Neonatal jaundice detection in low-resource Mexican settings: possibilities and barriers for innovation with mobile health.

BACKGROUND: Neonatal jaundice is a common condition that can lead to brain damage and disabilities when severe cases go undetected. Low- and middle-income countries often lack accurate methods for detecting neonatal jaundice and rely on visual assessment, resulting in a higher incidence of adverse consequences. Picterus Jaundice Pro (Picterus JP), an easy-to-use and affordable smartphone-based screening device for the condition, has demonstrated higher accuracy than visual assessment in Norwegian, Philippine and Mexican newborns. This study aimed to identify the barriers and facilitators to implementing Picterus JP in public health services in low-income settings in Mexico by exploring the current process of neonatal jaundice detection and stakeholders' perspectives in that context. METHODS: Qualitative data collection techniques, including one focus group, 15 semi-structured interviews and four observations, were employed in urban and rural health facilities in Oaxaca, Mexico. The participants included medical doctors, nurses and health administrators. The data were analysed by thematic analysis guided by the Consolidated Framework for Implementation Research. RESULTS: The analysis yielded four main themes: (I) the current state of neonatal care and NNJ detection, (II) the needs and desires for enhancing NNJ detection, (III) the barriers and facilitators to implementing Picterus JP in the health system and (IV) HCWs' expectations of Picterus JP. The findings identify deficiencies in the current neonatal jaundice detection process and the participants' desire for a more accurate method. Picterus JP was perceived as easy to use, useful and compatible with the work routine, but barriers to adoption were identified, including internet deficiencies and costs. CONCLUSIONS: The introduction of Picterus JP as a supporting tool to screen for neonatal jaundice is promising but contextual barriers in the setting must be addressed for successful implementation. There is also an opportunity to optimise visual assessment to improve detection of neonatal jaundice.

The Effect of Unequal Crank Arm Lengths and Cycling-Specific Prostheses for Recreational Riders with a Transtibial Amputation.

PURPOSE: We determined the effects of shorter affected side crank arm lengths and cycling with two different prostheses on joint and crank power, asymmetry, and net efficiency. METHODS: 12 participants with a TTA rode at 1.5 W·kg -1 with equal (175 mm) and shorter affected side crank arms (160, 165, 170 mm) using a daily-use prosthesis and CSP. We used statistical parametric mapping to determine differences in instantaneous joint and crank power between prostheses, and linear mixed-effects models to compare average joint and crank power, asymmetry, and net efficiency. RESULTS: Shorter affected side crank arm lengths reduced the magnitude of peak positive (p ≤ 0.001) and negative (p < 0.001) crank power on the affected side. Use of a CSP increased the magnitude of peak positive knee power (p < 0.001) and decreased the magnitude of peak negative crank power (p < 0.001) on the affected side compared to a daily-use prosthesis. Shorter affected side crank arm lengths while using a CSP reduced average hip joint (p = 0.014) and hip transfer (p = 0.025) power asymmetry from 35% to 20% and 118% to 62%, respectively. However, we found no significant differences in affected side average joint or crank power, knee joint or crank power asymmetry, or net efficiency. CONCLUSIONS: Cycling at 1.5 W·kg -1 with unequal crank arm lengths and CSPs improves hip joint power and hip transfer power asymmetry but does not alter crank asymmetry or net efficiency for recreational cyclists with a TTA.

Infrared thermography for normal endothelial function screening.

BACKGROUND: Endothelial dysfunction (ED) suspicion will allow to prevent accelerated atherosclerosis and premature death. OBJECTIVE: To establish the usefulness of thermography for endothelial function screening in adults with cardiovascular risk factors. MATERIAL AND METHODS: Cross-sectional, analytical diagnostic test. A brachial arterial diameter (BAD) increase < 11% at one-minute post-ischemia meant probable ED and was confirmed if BAD was ≥ 11% post-sublingual nitroglycerin. Thermographic photographs of the palmar region were obtained at one minute. Descriptive statistics, ROC curve, Mann-Whitney's U-test, chi-square test, or Fisher's exact test were used. RESULTS: Thirty-eight subjects with a median age of 50 years, and with 624 thermographic measurements were included. Nine had ED (flow-mediated vasodilation [FMV]: 2.5%). The best cutoff point for normal endothelial function in subjects with cardiovascular risk factors was ≥ 36 °C at one minute of ischemia, with 85% sensitivity, 70% specificity, positive and negative predictive values of 78 and 77%, area under the curve of 0.796, LR+ 2.82, LR- 0.22. CONCLUSION: An infrared thermography-measured temperature in the palmar region greater than or equal to 36 °C after one minute of ischemia is practical, non-invasive, and inexpensive for normal endothelial function screening in adults with cardiovascular risk factors.

ANTECEDENTES: La sospecha de disfunción endotelial (DE) permitirá prevenir la aterosclerosis acelerada y la muerte prematura. OBJETIVO: Establecer la utilidad de la termografía en el cribado de la función endotelial en adultos con factores de riesgo cardiovascular. MATERIAL Y MÉTODOS: Estudio transversal analítico de prueba diagnóstica. El incremento del diámetro de la arteria braquial < 11 % a un minuto posisquemia significó probable DE, confirmada si el diámetro fue ≥ 11 % posnitroglicerina sublingual. Se obtuvieron fotografías termográficas al minuto de la región palmar. Se aplicó estadística descriptiva, curva ROC, pruebas U de Mann-Whitney, chi cuadrada o exacta de Fisher. RESULTADOS: Se incluyeron 38 sujetos, mediana de edad de 50 años, con 624 mediciones termográficas; nueve presentaron DE (vasodilatación mediada por flujo de 2.5 %). El mejor punto de corte para la función endotelial normal en sujetos con factores de riesgo cardiovascular fue ≥ 36 °C al minuto de isquemia, con sensibilidad de 85%, especificidad de 70%, valores predictivos positivo y negativo de 78 y 77%, área bajo la curva de 0.796, razón de verisimilitud positiva de 2.82 y razón de verisimilitud negativa de 0.22. CONCLUSIÓN: La medición de la temperatura en la región palmar mediante termografía infrarroja ≥ 36 °C tras un minuto de isquemia es práctica, no invasiva y económica para el cribado de la función endotelial normal en adultos con factores de riesgo cardiovascular.

Coupled cluster-inspired geminal wavefunctions.

Electron pairs have an illustrious history in chemistry, from powerful concepts to understanding structural stability and reactive changes to the promise of serving as building blocks of quantitative descriptions of the electronic structure of complex molecules and materials. However, traditionally, two-electron wavefunctions (geminals) have not enjoyed the popularity and widespread use of the more standard single-particle methods. This has changed recently, with a renewed interest in the development of geminal wavefunctions as an alternative to describing strongly correlated phenomena. Hence, there is a need to find geminal methods that are accurate, computationally tractable, and do not demand significant input from the user (particularly via cumbersome and often ill-behaved orbital optimization steps). Here, we propose new families of geminal wavefunctions inspired by the pair coupled cluster doubles ansatz. We present a new hierarchy of two-electron wavefunctions that extends the one-reference orbital idea to other geminals. Moreover, we show how to incorporate single-like excitations in this framework without leaving the quasiparticle picture. We explore the role of imposing seniority restrictions on these wavefunctions and benchmark these new methods on model strongly correlated systems.

Flexible Ansatz for N-Body Perturbation Theory.

We propose a new perturbation theory framework that can be used to help with the projective solution of the Schrödinger equation for arbitrary wave functions. This Flexible Ansatz for N-body Perturbation Theory (FANPT) is based on our previously proposed Flexible Ansatz for the N-body Configuration Interaction (FANCI). We derive recursive FANPT expressions, including arbitrary orders in the perturbation hierarchy. We show that the FANPT equations are well-behaved across a wide range of conditions, including static correlation-dominated configurations and highly nonlinear wave functions.

A Novel Interaction of Nesidiocoris tenuis (Hemiptera: Miridae) as a Biological Control Agent of Bactericera cockerelli (Hemiptera: Triozidae) in Potato.

Nesidiocoris tenuis (Hemiptera: Miridae) is a generalist predator commonly used to control the whitefly Bemisia tabaci in Europe. This mirid has been found and established in South Texas, where it was initially observed feeding on nymphs of the psyllid Bactericera cockerelli (Hemiptera: Triozidae) in open tomato fields. B. cockerelli is the vector of the fastidious bacterium "Candidatus Liberibacter solanacearum" that causes diseases in several solanaceous crops, including zebra chip (ZC) disease in potatoes. There is a need to better understand how this predator impacts the control of important crop pests, such as potato psyllids. We assessed the interactions between N. tenuis and B. cockerelli in three different environmental settings. First, we estimated the numeric response of N. tenuis preying on B. cockerelli under laboratory and greenhouse conditions. Second, we evaluated the predator-prey interaction under controlled field cage conditions. Then, we exposed N. tenuis under controlled field release conditions to the natural occurrence of B. cockerelli. Finally, we assessed the compatibility between the use of N. tenuis as a biological control agent in a field study and its impact on ZC disease incidence, severity in potato tubers, and potato yield. Laboratory and greenhouse experiments resulted in diverse types of functional model responses, including exponential and linear mathematical models. Our findings revealed a significant predation effect exerted by N. tenuis, resulting in a reduction of more than fourfold in the number of B. cockerelli nymphs per cage. Specifically, the nymphal population decreased from 21 ± 3.2 in the absence of N. tenuis to 5 ± 1.6 when N. tenuis was present. Furthermore, the combination of N. tenuis with a reduced insecticide program increased potato yields, but only reduced ZC tuber incidence in one of two potato cultivars evaluated, and in one season. Findings from these studies indicate that N. tenuis could be effective as a biological control agent for B. cockerelli in potato production in South Texas. This is the first report of N. tenuis preying on immature stages of any psyllid species.

Association between systemic medication use and severity of dry eye signs and symptoms in the DRy eye assessment and management (DREAM) study.

PURPOSE: Some systemic medications are reported to be associated with dry eye disease (DED), yet their associations with the severity of DED signs and symptoms are not well studied. To evaluate these associations, we performed a secondary analysis of data from the DRy Eye Assessment and Management (DREAM) Study. METHODS: Participants (N = 535) were assessed for DED signs using tear break-up time (TBUT), Schirmer testing, corneal fluorescein staining, conjunctival lissamine green staining, meibomian gland dysfunction (MGD), and tear osmolarity and DED symptoms using the Ocular Surface Disease Index (OSDI). We derived a composite signs severity score from the 6 DED signs and categorized participant-reported systemic medications into antidepressants, antihistamines, aspirin, corticosteroids, diuretics, nonsteroidal anti-inflammatory drugs, proton pump inhibitors, statins, vitamin D3, and medications for diabetes mellitus, hypertension, hypothyroidism, migraine, and seizure. Generalized linear models were used to compare DED symptom and sign scores between medication users and non-users, with adjustment for factors associated with DED severity. RESULTS: Compared to non-users, antihistamine users had lower TBUT (p = 0.01) and higher OSDI score (p = 0.02); aspirin users had lower TBUT (p = 0.02); corticosteroid users had lower TBUT (p = 0.02), lower Schirmer test scores (p = 0.03), higher cornea fluorescein staining (p = 0.01), higher composite severity score (p = 0.01), and higher OSDI score (p = 0.03); seizure medication users had higher composite severity score (p = 0.02); vitamin D3 users had lower TBUT (p = 0.001) and greater MGD (p = 0.03); and diuretic users had less MGD (p = 0.03). CONCLUSIONS: Certain systemic medications may be associated with more severe DED. This may guide prescription practices in patients with DED.

Healthcare workers' perceptions about the use of mobile health technologies in public health facilities in Lagos, Nigeria.

Background: Mobile health has enormous potential in healthcare due to the increasing use of mobile phones in low- and middle-income countries; its effective deployment, uptake, and utilization may result in improved health outcomes, including a reduction in neonatal deaths. However, there is a suboptimal uptake of mobile health technologies among healthcare workers in low-resource settings like Nigeria, which are often context-specific. Objective: To investigate healthcare workers' perceptions of mobile health technologies in public health facilities in Lagos, Nigeria. Method: A qualitative study was conducted, and data were collected through six focus group discussions with 26 healthcare workers (doctors, nurses, and community health extension workers) from three public health facilities in Lagos, Nigeria. The collected data were analyzed using a thematic approach, where themes and subthemes were created. Results: Although the participants acknowledged that mobile health enhances patient-provider communication and saves time, they identified altering of healthcare workers' routine practices, information overload, power and network failure, skepticism, lack of trust, and concerns over diagnostic accuracy as potential barriers to its uptake. Conclusion: Addressing healthcare workers' perceptions of mobile health technologies may enhance the deployment and uptake of such solutions in Nigeria and similar low-resource settings. Developers and implementers of such can use them to create new or enhance existing mobile health solutions to better meet the needs and requirements of healthcare workers in low- to middle-income health settings, such as Lagos, Nigeria.

Maximum velocity and leg-specific ground reaction force production change with radius during flat curve sprinting.

Humans attain slower maximum velocity (vmax) on curves versus straight paths, potentially due to centripetal ground reaction force (GRF) production, and this depends on curve radius. Previous studies found GRF production differences between an athlete's inside versus outside leg relative to the center of the curve. Further, sprinting clockwise (CW) versus counterclockwise (CCW) slows vmax. We determined vmax, step kinematics and individual leg GRF on a straight path and on curves with 17.2 and 36.5 m radii for nine (8 male, 1 female) competitive sprinters running CW and CCW and compared vmax with three predictive models. We combined CW and CCW directions and found that vmax slowed by 10.0±2.4% and 4.1±1.6% (P<0.001) for the 17.2 and 36.5 m radius curves versus the straight path, respectively. vmax values from the predictive models were up to 3.5% faster than the experimental data. Contact length was 0.02 m shorter and stance average resultant GRF was 0.10 body weights (BW) greater for the 36.5 versus 17.2 m radius curves (P<0.001). Stance average centripetal GRF was 0.10 BW greater for the inside versus outside leg (P<0.001) on the 36.5 m radius curve. Stance average vertical GRF was 0.21 BW (P<0.001) and 0.10 BW (P=0.001) lower for the inside versus outside leg for the 17.2 and 36.5 m radius curves, respectively. For a given curve radius, vmax was 1.6% faster in the CCW compared with CW direction (P=0.003). Overall, we found that sprinters change contact length and modulate GRFs produced by their inside and outside legs as curve radius decreases, potentially limiting vmax.

Influence of visceral adiposity on cardiovascular risk in patients with systemic sclerosis.

Systemic sclerosis (SSc) is an autoimmune disease characterized by systemic inflammation, endothelial dysfunction, generalized fibrosis and high cardiovascular mortality. The evaluation of cardiovascular risk through the visceral adiposity index (VAI) has been helpful due to its direct relationship to the body and visceral fat percentage. We evaluated the influence of body composition and anthropometrics on cardiovascular risk as measured by VAI in healthy controls (HC) and SSc. An analytical cross-sectional study of 66 participants (33 SSc and 33 HC), mean age 52.7 ± 10, 95% women, was conducted from August 2020 to January 2021. Inclusion criteria in cases were consecutive patients with SSc (ACR/EULAR 2013), 63.6% were diffuse cutaneous (dcSS) subtype, and 36.4 were limited cutaneous (lcSS) subtype. HC was matched by age and gender. Serum lipid profiles and InBody anthropometrics were analyzed and compared. We performed descriptive statistics, bivariate analysis with Student's t, or Mann-Whitney U, correlation and chi-square according to the variable type and distribution. Total cholesterol was significantly higher in SSc than HC (345 vs 194, p = < 0.001). The BMI was higher in HC (26.2 vs 28.9, p < 0.001). Kilograms of muscle (19.8 vs 28.9, p < 0.001) and total fat (23.4 vs 28.9, p < 0.001) were lower in SSc patients compared to HC. VAI was similar when BMI < 25, but significantly higher when BMI > 25 in SSc than in HC (3 vs 1.9, p = 0.030). The increase in BMI at overweight or obese in SSc is associated with a significant increase in cardiovascular risk.

Compreensão de crianças e pré-adolescentes sobre forças de caráter: um estudo qualitativo / La comprensión de niños y pre-adolescentes sobre las fortalezas de carácter: un estudio cualitativo / Children and pre-adolescents' comprehension of character strengths: a qualitative study

RESUMO. Este estudo tem por objetivo analisar o conhecimento de crianças e pré-adolescentes em relação aos termos que designam as forças de caráter e compreender como percebem a expressão desses traços nos próprios comportamentos e nos de outras pessoas. Foram entrevistados 17 participantes, de oito a 13 anos (M = 10,6; DP = 1,5). Para cada força foram feitas sete perguntas, que investigavam a definição do termo e exemplos da expressão da força nos outros e nos próprios entrevistados. As entrevistas foram gravadas e transcritas para análise de conteúdo, ao fim gerando categorias para cada força. As forças descritas com maior facilidade pelos participantes e suas respectivas definições foram criatividade (capacidade de criar coisas), curiosidade e amor ao aprendizado (busca de conhecimento e novas experiências), honestidade (falar a verdade), amor (comportamento de dar carinho), bondade (ajudar e cuidar do outro), trabalho em equipe (realização de trabalhos colaborativos em brincadeiras ou atividades escolares), perdão (08 categorias a respeito de sua definição, sem destaque para alguma) e esperança (desejar acontecimento futuro). Esses achados podem tornar mais acessível o desenvolvimento e a avaliação das forças nessa faixa etária.

RESUMEN. Este estudio buscó analizar el conocimiento de niños y pre-adolescentes sobre los términos que fueron designados como fortalezas de carácter, y comprender cómo perciben estos rasgos en sus proprios comportamientos y en los de otras personas. Diecisiete participantes entre ocho y trece años fueron entrevistados (M = 10.6; SD = 1.5). Para cada fortaleza, se hicieron siete preguntas, que investigaron la definición del término y ejemplos prácticos de su expresión. Las entrevistas fueron grabadas y transcritas para el análisis de contenido, creando categorías para cada fortaleza. Las fortalezas descritas por los participantes con mayor facilidad y sus respectivas definiciones fueron: creatividad (capacidad de crear cosas), curiosidad y amor por el aprendizaje (búsqueda de conocimiento y nuevas experiencias), honestidad (decir la verdad), amor (comportamientos afectivos), amabilidad (ayudar y cuidar a los demás), trabajo en equipo (desempeño del trabajo colaborativo en juegos o actividades escolares), perdón (ocho categorías con respecto a su definición, sin énfasis en ninguna) y esperanza (deseo por un evento futuro). Estos hallazgos pueden facilitar el desarrollo y la evaluación de las fortalezas con este grupo de edad.

ABSTRACT This study aims to analyze the children and pre-adolescents' knowledge regarding terms that designate character strengths and to understand how they perceive the expression of these traits in their and other people's behavior. Seventeen participants aged eight to thirteen were interviewed (M = 10.6; SD = 1.5). For each strength, seven questions were asked, which investigated the definition and examples of the strength expression. The interviews were recorded and transcribed for content analysis, generating categories for each strength. The strengths most easily described by the participants and their respective definitions were: creativity (ability to create things), curiosity and love for learning (searching for knowledge and new experiences), honesty (speaking the truth), love (acts involving affection), kindness (helping and caring for others), teamwork (collaborative works in games or school activities), forgiveness (eight categories regarding their definition, without highlighting any) and hope (longing for a future event). These findings may make developing and evaluating character strengths in this age group more accessible.

Widespread Deviant Patterns of Heterozygosity in Whole-Genome Sequencing Due to Autopolyploidy, Repeated Elements, and Duplication.

Most population genomic tools rely on accurate single nucleotide polymorphism (SNP) calling and filtering to meet their underlying assumptions. However, genomic complexity, resulting from structural variants, paralogous sequences, and repetitive elements, presents significant challenges in assembling contiguous reference genomes. Consequently, short-read resequencing studies can encounter mismapping issues, leading to SNPs that deviate from Mendelian expected patterns of heterozygosity and allelic ratio. In this study, we employed the ngsParalog software to identify such deviant SNPs in whole-genome sequencing (WGS) data with low (1.5×) to intermediate (4.8×) coverage for four species: Arctic Char (Salvelinus alpinus), Lake Whitefish (Coregonus clupeaformis), Atlantic Salmon (Salmo salar), and the American Eel (Anguilla rostrata). The analyses revealed that deviant SNPs accounted for 22% to 62% of all SNPs in salmonid datasets and approximately 11% in the American Eel dataset. These deviant SNPs were particularly concentrated within repetitive elements and genomic regions that had recently undergone rediploidization in salmonids. Additionally, narrow peaks of elevated coverage were ubiquitous along all four reference genomes, encompassed most deviant SNPs, and could be partially associated with transposons and tandem repeats. Including these deviant SNPs in genomic analyses led to highly distorted site frequency spectra, underestimated pairwise FST values, and overestimated nucleotide diversity. Considering the widespread occurrence of deviant SNPs arising from a variety of sources, their important impact in estimating population parameters, and the availability of effective tools to identify them, we propose that excluding deviant SNPs from WGS datasets is required to improve genomic inferences for a wide range of taxa and sequencing depths.

Panmixia in the American eel extends to its tropical range of distribution: Biological implications and policymaking challenges.

The American eel (Anguilla rostrata) has long been regarded as a panmictic fish and has been confirmed as such in the northern part of its range. In this paper, we tested for the first time whether panmixia extends to the tropical range of the species. To do so, we first assembled a reference genome (975 Mbp, 19 chromosomes) combining long (PacBio and Nanopore and short (Illumina paired-end) reads technologies to support both this study and future research. To test for population structure, we estimated genotype likelihoods from low-coverage whole-genome sequencing of 460 American eels, collected at 21 sampling sites (in seven geographic regions) ranging from Canada to Trinidad and Tobago. We estimated genetic distance between regions, performed ADMIXTURE-like clustering analysis and multivariate analysis, and found no evidence of population structure, thus confirming that panmixia extends to the tropical range of the species. In addition, two genomic regions with putative inversions were observed, both geographically widespread and present at similar frequencies in all regions. We discuss the implications of lack of genetic population structure for the species. Our results are key for the future genomic research in the American eel and the implementation of conservation measures throughout its geographic range. Additionally, our results can be applied to fisheries management and aquaculture of the species.

Boosting the Hydrodeoxygenation Activity and Selectivity of Ni/(M)-SBA-15 Catalysts by Chemical Alteration of the Support.

The influence of the acid sites in the hydrodeoxygenation of anisole performed over Ni catalysts supported on SBA-15 modified with metal oxides (Ni/M-SBA-15, M = Ti, Zr, Al, or Nb) was demonstrated. Catalysts were characterized by SEM-EDX, nitrogen physisorption, XRD, UV-visible DRS, TPR, TPD of ammonia, IR-Py, O2 chemisorption, and high-resolution transmission electron microscopy. The mesoporous structure and the hexagonal arrangement of the supports were maintained in the catalysts. Ni catalysts supported on modified M-SBA-15 exhibited a higher metal-support interaction, an increase in the acidity and, as a consequence, improved selectivity to cyclohexane. The deoxygenation reaction rate constants increased as Ni/SBA-15 < Ni/Ti-SBA-15 < Ni/Nb-SBA-15 < Ni/Zr-SBA-15 < Ni/Al-SBA-15, which is attributed to the increase in the amount and strength of acid sites, especially of the Brønsted ones, which promotes the cleavage of the C-O bond. It is also important to keep the metal/acid sites together to obtain high activity and selectivity to hydrodeoxygenated products.

Psychological distress, anxiety, depression, stress level, and coping style in HIV-pregnant women in Mexico.

PURPOSE: To evaluate the presence of psychological distress (PD) and its association with the mental health and coping styles of pregnant women living with HIV (PWLWH). METHOD: An observational, cross-sectional descriptive study was performed. Seventy-three PWLWH were included. Patients responded to a psychometric battery for PD, depression, anxiety, stress, and coping style evaluation. The scales used in the study were: Goldberg's 30-item General Health Questionnaire (GHQ-30), State-Trait Anxiety Inventory (STAI), Zung Depression Self-Measurement Scale (ZDS), Nowack Stress Profile, Lazarus and Folkman's Coping Styles Questionnaire. RESULTS: PD was observed in 31.5% of the participants. PD-positive patients showed a higher probability of presenting traits of depression and anxiety and medium/high stress levels. Besides, they preferentially used emotion-focused coping styles. CONCLUSION: PD is associated with a higher probability of presenting anxiety and depression in PWLWH. Emotion-focused coping style could be a factor in decision-making associated with risk behaviors in PWLWH.

A psychometric study of an executive function assessment instrument (TDI-FE).

BACKGROUND: This study aims to present and discuss the psychometric properties of executive functions, which were measured using the TDI-FE instrument. The analysis encompasses its internal structure, potential sensitivity to fatigue factors, relationships with external criteria, and diagnostic accuracy. METHODS: The study sample comprised 382 students from Brazil, aged 6-8 years. Child development variables were screened using the TDI-FE and gold standard tests (Cancellation Attention and Trail Making Tests). The proposed scale comprised four activities: a test with fruit images with three tasks, and one memory game. RESULTS: The one-factor model of EF of the TDI-FE failed to fit to the data. However, fit substantially improved once a latent fatigue factor was controlled in the model. The latent factor of EF assessed by the TDI-FE tasks was coherently associated with a series of external variables, including two popular collateral measures of EF. The diagnostic accuracy was reasonable, and a cut-off of 37 points produced 70% of sensitivity and 60% of specificity. CONCLUSION: Results indicated that the TDI-FE demonstrated sound psychometric properties and diagnostic accuracy, then consisting of an efficient alternative for the assessment of EFs in early childhood education. The study also proved the need to control for response biases such as fatigue in the latent variable models of EF. The TDI-FE is notable because of its low cost and easy application, and it might fulfill a need for instruments for individuals from different contexts at this stage of development in Brazil.

In-hospital mortality and associated factors in patients with systemic lupus erythematosus: analysis over more than 11 years in a reference hospital center.

Systemic lupus erythematosus (SLE) is a disease that affects the immune system, and it can lead to increased morbidity and mortality. The primary causes of mortality for individuals with SLE are disease activity, infections, drug toxicity, and other health conditions. The aim of this study is to estimate the mortality rate of patients with SLE who are hospitalized, describe the causes of death, and identify factors associated with mortality. The study was conducted at a referral hospital from 2009 to 2021, utilizing a nested case-control design. The records of patients with SLE who were hospitalized in the Department of Rheumatology were reviewed. Cases were identified as individuals who died during their hospitalization, while controls were those who were discharged alive during the same period. Elective hospitalizations were not included in the study. The primary causes of death were recorded, and demographic, clinical, laboratory, and immunological variables were analyzed as potential risk factors associated with in-hospital mortality. The study included 105 patients who died while hospitalized and 336 who were discharged alive. The estimated mortality rate was 10.93 deaths per 1000 hospital admissions per year. The leading causes of death were SLE activity (20%), infections (34.2%), or a combination of both (24.8%). Risk factors associated with in-hospital mortality were any infection (OR 2.5, CI 95% 1.2-5.2), nosocomial infections (OR 5.0, CI 95% 1.8-13.7), SLEDAI-2K > 2 (OR 2.0, CI 95% 1.02-3.8), lymphopenia (OR 2.1, CI 95% 1.01-4.6), anemia (OR 2.9, CI 95% 1.4-5.7), and thrombocytopenia (OR 3.3, CI 95% 1.7-6.4). Disease activity and infections, particularly nosocomial infections, are significant causes of mortality in hospitalized patients with SLE. Furthermore, hematological manifestations play a significant role in in-hospital mortality for these patients.

Association of Emotional Self-Regulation with Psychological Distress and Positive Functioning Dimensions in Brazilian University Students during the COVID-19 Pandemic.

Emotional self-regulation is a relevant factor for human development capable of minimizing emotional difficulties in the face of adverse events, as was particularly useful during the COVID-19 pandemic. The present study aimed to evaluate emotional self-regulation in Brazilian health science university students and its relationship with positive psychology constructs (subjective well-being, hope, optimism, spirituality, self-compassion, and self-efficacy) and psychological distress (depression, anxiety, and stress). This was a prospective, cross-sectional, observational, analytic study of 1062 Brazilian undergraduate students with data collected using self-administered online questionnaires. Students in the first years of their undergraduate degree programs had significantly higher dysregulation scores than those in the final years. Multiple linear regression yielded a model that explained 71.8% of the variation in emotion dysregulation. The correlations of emotion dysregulation were significant and strong, scoring negatively with self-compassion, optimism, and subjective well-being and positively with psychological distress.

Cognition in older adults with healthy aging: analysis of the Mexican Health and Aging Study 2012-2015.

Introduction: Maintaining older adults' health and well-being can be achieved through the optimization of physical and mental health, while preserving independence, social participation, and quality of life. Cognitive change has been described as a normal process of aging and it involves domains such as processing speed, attention, memory, language, visuospatial abilities, and executive functioning, among others. Objective: To describe cognitive changes in older adults with healthy aging. Methods: This is a study that involved data from 14,893 and 14,154 individuals aged >60 years or older from the 2012 and 2015 waves, respectively, who participated in the Mexican Health and Aging Study (MHAS). Participants with healthy aging were identified and described in the MHAS-2012 wave and followed to 2015. Eight cognitive domains evaluated in the Cross-Cultural Cognitive Evaluation (CCCE,) as well as sociodemographic and health characteristics, were described. Criteria for healthy aging involved the following: CCCE ≥ -1.5 standard deviations above the mean on reference norms, independence on basic and instrumental activities of daily living, self-reported "life close to ideal," and preserved functional and social performance. Results: From a total of n = 9,160 older adults from the MHAS-2012 wave, n = 1,080 (11.8%) had healthy aging. In the healthy aging group, the median age was 67 years (IQR: 63-73), 58.1% were female and the median for education was 6 (IQR: 3-8) years. The mean CCCE score was 57 (SD: 16.9) points. In the MHAS-2012 cross-sectional analysis, except for orientation, visuospatial abilities, and verbal fluency, all cognitive domain scores were lower with passing age. When comparing cognitive domain scores in the 225 older adults identified with healthy aging between the 2012 and 2015 MHAS waves, there were almost no observable differences. Conclusion: In the cross-sectional analysis, Mexican adults with healthy aging had lower scores in the verbal learning memory, visual scanning, numeracy, visual memory, and verbal recall domains', as well as lower global cognitive scores in the higher age groups. There were no cognitive changes in the 3 year follow-up, except for a lower gradient of scores in the verbal recall memory domain. Longer prospective studies are needed to characterize greater cognitive changes.

Metabolic behavior for a mutant Oenococcus oeni strain with high resistance to ethanol to survive under oenological multi-stress conditions.

Malolactic fermentation (MLF) positively influences the quality of the wine, and it occurs as a result of a lactic acid bacteria's metabolism, mainly of the Oenococcus oeni species. However, delays and halting of MLF are frequent problems in the wine industry. This is mainly because O. oeni's development is inhibited by different kinds of stress. Even though the sequencing of the genome of the PSU-1 strain of O. oeni, as well as other strains, has made it possible to identify genes involved in the resistance to some types of stress, all of the factors that could be involved are still unknown. With the aim of contributing to this knowledge, the random mutagenesis technique was used in this study as a strategy for genetic improvement of strains of the O. oeni species. The technique proved to be capable of generating a different and improved strain when compared to the PSU-1 strain (the parent from which it descends). Then, we evaluated the metabolic behavior of both strains in three different wines. We used synthetic MaxOeno wine (pH 3.5; 15% v/v ethanol), red wine (Cabernet Sauvignon), and white wine (Chardonnay). Furthermore, we compared the transcriptome of both strains, grown in MaxOeno synthetic wine. The specific growth rate of the E1 strain was on average 39% higher in comparison to the PSU-1 strain. Interestingly, E1 strain showed an overexpression of the OEOE_1794 gene, which encodes a UspA-like protein, which has been described as promoting growth. We observed that the E1 strain was able to convert, on average, 34% more malic acid into lactate than the PSU-1 strain, regardless of the wine being used. On the other hand, the E1 strain showed a flux rate of fructose-6-phosphate production that was 86% higher than the mannitol production rate, and the internal flux rates increase in the direction of pyruvate production. This coincides with the higher number of OEOE_1708 gene transcripts observed in the E1 strain grown in MaxOeno. This gene encodes for an enzyme fructokinase (EC 2.7.1.4) involved in the transformation of fructose to fructose-6-phosphate.