The Role of Formulations in the Ageing Process of Vinyl Acetate Based Emulsion Films: A Multivariate Approach.

Vinyl acetate (VAc)-based emulsions represent one of the main media used by modern and contemporary artists. Their long-term behaviour is still not completely understood, especially due to the scarce knowledge on the influence of other compounds in the formulation, which may impact ageing over time. Besides the polymer backbone based on vinyl acetate, other co-monomers and additives can be added to the emulsion to alter the final film's physical, chemical, and optical properties. By extension, the formulation will also impact the long-term stability of artworks and objects on which it has been applied, as well as possible current and future conservation interventions such as cleaning. For those reasons, studies shedding light on the correlation between composition and long-term stability are largely necessary. In this study, different emulsions, including homopolymers, copolymers, plasticised, and un-plasticised compositions, were gathered and artificially aged. A multivariate analyses approach based on the application of principal component analyses (PCA) and hierarchical cluster analyses (HCA) was employed for the first time on the combination of data obtained by pH, contact angle (CA), colour measurements, Fourier transform infrared spectroscopy in attenuated total reflection (FTIR-ATR), and size exclusion chromatography (SEC). This approach helped to highlight the changes that occurred during ageing and find correlations with the formulation compositions. The results further sustain the thesis that not all vinyl acetate-based emulsions are chemically the same and that their formulation deeply impacts their long-term behaviour.

Collapse of a cephalic arch stent: An atypical complication of hemodialysis vascular access.

Access dysfunction is a significant contributor to morbidity in hemodialysis patients. The cephalic arch is a common location of vascular stenosis, with a considerable risk of relapse. While covered stents demonstrated a higher patency rate when compared to percutaneous transluminal angioplasty, their placement has some issues. Stent collapse and guttering are well-documented in arteries but not in arteriovenous fistulas. This report describes an unusual case of a cephalic arch stent collapsing 1 month after its positioning, as evidenced by access dysfunction.

Six-month combined aerobic and resistance exercise program enhances 6-minute walk test and physical fitness in people with peripheral arterial disease: A pilot study.

BACKGROUND: Exercise therapy is a recognized non-pharmacological intervention for peripheral arterial disease (PAD); however, the effects of combined exercise remain under investigation. This study aimed to compare the effects of a 6-month combined supervised exercise program (SUP) with a usual care (UC) approach on walking ability, physical fitness, and peripheral blood flow in people with PAD and claudication. METHODS: Twenty-three male participants (Age=64.1 ± 6.2years and ABI=0.58±0.07) with PAD and claudication were assigned to either the SUP group (n = 10), engaging in structured supervised treadmill walking combined with three resistance exercises, three times a week, or the UC group (n = 13), receiving advice to walk. The primary outcome measure was walking ability, with assessments conducted at baseline (M0), after 3 months (M3), and 6 months (M6). RESULTS: After the 6-month intervention, the SUP group exhibited significant improvements in absolute claudication time (ACT, p = 0.045), maximal walking time (MWT, p = 0.045), maximal walking distance (MWD, p = 0.027), and pause duration (p = 0.045) during the 6-minute walk test (6MWT), when compared to the UC group. Over time, a significant increase in walking speed during the 6MWT (Speed6MWT, p = 0.001) and walking speed without claudication (SpeedNoC, p < 0.001) was found, although no significant differences were found between the groups. The SUP group increased by 0.8 km/h in both Speed6MWT and SpeedNoC, while the UC group increased by 0.3 km/h and 0.6 km/h, respectively. Despite claudication consistently occurring at the same time, the SUP group demonstrated an improved tolerance to pain or a better understanding of pain, enabling them to walk longer distances at higher speeds. A positive effect of SUP was found for chair sit-and-reach test (p = 0.023), percentage of fat mass (p = 0.048), fat-free mass (p = 0.040), and total body water (p = 0.026), suggesting potential benefits attributed to the resistance strength exercises. CONCLUSION: A 6-month combined treadmill and resistance exercise program improved walking ability, walking speed, lower body and lower back flexibility, and body composition in people with PAD and claudication.

Regional impairment of left ventricular longitudinal strain in aortic regurgitation.

BACKGROUND: Aortic regurgitation (AR) has an important impact on myocardial mechanics and recent studies have proved the value of global longitudinal strain (GLS) in the assessment of its severity and prognosis. Our purpose was to assess if the direct impact of the regurgitant jet on the myocardial wall could affect regional longitudinal strain. METHODS: Eighty patients with chronic moderate/severe AR were retrospectively studied. Patients were considered to have a jet-related longitudinal strain reduction when the myocardial segments directly impacted by the jet had their longitudinal strain reduced by at least 30% compared to nonaffected segments. AR severity, left ventricular (LV) size and function were compared according to the presence/absence of this regional pattern. For those who underwent surgery, postoperative regional and global LV function was also analyzed. RESULTS: A pattern of regional longitudinal strain impairment was identified in 43% of patients, with a regional reduction (in median) of 10 percentage points in absolute strain values in the segments impacted by the jet, compared to nonaffected segments. In the subgroup who underwent surgery, this pattern became attenuated after surgery. Patients with regional longitudinal strain impairment were less likely to improve GLS after surgery (10% vs. 38% improved GLS by at least 2.5%, P = 0.049). CONCLUSIONS: To our knowledge, this study identifies for the first time, a link between the location of the impact of the regurgitant jet in AR and regional longitudinal strain impairment. The presence of this regional pattern might be associated with worse postoperative LV recovery.

Outcomes of amniotic membrane transplant for refractory macular hole - an optical coherence tomography and autofluorescence long-term study.

PURPOSE: To analyze anatomical and functional outcomes of cryopreserved human amniotic membrane (hAM) transplant in refractory macular hole (MH) surgery, present retinal layers structure after MH closure, identify visual acuity improvement determinants and complication rate. METHODS: Prospective and interventional case series including seventeen patients: 13 refractory and 4 chronic (8, 15, 18 and 30-years) MH. All patients underwent vitrectomy, hAM subretinal transplant, tamponade and positioning. Complete ophthalmological examination, axial length, best-corrected visual acuity, retinography, optical coherence tomography (OCT) and autofluorescence were recorded. RESULTS: Mean follow-up was 31 months (range 6-53). Mean LogMAR visual acuity (1.71 ± 0.42) improved significantly (1.13 ± 0.41) (P < 0.001). Patients with better baseline BCVA ended up with better final BCVA (P = 0.018). Mean MH minimum linear diameter was 831 ± 252 µm and base diameter was 1409 ± 358 µm. MH closed in all patients. Transitory ocular hypertension in one patient and transient vitreous cavity haemorrhage in another were the only postoperative complications. OCT matched scans showed plug integration and inner retinal layers rearrangement. MH size did not correlate with final BCVA. Autofluorescence showed no developing atrophy signs during long-term follow-up. CONCLUSION: Cryopreserved human amniotic membrane transplant may be a valuable approach to achieve macular hole closure and visual acuity improvement in refractory MH. KEY MESSAGES: What is known Human amniotic membrane transplantation is a recent surgical technique for refractory, chronic or extra-large macular holes. This surgical procedure has a shallow learning curve, high macular hole closure rate, does not require silicone oil tamponade and has very low complication rate. What is new Subretinal amniotic membrane transplant technique was successful at closing all patients' macular holes and improving visual acuity. Concerning final visual acuity predictors neither preoperative characteristics, namely the macular hole size or duration, etiology, lens status or axial length, nor surgical procedure modifications such as flap shape or tamponade lead to different outcomes. Our series included patients with refractory macular holes due to failed extended ILM peeling, failed inverted flap technique, failed autologous retinal transplant and failed epiretinal amniotic membrane transplant suggesting the technique's effectiveness in challenging refractory cases.

The three stages of eosinophilic cardiac damage: A series of case reports.

Hypereosinophilic syndrome is a rare systemic condition characterized by eosinophil-mediated organ damage. Cardiac involvement is common and typically occurs in sequential stages. We present two cases that demonstrate these different stages and presentations of eosinophilia-mediated myocardial disease, where multimodality imaging was essential for the diagnosis. More importantly, they demonstrate, for the first time, the dissociation between the eosinophil count and patients' clinical evolution, suggesting the need for close follow up even after the eosinophilia has been controlled. Learning objective: Cardiac involvement in hypereosinophilic syndrome typically occurs in three stages - necrotic, thrombotic, and fibrotic. Although cardiac damage is mediated by eosinophils, the blood eosinophil count and patients' clinical evolution are dissociated. Therefore, eosinophil count on its own is not an adequate marker of clinical evolution, and cardiac follow up should be continued even after the eosinophilia has been controlled.

Exploring the Bioactive Properties and Therapeutic Benefits of Pear Pomace.

The fruit juice industry generates a significant amount of waste, with a strong impact on the environment and the economy. Therefore, researchers have been focusing on the characterization of resources considered as food waste. This work provides information about the lipophilic and polar metabolites of pear pomace flours (PPFs) as a tool that can shed more light on the bioactive potential of this residue. Using UPLC-PDA, UPLC-FLR, and GC-MS, the study identified and quantified PPF's polar and non-polar metabolites. Essential, conditional, and non-essential amino acids were found, with asparagine being the most abundant. Isoprenoids, including lutein, zeaxanthin, and carotene isomers, ranged from 10.8 to 22.9 mg/100 g dw. Total flavonoids and phenolic compounds were 520.5-636.4 mg/100 g dw and 536.9-660.1 mg/100 g dw, respectively. Tocotrienols and tocopherols were identified, with concentrations of 173.1-347.0 mg/100 g dw and 468.7-913.4 mg/100 g dw. Fatty acids were the major non-polar compounds. All fractions significantly reduced matrix metalloproteinase-9 (MMP-9) activity. Although PPF had lower antioxidant potential (3-6 mmol Trolox/100 g dw), it inhibited AChE and BuChE by 23-30% compared to physostigmine salicylate. These findings suggest that pear pomace waste can be repurposed into functional products with valuable bioactive properties by re-introducing it in the food chain.

The Volatile Composition and the Potential Health Benefits of Different Microalgae Strains.

The use of microalgae as a food ingredient has been gaining attention in recent years due to its nutritional benefits. The main goals of this study were to (i) assess the nutritional potential of Chlorella vulgaris, Tetraselmis chuii, Microchloropsis gaditana, and Phaeodactylum tricornutum; (ii) evaluate their bioactive properties (antioxidant activity, total phenolic content, and α-amylase inhibitory activity) and (iii) assess the main volatile compounds composition. The protein content was considerably high (32-44 mg/100 g dw) for all the microalgae strains. The DPPH scavenging potential range was 14-25 mg Trolox/100 g dw (highest for T. chuii) and the ferric reducing power ability range was 13-67 µmol Trolox/dw (higher for T. chuii). The total phenolic content range was 2-7 mg of gallic acid equivalents/g dw, for M. gaditana and T. chuii, respectively, which was mainly due to the presence of catechin (1-9 µg/g dw), epicatechin (3-29 µg/g dw), and vanillic acid (1-14 µg/g dw). The ɑ-amylase inhibitory potential range was 26-42%. C. vulgaris was richer in chlorophyll a (18 mg/g dw), whilst T. chuii was particularly rich in chlorophyll b (29 mg/g dw). P. tricornutum showed the highest carotenoid content (4 mg/g dw). Aldehydes and alkanes were the major compounds identified in M. gaditana, whereas alcohols and N-based compounds existed in higher amounts in P. tricornutum. T. chuii and C. vulgaris were enriched in ketones and alkenes. This study's novelty lies in its comprehensive and integrative analysis of the nutritional, bioactive, and volatile properties of four distinct microalgae strains. By providing detailed comparisons and highlighting potential applications in functional foods, it offers a unique contribution to the field of microalgae research and its practical application in the food industry. This multifaceted approach sets it apart from existing studies, offering new insights and opportunities for leveraging microalgae as valuable food ingredients.

Dimensions of Arachnoid Bulk Ratio: A Superior Optic Nerve Sheath Index for Intracranial Pressure.

Background Discrepancies in the literature regarding optimal optic nerve sheath diameter (ONSD) cutoffs for intracranial pressure (ICP) necessitate alternative neuroimaging parameters to improve clinical management. Purpose To evaluate the diagnostic accuracy of the dimensions of the perineural subarachnoid space to the optic nerve sheath ratio, measured using US, in predicting increased ICP. Materials and Methods In a prospective cohort study from April 2022 to December 2023, patients with suspected increased ICP underwent optic nerve US to determine the dimensions of arachnoid bulk (DAB) ratio and ONSD before invasive ICP measurement. Correlation between the parameters and ICP, as well as diagnostic accuracy, was assessed using area under the receiver operating characteristic curve (AUC) analysis. Results A total of 30 participants were included (mean age, 39 years ± 14 [SD]; 24 female). The DAB ratio and ONSD were significantly larger in participants with increased ICP (38% [0.16 of 0.42] and 14% [0.82 of 6.04 mm], respectively; P < .001). The DAB ratio showed a stronger correlation with ICP than ONSD (rs = 0.87 [P < .001] vs rs = 0.61 [P < .001]). The DAB ratio and ONSD optimal cutoffs for increased ICP were 0.5 and 6.5 mm, respectively, and the ratio had higher sensitivity (100% vs 92%) and specificity (94% vs 83%) compared with ONSD. Moreover, the DAB ratio better predicted increased ICP than ONSD, with a higher AUC (0.98 [95% CI: 0.95, 1.00] vs 0.86 [95% CI: 0.71, 0.95], P = .047). Conclusion An imaging ratio was proposed to predict ICP based on the relative anatomy of the cerebrospinal fluid space, demonstrating more accurate diagnosis of increased ICP and a strong correlation with ICP values, suggesting its potential utility as a neuroimaging marker in clinical settings. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Shepherd in this issue.

The Pleural Mesothelioma Cases and Mortality in Portugal in 2014-2020: A Descriptive Study.

BACKGROUND: The incidence and mortality of pleural mesothelioma (PM) reflect the production and consumption of asbestos over time. However, despite the current global concern, these data remain to be known. OBJECTIVE: Our aim was to carry out a descriptive analysis of PM cases and mortality from some Portuguese databases between 2014 and 2020. METHODS: A retrospective observational study was carried out between 2014 and 2020. Data on the number of PM cases were provided by the Portuguese Cancer Registry, and data on mortality were from the Portuguese Death Certificate Information System. RESULTS: Between 2014 and 2020, 315 cases of PM were reported, with 222 (70.5%) men. The average age of patients was 72.1, with the highest number of cases in patients aged >70 years (n = 198; 62.9%). The highest number of cases was reported in 2018 (n = 62; 19.7%). Regarding mortality, 169 deaths were reported, with 126 (74.6%) men and mostly in individuals aged >70 years (n = 109; 64.5%). It is estimated that around 520 years of potential life were lost. The highest number of deaths occurred in 2015 (n = 33; 19.5%). CONCLUSION: It is mandatory to reinforce the need for surveillance programs that allow us to gather real and reliable data and eliminate asbestos-related diseases.

Classical and Nonclassical Nucleation Mechanisms of Insulin Crystals.

Although the Classical Nucleation Theory (CNT) is the most consensual theory to explain protein nucleation mechanisms, experimental observations during the shear-induced assays suggest that the CNT does not always describe the insulin nucleation process. This is the case at intermediate precipitant (ZnCl2) solution concentrations (2.3 mM) and high-temperature values (20 and 40 °C) as well as at low precipitant solution concentrations (1.6 mM) and low-temperature values (5 °C). In this work, crystallization events following the CNT registered at high precipitant solution concentrations (3.1 and 4.7 mM) are typically described by a Newtonian response. On the other hand, crystallization events following a nonclassical nucleation pathway seem to involve the formation of a metastable intermediate state before crystal formation and are described by a transition from Newtonian to shear-thinning responses. A dominant shear-thinning behavior (shear viscosity values ranging more than 6 orders of magnitude) is found during aggregation/agglomeration events. The rheological analysis is complemented with different characterization techniques (Dynamic Light Scattering, Energy-Dispersive Spectroscopy, Circular Dichroism, and Differential Scanning Calorimetry) to understand the insulin behavior in solution, especially during the occurrence of aggregation/agglomeration events. To the best of our knowledge, the current work is the first study describing nonclassical nucleation mechanisms during shear-induced crystallization experiments, which reveals the potential of the interdisciplinary approach herein described and opens a window for a clear understanding of protein nucleation mechanisms.

Discovery of Novel Fluorescent Azaindoles with Cytotoxic Action in A2780 Ovarian Carcinoma Cells.

Azaindole scaffold is a privileged structure in medicinal chemistry and some derivatives have demonstrated to be potential anticancer drugs. Herein, a set of novel azaindoles, comprising the four regioisomers, bearing a morpholine (azaindoles 3 a-d) and N-methyl-N-benzylamine (azaindoles 4 a-d) groups were prepared. Among these compounds, azaindoles 4 exhibited higher cytotoxicity against the ovarian cancer cell line A2780 and normal dermal fibroblasts compared to azaindoles 3. Furthermore, azaindoles 4 b and 4 c promoted a delay in the cell cycle of the cancer cell line, inspiring an investigation into the intracellular localization of these derivatives.

A unifying mechanism for seipin-mediated lipid droplet formation.

Lipid droplets (LDs) are dynamic organelles essential for cellular lipid homeostasis. Assembly of LDs occurs in the endoplasmic reticulum (ER), and the conserved ER membrane protein seipin emerged as a key player in this process. Here, we review recent advances provided by structural, biochemical, and in silico analysis that revealed mechanistic insights into the molecular role of the seipin complexes and led to an updated model for LD biogenesis. We further discuss how other ER components cooperate with seipin during LD biogenesis. Understanding the molecular mechanisms underlying seipin-mediated LD assembly is important to uncover the fundamental aspects of lipid homeostasis and organelle biogenesis and to provide hints on the pathogenesis of lipid storage disorders.

Relationship between event-related potentials and cognitive dysfunction in multiple sclerosis: A systematic review.

OBJECTIVE: This systematic review aimed to evaluate if event-related potentials (ERPs) can be a relevant tool for cognitive dysfunction diagnosis in Multiple Sclerosis (MS). METHODS: Four databases were consulted (PubMed, Embase, Scielo, and Web of Science). The included studies should include adults with clear MS diagnoses, independently of having cognitive complaints, and all should have been submitted to ERPs (P300, N400 or mismatch negativity (MMN)). The main outcomes evaluated were ERPs' amplitude and/or latency. RESULTS: 425 studies were obtained initially from all databases, with 26 studies fulfilling the eligibility criteria. P300 was the most used ERP (25 studies), showing a reduced amplitude or an increased latency in 84% of those. N400 was evaluated in one study, showing also abnormal results. MMN was addressed in two studies with inconsistent findings. Some studies further suggest that ERPs may show earlier abnormal results compared with neuropsychological tests. CONCLUSIONS: Most MS patient groups revealed ERP abnormalities, suggesting that these neurophysiological tests may be a relevant and appropriate diagnostic aid method for cognitive impairment in MS. SIGNIFICANCE: The use of ERPs in MS patients seems able to demonstrate cognitive impairment and its use should be considered as part of the regular patient evaluation.

Higher Levels of Cytokines in Patients with Chronic Limb-Threatening Ischemia.

BACKGROUND: Inflammation is a key element in the initiation and progression of peripheral arterial disease (PAD). Understanding the impact of inflammatory molecules, as cytokines in PAD could help us to improve the prognosis of these patients. The main goal of this study was to compare the serum level of cytokines between patients with claudication to those with chronic limb-threatening ischemia (CLTI). The second objective was to evaluate the relationship between the levels of cytokines and death or amputation rate. METHODS: An observational, single-center, and prospective study was conducted from January 2018 to July 2022. The study was approved by the ethical commission of the Local Hospital (75/2017). Patients with PAD, suggested by the clinical history and objective examination and confirmed with ankle-brachial index, attending vascular surgery consultations of the first author were included. The following exclusion criteria were applied: i) bedridden individuals or subjects who refused to participate in the protocol; ii) diseases responsible for body composition changes or proinflammatory state; iii) recent diet change, iv) active malignancy, v) autoimmune disease, vi) active infection, vii) chronic renal failure (glomerular filtration rate <30 mL/min/1.73 m2), or viii) heart failure in the past 3 months. This cohort was observed at admission, 3, 6, and 12 months. A panel of 27 cytokines was determined with ELISA, at baseline. RESULTS: We included 119 subjects (mean age: 67.58 ± 9.60 years old; 79.80% males), 65 patients with claudication and 54 with CLTI. From the 27 cytokines analyzed, patients with CLTI, when compared to those with claudication, had a higher serum level of 11 cytokines: IL1ra, IL-6, IL-8, IL12 p70, G-CSF, IP-10, MCP-1, MIP-1α, PDGF-ß, RANTES, and TNF-α. From the group of patients with CLTI those who underwent a major amputation had a higher serum level of FGF-basic [median = 49.04; interquartile range = 37.03-52.49; versus median = 33.04; interquartile range = 28.60-38.98; P = 0.001]. CONCLUSIONS: Patients with CLTI have higher serum level of inflammatory cytokines, which may have role in the prognosis of these patients.

Effects of high dietary inclusion of Arthrospira platensis, either extruded or supplemented with a super-dosing multi-enzyme mixture, on broiler growth performance and major meat quality parameters.

BACKGROUND: This investigation assessed the effects of high dietary inclusion of Spirulina (Arthrospira platensis) on broiler chicken growth performance, meat quality and nutritional attributes. For this, 120 male broiler chicks were housed in 40 battery brooders (three birds per brooder). Initially, for 14 days, a standard corn and soybean meal diet was administered. Subsequently, from days 14 to 35, chicks were assigned to one of the four dietary treatments (n = 10 per treatment): (1) control diet (CTR); (2) diet with 15% Spirulina (SP); (3) diet with 15% extruded Spirulina (SPE); and (4) diet with 15% Spirulina plus a super-dosing enzymes supplement (0.20% pancreatin extract and 0.01% lysozyme) (SPM). RESULTS: Throughout the experimental period, both SP and SPM diets resulted in decreased final body weight and body weight gain compared to control (p < 0.001), with the SPE diet showing comparable results to CTR. The SPE diet prompted an increase in average daily feed intake (p = 0.026). However, all microalga treatments increased the feed conversion ratio compared to CTR. Dietary inclusion of Spirulina notably increased intestinal content viscosity (p < 0.010), which was mitigated by the SPM diet. Spirulina supplementation led to lower pH levels in breast meat 24 h post-mortem and heightened the b* colour value in both breast and thigh meats (p < 0.010). Furthermore, Spirulina contributed to an increased accumulation of total carotenoids, n-3 polyunsaturated fatty acids (PUFA), and saturated fatty acids (SFA), while diminishing n-6 PUFA, thus altering the n-6/n-3 and PUFA/SFA ratios favourably (p < 0.001). However, it also reduced zinc concentration in breast meat (p < 0.001). CONCLUSIONS: The findings indicate that high Spirulina levels in broiler diets impair growth due to increased intestinal viscosity, and that extrusion pre-treatment mitigates this effect. Despite reducing digesta viscosity, a super-dosing enzyme mix did not improve growth. Data also indicates that Spirulina enriches meat with antioxidants and n-3 PUFA but reduces α-tocopherol and increases saturated fats. Reduced zinc content in meat suggests the need for Spirulina biofortification to maintain its nutritional value.

Protocol: The effect of restorative justice interventions for young people on offending and reoffending: A systematic review.

This is the protocol for a Campbell systematic review. The objectives are as follows. The primary aim of this mixed methods review is to synthesise the available evidence regarding the effectiveness of restorative justice interventions (RJIs) for reducing offending and reoffending outcomes in children and young people. We are also particularly interested in the impact of RJIs on children and young peoples' violent offending and violent reoffending. A second aim of the review is to examine whether the magnitude of effectiveness of RJIs may be influenced by study characteristics such as the population (e.g., age, ethnicity, or sex), the form of intervention (e.g., face-to-face mediation compared to family group conferencing), the place of delivery of the intervention (e.g., in independent office, in court), implementation (e.g., trained facilitators, dose, fidelity) and methodology (e.g., randomised controlled trial). The third aim of the review is to synthesise the qualitative evidence about RJ to develop a better contextual understanding of how these programmes may work and to elucidate factors that might increase the efficacy and implementation of RJ interventions. The specific research questions this systematic review aims to address are: (1) Do RJ interventions reduce children and young people's involvement in offending or reoffending relative to a comparison group? [RQ1]. (2) Is there variation in the impact of different RJ approaches on young people's involvement in offending or reoffending? [RQ2]. (3) Is there variation in the impact of RJIs on children and young people's offending or reoffending depending on the characteristics of the participants taking part in the RJI (e.g., sex, age, ethnicity)? [RQ3]. (4) What characteristics of RJIs, influence the effectiveness of RJIs for children and young people's offending and reoffending? [RQ4]. (5) What are the most notable barriers and facilitators, as reported by participants (e.g., the victims, children/young people, or mediators who have taken part in an evaluation of an RJI, or those children or young people who were meant to take part in an evaluation but ultimately did not), to the implementation of RJIs to reduce later offending or reoffending? [RQ5].

Reversion of the Inflammatory Markers in Patients With Chronic Limb-Threatening Ischemia.

BACKGROUND: Peripheral artery disease is characterized by an intense inflammatory process that can be associated with a higher mortality rate, particularly in chronic limb-threatening ischemia (CLTI). This study aims to compare the evolution of inflammatory markers between patients with claudication with those with CLTI at 3, 6, and 12 months. METHODS AND RESULTS: An observational, single-center, and prospective study was conducted. A total of 119 patients with peripheral artery disease (65 with claudication and 54 with CLTI) were observed and inflammatory markers collected at admission and 3, 6, and 12 months. At admission, patients with CLTI, when compared with patients with claudication, had significantly higher serum levels of C-reactive protein and fibrinogen (positive acute-phase proteins) and lower serum level of albumin, total cholesterol, and high-density lipoprotein (negative acute-phase proteins): C-reactive protein (g/dL), 2.90 (25th-75th percentile, 2.90-4.90) versus 6.80 (25th-75th percentile, 2.90-53.26) (P=0.000); fibrinogen (mg/dL), 293.00 (25th-75th percentile, 269.25-349.00) versus 415.50 (25th-75th percentile, 312.00-615.75) (P=0.000); total cholesterol (mg/dL), 161.79±95% [152.74-170.85] versus 146.42%±95% [135.30-157.53] (P=0.034); high-density lipoprotein (mg/dL), 50.00 (25th-75th percentile, 41.00-60.00) versus 37.00 (25th-75th percentile, 30.00-45.50) (P=0.000); albumin (g/dL): 4.00 (25th-75th percentile, 3.70-4.20) versus 3.60 (25th-75th percentile, 3.10-4.00) (P=0.003). The association between CLTI and total cholesterol was lost after adjusting for confounders. Three months after the resolution of the CLTI, there was an increase in the levels of negative acute-phase proteins and a decrease in positive acute-phase proteins. These inflammatory proteins did not register an evolution in patients with claudication. The differences in the inflammatory proteins between groups disappeared at 6 months. CONCLUSIONS: CLTI has an inflammatory environment that can be partially reverted after resolution of the ischemic process, emphasizing the importance of timely intervention.