Impact of obesity­associated myeloid­derived suppressor cells on cancer risk and progression (Review).

Obesity is a chronic disease caused by the accumulation of excessive adipose tissue. This disorder is characterized by chronic low­grade inflammation, which promotes the release of proinflammatory mediators, including cytokines, chemokines and leptin. Simultaneously, chronic inflammation can predispose to cancer development, progression and metastasis. Proinflammatory molecules are involved in the recruitment of specific cell populations in the tumor microenvironment. These cell populations include myeloid­derived suppressor cells (MDSCs), a heterogeneous, immature myeloid population with immunosuppressive abilities. Obesity­associated MDSCs have been linked with tumor dissemination, progression and poor clinical outcomes. A comprehensive literature review was conducted to assess the impact of obesity­associated MDSCs on cancer in both preclinical models and oncological patients with obesity. A secondary objective was to examine the key role that leptin, the most important proinflammatory mediator released by adipocytes, plays in MDSC­driven immunosuppression Finally, an overview is provided of the different therapeutic approaches available to target MDSCs in the context of obesity­related cancer.

The imprecision of measuring activated clotting time (ACT) from the guiding catheter during percutaneous coronary interventions.

BACKGROUND: Finding the balance between the reduction in ischemic events and bleeding complications is crucial for the success of percutaneous coronary intervention (PCI). The activated clotting time (ACT) is used routinely worldwide to monitor and titrate anticoagulation therapy with unfractionated heparin (UFH) during the procedure. OBJECTIVES: We aimed to test the accuracy of ACT measurements from the guiding catheter compared to the arterial access sheath. METHODS: Patients undergoing PCI with UFH therapy were prospectively enrolled. Blood samples were drawn from the coronary guide catheter and the arterial access sheath. ACT values were determined in the same ACT machine, and potential interactions with clinical variables were analyzed. RESULTS: The study included 331 patients with post PCI ACT measurements. The mean ACT value of the catheter samples was statistically higher than the arterial access sample [294 ± 77 s Vs. 250 ± 60 s, p < 0.001]. The mean difference between the guiding catheter and the arterial line sheath samples was 43 ± 27 s (P < 0.001). We found that in 101/331 [30 %] patients the ACT from the guiding catheter was above 250 s, while from the access sheath it was below 250 s. Notably, in 40/331 [12 %] the ACT from the guiding catheter was above 200 s, while from the access sheath it was below 200 s. CONCLUSIONS: Large proportion of patient may be considered to have therapeutic ACT if measured from guide catheter during PCI, while the corresponding ACT from arterial sheath is subtherapeutic. This difference may have clinical and safety significance.

Activation of Shh/Smo is sufficient to maintain oligodendrocyte precursor cells in an undifferentiated state and is not necessary for myelin formation and (re)myelination.

Myelination is the terminal step in a complex and precisely timed program that orchestrates the proliferation, migration and differentiation of oligodendroglial cells. It is thought that Sonic Hedgehog (Shh) acting on Smoothened (Smo) participates in regulating this process, but that these effects are highly context dependent. Here, we investigate oligodendroglial development and remyelination from three specific transgenic lines: NG2-CreERT2 (control), Smofl/fl/NG2-CreERT2 (loss of function), and SmoM2/NG2-CreERT2 (gain of function), as well as pharmacological manipulation that enhance or inhibit the Smo pathway (Smoothened Agonist (SAG) or cyclopamine treatment, respectively). To explore the effects of Shh/Smo on differentiation and myelination in vivo, we developed a highly quantifiable model by transplanting oligodendrocyte precursor cells (OPCs) in the retina. We find that myelination is greatly enhanced upon cyclopamine treatment and hypothesize that Shh/Smo could promote OPC proliferation to subsequently inhibit differentiation. Consistent with this hypothesis, we find that the genetic activation of Smo significantly increased numbers of OPCs and decreased oligodendrocyte differentiation when we examined the corpus callosum during development and after cuprizone demyelination and remyelination. However, upon loss of function with the conditional ablation of Smo, myelination in the same scenarios are unchanged. Taken together, our present findings suggest that the Shh pathway is sufficient to maintain OPCs in an undifferentiated state, but is not necessary for myelination and remyelination.

A template wizard for the cocreation of machine-readable data-reporting to harmonize the evaluation of (nano)materials.

Making research data findable, accessible, interoperable and reusable (FAIR) is typically hampered by a lack of skills in technical aspects of data management by data generators and a lack of resources. We developed a Template Wizard for researchers to easily create templates suitable for consistently capturing data and metadata from their experiments. The templates are easy to use and enable the compilation of machine-readable metadata to accompany data generation and align them to existing community standards and databases, such as eNanoMapper, streamlining the adoption of the FAIR principles. These templates are citable objects and are available as online tools. The Template Wizard is designed to be user friendly and facilitates using and reusing existing templates for new projects or project extensions. The wizard is accompanied by an online template validator, which allows self-evaluation of the template (to ensure mapping to the data schema and machine readability of the captured data) and transformation by an open-source parser into machine-readable formats, compliant with the FAIR principles. The templates are based on extensive collective experience in nanosafety data collection and include over 60 harmonized data entry templates for physicochemical characterization and hazard assessment (cell viability, genotoxicity, environmental organism dose-response tests, omics), as well as exposure and release studies. The templates are generalizable across fields and have already been extended and adapted for microplastics and advanced materials research. The harmonized templates improve the reliability of interlaboratory comparisons, data reuse and meta-analyses and can facilitate the safety evaluation and regulation process for (nano) materials.

Predictors for liver fibrosis in non-alcoholic patients with psoriatic diseases: A multicenter cross sectional-study.

Psoriasis has been related to metabolic dysfunction-associated fatty liver disease and, liver fibrosis. This study aimed to evaluate the prevalence of liver fibrosis in psoriasis and identify predictors for fibrosis. This is a cross-sectional study conducted from December 2012 to June 2016 assessing psoriasis and psoriatic arthritis patients attended at four centers in Mexico City. Data regarding history of the skin disease, previous and current medication, and previously diagnosed liver disease was collected. Liver fibrosis was assessed with four different non-invasive methods (FIB4, APRI, NAFLD score and elastography). We compared data based on the presence of fibrosis. Adjusted-logistic regression models were performed to estimate OR and 95% CI. A total of 160 patients were included. The prevalence of significant fibrosis using elastography was 25% (n = 40), and 7.5% (n = 12) for advanced fibrosis. Patients with fibrosis had higher prevalence of obesity (60% vs 30.8%, P = 0.04), type 2 diabetes (40% vs 27.5%, P = 0.003), gamma-glutamyl transpeptidase levels (70.8±84.4 vs. 40.1±39.2, P = 0.002), and lower platelets (210.7±58.9 vs. 242.8±49.7, P = 0.0009). Multivariate analysis showed that body mass index (OR1.11, 95%CI 1.02-1.21), type 2 diabetes (OR 3.44, 95%CI 1.2-9.88), and gamma-glutamyl transpeptidase (OR 1.01, 95%CI1-1.02) were associated with the presence of fibrosis. The use of methotrexate was not associated. Patients with psoriasis are at higher risk of fibrosis. Metabolic dysfunction, rather than solely the use of hepatotoxic drugs, likely plays a major role; it may be beneficial to consider elastography regardless of the treatment used. Metabolic factors should be assessed, and lifestyle modification should be encouraged.

Pulmonary interstitial emphysema and spontaneous pneumomediastinum are more prevalent in sighthounds than other dog breeds undergoing thoracic CT.

Spontaneous pneumomediastinum is an uncommon condition described in veterinary medicine with concurrent respiratory disease. It can be caused by the Macklin effect, which is when gas leaks from the alveoli into the surrounding interstitial lung tissue. Pulmonary interstitial emphysema (PIE) is the presence of gas within the pulmonary vascular sheaths and indicates the presence of the Macklin effect. In the authors' experience, spontaneous pneumomediastinum and PIE are more prevalent in sighthound dogs than in other breeds and are often considered incidental findings. This retrospective, observational, cross-sectional study compared the prevalence of PIE and subsequent pneumomediastinum in sighthound with other purebred dogs. It characterized the appearance of PIE in CT and analyzed a possible association with concomitant pulmonary pathologies or with the use of general anesthesia. Medical records and thoracic CTs of sighthounds and nonsighthound dogs from two institutions were reviewed. A total of 256 dogs, comprising 127 sighthounds and 129 other purebred dogs, were included. The prevalence of PIE and pneumomediastinum was statistically higher in sighthound (14.2%) compared with other nonsighthound dogs (2.2%). There was no statistical association between the presence of PIE and pneumomediastinum with different age and weight groups or with sex. There was no statistical difference in the prevalence of PIE and pneumomediastinum between dogs with and without pulmonary pathology or in dogs undergoing CT with sedation or general anesthesia. Spontaneous pneumomediastinum in sighthounds is more prevalent than in other breeds, and its prevalence is not associated with the presence of pulmonary pathology or the use of general anesthesia.

Shear wave elastography for assessing the anterior scalene elasticity in patients with neck pain.

PURPOSE: Shear-wave elastography (SWE) provides quantitative and absolute metrics for analyzing the elasticity of soft tissues. Despite the anterior scalene muscle (AS) is a key structure in patients with neck pain and nerve compressive syndromes, the majority of SWE studies only included asymptomatic subjects. This study aimed to analyze the Young's modulus and shear wave speed test-retest reliability in a sample of patients with neck pain symptoms to characterize the AS stiffness. METHODS: A diagnostic accuracy study acquiring a set of ultrasound images at C7 level in 42 patients with mechanical neck pain by one experienced examiner. After blinding the participants' identity, trial and side, the Young's modulus and shear wave velocity were measured by an independent experienced rater in randomized order. Intra-class correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable changes (MDC) and coefficient of variation (CV%) were calculated. RESULTS: The sample reported moderate pain intensity (5.9/10 points) and disability (17.38/100 points). AS stiffness metrics assessed showed no significant differences between males and females, left and right side nor painful and non-painful side. (all, p > 0.05). Intra-examiner reliability was excellent for calculating the Young's modulus for shear wave speed (ICC > 0.90). CONCLUSION: The results support the use of this procedure for assessing the AS stiffness in populations with mechanical neck pain as excellent reliability estimates were obtained. However, future research should analyze case-control differences and the association between SWE metrics with clinical severity indicators.

Association of Dietary Patterns with Cardiovascular Disease Risk Factors in Mexican Adults: Insights from a Cross-Sectional Descriptive Study.

Dietary patterns (DPs) are an essential tool to analyze the relationship between diet and health as they have presented an association with the incidence of chronic non-communicable diseases. Therefore, the aim of this study was the identification and characterization of DPs and their association with cardiovascular risk factors. For this purpose, a cross-sectional descriptive study was carried out in 165 Mexican adults, including dietary intakes derived from a validated food frequency questionnaire, clinical history, anthropometry, and biochemical biomarkers using standardized procedures for glucose, total cholesterol, triglycerides, LDL-c, and HDL-c. DPs were identified through principal component analysis and ordinal logistic regression was used to examine associations between DPs and cardiovascular disease risk factors. Three DPs were identified: Mexican Fast-Food, Variety-Food, and Healthy-Economic, with a high prevalence of overweight and obesity (78%). Having a high adherence to a Mexican Fast-Food pattern (OR 1.71 CI 1.4-2.8), being sedentary (OR 4.85 2.32-10.15) and smoking (0R 6.4 CI 2.40-16.9) increased the risk of having a high scale of risk factors (four or more risk factors simultaneously). In conclusion, the Mexican Fast-Food pattern showed an increase in the risk of having multiple risk factors, while a sedentary lifestyle and overeating were largely responsible for the prevalence of overweight and obesity in this group of Mexican adults.

Can Virtual Reality be Used for the Prevention of Peer Sexual Harassment in Adolescence? First Evaluation of the Virtual-PRO Program.

Objective: The present study analyzed the Virtual-PRO program's efficacy in preventing peer sexual harassment by promoting the bystanders' active intervention and incorporating a virtual reality (VR) component. The impact of the program on sexist attitudes, moral disengagement, the intention to intervene as bystanders, and the involvement in sexual aggression and victimization was tested. Method: Virtual-PRO is a VR-enhanced sexual harassment curricular prevention program of six one-hour sessions. The evaluation comprised a pre-test, a post-test after the intervention, and a follow-up measure at three months. In the study, 579 Spanish adolescent students aged between 12 and 17 years (M = 14.76, SD = 0.88; 47.1% boys) were randomly grouped into experimental (n = 286) and control (n = 293) conditions. Results: The Virtual-PRO program effectively controlled participants' levels of sexism and reduced moral disengagement in the experimental group compared to the control group three months after the intervention. The program also showed positive results in changing bystander behavior, increasing the intention to intervene when the victim was not a friend. Finally, visual/verbal and online victimization decreased in the experimental group and increased in the control group. No differences were found for physical sexual victimization and sexual aggression. Conclusions: The first trial of the Virtual-PRO program is promising and highlights the use of VR as a sexual harassment prevention tool. Follow-up measures are essential to determine the impact of interventions accurately.

Objetivo: El presente estudio analiza la eficacia del programa Virtual-PRO en la prevención del acoso sexual entre iguales promoviendo la intervención activa de los espectadores mediante el uso de la realidad virtual (RV). Se comprobó el impacto del programa en las actitudes sexistas, la desconexión moral, la intención de intervenir como espectadores y la implicación en agresión y victimización sexual. Método: Virtual-PRO es un programa curricular compuesto por seis unidades que incorpora la RV para mejorar la prevención del acoso sexual. La evaluación incluyó una medida pre-test, un post-test después de la intervención y una medida de seguimiento a los tres meses. En el estudio participaron 579 estudiantes españoles de entre 12 y 17 años (M = 14.76, DT = 0.88, 47.1% chicos), agrupados aleatoriamente en grupo experimental (n = 286) y control (n = 293). Resultados: El programa Virtual-PRO controló eficazmente los niveles de sexismo y redujo la desconexión moral en el grupo experimental en comparación con el grupo de control tres meses después de la intervención. También mostró resultados positivos en el cambio del comportamiento de los espectadores, mejorando la intención de intervenir cuando la víctima no era amigo o amiga. Por último, la victimización visual/verbal y online disminuyó en el grupo experimental y aumentó en el grupo control. No se encontraron diferencias en victimización sexual física y agresión sexual. Conclusiones: El primer ensayo del programa Virtual-PRO es prometedor y pone de relieve el uso de la RV como herramienta eficaz para la prevención del acoso sexual. Las medidas de seguimiento son esenciales para determinar con precisión el efecto de las intervenciones.

Ca-based materials derived from calcined cigarette butts for CO2 capture and thermochemical energy storage.

Cigarette butts (CBs) are one of the most common types of litter in the world. Due to the toxic substances they contain, the waste generated poses a harmful risk to the environment, and therefore there is an urgent need for alternative solutions to landfill storage. Thus, this work presents a possible revalorization of this waste material, which implies interesting environmental benefits. CBs were used as sacrificial templates for the preparation of CaO-based materials by impregnation with calcium and magnesium nitrates followed by flaming combustion. These materials presented enhanced porosity for their use in the Calcium Looping process applied either to thermochemical energy storage or CO2 capture applications. The influence of the concentration of Ca and Mg in the impregnating solutions on the multicycle reactivity of the samples was studied. An improved multicycle performance was obtained in terms of conversion for both applications.

Levator Scapulae Stiffness Measurement Reliability in Individuals with and without Chronic Neck Pain by Experienced and Novel Examiners.

The levator scapulae muscle is a key structure in the etiopathology of neck and shoulder musculoskeletal pain. Although previous studies used shear-wave elastography (SWE) for characterizing this muscle elasticity, limited evidence assessed the inter-examiner reliability of this procedure. This study aimed to analyze the inter-examiner reliability for calculating Young's modulus and shear wave speed in a cohort of participants with and without chronic neck pain. A diagnostic accuracy study was conducted, acquiring a set of SWE images at the C5 level in participants with and without neck pain (n = 34 and 33, respectively) by two examiners (one experienced and one novel). After blinding the participants' identity, examiner involved, and side, the stiffness indicators were calculated by an independent rater in a randomized order. Intra-class correlation coefficients (ICC), standard error of measurement, minimal detectable changes, and coefficient of variation were calculated. Both cohorts had comparable sociodemographic characteristics (p > 0.05). No significant levator scapulae elasticity differences were found between genders, sides, or cohorts (all, p > 0.05). Inter-examiner reliability for calculating Young's modulus and shear wave speed was moderate-to-good for assessing asymptomatic individuals (ICC = 0.714 and 0.779, respectively), while poor-to-moderate in patients with neck pain (ICC = 0.461 and 0.546, respectively). The results obtained in this study support the use of this procedure for assessing asymptomatic individuals. However, reliability estimates were unacceptable to support its use for assessing elasticity in patients with chronic neck pain. Future studies might consider that the shear wave speed is more sensitive to detect real changes in comparison with Young's modulus.

Magnesium calcites for CO2 capture and thermochemical energy storage using the calcium-looping process.

In this study, a precipitation-based synthesis method has been employed to prepare magnesium calcites with the general formula Ca1-xMgxCO3, with the objective of use them in the calcium looping (CaL) process for CO2 capture (CaL-CCS) and thermochemical energy storage (CaL-CSP). The structure and microstructure of the samples have been characterized. It has been found by X-ray diffraction that the samples with a Ca:Mg molar ratio of 0.5:0.5 and 0.55:0.45 are phase pure, while the samples with molar ratios of 0.7:0.3 and 0.8:0.2 are composed by two phases with different stoichiometry. In addition, the sample prepared with calcium alone shows the aragonite phase. The microstructure of the magnesium-containing samples is composed of nanocrystals, which are aggregated in spherical particles whereas the aragonite sample presents a typical rod-like morphology. The multicycle tests carried out under CaL-CCS conditions show that an increase on the MgO content in the calcined samples results in a reduced value of effective conversion when compared to aragonite. On the other hand, under CaL-CSP conditions, the samples with the higher MgO content exhibit nearly stable effective conversion values around 0.5 after 20 cycles, which improve the results obtained for aragonite and those reported for natural dolomite tested under the same conditions.

Can Virtual Reality be Used for the Prevention of Peer Sexual Harassment in Adolescence? First Evaluation of the Virtual-PRO Program / [¿Puede utilizarse la realidad virtual para prevenir el acoso sexual entre iguales en la adolescencia? Primera evaluación del programa Virtual-PRO]

Objective: The present study analyzed the Virtual-PRO program’s efficacy in preventing peer sexual harassment by promoting the bystanders’ active intervention and incorporating a virtual reality (VR) component. The impact of the program on sexist attitudes, moral disengagement, the intention to intervene as bystanders, and the involvement in sexual aggression and victimization was tested. Method: Virtual-PRO is a VR-enhanced sexual harassment curricular prevention program of six one-hour sessions. The evaluation comprised a pre-test, a post-test after the intervention, and a follow-up measure at three months. In the study, 579 Spanish adolescent students aged between 12 and 17 years (M = 14.76, SD = 0.88; 47.1% boys) were randomly grouped into experimental (n = 286) and control (n = 293) conditions. Results: The Virtual-PRO program effectively controlled participants’ levels of sexism and reduced moral disengagement in the experimental group compared to the control group three months after the intervention. The program also showed positive results in changing bystander behavior, increasing the intention to intervene when the victim was not a friend. Finally, visual/verbal and online victimization decreased in the experimental group and increased in the control group. No differences were found for physical sexual victimization and sexual aggression. Conclusions: The first trial of the Virtual-PRO program is promising and highlights the use of VR as a sexual harassment prevention tool. Follow-up measures are essential to determine the impact of interventions accurately.(AU)

Objetivo: El presente estudio analiza la eficacia del programa Virtual-PRO en la prevención del acoso sexual entre iguales promoviendo la intervención activa de los espectadores mediante el uso de la realidad virtual (RV). Se comprobó el impacto del programa en las actitudes sexistas, la desconexión moral, la intención de intervenir como espectadores y la implicación en agresión y victimización sexual. Método: Virtual-PRO es un programa curricular compuesto por seis unidades que incorpora la RV para mejorar la prevención del acoso sexual. La evaluación incluyó una medida pre-test, un post-test después de la intervención y una medida de seguimiento a los tres meses. En el estudio participaron 579 estudiantes españoles de entre 12 y 17 años (M = 14.76, DT = 0.88, 47.1% chicos), agrupados aleatoriamente en grupo experimental (n = 286) y control (n = 293). Resultados: El programa Virtual-PRO controló eficazmente los niveles de sexismo y redujo la desconexión moral en el grupo experimental en comparación con el grupo de control tres meses después de la intervención. También mostró resultados positivos en el cambio del comportamiento de los espectadores, mejorando la intención de intervenir cuando la víctima no era amigo o amiga. Por último, la victimización visual/verbal y online disminuyó en el grupo experimental y aumentó en el grupo control. No se encontraron diferencias en victimización sexual física y agresión sexual. Conclusiones: El primer ensayo del programa Virtual-PRO es prometedor y pone de relieve el uso de la RV como herramienta eficaz para la prevención del acoso sexual. Las medidas de seguimiento son esenciales para determinar con precisión el efecto de las intervenciones.(AU)

Reproducibility of Anterior Scalene Stiffness Measurement with Shear Wave Elastography: An Inter-Examiner Reliability Study.

PURPOSE: Although previous studies have highlighted the clinical relevance of the anterior scalene muscle (AS) in patients with neck pain or nerve compressive syndromes, evidence reporting the diagnostic accuracy of shear wave elastography (SWE) for assessing the AS stiffness properties is lacking. This study aimed to analyze the SWE inter-examiner reliability for calculating the Young's modulus and shear wave speed of the AS muscle in asymptomatic subjects. MATERIALS AND METHODS: Using a linear transducer, ultrasound images of the antero-lateral neck region at the C7 level were acquired in 35 healthy volunteers by one experienced examiner and one novice examiner. After codifying the images to blind the participants' identity, the trial, and the side, Young's modulus and shear wave speed were obtained by an independent experienced rater in randomized order. Intra-class correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable changes (MDC), and coefficient of variation (CV%) were calculated. RESULTS: The assessed AS metrics showed no side-to-side differences (p>0.05). Sex differences were found for muscle size (p=0.002), but muscle brightness and stiffness were similar (p>0.05). Inter-examiner reliability was good for determining the AS muscle stiffness (ICC = 0.881 for Young's modulus and 0.850 for shear wave speed). CONCLUSION: The obtained results suggest that assessing the AS stiffness properties in asymptomatic subjects is a reliable procedure. Further studies should verify the SWE capacity for discriminating healthy and clinical populations and identify potential factors contributing to the variance of measurement errors.

Wastewater surveillance in the COVID-19 post-emergency pandemic period: A promising approach to monitor and predict SARS-CoV-2 surges and evolution.

On May 24, 2023, approximately 3.5 years into the pandemic, the World Health Organization (WHO) declared the end of the COVID-19 global health emergency. However, as there are still ∼3000 COVID-19 deaths per day in May 2023, robust surveillance systems are still warranted to return to normalcy in times of low risk and respond appropriately in times of high risk. The different phases of the pandemic have been defined by infection numbers and variants, both of which have been determined through clinical tests that are subject to many biases. Unfortunately, the end of the COVID-19 emergency threatens to exasperate these biases, thereby warranting alternative tracking methods. We hypothesized that wastewater surveillance could be used as a more accurate and comprehensive method to track SARS-CoV-2 in the post-emergency pandemic period (PEPP). SARS-CoV-2 was quantified and sequenced from wastewater between June 2022 and March 2023 to research the anticipated 2022/23 winter surge. However, in the 2022/23 winter, there was lower-than-expected SARS-CoV-2 circulation, which was hypothesized to be due to diagnostic testing biases but was confirmed by our wastewater analysis, thereby emphasizing the unpredictable nature of SARS-CoV-2 surges while also questioning its winter seasonality. Even in times of low baseline circulation, we found wastewater surveillance to be sensitive enough to detect minor changes in circulation levels ∼30-46 days prior to diagnostic tests, suggesting that wastewater surveillance may be a more appropriate early warning system to prepare for unpredictable surges in the PEPP. Furthermore, sequencing of wastewater detected variants of concern that were positively correlated with clinical samples and also provided a method to identify mutations with a high likelihood of appearing in future variants, necessary for updating vaccines and therapeutics prior to novel variant circulation. Together, these data highlight the effectiveness of wastewater surveillance in the PEPP to limit the global health burden of SARS-CoV-2 due to increases in circulation and/or viral evolution.

Implementation of a PCR-based strategy to control an outbreak by Serratia marcescens in a Neonatal Intensive Care Unit.

OBJECTIVES: To evaluate the clinical and epidemiological impact of a new molecular surveillance strategy based on qPCR to control an outbreak by Serratia marcescens in a Neonatal Intensive Care Unit (NICU). METHODS: We design a specific qPCR for the detection of S. marcescens in rectal swabs of patients admitted to a NICU. We divided the surveillance study into two periods: (a) the pre-PCR, from the outbreak declaration to the qPCR introduction, and (b) the PCR period, from the introduction of the qPCR until the outbreak was solved. In all cases, S. marcescens isolates were recovered and their clonal relationship was analysed by PFGE. Control measures were implemented during the outbreak. Finally, the number of bloodstream infections (BSI) was investigated in order to evaluate the clinical impact of this molecular strategy. RESULTS: Nineteen patients colonized/infected by S. marcescens were detected in the pre-PCR period (October 2020-April 2021). On the contrary, after the PCR implementation, 16 new patients were detected. The PFGE revealed 24 different pulsotypes belonging to 7 different clonal groups, that were not overlapping at the same time. Regarding the clinical impact, 18 months after the qPCR implementation, no more outbreaks by S. marcescens have been declared in the NICU of our hospital, and only 1 episode of BSI has occurred, compared with 11 BSI episodes declared previously to the outbreak control. CONCLUSIONS: The implementation of this qPCR strategy has proved to be a useful tool to control the nosocomial spread of S. marcescens in the NICU.

The role of gastrointestinal endoscopy in Kaposi sarcoma / El papel de la endoscopia gastrointestinal en el sarcoma de Kaposi

We are writing to make endoscopists aware of the paramount of a prompt diagnosis of gastrointestinal Kaposi sarcoma (GI-KS). Patients with GI involvement have a two to five times higher risk of death and will benefit from chemotherapy to improve their survival. However, current evidence found that one out of three patients might have a false negative result even with HHV-8 since other entities such as gastrointestinal stromal tumors, angiosarcoma, and lymphoma shared macroscopic and histopathological characteristics. These cause a delay in treatment and significantly worsen the prognosis. We observed a trend for a positive diagnosis from ulcers and nodules. To our knowledge, this is the largest cohort of patients with GI-KS in the world. Our study suggests that in cases where a complete immunochemistry panel for KS is not available, HHV-8 remains as a bare minimum. However, other gastrointestinal lesions shared histopathological characteristics. Therefore, we suggest taking biopsies from nodular and ulcer-type lesions to increase the probability to establish a histopathological diagnosis.(AU)

Influence of Long-Term CaO Storage Conditions on the Calcium Looping Thermochemical Reactivity.

Long-term storage capability is often claimed as one of the distinct advantages of the calcium looping process as a potential thermochemical energy storage system for integration into solar power plants. However, the influence of storage conditions on the looping performance has seldom been evaluated experimentally. The storage conditions must be carefully considered as any potential carbonation at the CaO storage tank would reduce the energy released during the subsequent carbonation, thereby penalizing the round-trip efficiency. From lab-scale to conceptual process engineering, this work considers the effects of storing solids at low temperatures (50-200 °C) in a CO2 atmosphere or at high temperatures (800 °C) in N2. Experimental results show that carbonation at temperatures below 200 °C is limited; thus, the solids could be stored during long times even in CO2. It is also demonstrated at the lab scale that the multicycle performance is not substantially altered by storing the solids at low temperatures (under CO2) or high temperatures (N2 atmosphere). From an overall process perspective, keeping solids at high temperatures leads to easier heat integration, a better plant efficiency (+2-4%), and a significantly higher energy density (+40-62%) than considering low-temperature storage. The smooth difference in the overall plant efficiency with the temperature suggests a proper long-term energy storage performance if adequate energy integration is carried out.

Testing the Informativeness of Diverse Measures of Auditory Processing for Clinical Audiological Practice in Middle-Aged Adults in Mexico.

PURPOSE: Standard clinical audiologic assessment is limited in its ability to capture variance in self-reported hearing difficulty. Additionally, the costs associated with clinical testing in audiology create financial barriers for hearing health care in developing countries like Mexico. This study used an open-source Spanish-language tool called PART (Portable Automated Rapid Testing) to test the hypothesis that a battery of assessments of auditory processing can complement standard clinical audiological assessment to better capture the variance of self-reported hearing difficulty. METHOD: Forty-three adults between 40 and 69 years of age were tested in Mexico City using a traditional clinical pure-tone audiogram, cognitive screening, and a battery of PART-based auditory processing assessments including a speech-on-speech competition spatial release from masking task. Results were compared to self-reported hearing difficulty, assessed with a Spanish-language adaptation of the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S). RESULTS: Several measures from the PART battery exhibited stronger correlations with self-reported hearing difficulties than the pure-tone audiogram. The spatial release from masking task best captured variance in HHIE-S scores and remained significant after controlling for the effects of age, audibility, and cognitive score. CONCLUSIONS: The spatial release from masking task can complement traditional clinical measures to better account for patient's self-reported hearing difficulty. Open-source access to this test in PART supports its implementation for Spanish speakers in clinical settings around the world at low cost. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24470140.