TPPP-BRD9 fusion-related gallbladder carcinomas are frequently associated with intracholecystic neoplasia, neuroendocrine carcinoma, and a distinctive small tubular-type adenocarcinoma commonly accompanied with a syringomatous pattern.

A fusion between tubulin polymerization-promoting protein (TPPP), a regulatory cytoskeletal gene, and the chromatin remodeling factor, bromodomain-containing protein 9 (BRD9), TPPP-BRD9 fusion has been found in rare cancer cases, including lung and gallbladder cancers (GBC). In this study, we investigated the histopathological features of 16 GBCs previously shown by RNA sequencing to harbor the TPPP-BRD9 fusion. Findings in the fusion-positive GBCs were compared with 645 GBC cases from the authors' database. Among the 16 TPPP-BRD9 fusion-positive GBC cases, most were females (F:M = 7:1) of Chinese ethnicity (12/16), whereas the remaining cases were from Chile. The histopathological examination showed the following findings: 1) Intracholecystic neoplasm (ICN) in 7/15 (47% vs. 7% 645 reference GBCs, p < 0.001), all with gastro-pancreatobiliary phenotype, often with clear cell change, and in the background of pyloric gland metaplasia and extensive high-grade dysplasia. 2) Neuroendocrine carcinoma (NEC) morphology: 3 cases (27% vs. 4.6% in the reference database, p = 0.001) showed a sheet-like and nested/trabecular growth pattern of monotonous cells with salt-and-pepper chromatin characteristic of NECs. Two were large cell type, one had prominent clear cell features, a rare finding in GBNECs; the other one had relatively bland, well-differentiated morphology, and the remaining case was small cell type. 3) Adenocarcinoma identified in 8 cases had a distinctive pattern characterized by widely separated small, round tubular units with relatively uniform nuclei in a fashion seen in mesonephric adenocarcinomas, including hobnail-like arrangement and apical snouts, reminiscent of tubular carcinomas of the breast in many areas. In some foci, the epithelium was attenuated, and glands were elongated, some with comma shapes, which along with the mucinous/necrotic intraluminal debris created a "syringoid" appearance. 4) Other occasional patterns included the cribriform, glomeruloid patterns, and metaplastic tubular-spindle cell pattern accompanied by hemorrhage. In conclusion, TPPP-BRD9 fusion-positive GBCs often develop through intracholecystic neoplasms (adenoma-carcinoma sequence) of gastro-pancreatobiliary lineage, appear more prone to form NEC morphology and have a propensity to display clear cell change. Invasive adenocarcinomas arising in this setting often seem to display a distinctive appearance that we tentatively propose as the TPPP-BRD9 fusion-positive pattern of GBC.

Correction: Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions.

[This corrects the article DOI: 10.1371/journal.pone.0237979.].

Simple and Fast Prediction of Gestational Diabetes Mellitus Based on Machine Learning and Near-Infrared Spectra of Serum: A Proof of Concept Study at Different Stages of Pregnancy.

Gestational diabetes mellitus (GDM) is a hyperglycemic state that is typically diagnosed by an oral glucose tolerance test (OGTT), which is unpleasant, time-consuming, has low reproducibility, and results are tardy. The machine learning (ML) predictive models that have been proposed to improve GDM diagnosis are usually based on instrumental methods that take hours to produce a result. Near-infrared (NIR) spectroscopy is a simple, fast, and low-cost analytical technique that has never been assessed for the prediction of GDM. This study aims to develop ML predictive models for GDM based on NIR spectroscopy, and to evaluate their potential as early detection or alternative screening tools according to their predictive power and duration of analysis. Serum samples from the first trimester (before GDM diagnosis) and the second trimester (at the time of GDM diagnosis) of pregnancy were analyzed by NIR spectroscopy. Four spectral ranges were considered, and 80 mathematical pretreatments were tested for each. NIR data-based models were built with single- and multi-block ML techniques. Every model was subjected to double cross-validation. The best models for first and second trimester achieved areas under the receiver operating characteristic curve of 0.5768 ± 0.0635 and 0.8836 ± 0.0259, respectively. This is the first study reporting NIR-spectroscopy-based methods for the prediction of GDM. The developed methods allow for prediction of GDM from 10 µL of serum in only 32 min. They are simple, fast, and have a great potential for application in clinical practice, especially as alternative screening tools to the OGTT for GDM diagnosis.

Statin use is not associated with inflammation among Chilean women of Mapuche and non-Mapuche ancestry with gallstones.

Aim: Statins are associated with lower risk of gallstones due to anti-inflammatory effects. We assessed whether statins impact circulating inflammation among Chilean women with gallstones. Materials & methods: 200 Mapuche women were matched on statin use and age to 200 non-Mapuche women in the Chile Biliary Longitudinal Study. We analyzed 92 inflammatory biomarkers using multivariable-adjusted regression models, random forests and pathway analyses. Results: Statins were not significantly associated with any inflammation marker when women were analyzed jointly or stratified by ancestry. No significant associations were found through random forest methods and pathway analyses. Discussion: We did not find significant associations between statin use and inflammation markers in women with gallstones, suggesting that statins do not reduce inflammation once gallstones have formed.

Statins are prescribed to lower cholesterol and can also decrease the risk of gallstone formation by reducing inflammation. We assessed whether statin use reduces inflammation among women who have already developed gallstones. We analyzed 92 inflammation markers among 400 women in Chile, including 200 women with Mapuche Amerindian ancestry and 200 women of Latina/European ancestry. We found that statin use was not correlated with inflammation in this group of women overall nor by ancestry. This may mean that statin use does not reduce inflammation in women who already were diagnosed with gallstones.

Biodegradation of Polystyrene by Galleria mellonella: Identification of Potential Enzymes Involved in the Degradative Pathway.

Galleria mellonella is a lepidopteran whose larval stage has shown the ability to degrade polystyrene (PS), one of the most recalcitrant plastics to biodegradation. In the present study, we fed G. mellonella larvae with PS for 54 days and determined candidate enzymes for its degradation. We first confirmed the biodegradation of PS by Fourier transform infrared spectroscopy- Attenuated total reflectance (FTIR-ATR) and then identified candidate enzymes in the larval gut by proteomic analysis using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Two of these proteins have structural similarities to the styrene-degrading enzymes described so far. In addition, potential hydrolases, isomerases, dehydrogenases, and oxidases were identified that show little similarity to the bacterial enzymes that degrade styrene. However, their response to a diet based solely on polystyrene makes them interesting candidates as a potential new group of polystyrene-metabolizing enzymes in eukaryotes.

Adenomyomas of the Gallbladder: An Analysis of Frequency, Clinicopathologic Associations, and Relationship to Carcinoma of a Malformative Lesion.

CONTEXT.­: The nature and associations of gallbladder (GB) "adenomyoma" (AM) remain controversial. Some studies have attributed up to 26% of GB carcinoma to AMs. OBJECTIVE.­: To examine the true frequency, clinicopathologic characteristics, and neoplastic changes in GB AM. DESIGN.­: Cholecystectomy cohorts analyzed were 1953 consecutive cases, prospectively with specific attention to AM; 2347 consecutive archival cases; 203 totally embedded GBs; 207 GBs with carcinoma; and archival search of institutions for all cases diagnosed as AM. RESULTS.­: Frequency of AM was 9.3% (19 of 203) in totally submitted cases but 3.3% (77 of 2347) in routinely sampled archival tissue. A total of 283 AMs were identified, with a female to male ratio = 1.9 (177:94) and mean size = 1.3 cm (range, 0.3-5.9). Most (96%, 203 of 210) were fundic, with formed nodular trabeculated submucosal thickening, and were difficult to appreciate from the mucosal surface. Four of 257 were multifocal (1.6%), and 3 of 257 (1.2%) were extensive ("adenomyomatosis"). Dilated glands (up to 14 mm), often radially converging to a point in the mucosa, were typical. Muscle was often minimal, confined to the upper segment. Nine of 225 (4%) revealed features of a duplication. No specific associations with inflammation, cholesterolosis, intestinal metaplasia, or thickening of the uninvolved GB wall were identified. Neoplastic change arising in AM was seen in 9.9% (28 of 283). Sixteen of 283 (5.6%) had mural intracholecystic neoplasm; 7 of 283 (2.5%) had flat-type high-grade dysplasia/carcinoma in situ. Thirteen of 283 cases had both AM and invasive carcinoma (4.6%), but in only 5 of 283 (1.8%), carcinoma arose from AM (invasion was confined to AM, and dysplasia was predominantly in AM). CONCLUSIONS.­: AMs have all the features of a malformative developmental lesion, and may not show a significant muscle component (ie, the name "adeno-myoma" is partly a misnomer). While most are innocuous, some pathologies may arise in AMs, including intracholecystic neoplasms, flat-type high-grade dysplasia or carcinoma in situ, and invasive carcinoma (1.8%, 5 of 283). It is recommended that gross examination of GBs include serial slicing of the fundus for AM detection and total submission if one is found.

Citizen scientists study beach litter along 12,000 km of the East Pacific coast: A baseline for the International Plastic Treaty.

Anthropogenic Marine Litter (AML) accumulating on beaches causes damage to coastal ecosystems and high costs to local communities. Volunteers sampled AML on 130 beaches along the central and southern East Pacific coasts, with AML densities ranging from 0.46 to 2.26 items m-2 in the different countries. AML composition was dominated by plastics and cigarette butts, the latter especially in Mexico and Chile. The accumulation of AML in the upper zones of the beaches and substantial proportions of cigarette butts, glass and metal pointed mainly to local sources. Statistical modelling of litter sources on continental beaches revealed that tourism, access and related infrastructure (e.g. parking lots) best explained AML densities, while plastic densities were also influenced by the distance from river mouths and national Gross Domestic Product. Large-scale monitoring can be a useful tool to evaluate the effectiveness of public policies that should primarily focus on land sources.

Cuidados en salud humanizados: Construyendo camino desde la universidad

Introducción: La formación de estudiantes de la salud sobre buen trato y cuidado humanizado es fundamental, al ser un referente de calidad en la atención sanitaria. Lo anterior, debería ser coherente con el trato que reciben los estudiantes por parte de docentes y tutores clínicos, modelando culturas más humanizadas. Sin embargo, investigaciones evidencian la normalización del maltrato a estudiantes de medicina y enfermería. Se implementó una Unidad de Formación Humanizada en una escuela de enfermería chilena, que incluyó potenciar un Programa de acompañamiento a los estudiantes por parte de sus docentes entre 2020 y 2021. Objetivo: Indagar los impactos del Programa en el ejercicio de un cuidado humanizado, desde la perspectiva estudiantil. Material y Método: Estudio de caso intrínseco con enfoque cualitativo. Se realizaron 12 entrevistas semiestructuradas vía zoom a jóvenes que habían sido tutorizados virtualmente, por docentes del Programa entre 1 mes y 2 años durante su período estudiantil. Análisis de datos con el método de las comparaciones constantes y cumplimiento de criterios de rigor cualitativo. Resultados: El Programa tuvo impactos positivos en ámbitos personales, académicos y profesionales, permitiendo que los estudiantes se sintieran cuidados por sus docentes y reconociendo el desarrollo de habilidades transferibles a su relación con los usuarios para un cuidado más humanizado. Conclusiones: El Programa es replicable a otras carreras e instituciones, requiriendo tiempo, disposición y capacitación docente, lo cual puede ser una limitación. Los beneficios evidenciados justifican la utilidad del Programa para potenciar culturas de cuidado más humanizado en espacios educativos y sanitarios.

Background: The training of health students regarding good treatment and humanized care is essential; it is a quality benchmark in health care. The relevance of good treatment and humanized care should be consistent with the treatment students receive from teachers and clinical tutors, modeling humanized cultures. However, research shows the normalization of mistreatment of medical and nursing students. A Humanized Training Unit was implemented in a Chilean nursing school, which included promoting a support Program for students by their teachers between 2020 and 2021. Aim: Explore the Program's impact on the exercise of humanized care from the student's perspective. Material and Methods: An intrinsic case study with a qualitative approach, with the objective of 12 semi-structured interviews carried out via Zoom with young people who had been tutored virtually by program teachers for one month and two years during their student period. We performed the data analysis using the constant comparisons method and in compliance with qualitative rigor criteria. Results: The Program positively impacted personal, academic, and professional areas, allowing students to feel cared for by their teachers and recognizing the development of skills transferable to their relationship with users for more humanized care. Conclusions: The Program is replicable to other careers and institutions, requiring time, disposition, and teacher training, which can be a limitation. The benefits evidenced by our study demonstrate the program's usefulness in promoting cultures of more humanized care in educational and health spaces.

Evaluation of trefoil factor 3 as a non-invasive biomarker of gastric intestinal metaplasia and gastric cancer in a high-risk population / Evaluación de Trefoil factor 3 como un biomarcador no invasivo para la detección de metaplasia intestinal y cáncer gástrico en una población de alto riesgo

Background: Adenocarcinoma is preceded by chronic atrophic gastritis, gastric intestinal metaplasia and dysplasia. Trefoil factor 3 (TFF3) is a peptide secreted by goblet cells, which is abundantly present in intestinal metaplasia. Aim: To evaluate the utility of serum TFF3 as a non-invasive biomarker for the diagnosis of intestinal metaplasia and gastric cancer. Methods: Single-center, cross-sectional study of 274 patients who consecutively underwent upper gastrointestinal endoscopy with gastric biopsies (updated Sydney system). TFF3 levels were measured in serum by a commercial ELISA kit. Patients with normal histology or chronic atrophic gastritis without intestinal metaplasia comprised the control group. In addition, 14 patients with invasive gastric cancer were included as a reference group. The association between TFF3 levels and intestinal metaplasia was assessed by logistic regression. Results: Patients with intestinal metaplasia (n=110) had a higher median TFF3 level as compared to controls (n=164), 13.1 vs. 11.9ng/mL, respectively (p=0.024). Multivariable logistic regression showed a no significant association between TFF3 levels and intestinal metaplasia (OR=1.20; 95%CI: 0.87–1.65; p-trend=0.273). The gastric cancer group had a median TFF3 level of 20.5ng/mL, and a significant association was found (OR=3.26; 95%CI: 1.29–8.27; p-trend=0.013). Conclusion: Serum levels of TFF3 do not discriminate intestinal metaplasia in this high-risk Latin American population. Nevertheless, we confirmed an association between TFF3 levels and invasive gastric cancer.(AU)

Introducción: El adenocarcinoma gástrico es precedido por la gastritis crónica atrófica, metaplasia intestinal y displasia gástrica. Trefoil factor 3 (TFF3) es un péptido secretado por las células caliciformes, que están abundantemente presentes en la metaplasia intestinal. Objetivo: Evaluar la utilidad de TFF3 sérico como biomarcador no invasivo para el diagnóstico de metaplasia intestinal y cáncer gástrico. Métodos: Estudio transversal, de 274 pacientes a los que se les realizó endoscopia digestiva alta consecutivamente con biopsias gástricas (sistema Sydney actualizado). Los niveles de TFF3 se midieron en suero mediante un kit de ELISA comercial. Los pacientes con histología normal o gastritis crónica atrófica sin metaplasia intestinal formaron el grupo control. Además, se incluyeron como grupo de referencia 14 pacientes con cáncer gástrico avanzado. La asociación entre los niveles de TFF3 y la metaplasia intestinal se evaluó mediante una regresión logística. Resultados: Los pacientes con metaplasia intestinal (n=110) presentaron una mediana de TFF3 más alta en comparación con el grupo control (n=164), 13,1 vs. 11,9ng/ml, respectivamente (p=0,024). Sin embargo, la regresión logística multivariable no mostró una asociación significativa entre los niveles de TFF3 y la metaplasia intestinal (OR=1,20; IC95%: 0,87-1,65; p-trend=0,273). El grupo de cáncer gástrico tuvo una mediana significativamente mayor de TFF3 de 20,5ng/ml (OR=3,26; IC95%: 1,29-8,27; p-trend=0,013). Conclusión: Los niveles séricos de TFF3 no permiten el diagnóstico no invasivo de metaplasia intestinal en esta población latinoamericana de alto riesgo. La asociación entre los niveles de TFF3 y el cáncer gástrico avanzado fue confirmada.(AU)

Whole tumour cell-based vaccines: tuning the instruments to orchestrate an optimal antitumour immune response.

Immunotherapy, particularly those based on immune checkpoint inhibitors (ICIs), has become a useful approach for many neoplastic diseases. Despite the improvements of ICIs in supporting tumour regression and prolonging survival, many patients do not respond or develop resistance to treatment. Thus, therapies that enhance antitumour immunity, such as anticancer vaccines, constitute a feasible and promising therapeutic strategy. Whole tumour cell (WTC) vaccines have been extensively tested in clinical studies as intact or genetically modified cells or tumour lysates, injected directly or loaded on DCs with distinct adjuvants. The essential requirements of WTC vaccines include the optimal delivery of a broad battery of tumour-associated antigens, the presence of tumour cell-derived molecular danger signals, and adequate adjuvants. These factors trigger an early and robust local innate inflammatory response that orchestrates an antigen-specific and proinflammatory adaptive antitumour response capable of controlling tumour growth by several mechanisms. In this review, the strengths and weaknesses of our own and others' experiences in studying WTC vaccines are revised to discuss the essential elements required to increase anticancer vaccine effectiveness.

Machine learning applied in maternal and fetal health: a narrative review focused on pregnancy diseases and complications.

Introduction: Machine learning (ML) corresponds to a wide variety of methods that use mathematics, statistics and computational science to learn from multiple variables simultaneously. By means of pattern recognition, ML methods are able to find hidden correlations and accomplish accurate predictions regarding different conditions. ML has been successfully used to solve varied problems in different areas of science, such as psychology, economics, biology and chemistry. Therefore, we wondered how far it has penetrated into the field of obstetrics and gynecology. Aim: To describe the state of art regarding the use of ML in the context of pregnancy diseases and complications. Methodology: Publications were searched in PubMed, Web of Science and Google Scholar. Seven subjects of interest were considered: gestational diabetes mellitus, preeclampsia, perinatal death, spontaneous abortion, preterm birth, cesarean section, and fetal malformations. Current state: ML has been widely applied in all the included subjects. Its uses are varied, the most common being the prediction of perinatal disorders. Other ML applications include (but are not restricted to) biomarker discovery, risk estimation, correlation assessment, pharmacological treatment prediction, drug screening, data acquisition and data extraction. Most of the reviewed articles were published in the last five years. The most employed ML methods in the field are non-linear. Except for logistic regression, linear methods are rarely used. Future challenges: To improve data recording, storage and update in medical and research settings from different realities. To develop more accurate and understandable ML models using data from cutting-edge instruments. To carry out validation and impact analysis studies of currently existing high-accuracy ML models. Conclusion: The use of ML in pregnancy diseases and complications is quite recent, and has increased over the last few years. The applications are varied and point not only to the diagnosis, but also to the management, treatment, and pathophysiological understanding of perinatal alterations. Facing the challenges that come with working with different types of data, the handling of increasingly large amounts of information, the development of emerging technologies, and the need of translational studies, it is expected that the use of ML continue growing in the field of obstetrics and gynecology.

Evaluation of first and second trimester maternal thyroid profile on the prediction of gestational diabetes mellitus and post load glycemia.

Maternal thyroid alterations have been widely associated with the risk of gestational diabetes mellitus (GDM). This study aims to 1) test the first and the second trimester full maternal thyroid profile on the prediction of GDM, both alone and combined with non-thyroid data; and 2) make that prediction independent of the diagnostic criteria, by evaluating the effectiveness of the different maternal variables on the prediction of oral glucose tolerance test (OGTT) post load glycemia. Pregnant women were recruited in Concepción, Chile. GDM diagnosis was performed at 24-28 weeks of pregnancy by an OGTT (n = 54 for normal glucose tolerance, n = 12 for GDM). 75 maternal thyroid and non-thyroid parameters were recorded in the first and the second trimester of pregnancy. Various combinations of variables were assessed for GDM and post load glycemia prediction through different classification and regression machine learning techniques. The best predictive models were simplified by variable selection. Every model was subjected to leave-one-out cross-validation. Our results indicate that thyroid markers are useful for the prediction of GDM and post load glycemia, especially at the second trimester of pregnancy. Thus, they could be used as an alternative screening tool for GDM, independently of the diagnostic criteria used. The final classification models predict GDM with cross-validation areas under the receiver operating characteristic curve of 0.867 (p<0.001) and 0.920 (p<0.001) in the first and the second trimester of pregnancy, respectively. The final regression models predict post load glycemia with cross-validation Spearman r correlation coefficients of 0.259 (p = 0.036) and 0.457 (p<0.001) in the first and the second trimester of pregnancy, respectively. This investigation constitutes the first attempt to test the performance of the whole maternal thyroid profile on GDM and OGTT post load glycemia prediction. Future external validation studies are needed to confirm these findings in larger cohorts and different populations.

Evaluation of trefoil factor 3 as a non-invasive biomarker of gastric intestinal metaplasia and gastric cancer in a high-risk population.

BACKGROUND: Adenocarcinoma is preceded by chronic atrophic gastritis, gastric intestinal metaplasia and dysplasia. Trefoil factor 3 (TFF3) is a peptide secreted by goblet cells, which is abundantly present in intestinal metaplasia. AIM: To evaluate the utility of serum TFF3 as a non-invasive biomarker for the diagnosis of intestinal metaplasia and gastric cancer. METHODS: Single-center, cross-sectional study of 274 patients who consecutively underwent upper gastrointestinal endoscopy with gastric biopsies (updated Sydney system). TFF3 levels were measured in serum by a commercial ELISA kit. Patients with normal histology or chronic atrophic gastritis without intestinal metaplasia comprised the control group. In addition, 14 patients with invasive gastric cancer were included as a reference group. The association between TFF3 levels and intestinal metaplasia was assessed by logistic regression. RESULTS: Patients with intestinal metaplasia (n=110) had a higher median TFF3 level as compared to controls (n=164), 13.1 vs. 11.9ng/mL, respectively (p=0.024). Multivariable logistic regression showed a no significant association between TFF3 levels and intestinal metaplasia (OR=1.20; 95%CI: 0.87-1.65; p-trend=0.273). The gastric cancer group had a median TFF3 level of 20.5ng/mL, and a significant association was found (OR=3.26; 95%CI: 1.29-8.27; p-trend=0.013). CONCLUSION: Serum levels of TFF3 do not discriminate intestinal metaplasia in this high-risk Latin American population. Nevertheless, we confirmed an association between TFF3 levels and invasive gastric cancer.

Reappraisal of T1b gallbladder cancer (GBC): clinicopathologic analysis of 473 in situ and invasive GBCs and critical review of the literature highlights its rarity, and that it has a very good prognosis.

There are highly conflicting data on relative frequency (2-32%), prognosis, and management of pT1b-gallbladder carcinoma (GBC), with 5-year survival ranging from > 90% in East/Chile where cholecystectomy is regarded as curative, versus < 50% in the West, with radical operations post-cholecystectomy being recommended by guidelines. A total of 473 in situ and invasive extensively sampled GBCs from the USA (n = 225) and Chile (n = 248) were re-evaluated histopathologically per Western invasiveness criteria. 349 had invasive carcinoma, and only 24 were pT1. Seven cases previously staged as pT1b were re-classified as pT2. There were 19 cases (5% of all invasive GBCs) qualified as pT1b and most pT1b carcinomas were minute (< 1mm). One patient with extensive pTis at margins (but pT1b focus away from the margins) died of GBC at 27 months, two died of other causes, and the remainder were alive without disease (median follow-up 69.9 months; 5-year disease-specific survival, 92%). In conclusion, careful pathologic analysis of well-sampled cases reveals that only 5% of invasive GBCs are pT1b, with a 5-year disease-specific survival of > 90%, similar to findings in the East. This supports the inclusion of pT1b in the "early GBC" category, as is typically done in high-incidence regions. Pathologic mis-staging of pT2 as pT1 is not uncommon. Cases should not be classified as pT1b unless extensive, preferably total, sampling of the gallbladder to rule out a subtle pT2 is performed. Critical appraisal of the literature reveals that the Western guidelines are based on either SEER or mis-interpretation of stage IB cases as "pT1b." Although the prognosis of pT1b-GBC is very good, additional surgery (radical cholecystectomy) may be indicated, and long-term surveillance of the biliary tract is warranted.

[Humanization of Assistance; Building the path from the university]. / Cuidados en salud humanizados: Construyendo camino desde la universidad.

BACKGROUND: The training of health students regarding good treatment and humanized care is essential; it is a quality benchmark in health care. The relevance of good treatment and humanized care should be consistent with the treatment students receive from teachers and clinical tutors, modeling humanized cultures. However, research shows the normalization of mistreatment of medical and nursing students. A Humanized Training Unit was implemented in a Chilean nursing school, which included promoting a support Program for students by their teachers between 2020 and 2021. AIM: Explore the Program's impact on the exercise of humanized care from the student's perspective. MATERIAL AND METHODS: An intrinsic case study with a qualitative approach, with the objective of 12 semi-structured interviews carried out via Zoom with young people who had been tutored virtually by program teachers for one month and two years during their student period. We performed the data analysis using the constant comparisons method and in compliance with qualitative rigor criteria. RESULTS: The Program positively impacted personal, academic, and professional areas, allowing students to feel cared for by their teachers and recognizing the development of skills transferable to their relationship with users for more humanized care. CONCLUSIONS: The Program is replicable to other careers and institutions, requiring time, disposition, and teacher training, which can be a limitation. The benefits evidenced by our study demonstrate the program's usefulness in promoting cultures of more humanized care in educational and health spaces.

Machine learning-based models for gestational diabetes mellitus prediction before 24-28 weeks of pregnancy: A review.

Gestational Diabetes Mellitus (GDM) is a hyperglycemia state that impairs maternal and offspring health, short and long-term. It is usually diagnosed at 24-28 weeks of pregnancy (WP), but at that time the fetal phenotype is already altered. Machine learning (ML)-based models have emerged as an auspicious alternative to predict this pathology earlier, however, they must be validated in different populations before their implementation in routine clinical practice. This review aims to give an overview of the ML-based models that have been proposed to predict GDM before 24-28 WP, with special emphasis on their current validation state and predictive performance. Articles were searched in PubMed. Manuscripts written in English and published before January 1, 2022, were considered. 109 original research studies were selected, and categorized according to the type of variables that their models involved: medical, i.e. clinical and/or biochemical parameters; alternative, i.e. metabolites, peptides or proteins, micro-ribonucleic acid molecules, microbiota genera, or other variables that did not fit into the first category; or mixed, i.e. both medical and alternative data. Only 8.3 % of the reviewed models have had validation in independent studies, with low or moderate performance for GDM prediction. In contrast, several models that lack of independent validation have shown a very high predictive power. The evaluation of these promising models in future independent validation studies would allow to assess their performance on different populations, and continue their way towards clinical implementation. Once settled, ML-based models would help to predict GDM earlier, initiate its treatment timely and prevent its negative consequences on maternal and offspring health.

Anomalous (Exergonic) Behavior in the Transfer of Electrons between Donors and Acceptors: Mobility, Energy, Caloric Capacity, and Entropy.

Understanding the kinetics of electron transfer reactions involves active research in physics, chemistry, biology, and nano-tech. Here, we propose a model to apply in a broader framework by establishing a connection between thermodynamics and kinetics. From a purely thermodynamic point of view, electronic transfer Marcus' theory is revisited; consequently, calculations of thermodynamic variables such as mobility, energy, and entropy are provided. More significantly, two different regimes are explicitly established. In the anomalous region, an exergonic process associated with negative heat capacity appears. Further, in the same region, mobility, energy, and entropy decrease when the temperature increases.

Microplastic pollution on the soil and its consequences on the nitrogen cycle: a review.

Microplastics (MPs) correspond to plastics between 0.1 µm and 5 mm in diameter, and these can be intentionally manufactured to be microscopic or generated from the fragmentation of larger plastics. Currently, MP contamination is a complicated subject due to its accumulation in the environment. They are a novel surface and a source of nutrients in soils because MPs can serve as a substrate for the colonization of microorganisms. Its presence in soil triggers physical (stability of aggregates, soil bulk density, and water dynamics), chemical (nutrients availability, organic matter, and pH), and biological changes (microbial activity and soil fauna). All these changes alter organic matter degradation and biogeochemical cycles such as the nitrogen (N) cycle, which is a key predictor of ecological stability and management in the terrestrial ecosystem. This review aims to explore how MPs affect the N cycle in the soil, the techniques to detect it in soil, and their effects on the physicochemical and biological parameters, emphasizing the impact on the main bacterial groups, genes, and enzymes associated with the different stages of the N cycle.

Physical and anthropogenic drivers shaping the spatial distribution of microplastics in the marine sediments of Chilean fjords.

Several studies have focused on the presence and distribution of microplastics within the water column of coastal waters, but the dynamics of these particles in sediments have received little attention. Here we examine the concentrations and characteristics of microplastics in sediment samples collected from 35 stations within the Inner Sea of Chiloé, Chilean Patagonia. Current velocity, grain size, intensity of salmon farming activities, and human population density were all evaluated as factors potentially explaining concentrations and distribution of microplastic particles within these sediments. Microplastics were detected in all samples, with the highest abundance represented by fibers (88%), fragments (10%) and films (2%). Across the sampled sites, microplastic concentrations averaged 72.2 ± 32.4 (SD) items per kg dw (dry weight) sediment, with the principal polymers identified as polyethylene terephthalate (PET), acrylic, polypropylene (PP) and polyurethane (PUR). Approximately 40% of the variability in distribution and abundance of microplastics was explained by current velocity combined with proximity and intensity of local salmon production activities. SYNOPSIS: Marine currents and aquaculture intensity explain abundance and dynamics of microplastics in marine sediments.

Do the heel-rise test and isometric strength improve after Achilles tendon repair using Dresden technique?

BACKGROUND: Achilles' tendon ruptures result in impaired plantar flexion strength and endurance. It is interesting to know the plantar flexion strength, the number of heel-rise repetitions, and the maximal calf circumference following Achilles' tendon ruptures repair. METHODS: Both the injured and non-injured legs of thirty male patients with Achilles' tendon ruptures treated with the percutaneous Dresden technique were compared with the ankle function of 30 healthy participants. Rehabilitation involved partial weight-bearing for three weeks and then increased to full weight-bearing and ankle exercises. RESULTS: The injured legs had weaker plantar flexion strength (1.64 ± 0.17 Nm/kg) compared with the non-injured legs (1.91 ± 0.24 Nm/kg; p = 0.002) and the healthy participants' legs (1.93 ± 0.32 Nm/kg; p < 0.001). The non-injured leg had greater ability in doing heel-rise repetitions (39.4 ± 6.1 rep.) compared with the injured legs (37.2 ± 5.7 rep.; p < 0.023) and the healthy participants' legs (31.0 ± 13.0 rep.; p < 0.001). CONCLUSIONS: The injured leg had not recovered full isometric strength but had improved heel-rise repetition.