Delayed Type Hypersensitivity Reaction Induced By Liraglutide With Tolerance to Semaglutide.

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the management of type 2 diabetes and obesity. It was the first GLP-1 receptor agonist to be approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of obesity. To date, numerous skin adverse reactions to liraglutide have been reported, but data regarding hypersensitivity reactions are scarce, raising concerns about its safety and clinical management. We present the case of a 56-year-old female patient with class 3 obesity who was started on subcutaneous liraglutide (Saxenda) by her endocrinologist. One month after starting the aforementioned treatment, the patient presented well-defined, round, erythematous pruriginous plaques surrounding the injection site, around 24 hours after the drug administration. A liraglutide-induced, delayed-type hypersensitivity reaction was suspected, which could be subsequently confirmed by allergy testing and histopathological study. This paper explores the clinical use of liraglutide, the occurrence of hypersensitivity reactions, diagnosis, management, and implications for future research. Understanding and managing liraglutide hypersensitivity is crucial to ensuring the safety and efficacy of this medication.

Impact of a teaching hospital-based multidisciplinary telemedicine programme in Southwestern Colombia: a cross-sectional resource analysis.

BACKGROUND: Telemedicine, a method of healthcare service delivery bridging geographic distances between patients and providers, has gained prominence. This modality is particularly advantageous for outpatient consultations, addressing inherent barriers of travel time and cost. OBJECTIVE: We aim to describe economical outcomes towards the implementation of a multidisciplinary telemedicine service in a high-complexity hospital in Latin America, from the perspective of patients. DESIGN: A cross-sectional study was conducted, analysing the institutional data obtained over a period of 9 months, between April 2020 and December 2020. SETTING: A high-complexity teaching hospital located in Cali, Colombia. PARTICIPANTS: Individuals who received care via telemedicine. The population was categorised into three groups based on their place of residence: Cali, Valle del Cauca excluding Cali and Outside of Valle del Cauca. OUTCOME MEASURES: Travel distance, time, fuel and public round-trip cost savings, and potential loss of productivity were estimated from the patient's perspective. RESULTS: A total of 62 258 teleconsultations were analysed. Telemedicine led to a total distance savings of 4 514 903 km, and 132 886 hours. The estimated cost savings were US$680 822 for private transportation and US$1 087 821 for public transportation. Patients in the Outside of Valle del Cauca group experienced an estimated average time savings of 21.2 hours, translating to an average fuel savings of US$149.02 or an average savings of US$156.62 in public transportation costs. Areas with exclusive air access achieved a mean cost savings of US$362.9 per teleconsultation, specifically related to transportation costs. CONCLUSION: Telemedicine emerges as a powerful tool for achieving substantial travel savings for patients, especially in regions confronting geographical and socioeconomic obstacles. These findings underscore the potential of telemedicine to bridge healthcare accessibility gaps in low-income and middle-income countries, calling for further investment and expansion of telemedicine services in such areas.

Magnetic anisotropy engineering in onion-structured metal oxide nanoparticles combining dual exchange coupling and proximity effects.

A series of exchange-coupled magnetic nanoparticles combining several magnetic phases in an onion-type structure were synthesized by performing a three-step seed-mediated growth process. Iron and cobalt precursors were alternatively decomposed in high-boiling-temperature solvents (288-310 °C) to successively grow CoO and Fe3-δO4 shells (the latter in three stages) on the surface of Fe3-δO4 seeds. The structure and chemical composition of these nanoparticles were investigated in depth by combining a wide panel of advanced techniques, such as scanning transmission electron microscopy (STEM), electron energy-loss spectroscopy-spectrum imaging (EELS-SI), 57Fe Mössbauer spectrometry, and X-ray circular magnetic dichroism (XMCD) techniques. The size of the nanoparticles increased progressively after each thermal decomposition step, but the crystal structure of core-shell nanoparticles was significantly modified during the growth of the second shell. Indeed, the antiferromagnetic CoO phase was progressively replaced by the CoFe2O4 ferrimagnet due to the concomitant processes of partial solubilization/crystallization and the interfacial cationic diffusion of iron. A much more complex chemical structure than that suggested by a simple size variation of the nanoparticles is thus proposed, namely Fe3-δO4@CoO-CoFe2O4@Fe3-δO4, where an intermediate Co-based layer was shown to progressively become a single, hybrid magnetic phase (attributed to proximity effects) with a reduction in the CoO amount. In turn, the dual exchange-coupling of this hybrid Co-based intermediate layer (with high anisotropy and ordering temperature) with the surrounding ferrite (core and outer shells) stabilized the particle moment well above room temperature. These effects allow for the production of Fe oxide-based magnetic nanoparticles with high effective anisotropy, thus revealing the potential of this strategy to design rare-earth-free permanent nanomagnets at room temperature.

Serpine1 mRNA confers mesenchymal characteristics to the cell and promotes CD8+ T cells exclusion from colon adenocarcinomas.

Serine protease inhibitor clade E member 1 (SERPINE1) inhibits extracellular matrix proteolysis and cell detachment. However, SERPINE1 expression also promotes tumor progression and plays a crucial role in metastasis. Here, we solve this apparent paradox and report that Serpine1 mRNA per se, independent of its protein-coding function, confers mesenchymal properties to the cell, promoting migration, invasiveness, and resistance to anoikis and increasing glycolytic activity by sequestering miRNAs. Expression of Serpine1 mRNA upregulates the expression of the TRA2B splicing factor without affecting its mRNA levels. Through transcriptional profiling, we found that Serpine1 mRNA expression downregulates through TRA2B the expression of genes involved in the immune response. Analysis of human colon tumor samples showed an inverse correlation between SERPINE1 mRNA expression and CD8+ T cell infiltration, unveiling the potential value of SERPINE1 mRNA as a promising therapeutic target for colon tumors.

Unraveling Exchange Coupling in Ferrites Nano-Heterostructures.

The magnetic coupling of a set of SrFe12 O19 /CoFe2 O4 nanocomposites is investigated. Advanced electron microscopy evidences the structural coherence and texture at the interfaces of the nanostructures. The fraction of the lower anisotropy phase (CoFe2 O4 ) is tuned to assess the limits that define magnetically exchange-coupled interfaces by performing magnetic remanence, first-order reversal curves (FORCs), and relaxation measurements. By combining these magnetometry techniques and the structural and morphological information from X-ray diffraction, electron microscopy, and Mössbauer spectrometry, the exchange intergranular interaction is evidenced, and the critical thickness within which coupled interfaces have a uniform reversal unraveled.

El impacto psicológico de la Pandemia en los docentes. Un enfoque de la enfermera escolar / The psychological impact of the Pandemic on teachers. A school nurse's approach

Introducción: La pandemia del COVID-19 ha supuesto para los profesores la introducción de nuevos protocolos obligándoles a asumir nuevas responsabilidades relacionadas con el control de la salud de los alumnos. Esta circunstancia ha podido generar problemas psicológicos, como el burnout y el estrés. En el presente estudio se ha dimensionado la prevalencia de burnout, resiliencia y estrés percibido, entre los profesores y su relación y asociación entre ellas. Método: Es un estudio descriptivo, analítico y transversal, sobre una muestra compuesta por 222 docentes de centros educativos. Se han utilizado diferentes cuestionarios validados: La Escala BEL para medir el burnout, basada en el Maslach Burnout Inventory; La Escala de resiliencia de Connor-Davidson CD-RISC 23 y el cuestionario de Estrés Percibido PSS-14. Resultados: Los resultados muestran una baja prevalencia de burnout y una intensa relación entre todas las dimensiones. Los niveles de resiliencia son altos y el nivel de estrés percibido es muy bajo. La Odds Ratio muestra que las mujeres desarrollan el doble de resiliencia que los hombres y que la “experiencia” influye decisivamente en el desarrollo de la resiliencia, siendo factor protector, así como en el desarrollo de estrés. Conclusión: Este estudio podría orientar a los responsables de las administraciones sanitarias y educativas en el diseño de futuras políticas relacionadas con la salud psicosocial del profesorado. (AU)

Introduction: The COVID-19 pandemic has meant for teachers the introduction of new protocols forcing them to assume new responsibilities related to the control of students' health. This circumstance may have generated psychological problems, such as burnout and stress. The present study has measured the prevalence of burnout, resilience and perceived stress among teachers and their relationship and association with each other. Method: This is a descriptive, analytical and cross-sectional study on a sample of 222 teachers from educational centers. Different validated surveys were used to measure each dimensión: The BEL Scale for measuring burnout, based on the Maslach Burnout Inventory; the Connor-Davidson Resilience Scale CD-RISC 23 and the Perceived Stress Questionnaire PSS-14. Results: The results show a low prevalence of burnout and a high correlation between all the dimensions. The levels of resilience are high and the level of perceived stress is very low. The Odds Ratio showed that women are twice as resilient as men and "experience" has a decisive influence on the development of resilience, being a protective factor, as well as on the development of stress. Conclusión:This study could guide those responsible for health and educational administrations in the design of future policies related to the psychosocial health of teachers. (AU)

TGF-ß-Upregulated Lnc-Nr6a1 Acts as a Reservoir of miR-181 and Mediates Assembly of a Glycolytic Complex.

Long non-coding RNAs (lncRNAs) have emerged as key regulators in a wide range of biological processes. Here, we identified a mouse miRNA-host gene lncRNA (lnc-Nr6a1) upregulated early during epithelial-to-mesenchymal transition (EMT). We show that when lncRNA is processed, it gives rise to two abundant polyadenylated isoforms, lnc-Nr6a1-1 and lnc-Nr6a1-2, and a longer non-polyadenylated microprocessor-driven lnc-pri-miRNA containing clustered pre-miR-181a2 and pre-miR-181b2 hairpins. Ectopic expression of the lnc-Nr6a1-1 or lnc-Nr6a1-2 isoform enhanced cell migration and the invasive capacity of the cells, whereas the expression of the isoforms and miR-181a2 and miR-181b2 conferred anoikis resistance. Lnc-Nr6a1 gene deletion resulted in cells with lower adhesion capacity and reduced glycolytic metabolism, which are restored by lnc-Nr6a1-1 isoform expression. We performed identification of direct RNA interacting proteins (iDRIP) to identify proteins interacting directly with the lnc-Nr6a1-1 isoform. We defined a network of interacting proteins, including glycolytic enzymes, desmosome proteins and chaperone proteins; and we demonstrated that the lnc-Nr6a1-1 isoform directly binds and acts as a scaffold molecule for the assembly of ENO1, ALDOA, GAPDH, and PKM glycolytic enzymes, along with LDHA, supporting substrate channeling for efficient glycolysis. Our results unveil a role of Lnc-Nr6a1 as a multifunctional lncRNA acting as a backbone for multiprotein complex formation and primary microRNAs.

Effectiveness of Silver Nanoparticles Deposited in Facemask Material for Neutralising Viruses.

Cloth used for facemask material has been coated with silver nanoparticles using an aerosol method that passes pure uncoated nanoparticles through the cloth and deposits them throughout the volume. The particles have been characterized by electron microscopy and have a typical diameter of 4 nm with the atomic structure of pure metallic silver presented as an assortment of single crystals and polycrystals. The particles adhere well to the cloth fibers, and the coating consists of individual nanoparticles at low deposition times, evolving to fully agglomerated assemblies in heavy coatings. The cloth was exposed to Usutu virus and murine norovirus particles in suspension and allowed to dry, following which, the infectious virus particles were rescued by soaking the cloth in culture media. It was found that up to 98% of the virus particles were neutralized by this contact with the silver nanoparticles for optimum deposition conditions. The best performance was obtained with agglomerated films and with polycrystalline nanoparticles. The work indicates that silver nanoparticles embedded in masks can neutralize the majority of virus particles that enter the mask and thus increase the opacity of masks to infectious viruses by up to a factor of 50. In addition, the majority of the virus particles released from the mask after use are non-infectious.

Analysis of the Effects of Melanin Depigmentation on Immunohistochemical Staining.

Heavily pigmented lesions are difficult to evaluate histologically, as melanin obscures cellular details. Several classic laboratory techniques aim to clear melanin and allow evaluation. Most of them are old and appeared before immunohistochemistry (IHC) use. Many laboratories perform IHC with aminoethylcarbazole instead of diaminobenzidine (DAB) in heavily pigmented lesions, as red-stained is easy to interpret despite pigmentation. Nevertheless, many laboratories lack alternatives to DAB. The aim of this study is to compare 6 different tissue bleaching techniques and evaluate which is the best for immunohistochemical staining with DAB. In the present study we have selected a case with gross pigmentation because of the high grade of melanin deposition. We have performed 6 different bleaching techniques and subsequently performed 2 different IHC stains, frequently used in melanoma: SOX10 (nuclear) and Melan-A (cytoplasmic). Five different pathologists, 2 of them with expertise in dermatopathology, have blindly reviewed and scored the staining quality. Our results indicate a high grade of interobserver concordance in the evaluation of IHC results between pathologists. All the bleaching techniques that included a sulfuric acid led to tissue detachment from the slide. The best method for SOX10 was that based in potassium permanganate, with a high quality of staining (4 over 5), while the best method for Melan-A was the 1 based in peroxide hydrogen (4 over 5). We consider this study can be quite useful for those laboratories lacking aminoethylcarbazole for IHC techniques, allowing the use of DAB for IHC of heavily pigmented lesions.

Crossover From Individual to Collective Magnetism in Dense Nanoparticle Systems: Local Anisotropy Versus Dipolar Interactions.

Dense systems of magnetic nanoparticles may exhibit dipolar collective behavior. However, two fundamental questions remain unsolved: i) whether the transition temperature may be affected by the particle anisotropy or it is essentially determined by the intensity of the interparticle dipolar interactions, and ii) what is the minimum ratio of dipole-dipole interaction (Edd ) to nanoparticle anisotropy (Kef V, anisotropy⋅volume) energies necessary to crossover from individual to collective behavior. A series of particle assemblies with similarly intense dipolar interactions but widely varying anisotropy is studied. The Kef  is tuned through different degrees of cobalt-doping in maghemite nanoparticles, resulting in a variation of nearly an order of magnitude. All the bare particle compacts display collective behavior, except the one made with the highest anisotropy particles, which presents "marginal" features. Thus, a threshold of Kef V/Edd  ≈ 130 to suppress collective behavior is derived, in good agreement with Monte Carlo simulations. This translates into a crossover value of ≈1.7 for the easily accessible parameter TMAX (interacting)/TMAX (non-interacting) (ratio of the peak temperatures of the zero-field-cooled magnetization curves of interacting and dilute particle systems), which is successfully tested against the literature to predict the individual-like/collective behavior of any given interacting particle assembly comprising relatively uniform particles.

Functional analysis of arteriovenous fistulae in non-contrast magnetic resonance images.

BACKGROUND AND OBJECTIVE: Arteriovenous fistulae (AVF) are the preferred mode of hemodialysis vascular access and their successful maturation is critical to reduce patient morbidity, mortality, cost, and improve quality of life. Peri-anastomotic venous segment stenosis is the primary cause of AVF maturation failure. The objective is to develop a software protocol for the functional analysis of arteriovenous fistula. METHOD: We have developed a standard protocol for the anatomical analysis of the AVF to better understand the mechanisms involved in AVF stenosis and to identify future imaging biomarkers for AVF success or failure using non-contrast magnetic resonance imaging (MRI). The 3D model of the AVF is created using a polar dynamic programming technique. Analysis has been performed on six Yorkshire cross domestic swine, but techniques can be applied into clinical settings. RESULTS: Differences in AVF angles and vein curvature are associated with significant variability of venous cross-sectional area. This suggests that the pattern of stenosis is likely to be dependent upon hemodynamic profiles which are largely determined by AVF anatomical features and could play an important role in AVF maturation. CONCLUSIONS: This protocol enables us to visualize and study the hemodynamic profiles indirectly allowing early stratification of patients into high and low risk groups for AVF maturation failure. High risk patients could then be targeted with an enhanced process of care or future maturation enhancing therapies resulting in a much-needed precision-medicine approach to dialysis vascular access.

Gas Phase Synthesis of Multi-Element Nanoparticles.

The advantages of gas-phase synthesis of nanoparticles in terms of size control and flexibility in choice of materials is well known. There is increasing interest in synthesizing multi-element nanoparticles in order to optimize their performance in specific applications, and here, the flexibility of material choice is a key advantage. Mixtures of almost any solid materials can be manufactured and in the case of core-shell particles, there is independent control over core size and shell thickness. This review presents different methods of producing multi-element nanoparticles, including the use of multiple targets, alloy targets and in-line deposition methods to coat pre-formed cores. It also discusses the factors that produce alloy, core-shell or Janus morphologies and what is possible or not to synthesize. Some applications of multi-element nanoparticles in medicine will be described.

Reconfigurable Mechanical Anisotropy in Self-Assembled Magnetic Superstructures.

Enhancement of mechanical properties in self-assembled superstructures of magnetic nanoparticles is a new emerging aspect of their remarkable collective behavior. However, how magnetic interactions modulate mechanical properties is, to date, not fully understood. Through a comprehensive Monte Carlo investigation, this study demonstrates how the mechanical properties of self-assembled magnetic nanocubes can be controlled intrinsically by the nanoparticle magnetocrystalline anisotropy (MA), as well as by the superstructure shape anisotropy, without any need for changes in structural design (i.e., nanoparticle size, shape, and packing arrangement). A low MA-to-dipolar energy ratio, as found in iron oxide and permalloy systems, favors isotropic mechanical superstructure stabilization, whereas a high ratio yields magnetically blocked nanoparticle macrospins which can give rise to metastable superferromagnetism, as expected in cobalt ferrite simple cubic supercrystals. Such full parallel alignment of the particle moments is shown to induce mechanical anisotropy, where the superior high-strength axis can be remotely reconfigured by means of an applied magnetic field. The new concepts developed here pave the way for the experimental realization of smart magneto-micromechanical systems (based, e.g., on the permanent super-magnetostriction effect illustrated here) and inspire new design rules for applied functional materials.

Cell identity and nucleo-mitochondrial genetic context modulate OXPHOS performance and determine somatic heteroplasmy dynamics.

Heteroplasmy, multiple variants of mitochondrial DNA (mtDNA) in the same cytoplasm, may be naturally generated by mutations but is counteracted by a genetic mtDNA bottleneck during oocyte development. Engineered heteroplasmic mice with nonpathological mtDNA variants reveal a nonrandom tissue-specific mtDNA segregation pattern, with few tissues that do not show segregation. The driving force for this dynamic complex pattern has remained unexplained for decades, challenging our understanding of this fundamental biological problem and hindering clinical planning for inherited diseases. Here, we demonstrate that the nonrandom mtDNA segregation is an intracellular process based on organelle selection. This cell type-specific decision arises jointly from the impact of mtDNA haplotypes on the oxidative phosphorylation (OXPHOS) system and the cell metabolic requirements and is strongly sensitive to the nuclear context and to environmental cues.

Photocatalysis Meets Magnetism: Designing Magnetically Recoverable Supports for Visible-Light Photocatalysis.

While magnetic supports have been widely used to immobilize homogeneous catalysts in organic chemistry, this strategy has so far found very little application in photocatalysis. Indeed, magnetic supports are dark colored, and thus compete for photon absorption with photocatalysts themselves. We have developed a series of core-shell Fe(0)-silica nanoparticles as supports for immobilizing the photosensitizer Ru(bpy)32+, featuring various silica shell thicknesses-16-34 nm SiO2-on 9 nm Fe cores. The supports and the resulting photocatalytic systems were studied for their magnetic, optical, and catalytic properties in the context of the photooxidation of citronellol, and we found that thicker silica shells lead to higher catalytic activity. We correlated this effect as well as Ru(bpy)32+ fluorescence and singlet oxygen generation to the absorption properties of the supports. We were able to reuse our optimal system three times with minimal loss of activity and achieved turnover numbers largely surpassing the performance of homogeneous Ru(bpy)32+. This work highlights the role of material design in the conception of new supports for applications in heterogeneous photocatalysis.