Comparing the Chemistry of Malvidin-3-O-glucoside and Malvidin-3,5-O-diglucoside Networks: A Holistic Approach to the Acidic and Basic Paradigms with Implications in Biological Studies.

The kinetics, thermodynamics, and degradation of malvidin mono- and diglucosides were studied following a holistic approach by extending to the basic medium. In acidic conditions, the reversible kinetics of the flavylium cation toward the equilibrium is controlled by the hydration and cis-trans isomerization steps, while in the basic medium, the OH- nucleophilic addition to the anionic quinoidal bases is the slowest step. There is a pH range (transition pHs), between the acidic and basic paradigms, that includes physiological pH (7.4), where degradation reactions occur faster, preventing the system from reaching the equilibrium. The transition pH of the diglucoside is narrower, and in contrast with the monoglucoside, there is no evidence for the formation of colored oligomers among the degradation products. Noteworthy, OH- addition in position 4 to form B42-, a kinetic product that decreases the overall equilibration rate, was observed only for the diglucoside.

Early Impairment of Paracrine and Phenotypic Features in Resident Cardiac Mesenchymal Stromal Cells after Thoracic Radiotherapy.

Radiotherapy-induced cardiac toxicity and consequent diseases still represent potential severe late complications for many cancer survivors who undergo therapeutic thoracic irradiation. We aimed to assess the phenotypic and paracrine features of resident cardiac mesenchymal stromal cells (CMSCs) at early follow-up after the end of thoracic irradiation of the heart as an early sign and/or mechanism of cardiac toxicity anticipating late organ dysfunction. Resident CMSCs were isolated from a rat model of fractionated thoracic irradiation with accurate and clinically relevant heart dosimetry that developed delayed dose-dependent cardiac dysfunction after 1 year. Cells were isolated 6 and 12 weeks after the end of radiotherapy and fully characterized at the transcriptional, paracrine, and functional levels. CMSCs displayed several altered features in a dose- and time-dependent trend, with the most impaired characteristics observed in those exposed in situ to the highest radiation dose with time. In particular, altered features included impaired cell migration and 3D growth and a and significant association of transcriptomic data with GO terms related to altered cytokine and growth factor signaling. Indeed, the altered paracrine profile of CMSCs derived from the group at the highest dose at the 12-week follow-up gave significantly reduced angiogenic support to endothelial cells and polarized macrophages toward a pro-inflammatory profile. Data collected in a clinically relevant rat model of heart irradiation simulating thoracic radiotherapy suggest that early paracrine and transcriptional alterations of the cardiac stroma may represent a dose- and time-dependent biological substrate for the delayed cardiac dysfunction phenotype observed in vivo.

Correction: Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses.

[This corrects the article DOI: 10.1371/journal.pone.0281680.].

Hemodynamic implications of mitral annular calcification in patients undergoing transcatheter aortic valve implantation for severe aortic stenosis.

PURPOSES: Predicting hemodynamic changes of stenotic mitral valve (MV) lesions with mitral annular calcification (MAC) following transcatheter aortic valve implantation (TAVI) may inform clinical decision-making. This study aimed to investigate the association between the MAC severity quantified by computed tomography (CT) and changes in mean transmitral gradient (mTMG), mitral valve area (MVA) and stroke volume index (SVi) following TAVI. METHODS AND RESULTS: A total of 708 patients (median age 81, 52% male) with severe aortic stenosis (AS) underwent pre-procedural CT and pre- and post-TAVI transthoracic echocardiography. According to the classification of MAC severity determined by CT, 299 (42.2%) patients had no MAC, 229 (32.3%) mild MAC, 102 (14.4%) moderate MAC, and 78 (11.0%) severe MAC. After adjusting for age and sex, there was no significant change in mTMG following TAVI (Δ mTMG = 0.07 mmHg, 95% CI -0.10 to 0.23, P = 0.92) for patients with no MAC. In contrast, patients with mild MAC (Δ mTMG = 0.21 mmHg, 95% CI 0.01 to 0.40, P = 0.018), moderate MAC (Δ mTMG = 0.31 mmHg, 95% CI 0.02 to 0.60, P = 0.019) and severe MAC (Δ mTMG = 0.43 mmHg, 95% CI 0.10 to 0.76, P = 0.0012) had significant increases in mTMG following TAVI, with greater changes associated with increasing MAC severity. In contrast, there was no significant change in MVA or SVi following TAVI. CONCLUSION: In patients with severe AS undergoing TAVI, MAC severity was associated with greater increases in post-procedural mTMG whereas MVA or SVi remained unchanged. MAC severity should be considered for potential subsequent MV interventions if TAVI does not improve symptoms.

Parabens as environmental contaminants of aquatic systems affecting water quality and microbial dynamics.

Among different pollutants of emerging concern, parabens have gained rising interest due to their widespread detection in water sources worldwide. This occurs because parabens are used in personal care products, pharmaceuticals, and food, in which residues are generated and released into aquatic environments. The regulation of the use of parabens varies across different geographic regions, resulting in diverse concentrations observed globally. Concentrations of parabens exceeding 100 µg/L have been found in wastewater treatment plants and surface waters while drinking water (DW) sources typically exhibit concentrations below 6 µg/L. Despite their low levels, the presence of parabens in DW is a potential exposure route for humans, raising concerns for both human health and environmental microbiota. Although a few studies have reported alterations in the functions and characteristics of microbial communities following exposure to emerging contaminants, the impact of the exposure to parabens by microbial communities, particularly biofilm colonizers, remains largely understudied. This review gathers the most recent information on the occurrence of parabens in water sources, as well as their effects on human health and aquatic organisms. The interactions of parabens with microbial communities are reviewed for the first time, filling the knowledge gaps on the effects of paraben exposure on microbial ecosystems and their impact on disinfection tolerance and antimicrobial resistance, with potential implications for public health.

Intra- and interlaboratory reproducibility of the RIATOL qPCR HPV genotyping assay.

The implementation of cervical screening based on human papillomavirus (HPV) continues to progress rapidly across countries. Evidence has shown that assays detecting high-risk human papillomavirus (hrHPV) deoxyribonucleic acid (DNA) are more effective than cytology-based screening. Validation of new hrHPV DNA assays requires both noninferior clinical accuracy compared to a standard comparator for cervical precancer and good reproducibility. This study builds upon previous diagnostic accuracy assessments of the RIATOL HPV genotyping qPCR assay and aims to evaluate the international validation criteria for reproducibility. The intra- and interreproducibility of the RIATOL-qPCR assay were assessed using 550 remnant cervical cell material from the cytology archive of the National Reference Center for HPV in Belgium. Specimens were collected in the context of cervical cancer screening and tested in two different laboratories. The international reproducibility criteria include the lower bound of 95% confidence interval of the intra- and interlaboratory agreement regarding the detection of hrHPV DNA exceeding 87% with kappa ≥0.50. The RIATOL-qPCR assay demonstrated excellent intralaboratory reproducibility, achieving an overall agreement of 98.2 (95% CI 96.6-99.1%) and a kappa of 0.96. Interlaboratory testing showed an overall agreement of 98.5 (95% CI 97.1-99.4%) with a kappa of 0.97. The RIATOL-qPCR assay fulfills the third criterion for HPV test reproducibility requirement for use in cervical cancer screening.

Clinical validation of the Neonatal Skin Condition Score with Portuguese newborns.

OBJECTIVE: Clinically validate the Neonatal Skin Condition Score - Portuguese version with Portuguese newborns, verifying if the risk of skin injury in this population is influenced by their condition. METHOD: Observational, cross-sectional and methodological study, conducted from 2018 to 2021. The Neonatal Skin Risk Assessment Scale - Portuguese version and Neonatal Skin Condition Score were used in data collection. Of the latter, content validation and sensitivity of the items were improved. MANOVA was used to evaluate whether the effect of independent variables (intrinsic and extrinsic factors) on dependent variables (score of both scales) was statistically significant. Non-random sampling (n=167). RESULTS: The items showed good sensitivity. MANOVA revealed that the factors had a significant effect on the scores of the two scales. CONCLUSION: The comparison of the scales shows clinical validity, revealing that better skin condition corresponds to a lower risk of injury, and the two scales can be applied concomitantly.

Glossopharyngeal neuralgia with cardioinhibitory syncope: Is a permanent pacemaker required?

Glossopharyngeal neuralgia is a rare facial pain syndrome, which in more rare cases can be associated with syncope. We present the outcome of a case report that combines this rare association that received medical therapy with anti-epileptic medication and permanent dual chamber pacemaker implantation. In this case, syncope episodes were associated with both vasodepressor and cardioinhibitory reflex syncope types. The patient found relief from syncope, hypotension, and pain after initiation of anti-epileptic therapy. Although a dual chamber pacemaker was implanted, the pacemaker interrogation revealed no requirement for pacing at one-year follow-up. As far as we know, this is the first case that reports pacemaker interrogation during follow-up and, taking into account the absence of pacemaker activation at one-year follow-up, the device was not needed to prevent bradycardia and syncope episodes. This case report supports the current guidelines for pacing in neurocardiogenic syncope, by demonstrating a lack of requirement for pacing in the event of both cardioinhibitory and vasodepressor responses.

Translation, validity, and reliability of the European Portuguese version of the Touch Experiences and Attitudes Questionnaire.

Background: Positive touch experiences have proved to be extremely important throughout our lifespan, with cascading effects on our social life. However, few questionnaires are available to measure attitudes and experiences of touch in the Portuguese population. This study aimed to translate and validate the European Portuguese version of the Touch Experiences and Attitudes Questionnaire (TEAQ), as a reliable and valid instrument to measure different aspects of affective touch experiences and attitudes. Methods: Therefore, an online sample of 384 (299 females and 85 males) participants, aged between 18 and 75 years (M = 24.59; SD = 9.56) was collected. Multidimensional Rasch model and confirmatory factor analysis were carried out, and also reliability and convergent and discriminant validity were determined. In addition, we examined sex differences in attitudes and experiences of touch. Results: Results showed good fit indexes for the 52-item six-factor model structure (friends and family touch, current intimate touch, childhood touch, attitudes to self-care, attitudes to intimate touch, and attitudes to unfamiliar touch). This instrument also showed good reliability and acceptable convergent and discriminant validity. Significant sex differences were found, with female participants reporting more positive touch experiences (including childhood touch, friends and family touch, and current intimate touch) and a more favourable attitude to self-care, with males showing a more positive attitude towards unfamiliar touch. Regarding attitudes towards the intimate touch, scores for both groups were comparable. Conclusion: Overall, the European Portuguese version of the TEAQ presented good psychometric properties and appears to be a reliable and valid self-report measure, being a useful and beneficial instrument in research and clinical settings.

Exploring the Potential of Vine Shoots as a Source of Valuable Extracts and Stable Lignin Nanoparticles for Multiple Applications.

Large amounts of vine shoots are generated every year during vine pruning. This residue still presents many of the compounds found in the original plant, including low molecular weight phenolic compounds and structural compounds such as cellulose, hemicellulose, and lignin. For wine-producing regions, the challenge is to develop alternatives that will increase the value of this residue. This work proposes the full valorization of vine shoots, focusing on the extraction of lignin by mild acidolysis for the preparation of nanoparticles. The effect of the pretreatment solvents (ethanol/toluene, E/T, and water/ethanol, W/E), on the chemical and structural features of lignin, was evaluated. The chemical analysis suggests similar composition and structure regardless of the pretreatment solvent, although lignin isolated after pretreatment of biomass with E/T showed a higher content of proanthocyanidins (11%) compared with W/E (5%). Lignin nanoparticles (LNPs) presented an average size ranging from 130-200 nm and showed good stability for 30 days. Lignin and LNPs showed excellent antioxidant properties (half maximal inhibitory concentration, IC50 0.016-0.031 mg/mL) when compared to commercial antioxidants. In addition, extracts resulting from biomass pretreatment showed antioxidant activity, with W/E presenting a lower IC50 (0.170 mg/mL) than E/T (0.270 mg/mL), correlated with the higher polyphenol content of W/E, with (+)-catechin and (-)-epicatechin being the main compounds detected. Overall, this work shows that the pre-treatment of vine shoots with green solvents can yield (i) the production of high-purity lignin samples with antioxidant properties and (ii) phenolic-rich extracts, promoting the integral reuse of this byproduct and contributing to sustainability.

Ultraviolet C irradiation: A promising approach for the disinfection of public spaces?

Ultraviolet irradiation C (UVC) has emerged as an effective strategy for microbial control in indoor public spaces. UVC is commonly applied for air, surface, and water disinfection. Unlike common 254 nm UVC, far-UVC at 222 nm is considered non-harmful to human health, being safe for occupied spaces, and still effective for disinfection purposes. Therefore, and allied to the urgency to mitigate the current pandemic of SARS-CoV-2, an increase in UVC-based technology devices appeared in the market with levels of pathogens reduction higher than 99.9 %. This environmentally friendly technology has the potential to overcome many of the limitations of traditional chemical-based disinfection approaches. The novel UVC-based devices were thought to be used in public indoor spaces such as hospitals, schools, and public transport to minimize the risk of pathogens contamination and propagation, saving costs by reducing manual cleaning and equipment maintenance provided by manpower. However, a lack of information about UVC-based parameters and protocols for disinfection, and controversies regarding health and environmental risks still exist. In this review, fundamentals on UVC disinfection are presented. Furthermore, a deep analysis of UVC-based technologies available in the market for the disinfection of public spaces is addressed, as well as their advantages and limitations. This comprehensive analysis provides valuable inputs and strategies for the development of effective, reliable, and safe UVC disinfection systems.

Percutaneous versus surgical revascularization of unprotected left main coronary artery: Data from the Portuguese Registry of Acute Coronary Syndromes (ProACS).

BACKGROUND: In acute coronary syndromes (ACS), the optimal revascularization strategy for unprotected left main coronary artery (ULMCA) culprit lesion has been under-investigated. Therefore, we compared clinical characteristics and short- and medium-term outcomes of percutaneous and surgical revascularization in ACS. METHODS AND RESULTS: Of 31886 patients enrolled in a multicenter, national, prospective registry study between October 2010 and December 2020, 246 (0.8%) had ULMCA as a culprit lesion and underwent percutaneous coronary intervention (PCI) alone (n=133, 54%) or coronary artery bypass grafting (CABG) alone (n=113, 46%). Patients undergoing PCI presented more frequently ongoing chest pain (68% versus 41%, p<0.001) and cardiogenic shock (25% versus 1%, p<0.001). Time from admission to revascularization was higher in surgical group with a median time to CABG of 4.5 days compared to 0 days to PCI (p<0.001). Angiographic success rate was 93.2% in patients who underwent PCI. Primary endpoint (all-cause death, non-fatal reinfarction and/or non-fatal stroke during hospitalization) occurred in 15.9% of patients and was more frequent in the PCI group (p<0.001). After adjustment, surgical revascularization was associated with better in-hospital prognosis (odds ratio (OR) 0.164; 95% confidence interval (CI), 0.04-0.64; p=0.009). Similar results were achieved after propensity score matching. No difference was found at one-year all-cause death. CONCLUSION: Percutaneous coronary intervention was the most common revascularization strategy in the ACS with ULMCA culprit lesion. PCI was preferred in unstable patients and presented a high angiographic success. CABG was often delayed and preferred in low-risk patients. At one-year follow-up, PCI and CABG conferred a similar prognosis. The two approaches appear complementary in this high risk cohort.

Impact of parabens on drinking water bacteria and their biofilms: The role of exposure time and substrate materials.

Parabens have been detected in drinking water (DW) worldwide, however, their impact on DW microbial communities remains to be explored. Microorganisms can easily adapt to environmental changes. Therefore, their exposure to contaminants of emerging concern, particularly parabens, in DW distribution systems (DWDS) may affect the microbiological quality and safety of the DW reaching the consumers tap. This work provides a pioneer evaluation of the effects of methylparaben (MP), propylparaben (PP), butylparaben (BP), and their combination (MIX), in bacterial biofilms formed on different surfaces, representative of DWDS materials - high-density polyethylene (HDPE), polypropylene (PPL) and polyvinyl chloride (PVC). Acinetobacter calcoaceticus and Stenotrophomonas maltophilia, isolated from DW, were used to form single and dual-species biofilms on the surface materials selected. The exposure to MP for 7 days caused the most significant effects on biofilms, by increasing their cellular culturability, density, and thickness up to 233%, 150%, and 224%, respectively, in comparison to non-exposed biofilms. Overall, more pronounced alterations were detected for single biofilms than for dual-species biofilms when HDPE and PPL, demonstrating that the surface material used affected the action of parabens on biofilms. Swimming motility and the production of virulence factors (protease and gelatinase) by S. maltophilia were increased up to 141%, 41%, and 73%, respectively, when exposed to MP for 7 days. The overall results highlight the potential of parabens to interfere with DW bacteria in planktonic state and biofilms, and compromise the DW microbiological quality and safety.

Capturing the attentional response to clinical auditory alarms: An ERP study on priority pulses.

Clinical auditory alarms are often found in hospital wards and operating rooms. In these environments, regular daily tasks can result in having a multitude of concurrent sounds (from staff and patients, building systems, carts, cleaning devices, and importantly, patient monitoring devices) which easily amount to a prevalent cacophony. The negative impact of this soundscape on staff and patients' health and well-being, as well as in their performance, demand for accordingly designed sound alarms. The recently updated IEC60601-1-8 standard, in guidance for medical equipment auditory alarms, proposed a set of pointers to distinctly convey medium or high levels of priority (urgency). However, conveying priority without compromising other features, such as ease of learnability and detectability, is an ongoing challenge. Electroencephalography, a non-invasive technique for measuring the brain response to a given stimulus, suggests that certain Event-Related Potentials (ERPs) components such as the Mismatch Negativity (MMN) and P3a may be the key to uncovering how sounds are processed at the pre-attentional level and how they may capture our attention. In this study, the brain dynamics in response to the priority pulses of the updated IEC60601-1-8 standard was studied via ERPs (MMN and P3a), for a soundscape characterised by the repetition of a sound (generic SpO2 "beep"), usually present in operating and recovery rooms. Additional behavioural experiments assessed the behavioural response to these priority pulses. Results showed that the Medium Priority pulse elicits a larger MMN and P3a peak amplitude when compared to the High Priority pulse. This suggests that, at least for the applied soundscape, the Medium Priority pulse is more easily detected and attended at the neural level. Behavioural data supports this indication, showing significantly shorter reaction times for the Medium Priority pulse. The results pose the possibility that priority pointers of the updated IEC60601-1-8 standard may not be successfully conveying their intended priority levels, which may not only be due to design properties but also to the soundscape in which these clinical alarms are deployed. This study highlights the need for intervention in both hospital soundscapes and auditory alarm design settings.

Clinical validation of the Neonatal Skin Condition Score with Portuguese newborns / Validación clínica de la Neonatal Skin Condition Score con recién nacidos portugueses / Validação clínica da Neonatal Skin Condition Score com recém-nascidos portugueses

ABSTRACT Objective: Clinically validate the Neonatal Skin Condition Score - Portuguese version with Portuguese newborns, verifying if the risk of skin injury in this population is influenced by their condition. Method: Observational, cross-sectional and methodological study, conducted from 2018 to 2021. The Neonatal Skin Risk Assessment Scale - Portuguese version and Neonatal Skin Condition Score were used in data collection. Of the latter, content validation and sensitivity of the items were improved. MANOVA was used to evaluate whether the effect of independent variables (intrinsic and extrinsic factors) on dependent variables (score of both scales) was statistically significant. Non-random sampling (n=167). Results: The items showed good sensitivity. MANOVA revealed that the factors had a significant effect on the scores of the two scales. Conclusion: The comparison of the scales shows clinical validity, revealing that better skin condition corresponds to a lower risk of injury, and the two scales can be applied concomitantly.

RESUMEN Objetivo: Validar clínicamente el Neonatal Skin Condition Score - versión portuguesa con recién nacidos portugueses, comprobando si el riesgo de lesión cutánea en esta población está influenciado por su condición. Método: Estudio observacional, transversal y metodológico, realizado de 2018 a 2021. En la recolección de datos se utilizaron el Neonatal Skin Condition Score - versión portuguesa y el Neonatal Skin Condition Score. De estos últimos, se mejoró la validación del contenido y la sensibilidad de los ítems. La MANOVA se utilizó para evaluar si el efecto de variables independientes (factores intrínsecos y extrínsecos) sobre variables dependientes (puntuación de ambas escalas) fue estadísticamente significante. Muestreo no aleatorio (n=167). Resultados: Los artículos mostraron buena sensibilidad. La MANOVA reveló que los factores tuvieron un efecto significante en las puntuaciones de las dos escalas. Conclusión: La comparación de las escalas muestra validez clínica, revelando que una mejor condición de la piel corresponde a un menor riesgo de lesión, y las dos escalas se pueden aplicar concomitantemente.

RESUMO Objetivo: Validar clinicamente a Neonatal Skin Condition Score - versão portuguesa com recém-nascidos portugueses, verificando se o risco de lesão da pele nessa população é influenciado pela sua condição. Método: Estudo observacional, transversal e metodológico, realizado de 2018 a 2021. Na coleta de dados, utilizaram-se a Neonatal Skin Risk Assessment Scale - versão portuguesa e a Neonatal Skin Condition Score. Desta última, realizou-se a validação de conteúdo e a estimação da sensibilidade dos itens. Utilizou-se a MANOVA para avaliar se o efeito das variáveis independentes (fatores intrínsecos e extrínsecos) sobre as dependentes (escoredas duas escalas) era estatisticamente significante. Amostragem não aleatória (n=167). Resultados: Os itens apresentaram boa sensibilidade. A MANOVA revelou que os fatores tiveram efeito significante sobre os escores das duas escalas. Conclusão: A comparação das escalas evidencia validade clínica, demonstrando que melhor condição da pele corresponde a menor risco de lesão, podendo as duas escalas ser aplicadas concomitantemente.

Functionalization of 7-Hydroxy-pyranoflavylium: Synthesis of New Dyes with Extended Chromatic Stability.

This work reports the functionalization of pyranoflavyliums pigment using 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride coupling chemistry. Four cinnamic acids were used to establish an ester bond with the hydroxyl group of the pyranoflavylium, namely 4-dimethylamino-, 4-amino-, 4-bromo-, and trans-cinnamic acids. The experimental condition, namely the molar ratios, solvent, and reaction time, were adjusted to obtain higher reaction yields in a reduced period. Excellent reaction yields of 68%, 85%, 94%, and 99% were achieved for 4-amino, trans-, 4-bromo, and 4-dimethylamino pyranoflavylium cinnamates, respectively. The structure of the functionalized pigments was fully clarified using one-dimensional (1H) and two-dimensional (COSY, HSQC, and HMBC) NMR experiments and HRSM analysis. Regardless of the type of functionalization, the UV-Visible spectrum showed a bathochromic shift (red region) on the maximum absorption wavelength and the absence of acid-base reactions throughout a broad pH range in comparison to the pyranoflavylium precursor. This work offers a valuable environmentally friendly, quick, and straightforward alternative to flavylium compounds' challenging and labor-intensive functionalization, resulting in novel dyes with higher stability and dissimilar chromatic features.

Continuous Aspiration Mechanical Thrombectomy for the management of intermediate- and high-risk pulmonary embolism: Data from the first cohort in Portugal.

INTRODUCTION: This study describes the experience of a reference center using continuous aspiration mechanical thrombectomy for acute high- and intermediate-high-risk pulmonary embolism (PE). METHODS: Twenty-nine consecutive patients with acute central PE (48.3% high-risk PE; 82.8% in class >III from the original Pulmonary Embolism Severity Index score; median Charlson Comorbidity Index of 4) were treated with the Indigo® Mechanical Thrombectomy System between March 2018 and March 2020. Technical success was defined as successful placement of the device and initiation of aspiration thrombectomy. Clinical success was defined as any improvement in hemodynamic and/or oxygenation parameters, pulmonary hypertension or right heart strain at 48 hours, and survival to hospital discharge. Safety was defined as freedom from severe adverse events potentially related to the procedure. Three-month follow-up results were collected. RESULTS: Technical success was 96.6%. Miller index and systolic pulmonary arterial pressure were significantly reduced after the procedure (-5.5±3.0, and -10.2±11.5 mmHg, respectively, both p<0.001). There was a significant improvement in mean paO2/FiO2 ratio (+77.1±103.2; p=0.001), shock index (-0.4±0.4; p<0.001), need for aminergic support at 48 h after the procedure (-75.0%, p=0.006) and improvement in right ventricular function in 66.6% (p=0.008). Clinical success was 75.9%. Severe adverse event rate was 10.3%: two deaths during the procedure and one pulmonary macroembolization during device progression. In-hospital and three-month survival rates were 82.8% and 72.4%, respectively. CONCLUSIONS: Aspiration thrombectomy for acute high- and intermediate-high-risk PE is feasible with a high technical and clinical success rate. Nevertheless, all-cause mortality is still high, probably related to the baseline high-risk features of the studied population and associated comorbidities.

Effectiveness of probiotics for the treatment of infantile colic.

BACKGROUND: Infantile colic is one of the most common health issues that can occur during an infant's first months of life, affecting approximately 20% of all infants. The aetiology of infantile colic is not well understood; however, studies have suggested that changes in the intestinal microbiota can lead to symptoms of infantile colic. For this reason, different strains of probiotics have been studied to help understand their effectiveness in the treatment of infantile colic. OBJECTIVE: The aim of this evidence-based review is to summarise the evidence of the effectiveness of probiotics in the treatment of infantile colic. DISCUSSION: Several strains of probiotics have been studied, with some presenting positive results for reducing the symptoms of infantile colic in groups with specific characteristics. However, more studies are required to evaluate efficacy and effectiveness of probiotics in different degrees of severity and in larger and more heterogenous samples.

Explicit Instructions Do Not Enhance Auditory Statistical Learning in Children With Developmental Language Disorder: Evidence From Event-Related Potentials.

A current issue in psycholinguistic research is whether the language difficulties exhibited by children with developmental language disorder [DLD, previously labeled specific language impairment (SLI)] are due to deficits in their abilities to pick up patterns in the sensory environment, an ability known as statistical learning (SL), and the extent to which explicit learning mechanisms can be used to compensate for those deficits. Studies designed to test the compensatory role of explicit learning mechanisms in children with DLD are, however, scarce, and the few conducted so far have led to inconsistent results. This work aimed to provide new insights into the role that explicit learning mechanisms might play on implicit learning deficits in children with DLD by resorting to a new approach. This approach involved not only the collection of event-related potentials (ERPs), while preschool children with DLD [relative to typical language developmental (TLD) controls] were exposed to a continuous auditory stream made of the repetition of three-syllable nonsense words but, importantly, the collection of ERPs when the same children performed analogous versions of the same auditory SL task first under incidental (implicit) and afterward under intentional (explicit) conditions. In each of these tasks, the level of predictability of the three-syllable nonsense words embedded in the speech streams was also manipulated (high vs. low) to mimic natural languages closely. At the end of both tasks' exposure phase, children performed a two-alternative forced-choice (2-AFC) task from which behavioral evidence of SL was obtained. Results from the 2-AFC tasks failed to show reliable signs of SL in both groups of children. The ERPs data showed, however, significant modulations in the N100 and N400 components, taken as neural signatures of word segmentation in the brain, even though a detailed analysis of the neural responses revealed that only children from the TLD group seem to have taken advantage of the previous knowledge to enhance SL functioning. These results suggest that children with DLD showed deficits both in implicit and explicit learning mechanisms, casting doubts on the efficiency of the interventions relying on explicit instructions to help children with DLD to overcome their language difficulties.