Agave distribution and floral display influence foraging rates of an endangered pollinating bat and implications for conservation.

Wildlife conservation involves making management decisions with incomplete knowledge of ecological relationships. Efforts to augment foraging resources for the endangered Mexican long-nosed bat (Leptonycteris nivalis) are progressing despite limited knowledge about the species' foraging behavior and requirements. This study aimed to understand L. nivalis responses to floral resource availability, focusing on individual agave- and local-scale characteristics influencing visitation rates to flowering agaves. We observed bat visitation at 62 flowering agaves around two roosts in northeast Mexico on 46 nights in the summers of 2017 and 2018. We found visitation rate had positive relationships with two agave-scale characteristics: the number of umbels with open flowers and the lower vertical position on the stalk of those umbels (i.e., earlier phenological stages of flowering). However, these factors exhibited strong negative interaction: with few umbels with open flowers, the position of flowering umbels had little effect on visitation rate, but when umbels with open flowers were abundant, visitation rate was more strongly related to the lower flowering umbel position. We also found relationships between visitation rate and two local-scale characteristics: negative for the density of flowering conspecifics within 30 m of the focal agave and positive for the density of dead standing agave stalks within 30 m. Our findings suggest opportunities to augment foraging resources for L. nivalis in ways that are consistent with their foraging behavior, including: increasing the supply of simultaneously blooming flowers by planting agave species that tend to have more umbels with simultaneously open flowers; planting multiple species of agaves with different flowering times to increase the availability of agaves with open flowers on lower-positioned umbels throughout the period when bats are present in the region; planting agaves in clusters; and keeping dead standing agave stalks on the landscape. Our study points to useful management strategies that can be implemented and monitored as part of an adaptive management approach to aid in conservation efforts.

Alginate Microsponges as a Scaffold for Delivery of a Therapeutic Peptide against Rheumatoid Arthritis.

The quest for biocompatible drug-delivery devices that could be able to open new administration routes is at the frontier of biomedical research. In this contribution, porous polysaccharide-based microsponges based on crosslinked alginate polymers were developed and characterized by optical spectroscopy and nanoscopic microscopy techniques. We show that macropores with a size distribution ranging from 50 to 120 nm enabled efficient loading and delivery of a therapeutic peptide (CIGB814), presently under a phase 3 clinical trial for the treatment of rheumatoid arthritis. Alginate microsponges showed 80% loading capacity and sustained peptide release over a few hours through a diffusional mechanism favored by partial erosion of the polymer scaffold. The edible and biocompatible nature of alginate polymers open promising perspectives for developing a new generation of polysaccharide-based carriers for the controlled delivery of peptide drugs, exploiting alternative routes with respect to intravenous administration.

Pesticide residue analysis in different spice samples by automatic µSPE clean-up workflow determination using LC-MS/MS.

Spices such as paprika, curry, turmeric, dry chilli, and black pepper are grown in various geographic locations and widely used by consumers across the world. Pesticides applied during crop production practices could contaminate the produce, affecting the quality and posing a health risk for consumers. The complexity of the spice matrix and the wide range of target pesticides potentially present require special sample extraction and clean-up treatments to overcome matrix interference and ion suppression. In this study, sample extracts from spice matrices (paprika/curry/turmeric/dry chilli/black pepper) were cleaned up by an automated µSPE clean-up method for multi-residue analysis of pesticides using LC-MS/MS. The automated µSPE clean-up method involves pre-filled cartridges containing various sorbent materials suitable for numerous co-extractives and the automated clean-up process was carried out using an autosampler. The regulatory limit for pesticides in spices varies with type, with a low MRL of 0.05 mg kg-1 or higher for 99% of the analytes. At spiking concentrations of 0.05 and 0.1 mg kg-1, good recoveries between 70 and 120% with RSD values below 20% were achieved for more than 98% of the compounds. With automatic clean-up of samples that takes 5 min/sample, 20% increased output per day shows an important advantage achieved compared to manual clean-up.

An Assessment of In-the-Wild Datasets for Multimodal Emotion Recognition.

Multimodal emotion recognition implies the use of different resources and techniques for identifying and recognizing human emotions. A variety of data sources such as faces, speeches, voices, texts and others have to be processed simultaneously for this recognition task. However, most of the techniques, which are based mainly on Deep Learning, are trained using datasets designed and built in controlled conditions, making their applicability in real contexts with real conditions more difficult. For this reason, the aim of this work is to assess a set of in-the-wild datasets to show their strengths and weaknesses for multimodal emotion recognition. Four in-the-wild datasets are evaluated: AFEW, SFEW, MELD and AffWild2. A multimodal architecture previously designed is used to perform the evaluation and classical metrics such as accuracy and F1-Score are used to measure performance in training and to validate quantitative results. However, strengths and weaknesses of these datasets for various uses indicate that by themselves they are not appropriate for multimodal recognition due to their original purpose, e.g., face or speech recognition. Therefore, we recommend a combination of multiple datasets in order to obtain better results when new samples are being processed and a good balance in the number of samples by class.

Knee flexion of saxophone players anticipates tonal context of music.

Music performance requires high levels of motor control. Professional musicians use body movements not only to accomplish and help technical efficiency, but to shape expressive interpretation. Here, we recorded motion and audio data of twenty participants performing four musical fragments varying in the degree of technical difficulty to analyze how knee flexion is employed by expert saxophone players. Using a computational model of the auditory periphery, we extracted emergent acoustical properties of sound to inference critical cognitive patterns of music processing and relate them to motion data. Results showed that knee flexion is causally linked to tone expectations and correlated to rhythmical density, suggesting that this gesture is associated with expressive and facilitative purposes. Furthermore, when instructed to play immobile, participants tended to microflex (>1 Hz) more frequently compared to when playing expressively, possibly indicating a natural urge to move to the music. These results underline the robustness of body movement in musical performance, providing valuable insights for the understanding of communicative processes, and development of motor learning cues.

Clinical prediction model for pulmonary thrombosis diagnosis in hospitalized patients with SARS-CoV-2 infection.

Background and Aim: We aimed to develop a clinical prediction model for pulmonary thrombosis (PT) diagnosis in hospitalized COVID-19 patients. Methods: Non-intensive care unit hospitalized COVID-19 patients who underwent a computed tomography pulmonary angiogram (CTPA) for suspected PT were included in the study. Demographic, clinical, analytical, and radiological variables as potential factors associated with the presence of PT were selected. Multivariable Cox regression analysis to develop a score for estimating the pre-test probability of PT was performed. The score was internally validated by bootstrap analysis. Results: Among the 271 patients who underwent a CTPA, 132 patients (48.7%) had PT. Heart rate >100 bpm (OR = 4.63 [95% CI: 2.30-9.34]; P < 0.001), respiratory rate >22 bpm (OR = 5.21 [95% CI: 2.00-13.54]; P < 0.001), RALE score ≥4 (OR = 3.24 [95% CI: 1.66-6.32]; P < 0.001), C-reactive protein (CRP) >100 mg/L (OR = 2.10 [95% CI: 0.95-4.63]; P = 0.067), and D-dimer >3.000 ng/mL (OR = 6.86 [95% CI: 3.54-13.28]; P < 0.001) at the time of suspected PT were independent predictors of thrombosis. Using these variables, we constructed a nomogram (CRP, Heart rate, D-dimer, RALE score, and respiratory rate [CHEDDAR score]) for estimating the pre-test probability of PT. The score showed a high predictive accuracy (area under the receiver-operating characteristics curve = 0.877; 95% CI: 0.83-0.92). A score lower than 182 points on the nomogram confers a low probability for PT with a negative predictive value of 92%. Conclusions: CHEDDAR score can be used to estimate the pre-test probability of PT in hospitalized COVID-19 patients outside the intensive care unit. Relevance for Patients: Developing a new clinical prediction model for PT diagnosis in COVID-19 may help in the triage of patients, and limit unnecessary exposure to radiation and the risk of nephrotoxicity due to iodinated contrast.

Holistic Variability Analysis in Resistive Switching Memories Using a Two-Dimensional Variability Coefficient.

We present a new methodology to quantify the variability of resistive switching memories. Instead of statistically analyzing few data points extracted from current versus voltage (I-V) plots, such as switching voltages or state resistances, we take into account the whole I-V curve measured in each RS cycle. This means going from a one-dimensional data set to a two-dimensional data set, in which every point of each I-V curve measured is included in the variability calculation. We introduce a new coefficient (named two-dimensional variability coefficient, 2DVC) that reveals additional variability information to which traditional one-dimensional analytical methods (such as the coefficient of variation) are blind. This novel approach provides a holistic variability metric for a better understanding of the functioning of resistive switching memories.

Cholinergic-related pupil activity reflects level of emotionality during motor performance.

Pupil size covaries with the diffusion rate of the cholinergic and noradrenergic neurons throughout the brain, which are essential to arousal. Recent findings suggest that slow pupil fluctuations during locomotion are an index of sustained activity in cholinergic axons, whereas phasic dilations are related to the activity of noradrenergic axons. Here, we investigated movement induced arousal (i.e., by singing and swaying to music), hypothesising that actively engaging in musical behaviour will provoke stronger emotional engagement in participants and lead to different qualitative patterns of tonic and phasic pupil activity. A challenge in the analysis of pupil data is the turbulent behaviour of pupil diameter due to exogenous ocular activity commonly encountered during motor tasks and the high variability typically found between individuals. To address this, we developed an algorithm that adaptively estimates and removes pupil responses to ocular events, as well as a functional data methodology, derived from Pfaffs' generalised arousal, that provides a new statistical dimension on how pupil data can be interpreted according to putative neuromodulatory signalling. We found that actively engaging in singing enhanced slow cholinergic-related pupil dilations and having the opportunity to move your body while performing amplified the effect of singing on pupil activity. Phasic pupil oscillations during motor execution attenuated in time, which is often interpreted as a measure of sense of agency over movement.

Basis expansion approaches for functional analysis of variance with repeated measures.

The methodological contribution in this paper is motivated by biomechanical studies where data characterizing human movement are waveform curves representing joint measures such as flexion angles, velocity, acceleration, and so on. In many cases the aim consists of detecting differences in gait patterns when several independent samples of subjects walk or run under different conditions (repeated measures). Classic kinematic studies often analyse discrete summaries of the sample curves discarding important information and providing biased results. As the sample data are obviously curves, a Functional Data Analysis approach is proposed to solve the problem of testing the equality of the mean curves of a functional variable observed on several independent groups under different treatments or time periods. A novel approach for Functional Analysis of Variance (FANOVA) for repeated measures that takes into account the complete curves is introduced. By assuming a basis expansion for each sample curve, two-way FANOVA problem is reduced to Multivariate ANOVA for the multivariate response of basis coefficients. Then, two different approaches for MANOVA with repeated measures are considered. Besides, an extensive simulation study is developed to check their performance. Finally, two applications with gait data are developed.

Effectiveness of Virtual Reality on Balance and Risk of Falls in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis.

The aim of this study was to systematically review the scientific evidence related to the physiotherapy interventions in neurorehabilitation that utilize virtual reality (VR) for balance training and risk of falls in people with multiple sclerosis (MS). A search was conducted in Medline (PubMed), PEDro, and Google Scholar to identify all the relevant studies. Clinical trials assessing the effects of VR in people with MS were included. Risk of bias was evaluated using the Cochrane Risk of Bias Tool and PEDro scale. Qualitative analysis was performed according to the GRADE. In total, 16 studies (n = 663) were included. The meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for balance, with a moderate clinical effect in eight studies (SMD: 0.63; 95% CI 0.34-0.92; p < 0.05). In addition, the meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for risk of falls, with a small clinical effect in six studies (SMD: -0.55; 95% CI -1.07-0.04; p < 0.05). VR-based treatments are more effective than non-intervention in improving balance and fall risk in people with MS, with a very low certainty of evidence. In addition, they also show to be more effective than conventional rehabilitation, with a very low certainty of evidence.

Functional ANOVA approaches for detecting changes in air pollution during the COVID-19 pandemic.

Faced with novel coronavirus outbreak, the most hard-hit countries adopted a lockdown strategy to contrast the spread of virus. Many studies have already documented that the COVID-19 control actions have resulted in improved air quality locally and around the world. Following these lines of research, we focus on air quality changes in the urban territory of Chieti-Pescara (Central Italy), identified as an area of criticality in terms of air pollution. Concentrations of NO 2 , PM 10 , PM 2.5 and benzene are used to evaluate air pollution changes in this Region. Data were measured by several monitoring stations over two specific periods: from 1st February to 10 th March 2020 (before lockdown period) and from 11st March 2020 to 18 th April 2020 (during lockdown period). The impact of lockdown on air quality is assessed through functional data analysis. Our work makes an important contribution to the analysis of variance for functional data (FANOVA). Specifically, a novel approach based on multivariate functional principal component analysis is introduced to tackle the multivariate FANOVA problem for independent measures, which is reduced to test multivariate homogeneity on the vectors of the most explicative principal components scores. Results of the present study suggest that the level of each pollutant changed during the confinement. Additionally, the differences in the mean functions of all pollutants according to the location and type of monitoring stations (background vs traffic), are ascribable to the PM 10 and benzene concentrations for pre-lockdown and during-lockdown tenure, respectively. FANOVA has proven to be beneficial to monitoring the evolution of air quality in both periods of time. This can help environmental protection agencies in drawing a more holistic picture of air quality status in the area of interest.

A simplified homogenization model applied to viscoelastic behavior of cortical bone at ultrasonic frequencies.

Cortical bone is a complex multiscale medium and its study is of importance for clinical fracture prevention. In particular, cortical attenuation is known to be linked with shock energy absorption and ability to resist fracture. However, the links between cortical bone absorption and its multiscale structure are still not well understood. This work is about the use of homogenized tensors in order to characterize the viscoelastic behavior of cortical bone at ultrasonic frequencies, i.e., about 0.1 to 10 MHz. Such tensors are derived from the cell problem via two-scale homogenization theory for linear elastic and Kelvin-Voigt viscoelastic descriptions. The elliptic formulations obtained from the cell problems are implemented within the range of medically-observed porosities. Microstructure is assessed considering cubic cells with cylindrical inclusion and transverse isotropic assumption. A simplified model, adding one temporal parameter τ per phase, allows a good agreement with experimental data. The corresponding attenuation is proportional to the square of the frequency, in agreement with Kramer-Kronig relations. This development is proposed in the context of robust clinical inverse problem approaches using a restricted number of parameter. Two main properties for the material filling the pores are adjusted and discussed: absorption and shear contribution. Best agreement with experimental data is observed for material inside the pores being solid and highly attenuating.

Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network.

AIM: This report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum ß-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico. MATERIAL AND METHODS: A total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes. RESULTS: Among blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each). CONCLUSION: Our study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae.

Nanoporous Microsponge Particles (NMP) of Polysaccharides as Universal Carriers for Biomolecules Delivery.

Different polysaccharides-namely dextran, carboxymethyl dextran, alginate, and hyaluronic acid-were compared for the synthesis of nanoporous microsponges particles (NMPs) obtained from a one-pot self-precipitation/cross-linking process. The morphologies and sizes of the NMPs were evaluated comparatively with respect to polymer-to-polymer and cross-linker solvents (water-based vs. DMSO). We found that the radial distribution of the polymer in the near-spherical NMPs was found to peak either at the core or in the corona of the particle, depending both on the specific polymer or the solvent used for the formation of NMPs. The NMP porosity and the swelling capability were evaluated via scanning electron microscopy (SEM). The degradation study indicated that after 10 h incubation with a reducing agent, approximately 80% of the NMPs were disassembled into soluble polysaccharide chains. The adsorption and release capacity of each type of NMP were evaluated using fluorescently labeled bovine serum albumin and lysozyme as model proteins, highlighting a release time typically much longer than the corresponding adsorption time. The dependence of the adsorption-release performance on pH was demonstrated as well. Confocal microscopy images allowed us to probe the different distribution of labeled proteins inside the NMP. The safety and non-cytotoxicity of NMPs were evaluated after incubation with fibroblast 3T3 cells and showed that all types of NMPs did not adversely affect the cell viability for concentrations up to 2.25 µg/mL and an exposure time up to 120 h. Confocal microscopy imaging revealed also the effective interaction between NMPs and fibroblast 3T3 cells. Overall, this study describes a rapid, versatile, and facile approach for preparing a universal non-toxic, nanoporous carrier for protein delivery under physiological conditions.

Assessment of Aedes aegypti (Diptera: Culicidae) Males Flight Ability for SIT Application: Effect of Device Design, Duration of Test, and Male Age.

The Sterile Insect Technique (SIT) is a pest control method where large numbers of sterile males are released to induce sterility in wild populations. Since a successful SIT application depends on the released sterile males being competitive with wild males, standard quality control tests are a necessary component of any SIT program. Flight ability (ability to fly out from a device) is a reliable indicator of insect quality. Based on previous studies, we developed four new tubular devices constructed with locally available materials to explore their potential as flight test devices for Aedes aegypti (L.) mass-reared males. Males were allowed to fly upwards through a vertical tube, the ones that flew out were considered successful. The effect of male age (0 to 21 d old), test time interval (30 min to 24 h), and the design of the device (40 and 80 cm height and 2 and 3.5 cm diameter) were evaluated. Our devices determined differences in the flight ability of Ae. aegypti males of different ages. During the first minutes, more old males escaped than young males in three out of four types of devices. However, young males reached higher rates of escape in all cases after 24 h. For standard quality control tests, we recommend testing 2- to 3-d-old sexually mature males in the high and narrow device (80 × 2 cm). Further observations for time intervals between 1 and 5 h might be performed to decide the shortest and more representative interval to use.

Prevención de enfermedades periodontales. Métodos mecánicos de control de placa dentobacteriana / Prevention of periodontal diseases. Mechanical methods of dentobacterial plaque control

Las enfermedades periodontales afectan a las encías y las estructuras que soportan los dientes. Hablamos de la gingivitis y la periodontitis. Algunos de sus síntomas son la inflamación y el sangrado de las encías. La causa principal de desarrollo de estas afecciones suele ser la falta de higiene, que favorece la acumulación de placa dentobacteriana entre los dientes y las encías. Con el objetivo de describir los diferentes métodos que existen para remover la placa dentobacteriana causa principal de las enfermedades periodontales, se revisaron 6 bibliografías que incluyen documentos en bibliotecas, y portales digitales en internet, haciéndose uso de la información más actualizada y relacionada con el tema. Se llegó a la conclusión de que con la descripción de los métodos de control de la placa dentobacteriana estaremos capacitados para prevenir las enfermedades periodontales(AU)

Periodontal diseases affect the gums and the structures that support the teeth. We are talking about gingivitis and periodontitis. Some of its symptoms are inflammation and bleeding of the gums. The main cause of development of these conditions is usually the lack of hygiene, which favors the accumulation of dentobacterial plaque between the teeth and the gums. In order to describe the different methods that exist to remove the plaque dentobacteriana main cause of periodontal diseases, we reviewed 6 bibliographies that include documents in libraries, and digital portals on the Internet, making use of the most updated information related to the subject. It was concluded that with the description of the methods of control of the plaque dentobacteriana we will be trained to prevent periodontal diseases(EU)

Prevención de enfermedades periodontales. Métodos mecánicos de control de placa dentobacteriana

Las enfermedades periodontales afectan a las encías y las estructuras que soportan los dientes. Hablamos de la gingivitis y la periodontitis. Algunos de sus síntomas son la inflamación y el sangrado de las encías. La causa principal de desarrollo de estas afecciones suele ser la falta de higiene, que favorece la acumulación de placa dentobacteriana entre los dientes y las encías. Con el objetivo de describir los diferentes métodos que existen para remover la placa dentobacteriana causa principal de las enfermedades periodontales, se revisaron 6 bibliografías que incluyen documentos en bibliotecas, y portales digitales en internet, haciéndose uso de la información más actualizada y relacionada con el tema. Se llegó a la conclusión de que con la descripción de los métodos de control de la placa dentobacteriana estaremos capacitados para prevenir las enfermedades periodontales. .

Periodontal diseases affect the gums and the structures that support the teeth. We are talking about gingivitis and periodontitis. Some of its symptoms are inflammation and bleeding of the gums. The main cause of development of these conditions is usually the lack of hygiene, which favors the accumulation of dentobacterial plaque between the teeth and the gums. In order to describe the different methods that exist to remove the plaque dentobacteriana main cause of periodontal diseases, we reviewed 6 bibliographies that include documents in libraries, and digital portals on the Internet, making use of the most updated information related to the subject. It was concluded that with the description of the methods of control of the plaque dentobacteriana we will be trained to prevent periodontal diseases.

Effectiveness and safety of ertapenem used in hospital-at-home units: data from Spanish Outpatient Parenteral Antimicrobial Therapy Registry.

AIM: To evaluate the effectiveness and safety of ertapenem in patients hospitalized at home. PATIENTS & METHODS: Retrospective analysis of data from Spanish Outpatient Parenteral Antimicrobial Therapy (OPAT) registry. RESULTS: Data from 1428 patients (median age 70 years; 5.4% institutionalized) and 1547 infectious processes (24% self-administration) were analyzed. Clinical cure or improvement was achieved in 93.8% of cases. Rate of related readmissions was 4.2%, of clinically important complications -3.9%, and of adverse drug reactions -3.2%. High comorbidity burden, contagion in nursing home and certain types of infection were associated with worse prognosis. Self-administration was effective and safe, except in case of nursing home-acquired infections. CONCLUSION: Ertapenem OPAT was effective and safe. Caregivers in nursing homes should be better trained in OPAT-related procedures.

Home transfusion: three decades of practice at a tertiary care hospital.

BACKGROUND: Hospital at Home (HH) provides specialized care at the patients' homes. Keeping patients in familial surroundings can result in better outcomes reducing readmission to hospital, mortality, and costs of care. Home transfusion (HT) can be a key element in HH management but is scarcely deployed due to concerns about safety and cost. We have reviewed our HT practice to assess its feasibility and safety. STUDY DESIGN AND METHODS: We prospectively reviewed data collected from 1985 to 2015, focusing specially on feasibility and procedural safety, looking for adverse events of transfusion. We also assessed the situation in similar hospitals in Spain with a survey about their practice. RESULTS: A total of 613 patients received 2260 blood components in 2126 transfusion episodes. A total of 93% patients received fewer than 10 transfusions. Most patients were treated for blood diseases (32%) or cancers (20%). The rate of adverse effects was 2.68% and decreased significantly with time. Fever was the most common adverse reaction. Patients who received transfusion of more than one blood product in a day were at higher risk of adverse events. No errors or near-miss events were detected, and no patient had to be readmitted to hospital for this cause. The survey on HT practices in similar hospitals showed great variation in practice. CONCLUSION: HT is feasible, sustainable, and safe, when performed on selected patients by dedicated HH units with well-trained staff, under specific protocols.