A Latent Class Analysis of Adverse Life Events for Kenyan Adolescents.

Extant evidence indicates that exposure to adverse childhood experiences (ACE) tend to cluster among children and adolescents. Considering that adolescents from African countries present higher risk of being exposed to multiple ACE compared to other countries, the identification of victimization profiles in this population is clearly warranted. The aim of this study was to determine meaningful clusters of individuals with similar experiences of ACE in a sample of Kenyan adolescents. Latent class analysis (LCA) was conducted to identify latent classes of exposure to ACE. In addition, the relationships between the latent classes and gender, parental education, living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A three-class solution was found to be the best description of ACE, and the classes were labelled ''Low Risk'', ''Intermediate Risk'', and ''High Risk''. Compared with the Low-Risk class, the High-Risk class was found to be significantly more likely to have a diagnosis of PTSD and being a female may be an antecedent risk factor for high exposure to ACE. The Intermediate Risk class was significantly less likely to have parents with high school or college education. This paper indicates that Kenyan adolescents present higher risk of being exposed to multiple ACE and that trauma research may turn its focus on the individual as the unit of analysis rather than traumatic events.

Nephropathia Epidemica Caused by Puumala Virus in Bank Voles, Scania, Southern Sweden.

In 2018, a local case of nephropathia epidemica was reported in Scania, southern Sweden, more than 500 km south of the previously known presence of human hantavirus infections in Sweden. Another case emerged in the same area in 2020. To investigate the zoonotic origin of those cases, we trapped rodents in Ballingslöv, Norra Sandby, and Sörby in southern Sweden during 2020‒2021. We found Puumala virus (PUUV) in lung tissues from 9 of 74 Myodes glareolus bank voles by screening tissues using a hantavirus pan-large segment reverse transcription PCR. Genetic analysis revealed that the PUUV strains were distinct from those found in northern Sweden and Denmark and belonged to the Finnish PUUV lineage. Our findings suggest an introduction of PUUV from Finland or Karelia, causing the human PUUV infections in Scania. This discovery emphasizes the need to understand the evolution, cross-species transmission, and disease outcomes of this newly found PUUV variant.

Lyotropic liquid crystalline phases: Drug delivery and biomedical applications.

Liquid crystal (LC)-based nanoformulations may efficiently deliver drugs and therapeutics to targeted biological sites. Lyotropic liquid crystalline phases (LLCPs) have received much interest in recent years due to their unique structural characteristics of both isotropic liquids and crystalline solids. These LLCPs can be utilized as promising drug delivery systems to deliver drugs, proteins, peptides and vaccines because of their improved drug loading, stabilization, and controlled drug release. The effects of molecule shape, microsegregation, and chirality are very important in the formation of liquid crystalline phases (LCPs). Homogenization of self-assembled amphiphilic lipids, water and stabilizers produces LLCPs with different types of mesophases, bicontinuous cubic (cubosomes) and inverse hexagonal (hexosomes). Moreover, many studies have also shown higher bioadhesivity and biocompatibility of LCs due to their structural resemblance to biological membranes, thus making them more efficient for targeted drug delivery. In this review, an outline of the engineering aspects of LLCPs and polymer-based LLCPs is summarized. Moreover, it covers parenteral, oral, transdermal delivery and medical imaging of LC in targeting various tissues and is discussed with a scope to design more efficient next-generation novel nanosystems. In addition, a detailed overview of advanced liquid crystal-based drug delivery for vaccines and biomedical applications is reviewed.

Assessing compatibility and viral fitness between poultry-adapted H9N2 and wild bird-derived neuraminidases.

Exchange of viral segments between one or more influenza virus subtypes can contribute to a shift in virulence and adaptation to new hosts. Among several influenza subtypes, H9N2 is widely circulating in poultry populations worldwide and has the ability to infect humans. Here, we studied the reassortant compatibility between chicken H9N2 with N1-N9 gene segments of wild bird origin, either with an intact or truncated stalk. Naturally occurring amino acid deletions in the NA stalk of the influenza virus can lead to increased virulence in both mallard ducks and chickens. Our findings show extended genetic compatibility between chicken H9Nx gene segments and the wild-bird NA with and without 20 amino acid stalk deletion. Replication kinetics in avian, mammalian and human cell lines revealed that parental chH9N2 and rH9N6 viruses with intact NA-stalk replicated significantly better in avian DF1 cells compared to human A549 cells. After introducing a stalk deletion, an enhanced preference for replication in mammalian and human cell lines could be observed for rH9N2Δ(H6), rH9N6Δ and rH9N9Δ compared to the parental chH9N2 virus. This highlights the potential emergence of novel viruses with variable phenotypic traits, warranting the continuous monitoring of H9N2 and co-circulating subtypes in avian hosts.

Stem cell membrane-coated abiotic nanomaterials for biomedical applications.

Nanoscale materials have been extensively employed for diagnostic and therapeutic purposes. However, the developed nanosystems still suffer from some limitations, namely the rapid elimination by the immune system, lack of targeting to specific cells, and insufficient biocompatibility. Therefore, novel strategies based upon a biomimetic approach have received attention to improving the pharmacokinetics and safety profile of nanosystems. One promising strategy is the application of a biomimetic coating consisting of cell membranes derived from different cell types onto nanoparticle cores. Stem cells have been investigated to develop targeted nanodevices owing to their excellent intrinsic tissue-specific homing features, protecting them from the immune system to reach the sites of inflammation. This targeting ability is conferred by a surface repertoire of stem cell-associated biomolecules. Such nanoscopical materials offer sustained circulation and boosted drug accumulation at target sites, augmenting therapeutic efficacy and safety. Additionally, the coating of nanoparticles with cell membranes acts as a camouflage mechanism to increase their circulation time. The current review explores the particular features of stem cell membrane coating as multifunctional biomimetic surface functionalization agents to camouflage nanoparticle cores. Biomedical applications of engineered stem cell membrane-coated nanoparticles, challenges in clinical translation, and their future prospects are addressed.

Barriers and facilitators to implementing a continuing medical education intervention in a primary health care setting.

BACKGROUND: Continuing medical education (CME), as a systematic attempt to facilitate change in General Practitioners' (GPs) practices, is considered crucial, assuming that if physicians are up-to-date, they will change and improve their practice, resulting in better performance and ultimately better patient care. However, studies continue to demonstrate considerable gaps between the real and ideal performance and patient-related outcomes. The objective of this study was to explore GP's perception of the factors affecting the implementation of a CME digital platform in a primary health care setting in Portugal. METHODS: Our work is framed in a larger effectiveness-implementation hybrid type 1 study, where a Digital Behaviour Change Intervention (DBCI), called ePrimaPrescribe, was developed and implemented with the aim of changing benzodiazepines (BZD) prescribing patterns. Our design used mixed methodologies to obtain an enriched knowledge on GPs' perspectives on the facilitators and barriers to implementing a Digital Behaviour Change Intervention (DBCI) applied to CME. To do so, we used data coming from an onsite questionnaire, an adapted version of the Barriers and Facilitators Assessment Instrument (BaFAI) and in-depth interviews. RESULTS: From the 47 GPs successfully included in the intervention arm of our cluster-randomized effectiveness study, we collected 37 onsite questionnaires, 24 BaFAIs, and performed 12 in-depth interviews. GPs reported as the main barriers to CME a lack of time, a perception of work overload, a lack of digital competence, a lack of digital infrastructure, and motivational and emotional factors. They reported as facilitators to CME delivered through a DBCI the convenience of the delivery method, the practical and pragmatic characteristics of the content, and the possibility for CME to be mandatory. CONCLUSIONS: The perceptions of the barriers and facilitators reported by GPs represent an important contribution to improving knowledge regarding the factors influencing the implementation of CME in primary health care settings. We consider that our study might bring useful insights to other countries where primary health care plays a central role in the provision of care. TRIAL REGISTRATION: ClinicalTrials.gov number NCT04925596 .

Nanocarrier-based dermopharmaceutical formulations for the topical management of atopic dermatitis.

Atopic dermatitis (AD) is a chronic disease that affects the skin, and that is characterized by highly itchy inflammation, frequent eczematous lesions, and a fluctuating course. The current treatment consists of a multi-stage approach that aims to establish persistent disease control towards the improvement of the quality of life of the patients. Topical therapy is the basis of AD treatment, however, due to the difficulty of crossing the skin barrier, topical application of drugs remains a challenge. In fact, in addition to the low skin bioavailability, and limited accessibility to deeper skin of the drugs - due to difficulty in penetrating the epidermis - implemented drugs in the clinical are associated with serious adverse effects, which are responsible for safety and efficacy limitations, leading to a reduction in patients' compliance. Nanotechnology arises as an emerging approach for the treatment of AD, allowing for controlled release, targeted delivery, improved penetration, and bioavailability of drugs assets, resulting in marked improved therapeutic efficacy and reduction of adverse effects. Although its promising outputs, additional studies are needed to recognize the toxicological characteristics, cost-benefit, and long-term safety of nanocarriers applied to this end. Advanced drug delivery systems, particularly nanoemulsions, liposomes, ethosomes, transfersomes, solid lipid nanoparticles, nanostructured lipid carriers, nanocrystals, polymeric nanoparticles, and polymeric micelles have been used, and are thoroughly addressed in this review as promising nanoformulations towards the topical treatment of AD.

Nano- and microparticle-stabilized Pickering emulsions designed for topical therapeutics and cosmetic applications.

Pickering emulsions are systems composed of two immiscible fluids, which are stabilized by solid organic or inorganic particles. These solid particles include a broad range of particles that can be used to stabilize Pickering emulsions. An improved resistance against coalescence and lower toxicity, against conventional emulsions stabilized by surfactants, make Pickering emulsions suitable candidates for numerous applications, such as catalysis, food, oil recovery, cosmetics, and pharmaceutical industries. In this article, we give an overview of Pickering emulsions focusing on topical applications. First, we reference the parameters that influence the stabilization of Pickering emulsions. Second, we discuss some of the already investigated topical applications of nano- and microparticles used to stabilize Pickering emulsions. Afterwards, we consider some of the most promising stabilizers of Pickering emulsions for topical applications. Ultimately, we carried out a brief analysis of toxicity and advances in future perspectives, highlighting the promising use of these emulsions in cosmetics and dermopharmaceutical formulations.

Recurrent Left Pneumonia, is it the Right Diagnosis? / Neumonía izquierda recurrente ¿estamos ante el diagnóstico correcto?

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Therapeutic Navigations and Social Networking: Mozambican Women's Quests for Fertility.

In Mozambique, involuntary childlessness triggers immediate treatment seeking, especially on the woman's side. Treatment processes involve the activation and/or creation of situational social networks that provide emotional, instrumental, and informational support. These are formed through careful processes of disclosure management, and are embedded in social relations and local moral configurations of family making, reproduction, and healing. In this article I explore social networks involving friends, family, religion, and emerging biosocial relations, some or all of which are involved in Mozambican women's and couples' therapeutic navigations in the quest for fertility.

Manual asymmetries in bimanual isochronous tapping tasks in children.

Tapping tasks have been investigated throughout the years, with variations in features such as the complexity of the task, the use of one or both hands, the employ of auditory or visual stimuli, and the characteristics of the subjects. The evaluation of lateral asymmetries in tapping tasks in children offers an insight into the structure of rhythmic movements and handedness at early stages of development. The current study aims to investigate the ability of children (aged six and seven years-old) to maintain a rhythm, in a bimanual tapping task at two different target frequencies, as well as the manual asymmetries displayed while doing so. The analyzed data in this work are the series of the time intervals between successive taps. We suggest several profiles of behavior, regarding the overall performance of children in both tempo conditions. We also propose a new method of quantifying the variability of the performance and the asymmetry of the hands, based on ellipses placed on scatter plots of the non-dominant-dominant series versus the dominant-non-dominant series. We then use running correlations to identify changes of coordination tendencies over time. The main results show that variability is larger in the task with the longer target interval. Furthermore, most children evidence lateral asymmetries, but in general they show the capacity to maintain the mean of consecutive intertap intervals of both hands close to the target interval. Finally, we try to interpret our findings in the light of existing models and timing modes.

Tos crónica e insuficiencia respiratoria. ¿Por qué? / Finding the Cause of Chronic Cough and Respiratory Failure

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TELEMOLD project: oximetry and exercise telemonitoring to improve long-term oxygen therapy.

BACKGROUND: Standard assessment of long-term oxygen therapy (LTOT) prescription involves hospital-based clinical tests. However, there is some evidence suggesting that oxygen demand during daily activities may not be correctly estimated by such tests, when compared with continuous ambulatory oximetry. The authors describe the results of a study aiming to evaluate the clinical relevance of a home telemonitoring system in LTOT optimization. SUBJECTS AND METHODS: Thirty-five chronic respiratory failure patients were monitored in real time with an oximeter sensor and an accelerometer. Signals were sent via Bluetooth(®) (Bluetooth SIG, Kirkland, WA) to a mobile phone and then via 3G or general packet radio service to a server. Continuous and secure access to data was established through an Internet site. RESULTS: Each patient was monitored an average of 7.6 ± 4.5 days (total, 83 ± 67 h). Valid records were on average 65 ± 24%. Records of rest, activity, and sleep time per patient were, on average, 28 ± 21%, 7 ± 6%, and 59 ± 25%, respectively. Significant desaturation during rest, activity, and sleep was found in 2, 26, and 9 patients, respectively. Patients' ratings of the user-friendliness of the equipments, assessed by questionnaire, were fairly good (76% reported it as easy/very easy). CONCLUSIONS: Our study suggests that a telemonitoring system combining oximetry and physical activity evaluation might contribute to a more adequate oxygen prescription, mainly during daily activities.