Chest X-Ray-Based Telemedicine Platform for Pediatric Tuberculosis Diagnosis in Low-Resource Settings: Development and Validation Study.

BACKGROUND: Tuberculosis (TB) remains a major cause of morbidity and death worldwide, with a significant impact on children, especially those under the age of 5 years. The complex diagnosis of pediatric TB, compounded by limited access to more accurate diagnostic tests, underscores the need for improved tools to enhance diagnosis and care in resource-limited settings. OBJECTIVE: This study aims to present a telemedicine web platform, BITScreen PTB (Biomedical Image Technologies Screen for Pediatric Tuberculosis), aimed at improving the evaluation of pulmonary TB in children based on digital chest x-ray (CXR) imaging and clinical information in resource-limited settings. METHODS: The platform was evaluated by 3 independent expert readers through a retrospective assessment of a data set with 218 imaging examinations of children under 3 years of age, selected from a previous study performed in Mozambique. The key aspects assessed were the usability through a standardized questionnaire, the time needed to complete the assessment through the platform, the performance of the readers to identify TB cases based on the CXR, the association between the TB features identified in the CXRs and the initial diagnostic classification, and the interreader agreement of the global assessment and the radiological findings. RESULTS: The platform's usability and user satisfaction were evaluated using a questionnaire, which received an average rating of 4.4 (SD 0.59) out of 5. The average examination completion time ranged from 35 to 110 seconds. In addition, the study on CXR showed low sensitivity (16.3%-28.2%) but high specificity (91.1%-98.2%) in the assessment of the consensus case definition of pediatric TB using the platform. The CXR finding having a stronger association with the initial diagnostic classification was air space opacification (χ21>20.38, P<.001). The study found varying levels of interreader agreement, with moderate/substantial agreement for air space opacification (κ=0.54-0.67) and pleural effusion (κ=0.43-0.72). CONCLUSIONS: Our findings support the promising role of telemedicine platforms such as BITScreen PTB in enhancing pediatric TB diagnosis access, particularly in resource-limited settings. Additionally, these platforms could facilitate the multireader and systematic assessment of CXR in pediatric TB clinical studies.

Two new records and description of a new Perinereis (Annelida, Nereididae) species for the Saudi Arabian Red Sea region.

Annelid biodiversity studies in the Red Sea are limited and integrative taxonomy is needed to accurately improve reference libraries in the region. As part of the bioblitz effort in Saudi Arabia to assess the invertebrate biodiversity in the northern Red Sea and Gulf of Aqaba, Perinereis specimens from intertidal marine and lagoon-like rocky environments were selected for an independent assessment, given the known taxonomic ambiguities in this genus. This study used an integrative approach, combining molecular with morphological and geographic data. Our results demonstrate that specimens found mainly in the Gulf of Aqaba are not only morphologically different from other five similar Perinereis Group I species reported in the region, but phylogenetic analysis using available COI sequences from GenBank revealed different molecular operational taxonomic units, suggesting an undescribed species, P.kaustianasp. nov. The new species is genetically close and shares a similar paragnath pattern to the Indo-Pacific distributed P.helleri, in particular in Area III and Areas VII-VIII. Therefore, we suggest it may belong to the same species complex. However, P.kaustianasp. nov. differs from the latter mainly in the shorter length of the postero-dorsal tentacular cirri, median parapodia with much longer dorsal Tentacular cirri, posteriormost parapodia with much wider and greatly expanded dorsal ligules. Additionally, two new records are reported for the Saudi Neom area belonging to P.damietta and P.suezensis, previously described only for the Egyptian coast (Suez Canal) and are distributed sympatrically with the new species, but apparently not sympatric with each other.

Deciphering lineage specification during early embryogenesis in mouse gastruloids using multilayered proteomics.

Gastrulation is a critical stage in embryonic development during which the germ layers are established. Advances in sequencing technologies led to the identification of gene regulatory programs that control the emergence of the germ layers and their derivatives. However, proteome-based studies of early mammalian development are scarce. To overcome this, we utilized gastruloids and a multilayered mass spectrometry-based proteomics approach to investigate the global dynamics of (phospho) protein expression during gastruloid differentiation. Our findings revealed many proteins with temporal expression and unique expression profiles for each germ layer, which we also validated using single-cell proteomics technology. Additionally, we profiled enhancer interaction landscapes using P300 proximity labeling, which revealed numerous gastruloid-specific transcription factors and chromatin remodelers. Subsequent degron-based perturbations combined with single-cell RNA sequencing (scRNA-seq) identified a critical role for ZEB2 in mouse and human somitogenesis. Overall, this study provides a rich resource for developmental and synthetic biology communities endeavoring to understand mammalian embryogenesis.

The mouse motor system contains multiple premotor areas and partially follows human organizational principles.

While humans are known to have several premotor cortical areas, secondary motor cortex (M2) is often considered to be the only higher-order motor area of the mouse brain and is thought to combine properties of various human premotor cortices. Here, we show that axonal tracer, functional connectivity, myelin mapping, gene expression, and optogenetics data contradict this notion. Our analyses reveal three premotor areas in the mouse, anterior-lateral motor cortex (ALM), anterior-lateral M2 (aM2), and posterior-medial M2 (pM2), with distinct structural, functional, and behavioral properties. By using the same techniques across mice and humans, we show that ALM has strikingly similar functional and microstructural properties to human anterior ventral premotor areas and that aM2 and pM2 amalgamate properties of human pre-SMA and cingulate cortex. These results provide evidence for the existence of multiple premotor areas in the mouse and chart a comparative map between the motor systems of humans and mice.

Plasticlusters: A marine litter microhabitat in a marina of Tunisia, N Africa.

Plastic debris is a significant and rapidly developing ecological issue in coastal marine ecosystems, especially in areas where it accumulates. This study introduces "plasticlusters", a new form of floating debris agglomeration found in the Yasmine Hammamet marina (Tunisia, North-Africa), loosely attached to pontoon ropes around the water surface level. The analysis of two samples revealed that they were formed primarily by average 2.11 mm polystyrene fragments, 3.43 mm fibers, 104 mm polypropylene and polyethylene sheets, and 122 mm decomposing seagrass leaves. They were inhabited by several taxa, including at least 2 cryptogenic and 5 non-indigenous species (NIS). Unlike other plastic formations, plasticlusters provide a novel and potentially temporal microhabitat to fouling assemblages due to their loose and unconsolidated structure which, combined with marinas being NIS hubs, could enhance NIS dispersion. The results of this study raise concerns about the combined ecological effects of debris accumulation and biocontamination inside marinas.

Surface integrity could limit the potential of concrete as a bio-enhanced material in the marine environment.

Coastal sprawl is among the main drivers of global degradation of shallow marine ecosystems. Among artificial substrates, quarry rock can have faster recruitment of benthic organisms compared to traditional concrete, which is more versatile for construction. However, the factors driving these differences are poorly understood. In this context, this study was designed to compare the intertidal and subtidal benthic and epibenthic assemblages on concrete and artificial basalt boulders in six locations of Madeira Island (northeastern Atlantic, Portugal). To assess the size of the habitat, the shorelines in the study area were quantified using satellite images, resulting in >34 % of the south coast of Madeira being artificial. Benthic assemblages differed primarily between locations and secondarily substrates. Generally, assemblages differed between substrates in the subtidal, with lower biomass and abundance in concrete than basalt. We conclude that these differences are not related to chemical effects (e.g., heavy metals) but instead to a higher detachment rate of calcareous biocrusts from concrete, as surface abrasion is faster in concrete than basalt. Consequently, surface integrity emerges as a factor of ecological significance in coastal constructions. This study advances knowledge on the impact and ecology of artificial shorelines, providing a baseline for future research towards ecological criteria for coastal protection and management.

A Smartphone App for Real-Time Assessment of Malaria Prophylaxis Adverse Events.

Background: Growth of international travel to malarial areas over the last decades has contributed to more travelers taking malaria prophylaxis. Travel-related symptoms may be wrongly attributed to malaria prophylaxis and hinder compliance. Here, we aimed to assess the frequency of real-time reporting of symptoms by travelers following malaria prophylaxis using a smartphone app. Method: Adult international travelers included in this single-center study (Barcelona, Spain) used the smartphone Trip Doctor® app developed by our group for real-time tracking of symptoms and adherence to prophylaxis. Results: Six hundred four (n = 604) international travelers were included in the study; 74.3% (449) used the app daily, and for one-quarter of travelers, malaria prophylaxis was prescribed. Participants from the prophylaxis group traveled more to Africa (86.7% vs. 4.3%; p < 0.01) and to high travel medical risk countries (60.8% vs. 18%; p < 0.01) and reported more immunosuppression (30.8% vs. 23.1% p < 0.01). Regarding symptoms, no significant intergroup differences were observed, and no relationship was found between the total number of malarial pills taken and reported symptoms. Conclusions: In our cohort, the number of symptoms due to malaria prophylaxis was not significantly higher than in participants for whom prophylaxis was not prescribed, and the overall proportion of symptoms is higher compared with other studies.

Oncogenic signals prime cancer cells for toxic cell overgrowth during a G1 cell cycle arrest.

CDK4/6 inhibitors are remarkable anti-cancer drugs that can arrest tumor cells in G1 and induce their senescence while causing only relatively mild toxicities in healthy tissues. How they achieve this mechanistically is unclear. We show here that tumor cells are specifically vulnerable to CDK4/6 inhibition because during the G1 arrest, oncogenic signals drive toxic cell overgrowth. This overgrowth causes permanent cell cycle withdrawal by either preventing progression from G1 or inducing genotoxic damage during the subsequent S-phase and mitosis. Inhibiting or reverting oncogenic signals that converge onto mTOR can rescue this excessive growth, DNA damage, and cell cycle exit in cancer cells. Conversely, inducing oncogenic signals in non-transformed cells can drive these toxic phenotypes and sensitize the cells to CDK4/6 inhibition. Together, this demonstrates that cell cycle arrest and oncogenic cell growth is a synthetic lethal combination that is exploited by CDK4/6 inhibitors to induce tumor-specific toxicity.

CDK4/6 inhibitor-mediated cell overgrowth triggers osmotic and replication stress to promote senescence.

Abnormal increases in cell size are associated with senescence and cell cycle exit. The mechanisms by which overgrowth primes cells to withdraw from the cell cycle remain unknown. We address this question using CDK4/6 inhibitors, which arrest cells in G0/G1 and are licensed to treat advanced HR+/HER2- breast cancer. We demonstrate that CDK4/6-inhibited cells overgrow during G0/G1, causing p38/p53/p21-dependent cell cycle withdrawal. Cell cycle withdrawal is triggered by biphasic p21 induction. The first p21 wave is caused by osmotic stress, leading to p38- and size-dependent accumulation of p21. CDK4/6 inhibitor washout results in some cells entering S-phase. Overgrown cells experience replication stress, resulting in a second p21 wave that promotes cell cycle withdrawal from G2 or the subsequent G1. We propose that the levels of p21 integrate signals from overgrowth-triggered stresses to determine cell fate. This model explains how hypertrophy can drive senescence and why CDK4/6 inhibitors have long-lasting effects in patients.

A cyclin-dependent kinase-mediated phosphorylation switch of disordered protein condensation.

Cell cycle transitions result from global changes in protein phosphorylation states triggered by cyclin-dependent kinases (CDKs). To understand how this complexity produces an ordered and rapid cellular reorganisation, we generated a high-resolution map of changing phosphosites throughout unperturbed early cell cycles in single Xenopus embryos, derived the emergent principles through systems biology analysis, and tested them by biophysical modelling and biochemical experiments. We found that most dynamic phosphosites share two key characteristics: they occur on highly disordered proteins that localise to membraneless organelles, and are CDK targets. Furthermore, CDK-mediated multisite phosphorylation can switch homotypic interactions of such proteins between favourable and inhibitory modes for biomolecular condensate formation. These results provide insight into the molecular mechanisms and kinetics of mitotic cellular reorganisation.

Melatonin Postharvest Treatment in Leafy 'Fino' Lemon Maintains Quality and Bioactive Compounds.

Spain is a great producer of organic lemon; however, it is necessary to reduce the losses caused by post-harvest diseases. Melatonin (MEL) is a naturally occurring compound with physiological functions in fruit growth and ripening and is able to modulate postharvest ripening and senescence, most of it being concentrated in climacteric fruit. Thus, the aim of this study was to apply MEL to organic lemon fruit with stems and leaves (LEAF) and to organic lemon without those components (LEAFLESS) after harvesting and storage during 21 days at 2 °C to understand the effects of this treatment on the fruit quality. For this purpose, two experiments were carried out. First, MEL was applied at 0.01 mM, 0.1 mM and 1.0 mM by immersion for 15 min on lemon fruits, and the quality parameters and bioactive compounds of the fruit were analysed. Subsequently, a second experiment was carried out where the best concentration (1 mM) was selected and another time (15 and 30 min) was added, with the same quality parameters being analysed. As a result, we observed that all MEL treatments showed positive effects on weight loss reduction, softening (higher fruit firmness), total acidity and lower colour changes. Total phenols increased in MEL-treated lemons, both in peel and juice. For the three concentrations tested, the best efficiency was obtained with MEL at 1.0 mM, while LEAF lemons were the most effective. In conclusion, lemons containing stems and leaves (LEAF) improved preservability by using MEL at 1.0 mM with better organoleptic quality and enhanced phenolic compounds.

Predation facilitates the abundance of biofouling non-indigenous species in estuarine marinas in NE Atlantic Portugal.

Harbours are highly modified habitats that differ from natural areas. They are hotspots of non-indigenous species (NIS) and act as stepping-stones in invasive processes. However, local communities can exert biotic resistance against biological invasions through trophic interactions and competition. This study assesses the biotic effects of predation on the recruitment of fouling assemblages in three marinas of NE Atlantic Portugal (Cascais, Setúbal and Sines), with particular emphasis on NIS, using predator exclusion experiments. Predation increased the relative abundance of NIS, mainly Watersipora subatra, in the estuarine marinas of Cascais and Setúbal, while no predation effects were registered in the coastal marina of Sines. Therefore, predation can increase the risk of NIS invasion (biotic facilitation). Furthermore, local ecosystems may have different effects and differ in vulnerability against NIS invasions. Finally, a better understanding of coastal invasive ecology and biotic effects in coastal artificial habitats will improve our capacity for NIS management.

A Low-Cost Hardware Architecture for EV Battery Cell Characterization Using an IoT-Based Platform.

Since 1997, when the first hybrid vehicle was launched on the market, until today, the number of NIMH batteries that have been discarded due to their obsolescence has not stopped increasing, with an even faster rate more recently due to the progressive disappearance of thermal vehicles on the market. The battery technologies used are mostly NIMH for hybrid vehicles and Li ion for pure electric vehicles, making recycling difficult due to the hazardous materials they contain. For this reason, and with the aim of extending the life of the batteries, even including a second life within electric vehicle applications, this paper describes and evaluates a low-cost system to characterize individual cells of commercial electric vehicle batteries by identifying such abnormally performing cells that are out of use, minimizing regeneration costs in a more sustainable manner. A platform based on the IoT technology is developed, allowing the automation of charging and discharging cycles of each independent cell according to some parameters given by the user, and monitoring the real-time data of such battery cells. A case study based on a commercial Toyota Prius battery is also included in the paper. The results show the suitability of the proposed solution as an alternative way to characterize individual cells for subsequent electric vehicle applications, decreasing operating costs and providing an autonomous, flexible, and reliable system.

Location and building material determine fouling assemblages within marinas: A case study in Madeira Island (NE Atlantic, Portugal).

Marinas are hubs for non-indigenous species (NIS) and constitute the nodes of a network of highly modified water bodies (HMWB) connected by recreational maritime traffic. Floating structures, such as pontoons, are often the surfaces with higher NIS abundance inside marinas and lead the risk for NIS introduction, establishment and spread. However, there is still little information on how the location within the marina and the substratum type can influence the recruitment of fouling assemblages depending on water parameters and substratum chemical composition. In this study, fouling recruitment was studied using an experimental approach with three materials (basalt, concrete and HDPE plastic) in two sites (close and far to the entrance) in two marinas of Madeira Island (NE Atlantic, Portugal). The structure of benthic assemblages after 6- and 12-months colonization, as well as biotic abundance, NIS abundance, richness, diversity, assemblages' volume, biomass and assemblages' morphology were explored. Differences between marinas were the main source of variation for both 6- and 12-month assemblages, with both marinas having different species composition and biomass. The inner and outer sites of both marinas varied in terms of structure and heterogeneity of assemblages and heterogeneity of morphological traits, but assemblages did not differ among substrata. However, basalt had a higher species richness and diversity while concrete showed a higher bioreceptivity in terms of total biotic coverage than the rest of materials. Overall, differences between and within marinas could be related to their structural morphology. This study can be valuable for management of urban ecosystems, towards an increase in the environmental and ecological status of existing marinas and their HMWB and mitigation coastal ecosystems degradation.

Can working at home be a hazard? Ergonomic factors associated with musculoskeletal disorders among teleworkers during the COVID-19 pandemic: a scoping review.

Objectives. The improvised and massive adoption of remote work in the context of COVID-19 has forced us to adapt homes as workspaces, which could promote development of musculoskeletal disorders (MSDs). This review explores the evidence for ergonomic factors associated with MSDs in teleworkers. Methods. A literature search was conducted in MEDLINE, Embase, Scopus, SciELO and EBSCO. We included observational studies published between March 2020 and October 2021 that included teleworking personnel due to the restrictions of the pandemic. Results. A total of 212 studies were identified, 14 were chosen for complete review. Associated factors were change of work modality (on-site work to telework), use of home environments as workspaces (areas not adapted for work and with low lighting), working furniture (non-ergonomic chairs and desks), use of electronic devices (tablets, cell phones and laptops), organizational factors (working hours, active breaks, sitting time) and individual factors (physical activity practice). Conclusion. Various ergonomic home factors and the characteristics of teleworking - mainly furniture, the environment of work and physical activity - are associated with MSDs. This evidence suggests that the norms and regulation of telework can consider the adaptation of workspace and conditions at home to prevent health problems in the medium and long term.

Automatic Cerebral Hemisphere Segmentation in Rat MRI with Ischemic Lesions via Attention-based Convolutional Neural Networks.

We present MedicDeepLabv3+, a convolutional neural network that is the first completely automatic method to segment cerebral hemispheres in magnetic resonance (MR) volumes of rats with ischemic lesions. MedicDeepLabv3+ improves the state-of-the-art DeepLabv3+ with an advanced decoder, incorporating spatial attention layers and additional skip connections that, as we show in our experiments, lead to more precise segmentations. MedicDeepLabv3+ requires no MR image preprocessing, such as bias-field correction or registration to a template, produces segmentations in less than a second, and its GPU memory requirements can be adjusted based on the available resources. We optimized MedicDeepLabv3+ and six other state-of-the-art convolutional neural networks (DeepLabv3+, UNet, HighRes3DNet, V-Net, VoxResNet, Demon) on a heterogeneous training set comprised by MR volumes from 11 cohorts acquired at different lesion stages. Then, we evaluated the trained models and two approaches specifically designed for rodent MRI skull stripping (RATS and RBET) on a large dataset of 655 MR rat brain volumes. In our experiments, MedicDeepLabv3+ outperformed the other methods, yielding an average Dice coefficient of 0.952 and 0.944 in the brain and contralateral hemisphere regions. Additionally, we show that despite limiting the GPU memory and the training data, our MedicDeepLabv3+ also provided satisfactory segmentations. In conclusion, our method, publicly available at https://github.com/jmlipman/MedicDeepLabv3Plus , yielded excellent results in multiple scenarios, demonstrating its capability to reduce human workload in rat neuroimaging studies.

Evaluation of the Optimal Uses of Five Genotypes of Musa textilis Fiber Grown in the Tropical Region.

Knowing the genotypes of Musa textilis and its fiber production properties is key for developing cultivars with homogeneous properties and focusing on specific products or market segments that generate added value to the fiber. For this reason, the objective was to determine the optimal use of five genotypes of M. textilis (MT01, MT03, MT07, MT11, and CF01) with high productivity grown in the tropical region of Costa Rica. Therefore, anatomical, physical-mechanical, chemical, and energetic analyses were carried out on these fibers to define whether any genotype has the ideal conditions for a specific use. The results showed differences between the genotypes, obtaining significant differences in physical-mechanical properties (tension, water retention, and color), chemical properties (holocellulose, lignin, extractives, and elemental values of nitrogen, carbon, and sulfur), and energetic properties (volatiles, ash, and caloric value thermogravimetric analyses), which resulted in the establishment of two groups of genotypes with a dissimilarity degree of 35%. The first group, composed of MT03 and MT01, presented characteristics suitable for paper production, biodegradable materials, and composite materials. On the other hand, the second group, made up of MT07, MT11, and CF01, showed properties suitable for textiles, heavy-duty fibers, and bioenergy.

Impact of quarantine due to COVID-19 pandemic on health and lifestyle conditions in older adults from Centro American countries.

BACKGROUND: The impact of quarantine in older adults have been reported in several studies with contradictory results, reporting from negative effects to no significant outcomes or even beneficial consequences. Heterogeneity in aging plays a role in each region, the aim of this study is to analyze the impact of quarantine on health conditions (physical and mental) and lifestyle in older adults in five Centro American countries during COVID-19 pandemic. METHOD: In this cross-sectional study, n = 712 older adults 60 years and older from Mexico, Guatemala, El Salvador, Honduras and Costa Rica were assessed by telephone. Sociodemographic data, physical and mental health, lifestyle and quarantine conditions were asked previous informed consent. RESULTS: In general, mean of days in quarantine at the moment of the study was 142 days (approximately four months and three weeks). In the analysis of the impact of the days in quarantine effects were found on the frequency of falls, functional ability in Activities of Daily Living (ADL), general cognitive function, memory, orientation, language, frequency of drinking alcohol, having a balanced diet, and being active cognitively. Some differences were found between countries. CONCLUSIONS: Effects of quarantine on older adults in Centro America, requires attention of governments and healthcare to prevent long term morbidity and disability, and to promote healthy aging.

Telemedicine for international travelers through a Smartphone-based monitoring platform (Trip Doctor®).

BACKGROUND: Overall, more than 50% of international travelers develop symptoms while traveling and 55% of them seek medical assistance during the trip. We conducted a study to evaluate the usefulness of a Smartphone app called TRIP Doctor® to provide telemedicine to international travelers. METHODS: Participants over 18 years old attending our travel clinic at Hospital Clinic in Barcelona were invited to participate during 2017-2019. After downloading the app, the health status of the traveler was monitored on a daily basis, providing specific medical advice and offering remote contact with specialized physicians through an integrated chat, if needed. RESULTS: From 449 users, 59 (13%) contacted for medical assistance through the app during the trip. Main reasons for telemedicine were diarrhea (25.7%), skin conditions (19.7%) and fever (12.1%). Among patients who contacted, 90% of the travelers did not require to be referred to a local doctor. Symptomatic treatment was the main treatment prescribed (38%). In a 14.7% of the cases a follow-up was not required, a 63.2% recovered and 22.1% were loss of follow-up. After a multivariate analysis, duration of trip >14 days was found to be the only factor associated with the use of telemedicine (OR 2.2, CI 95% 1.1-4.5, p = 0.03). CONCLUSION: In conclusion, travelers using telemedicine travelled for longer periods of time and mostly contacted for mild symptoms which could be solved successfully by remote assistance with our specialized doctors.

Convolutional Neural Networks Enable Robust Automatic Segmentation of the Rat Hippocampus in MRI After Traumatic Brain Injury.

Registration-based methods are commonly used in the automatic segmentation of magnetic resonance (MR) brain images. However, these methods are not robust to the presence of gross pathologies that can alter the brain anatomy and affect the alignment of the atlas image with the target image. In this work, we develop a robust algorithm, MU-Net-R, for automatic segmentation of the normal and injured rat hippocampus based on an ensemble of U-net-like Convolutional Neural Networks (CNNs). MU-Net-R was trained on manually segmented MR images of sham-operated rats and rats with traumatic brain injury (TBI) by lateral fluid percussion. The performance of MU-Net-R was quantitatively compared with methods based on single and multi-atlas registration using MR images from two large preclinical cohorts. Automatic segmentations using MU-Net-R and multi-atlas registration were of excellent quality, achieving cross-validated Dice scores above 0.90 despite the presence of brain lesions, atrophy, and ventricular enlargement. In contrast, the performance of single-atlas segmentation was unsatisfactory (cross-validated Dice scores below 0.85). Interestingly, the registration-based methods were better at segmenting the contralateral than the ipsilateral hippocampus, whereas MU-Net-R segmented the contralateral and ipsilateral hippocampus equally well. We assessed the progression of hippocampal damage after TBI by using our automatic segmentation tool. Our data show that the presence of TBI, time after TBI, and whether the hippocampus was ipsilateral or contralateral to the injury were the parameters that explained hippocampal volume.