: The immune system has a central role in preventing carcinogenesis. Alteration of systemic immune cell levels may increase cancer risk. However, the extent to which common genetic variation influences blood traits and cancer risk remains largely undetermined. Here, we identify pleiotropic variants and predict their underlying molecular and cellular alterations. METHODS: Multivariate Cox regression was used to evaluate associations between blood traits and cancer diagnosis in cases in the UK Biobank. Shared genetic variants were identified from the summary statistics of the genome-wide association studies of 27 blood traits and 27 cancer types and subtypes, applying the conditional/conjunctional false-discovery rate approach. Analysis of genomic positions, expression quantitative trait loci, enhancers, regulatory marks, functionally defined gene sets, and bulk- and single-cell expression profiles predicted the biological impact of pleiotropic variants. Plasma small RNAs were sequenced to assess association with cancer diagnosis. RESULTS: The study identified 4093 common genetic variants, involving 1248 gene loci, that contributed to blood-cancer pleiotropism. Genomic hotspots of pleiotropism include chromosomal regions 5p15-TERT and 6p21-HLA. Genes whose products are involved in regulating telomere length are found to be enriched in pleiotropic variants. Pleiotropic gene candidates are frequently linked to transcriptional programs that regulate hematopoiesis and define progenitor cell states of immune system development. Perturbation of the myeloid lineage is indicated by pleiotropic associations with defined master regulators and cell alterations. Eosinophil count is inversely associated with cancer risk. A high frequency of pleiotropic associations is also centered on the regulation of small noncoding Y-RNAs. Predicted pleiotropic Y-RNAs show specific regulatory marks and are overabundant in the normal tissue and blood of cancer patients. Analysis of plasma small RNAs in women who developed breast cancer indicates there is an overabundance of Y-RNA preceding neoplasm diagnosis. CONCLUSIONS: This study reveals extensive pleiotropism between blood traits and cancer risk. Pleiotropism is linked to factors and processes involved in hematopoietic development and immune system function, including components of the major histocompatibility complexes, and regulators of telomere length and myeloid lineage. Deregulation of Y-RNAs is also associated with pleiotropism. Overexpression of these elements might indicate increased cancer risk.

Host and Microbe Blood Metagenomics Reveals Key Pathways Characterizing Critical Illness Phenotypes.

Rationale: Two molecular phenotypes of sepsis and acute respiratory distress syndrome, termed hyperinflammatory and hypoinflammatory, have been consistently identified by latent class analysis in numerous cohorts, with widely divergent clinical outcomes and differential responses to some treatments; however, the key biological differences between these phenotypes remain poorly understood.Objectives: We used host and microbe metagenomic sequencing data from blood to deepen our understanding of biological differences between latent class analysis-derived phenotypes and to assess concordance between the latent class analysis-derived phenotypes and phenotypes reported by other investigative groups (e.g., Sepsis Response Signature [SRS1-2], molecular diagnosis and risk stratification of sepsis [MARS1-4], reactive and uninflamed).Methods: We analyzed data from 113 patients with hypoinflammatory sepsis and 76 patients with hyperinflammatory sepsis enrolled in a two-hospital prospective cohort study. Molecular phenotypes had been previously assigned using latent class analysis.Measurements and Main Results: The hyperinflammatory and hypoinflammatory phenotypes of sepsis had distinct gene expression signatures, with 5,755 genes (31%) differentially expressed. The hyperinflammatory phenotype was associated with elevated expression of innate immune response genes, whereas the hypoinflammatory phenotype was associated with elevated expression of adaptive immune response genes and, notably, T cell response genes. Plasma metagenomic analysis identified differences in prevalence of bacteremia, bacterial DNA abundance, and composition between the phenotypes, with an increased presence and abundance of Enterobacteriaceae in the hyperinflammatory phenotype. Significant overlap was observed between these phenotypes and previously identified transcriptional subtypes of acute respiratory distress syndrome (reactive and uninflamed) and sepsis (SRS1-2). Analysis of data from the VANISH trial indicated that corticosteroids might have a detrimental effect in patients with the hypoinflammatory phenotype.Conclusions: The hyperinflammatory and hypoinflammatory phenotypes have distinct transcriptional and metagenomic features that could be leveraged for precision treatment strategies.

Insatisfacción corporal, ortorexia y dependencia al ejercicio en corredores amateur de resistencia / Insatisfação corporal, ortorexia e dependência do treino em corredores amadores de resistência / Body image dissatisfaction, orthorexia and training addiction in amateur endurance runners

El objetivo del estudio fue conocer si existe relación entre la insatisfacción corporal, la ortorexia y la dependencia al ejercicio en una muestra de corredores de resistencia aficionados, así como examinar las variables psicológicas como la identidad, el perfeccionismo y el enfoque a través de la comparación entre grupos y la obtención de perfiles. Para ello, 129 corredores participantes en la edición XIII del Trail 7 Colinas de Tartessos en 2023 (96 hombres y 33 mujeres; media de edad M=45.5; DT=8.4), completaron el cuestionario de imagen corporal (Body Shape Qustionnaire, BSQ 14), la ortorexia 11 (ORTO-11), el Inventario de perfeccionismo multidimensional en el Deporte en competición (MIPS), la Escala de medición de identidad deportiva (AIMS), el cuestionario ad hoc de Satisfacción Manifiesta (CS), el cuestionario de Percepción de Éxito (POSQ). También se registraron los datos y parámetros como corredor. Los resultados mostraron que el 15% de los corredores presentaron insatisfacción corporal y el 16 % ortorexia. Además, el 13 % de los corredores presentaron ambas manifestaciones. Se encontró una correlación significativa positiva entre la insatisfacción corporal y la ortorexia. Ambas variables también presentaron correlaciones negativas con la satisfacción manifiesta sobre la imagen corporal. Sin embargo, no se encontró relación con la dependencia del ejercicio, aunque los componentes de esta última se relacionaron con variables psicológicas; el componente positivo mostró una correlación negativa con el perfeccionismo, y el componente negativo se relacionó positivamente con la identidad deportiva. Ambas variables resultaron relevantes en la comparación de los grupos en relación a la ortorexia, y de manera separadas en la discriminación; el perfeccionismo sobre la insatisfacción manifiesta y la escala de identidad sobre la ortorexia.(AU)

The aim of the present study was to find out whether there is a relationship between body dissatisfaction, orthorexia, and exercise dependence in a sample of amateur endurance runners, as well as to examine psychological variables such as identity, perfectionism, and focus by comparing groups and obtaining profiles. To this end, 129 runners participating in the XIII edition of the Trail 7 Colinas de Tartessos in 2023 (96 men and 33 women; mean age M=45.5; SD=8.4), completed the Body Shape Questionnaire (BSQ14),the Orthorexia 11 (ORTO-11), the Multidimensional Perfectionism Inventory in Competitive Sport (MIPS), the Athletic Identity Measurement Scale (AIMS), the ad hoc Satisfaction Questionnaire (CS), the Perception of Success Questionnaire (POSQ). Data and parameters as a runner were also recorded. The results showed that 15% of the runners presented body dissatisfaction and 16% orthorexia. In addition, 13 % of the runners had both manifestations. A significant positive correlation was found between body dissatisfaction and orthorexia. Both variables were also negatively correlated with expressed satisfaction with body image. However, no relationshipwas found with exercise dependence, although components of exercise dependence were related to psychological variables; the positive component showed a negative correlation with perfectionism, and the negative component was positively related to sports identity. Both variables were relevant in the comparison of the groups in relation to orthorexia, and separately in discrimination,perfectionism on manifest dissatisfaction and the identity scale on orthorexia.(AU)

O objectivo do estudo foi analisar se existe uma relação entre insatisfação corporal, ortorexia e dependência do exercício numa amostra de corredores amadores de endurance, bem como analisar variáveis psicológicas como a identidade, o perfeccionismo e o foco, através da comparação entre grupos e da obtenção de perfis. Para o efeito, 129 corredores participantes na XIII edição do Trail 7 Colinas de Tartessos em 2023 (96 homens e 33mulheres; idade média M=45.5; DP=8.4), preencheram o Body ShapeQuestionnaire(BSQ 14), o Orthorexia 11 (ORTO-11), o Multidimensional Perfectionism Inventory in Competitive Sport (MIPS), a Athletic Identity Measurement Scale (AIMS), o ad hoc Satisfaction Questionnaire (CS), e o Perception of Success Questionnaire (POSQ). Foram igualmente registados os dados e os parâmetros enquanto corredores. Os resultados mostraram que 15% dos corredores apresentavam insatisfação corporal e 16% ortorexia. Para alémdisso, 13% dos corredores apresentavam ambas as manifestações. Foi encontrada uma correlação positiva significativa entre a insatisfação corporal e a ortorexia. Ambas as variáveis estavam também negativamente correlacionadas com a satisfação expressa com a imagem corporal. No entanto, não foi encontrada qualquer relação com a dependência do exercício, embora os componentes da dependência do exercício estivessem relacionados com variáveis psicológicas; a componente positiva evidenciou uma correlação negativa com o perfeccionismo, e a componente negativa estava positivamente relacionado coma identidade desportiva. Ambas as variáveis foram relevantes na comparação dos grupos em relação à ortorexia, e separadamente na discriminação; o perfeccionismo na insatisfação manifesta e a escala de identidade na ortorexia.(AU)

Reverse time migration and genetic algorithms Combined for Reconstruction in Transluminal Shear Wave Elastography: An In Silico Case Study.

A new reconstruction approach that combines Reverse Time Migration (RTM) and Genetic Algorithms (GAs) is proposed for solving the inverse problem associated with transluminal shear wave elastography. The transurethral identification of the first thermal lesion generated by transrectal High Intensity Focused Ultrasound (HIFU) for the treatment of prostate cancer, was used to preliminarily test in silico the combined reconstruction method. The RTM method was optimised by comparing reconstruction images from several cross-correlation techniques, including a new proposed one, and different device configurations in terms of the number and arrangement of emitters and receivers of the conceptual transurethral probe. The best results were obtained for the new proposed cross-correlation method and a device configuration with 3 emitters and 32 receivers. The RTM reconstructions did not completely contour the shape of the HIFU lesion, however, as planned for the combined approach, the areas in the RTM images with high level of correlation were used to narrow down the search space in the GA-based technique. The GA-based technique was set to find the location of the HIFU lesion and the increment in stiffness and viscosity due to thermal damage. Overall, the combined approach achieves lower level of error in the reconstructed values, and in a shorter computational time, compared to the GA-based technique alone. The lowest errors were accomplished for the location of HIFU lesion, followed by the contrast ratio of stiffness between thermally treated tissue and non-treated normal tissue. The homologous ratio of viscosity obtained higher level of error. Further investigation considering diverse scenarios to be reconstructed and with experimental data is required to fully evaluate the feasibility of the combined approach.

Achieving the UNAIDS goals by 2030 in people living with HIV: A simulation model to support the prioritization of health care interventions / Alcanzar los objetivos de ONUSIDA para 2030 en personas con VIH: un modelo de simulación para respaldar la priorización de las intervenciones sanitarias

Objective: We simulated the impact of implementing different health interventions to improve the HIV continuum of care for people diagnosed, on treatment, and virologically suppressed in Spain for the 2020–2030 period. Methods: The model was carried out in four phases involving a multidisciplinary expert panel: (1) literature review; (2) selection/definition of the interventions and their effectiveness; (3) consensus meeting; and (4) development of an analytical decision model to project the impact of implementing/strengthening these interventions to improve the HIV continuum of care, corresponding to 2017–2019 (87% diagnosed, 97% on treatment, 90% with viral suppression), through the creation of different scenarios for 2020–2030. A total of 19 interventions were selected based on expanding the offer of HIV rapid tests and implementing training/peer programmes, electronic alerts, multidisciplinary care, and mHealth, among others. The effectiveness of the interventions was defined by the percentage increases in diagnosis, treatment, and viral suppression after their implementation, targeting the entire population and specific groups at high-risk (men who have sex with men, migrants, female sex workers, transgender people, and people who inject drugs). Results: Implementing eight interventions for diagnosis, three for treatment, and eight for viral suppression for the target populations during 2020–2030 would increase the continuum of care to approximately 100% diagnosed (remaining residual undetectable cases), 98% treated, and 96% virologically suppressed. Conclusions: Planification, prioritization, and implementation of selected interventions based on the current HIV continuum of care could allow achievement of the 95-95-95 UNAIDS goals in Spain by 2030.(AU)

Objetivo: Simulamos el impacto de la implementación de diferentes intervenciones sanitarias para mejorar la atención continua de las personas diagnosticadas, en tratamiento y con supresión vírica del VIH en España para el período 2020-2030. Métodos: El modelo se llevó a cabo en 4 fases con la participación de un panel de expertos multidisciplinario: (1) revisión de la literatura médica publicada; (2) selección/definición de las intervenciones y su eficacia; (3) reunión de consenso, y (4) desarrollo de un modelo de toma de decisiones analítico para proyectar el impacto de la implementación/refuerzo de estas intervenciones para mejorar la atención continua de las personas con VIH, correspondiente al período 2017-2019 (87% diagnosticados, 97% en tratamiento y 90% con supresión vírica), a través de la creación de diferentes escenarios para el período 2020-2030. Se seleccionaron un total de 19 intervenciones sobre la base de ampliar la oferta de pruebas rápidas de VIH, y la implementación de programas de formación/entre pares, alertas electrónicas, atención multidisciplinaria y mHealth, entre otras. La efectividad de las intervenciones se definió a partir del porcentaje de incremento en el diagnóstico, tratamiento y supresión vírica tras la implementación, dirigida a toda la población y a grupos específicos de alto riesgo (hombres que mantienen relaciones sexuales con otros hombres, migrantes, trabajadoras sexuales, personas transgénero y personas que consumen drogas inyectables). Resultados: La implementación de 8 intervenciones para el diagnóstico, 3 para el tratamiento y 8 para la supresión vírica dirigidas a las poblaciones objetivo durante el período 2020-2030 debería mejorar la atención continua recibida en aproximadamente un 100% de personas diagnosticadas (con un remanente de casos residuales indetectables), un 98% de personas tratadas y un 96% de personas con supresión vírica...(AU)

Exploring IoT Vulnerabilities in a Comprehensive Remote Cybersecurity Laboratory.

With the rapid proliferation of Internet of things (IoT) devices across various sectors, ensuring robust cybersecurity practices has become paramount. The complexity and diversity of IoT ecosystems pose unique security challenges that traditional educational approaches often fail to address comprehensively. Current curricula may provide theoretical knowledge but typically lack the practical components necessary for students to engage with real-world cybersecurity scenarios. This gap hinders the development of proficient cybersecurity professionals capable of securing complex IoT infrastructures. To bridge this educational divide, a remote online laboratory was developed, allowing students to gain hands-on experience in identifying and mitigating cybersecurity threats in an IoT context. This virtual environment simulates real IoT ecosystems, enabling students to interact with actual devices and protocols while practicing various security techniques. The laboratory is designed to be accessible, scalable, and versatile, offering a range of modules from basic protocol analysis to advanced threat management. The implementation of this remote laboratory demonstrated significant benefits, equipping students with the necessary skills to confront and resolve IoT security issues effectively. Our results show an improvement in practical cybersecurity abilities among students, highlighting the laboratory's efficacy in enhancing IoT security education.

The Potential of Essential Oils from Active Packaging to Reduce Ethylene Biosynthesis in Plant Products. Part 1: Vegetables (Broccoli and Tomato).

Essential oils (EOs) extracted from plants have a high potential to reduce ethylene biosynthesis, although their effects have not been deeply studied yet on the key components of the ethylene biosynthesis pathway: l-aminocyclopropane-1-carboxylic (ACC) oxidase activity, ACC synthase activity, and ACC content. Hence, the present study aimed to elucidate the effects of released EOs from active packaging (with different EO doses ranging from 100 to 1000 mg m-2) on the ethylene biosynthesis key components of broccoli and tomato under different storage temperature scenarios. The largest ethylene inhibitory effects on broccoli and tomatoes were demonstrated by grapefruit EO and thyme essential EO (up to 63%), respectively, which were more pronounced at higher temperatures. Regarding EO doses, active packaging with a thyme EO dose of 1000 mg m-2 resulted in the strongest reduction (33-38%) of ethylene production in tomatoes. For broccoli, identical results were shown with a lower grapefruit EO dose of 500 mg m-2. The studied EO-active packaging decreased ACC synthase and ACC oxidase activities by 40-50% at 22 °C. Therefore, this EO-active packaging is a natural and effective technology to reduce ethylene biosynthesis in broccoli and tomatoes when they are stored, even in unsuitable scenarios at high temperatures.

The Potential of Essential Oils from Active Packaging to Reduce Ethylene Biosynthesis in Plant Products. Part 2: Fruits (Blueberries and Blackberries).

Plant essential oils (EOs) have an important ability to inhibit ethylene biosynthesis. Nevertheless, the effects of EOs on the key components of ethylene biosynthesis (l-aminocyclopropane-1-carboxylic (ACC) oxidase activity, ACC synthase activity, and ACC content) have not yet been thoroughly studied. Accordingly, this study focused on the effects of emitted EOs from active packaging (EO doses from 100 to 1000 mg m-2) on the key components of ethylene biosynthesis of blueberries and blackberries under several storage temperatures. Anise EO and lemon EO active packaging induced the greatest inhibitory effects (60-76%) on the ethylene production of blueberries and blackberries, respectively, even at high storage temperatures (22 °C). In terms of EO doses, active packaging with 1000 mg m-2 of anise EO or lemon EO led to the highest reduction of ethylene production, respectively. At 22 °C, the investigated EO active packing reduced the activities of ACC synthase and ACC oxidase up to 50%. In order to minimise ethylene biosynthesis in blueberries and blackberries when they are stored even under improper temperature scenarios at high temperatures, this EO active packaging is a natural and efficient technological solution.

Assessing the real-world effectiveness of five SARS-CoV-2 vaccines in a cohort of Mexican pensioners: a nationwide nested test-negative design study.

Background: Despite the extensive distribution of COVID-19 vaccines across Latin America, research on their real-world performance remains limited. We aimed to evaluate the effectiveness of five vaccines (BNT162b2, AZD1222, CoronaVac, Gam-COVID-Vac, and Ad5-nCoV) in a cohort of 2,559,792 pensioners covered by the Mexican Institute of Social Security. Methods: We conducted a nested test-negative design study on 28,271 individuals tested for SARS-CoV-2 infection between April and November 2021, accounting for 29,226 separate episodes. We used mixed-effects logistic regression models to estimate the vaccine effectiveness (VE) in fully vaccinated individuals for symptomatic infection, hospitalization, severe disease, and death. Findings: The median age of the study population was 70 years (interquartile range 65-76) and 76.4% (21,598/28,271) were male. VE rates were 56.3%, 75.3%, 79.7%, and 79.8% against symptomatic infection (95% confidence interval [CI]: 53.5-59.0), hospitalization (95% CI: 73.4-77.0), severe disease (95% CI: 78.0-81.3), and death (95% CI: 78.1-81.4), respectively. When evaluating vaccines individually, all showed moderate to high VE, with the best being BNT162b2 (symptomatic infection, 69.8%, 95% CI: 67.3-72.0; hospitalization, 84.1%, 95% CI: 82.5-85.6; severe disease, 88.2%, 95% CI: 86.7-89.5; and death, 88.3%, 95% CI: 86.9-89.6) and Gam-COVID-Vac (symptomatic infection, 70.0%, 95% CI: 64.8-74.4; hospitalization, 86.8%, 95% CI: 83.7-89.3; severe disease, 91.9%, 95% CI: 89.4-93.9; and death, 92.0%, 95% CI: 89.5-93.9). Interpretation: All five SARS-CoV-2 vaccines available for this population showed moderate to high levels of protection against COVID-19 and its progression to severe outcomes. Funding: Fundación IMSS, México.

Biomimetic superabsorbent hydrogel acts as a gut protective dynamic exoskeleton improving metabolic parameters and expanding A. muciniphila.

The rising prevalence of obesity and metabolic disorders worldwide highlights the urgent need to find new long-term and clinically meaningful weight-loss therapies. Here, we evaluate the therapeutic potential and the mechanism of action of a biomimetic cellulose-based oral superabsorbent hydrogel (OSH). Treatment with OSH exerts effects on intestinal tissue and gut microbiota composition, functioning like a protective dynamic exoskeleton. It protects from gut barrier permeability disruption and induces rapid and consistent changes in the gut microbiota composition, specifically fostering Akkermansia muciniphila expansion. The mechanobiological, physical, and chemical structures of the gel are required for A. muciniphila growth. OSH treatment induces weight loss and reduces fat accumulation, in both preventative and therapeutic settings. OSH usage also prevents liver steatosis, immune infiltration, and fibrosis, limiting the progression of non-alcoholic fatty liver disease. Our work shows the potential of using OSH as a non-systemic mechanobiological approach to treat metabolic syndrome and its comorbidities.

Full endoscopic minimally invasive extraperitoneal modified Sugarbaker approach for para-colostomy hernia repair: Technical aspects and 2-year follow-up results of a prospective cohort.

AIM: This study aimed to assess technical aspects and clinical results of a new minimally invasive technique in parastomal hernia (PSH) repair, full endoscopic retromuscular access, after 2 years of follow-up. METHODS: Data from consecutive patients requiring minimally invasive ventral PSH repair were collected from 2019 to 2022. The inclusion criteria were patients aged between 18 and 80 years old with symptomatic PSH. Demographics and perioperative and postoperative data were collected. Postoperative pain and functional recovery were compared with preoperative data. RESULTS: Twelve patients with symptomatic PSH were included. The mean PSH defect area was 16.2 cm2 and the mean midline defect was 8.7 cm2 . No intra-operative complications or conversion to open surgery were detected. One patient (8%) required postoperative readmission due to partial bowel obstruction symptoms that required catheterization of the stoma. Pain significantly worsened after the first postoperative day compared to preoperative data but improved after the first postoperative month compared to the first postoperative week and after the 90th postoperative day compared to the first postoperative month, with significant differences. Significant restriction improvement was identified when 30 days after surgery data were compared to preoperative data and when the 180th postoperative day results were compared to 30 days after surgery. The average follow-up was 29 months. During the follow-up no clinical or radiological recurrence was observed. CONCLUSION: This paper shows low rate of intra- and postoperative complications with significant improvement in terms of pain activities restriction compared to preoperatory. After 29 months follow-up, no recurrence was identified, confirming that this approach offers good mid-term results.

Motivación y actividad física de los padres e índice de masa corporal de futbolistas infantiles / Motivation and physical activity of parents and body mass index of children footballers

El objetivo de este estudio fue comprobar si existe relación entre la motivación y la actividad física de los padres con la actividad física, el deseo y consumo alimentario y el índice de masa corporal de los hijos deportistas. Para ello, se llevó a cabo una revisión médica a 176 jugadores de fútbol (170 niños y 6 niñas; media de edad M=7.3 DT=.16) pertenecientes a la Escuela Municipal de Fútbol de Arahal (Sevilla); y de las categorías alevín (33 jugadores), benjamín (49), prebenjamín (44) e iniciación (50). Se calculó el índice de masa corporal a los infantes y luego se pidió a sus padres que completaran un cuestionario de motivación de padres, el cuestionario ad-hoc sobre la alimentación de los hijos, y que respondieran preguntas sobre su propia actividad física y la de sus hijos. Se realizaron análisis descriptivo, correlacional, comparativo, regresión y discriminante. Los resultados mostraron que la actividad física de los padres predecía un índice de masa corporal normal en los hijos, mientras que el mayor número de horas dedicadas a actividad extraescolares no deportivas (condición conductual) y el consumo excesivo de alimentos, mayor deseo de ingesta (condición cognitiva) por parte de los hijos se asociaron con sobrepeso u obesidad. Ambos resultados se produjeron independientemente del tipo de motivación que los padres presentaran sobre la práctica deportiva de sus hijos. (AU)

The im of this study was to check if there is a relationship between parental motivation and physical activity with physical activity, food desire and consumption and the body mass index of their sporting children. For this purpose, a medical check-up was carried out on 176 football players (170 boys and 6 girls; mean age M=7.3 SD=.16) belonging to the Municipal Football School of Arahal (Seville); and of the categories alevín (33 players), benjamín (49), prebenjamín (44) and iniciación (50). The children's body mass index was calculated and then their parents were asked to complete a parental motivation questionnaire, the ad-hoc questionnaire on their children's diet, and to answer questions about their own and their children's physical activity. Descriptive, correlational, comparative, regression and discriminant analyses were performed. Results showed that parental physical activity predicted normal body mass index in children, while more hours spent in non-sport extracurricular activity (behavioural condition) and excessive food consumption, higher food craving (cognitive condition) by children were associated with overweight or obesity. Both results were independent of the type of motivation parents had about their children's sport practice. (AU)

Identifying molecular phenotypes in sepsis: an analysis of two prospective observational cohorts and secondary analysis of two randomised controlled trials.

BACKGROUND: In sepsis and acute respiratory distress syndrome (ARDS), heterogeneity has contributed to difficulty identifying effective pharmacotherapies. In ARDS, two molecular phenotypes (hypoinflammatory and hyperinflammatory) have consistently been identified, with divergent outcomes and treatment responses. In this study, we sought to derive molecular phenotypes in critically ill adults with sepsis, determine their overlap with previous ARDS phenotypes, and evaluate whether they respond differently to treatment in completed sepsis trials. METHODS: We used clinical data and plasma biomarkers from two prospective sepsis cohorts, the Validating Acute Lung Injury biomarkers for Diagnosis (VALID) study (N=1140) and the Early Assessment of Renal and Lung Injury (EARLI) study (N=818), in latent class analysis (LCA) to identify the optimal number of classes in each cohort independently. We used validated models trained to classify ARDS phenotypes to evaluate concordance of sepsis and ARDS phenotypes. We applied these models retrospectively to the previously published Prospective Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis and Septic Shock (PROWESS-SHOCK) trial and Vasopressin and Septic Shock Trial (VASST) to assign phenotypes and evaluate heterogeneity of treatment effect. FINDINGS: A two-class model best fit both VALID and EARLI (p<0·0001). In VALID, 804 (70·5%) of the 1140 patients were classified as hypoinflammatory and 336 (29·5%) as hyperinflammatory; in EARLI, 530 (64·8%) of 818 were hypoinflammatory and 288 (35·2%) hyperinflammatory. We observed higher plasma pro-inflammatory cytokines, more vasopressor use, more bacteraemia, lower protein C, and higher mortality in the hyperinflammatory than in the hypoinflammatory phenotype (p<0·0001 for all). Classifier models indicated strong concordance between sepsis phenotypes and previously identified ARDS phenotypes (area under the curve 0·87-0·96, depending on the model). Findings were similar excluding participants with both sepsis and ARDS. In PROWESS-SHOCK, 1142 (68·0%) of 1680 patients had the hypoinflammatory phenotype and 538 (32·0%) had the hyperinflammatory phenotype, and response to activated protein C differed by phenotype (p=0·0043). In VASST, phenotype proportions were similar to other cohorts; however, no treatment interaction with the type of vasopressor was observed (p=0·72). INTERPRETATION: Molecular phenotypes previously identified in ARDS are also identifiable in multiple sepsis cohorts and respond differently to activated protein C. Molecular phenotypes could represent a treatable trait in critical illness beyond the patient's syndromic diagnosis. FUNDING: US National Institutes of Health.