aProceedings of the 5th Meeting of Translational Hepatology, organized by the Spanish Association for the Study of the Liver (AEEH).

This is the summary report of the 5th Translational Hepatology Meeting, endorsed by the Spanish Association for the Study of the Liver (AEEH) and held in Seville, Spain, in October 2023. The meeting aimed to provide an update on the latest advances in the field of basic and translational hepatology, covering different molecular, cellular, and pathophysiological aspects of the most relevant clinical challenges in liver pathologies. This includes the identification of novel biomarkers and diagnostic tools, the understanding of the relevance of immune response and inflammation in liver diseases, the characterization of current medical approaches to reverse liver diseases, the incorporation of novel molecular insights through omics techniques, or the characterization of the impact of toxic and metabolic insults, as well as other organ crosstalk, in liver pathophysiology.

Unveiling ecological/evolutionary insights in HIV viral load dynamics: Allowing random slopes to observe correlational changes to CpG-contents and other molecular and clinical predictors.

In the context of infectious diseases, the dynamic interplay between ever-changing host populations and viral biology demands a more flexible modeling approach than common fixed correlations. Embracing random-effects regression models allows for a nuanced understanding of the intricate ecological and evolutionary dynamics underlying complex phenomena, offering valuable insights into disease progression and transmission patterns. In this article, we employed a random-effects regression to model an observed decreasing median plasma viral load (pVL) among individuals with HIV in Mexico City during 2019-2021. We identified how these functional slope changes (i.e. random slopes by year) improved predictions of the observed pVL median changes between 2019 and 2021, leading us to hypothesize underlying ecological and evolutionary factors. Our analysis involved a dataset of pVL values from 7325 ART-naïve individuals living with HIV, accompanied by their associated clinical and viral molecular predictors. A conventional fixed-effects linear model revealed significant correlations between pVL and predictors that evolved over time. However, this fixed-effects model could not fully explain the reduction in median pVL; thus, prompting us to adopt random-effects models. After applying a random effects regression model-with random slopes and intercepts by year-, we observed potential "functional changes" within the local HIV viral population, highlighting the importance of ecological and evolutionary considerations in HIV dynamics: A notably stronger negative correlation emerged between HIV pVL and the CpG content in the pol gene, suggesting a changing immune landscape influenced by CpG-induced innate immune responses that could impact viral load dynamics. Our study underscores the significance of random effects models in capturing dynamic correlations and the crucial role of molecular characteristics like CpG content. By enriching our understanding of changing host-virus interactions and HIV progression, our findings contribute to the broader relevance of such models in infectious disease research. They shed light on the changing interplay between host and pathogen, driving us closer to more effective strategies for managing infectious diseases. SIGNIFICANCE OF THE STUDY: This study highlights a decreasing trend in median plasma viral loads among ART-naïve individuals living with HIV in Mexico City between 2019 and 2021. It uncovers various predictors significantly correlated with pVL, shedding light on the complex interplay between host-virus interactions and disease progression. By employing a random-slopes model, the researchers move beyond traditional fixed-effects models to better capture dynamic correlations and evolutionary changes in HIV dynamics. The discovery of a stronger negative correlation between pVL and CpG content in HIV-pol sequences suggests potential changes in the immune landscape and innate immune responses, opening avenues for further research into adaptive changes and responses to environmental shifts in the context of HIV infection. The study's emphasis on molecular characteristics as predictors of pVL adds valuable insights to epidemiological and evolutionary studies of viruses, providing new avenues for understanding and managing HIV infection at the population level.

Increases in the soil ammonia oxidizing phylotypes and their rechange due to long-term irrigation with wastewater.

Wastewater irrigation is a common practice for agricultural systems in arid and semiarid zones, which can help to overcome water scarcity and contribute with nutrient inputs. Ammonia-oxidizing bacteria (AOB) and archaea (AOA) are key in the transformation of NH4+-N in soil and can be affected by variations in soil pH, EC, N and C content, or accumulation of pollutants, derived from wastewater irrigation. The objective of this study was to determine the changes in the ammonia oxidizing communities in agricultural soils irrigated with wastewater for different periods of time (25, 50, and 100 years), and in rainfed soils (never irrigated). The amoA gene encoding for the catalytic subunit of the ammonia monooxygenase was used as molecular reporter; it was quantified by qPCR and sequenced by high throughput sequencing, and changes in the community composition were associated with the soil physicochemical characteristics. Soils irrigated with wastewater showed up to five times more the abundance of ammonia oxidizers (based on 16S rRNA gene relative abundance and amoA gene copies) than those under rainfed agriculture. While the amoA-AOA: amoA-AOB ratio decreased from 9.8 in rainfed soils to 1.6 in soils irrigated for 100 years, indicating a favoring environment for AOB rather than AOA. Further, the community structure of both AOA and AOB changed during wastewater irrigation compared to rainfed soils, mainly due to the abundance variation of certain phylotypes. Finally, the significant correlation between soil pH and the ammonia oxidizing community structure was confirmed, mainly for AOB; being the main environmental driver of the ammonia oxidizer community. Also, a calculated toxicity index based on metals concentrations showed a correlation with AOB communities, while the content of carbon and nitrogen was more associated with AOA communities. The results indicate that wastewater irrigation influence ammonia oxidizers communities, manly by the changes in the physicochemical environment.

Integrated water quality assessment of two Rivers Basins from a semiarid region of Argentina.

The Tunuyán and Mendoza River Basins (Province of Mendoza, Argentina) have been selected as a representative semiarid region to test the applicability of an integrated water quality evaluation. To detect spatio-temporal variations of anthropic contamination, physicochemical and bacteriological parameters, as well as three ecotoxicological assays, were assessed in reference sites for 3 years. Bioassays based on the nematode Caenorhabditis elegans, the vascular plant Lactuca sativa, and the algae Pseudokirchneriella subcapitata were performed and toxicological categories were established. Our results showed that water quality, as well as water toxicity, deteriorates as both river systems run through urban areas. Interestingly, monitoring sites with good physicochemical and bacteriological qualities but with toxicity were identified, illustrating that traditional water quality studies do not predict potential toxic effects on living organisms. In addition, a multivariate statistical analysis was performed to detect clusters of monitoring sites according to the water quality status. In the context of climate change, this study provides information to support that integrated water monitoring is an essential tool to ensure sustainable water management and to guarantee economic growth, human health, food security, and environmental protection.

Roles of the α1B-Adrenergic Receptor Phosphorylation Domains in Signaling and Internalization.

The function of the α1B-adrenergic receptor phosphorylation sites previously detected by mass spectrometry was evaluated by employing mutants, substituting them with non-phosphorylatable amino acids. Substitution of the intracellular loop 3 (IL3) sites did not alter baseline or stimulated receptor phosphorylation, whereas substitution of phosphorylation sites in the carboxyl terminus (Ctail) or both domains (IL3/Ctail) markedly decreased receptor phosphorylation. Cells expressing the IL3 or Ctail receptor mutants exhibited a noradrenaline-induced calcium-maximal response similar to those expressing the wild-type receptor, and a shift to the left in the concentration-response curve to noradrenaline was also noticed. Cells expressing the IL3/Ctail mutant exhibited higher apparent potency and increased maximal response to noradrenaline than those expressing the wild-type receptor. Phorbol ester-induced desensitization of the calcium response to noradrenaline was reduced in cells expressing the IL3 mutant and abolished in cells in which the Ctail or the IL3/Ctail were modified. In contrast, desensitization in response to preincubation with noradrenaline was unaffected in cells expressing the distinct receptor mutants. Noradrenaline-induced ERK phosphorylation was surprisingly increased in cells expressing IL3-modified receptors but not in those expressing receptors with the Ctail or IL3/Ctail substitutions. Our data indicate that phosphorylation sites in the IL3 and Ctail domains mediate and regulate α1B-adrenergic receptor function. Phorbol ester-induced desensitization seems to be closely associated with receptor phosphorylation, whereas noradrenaline-induced desensitization likely involves other elements.

Liver enzyme alteration in response to dengue virus.

Infectious diseases are extremely important in the global health landscape, specifically dengue and its severe forms. Clinical characterization is very variable due to the wide spectrum of manifestations the virus induces. Dengue is a viral infection caused by the dengue virus and is transmitted to humans by mosquitos of the Aedes family. Dengue is the most important arthropod-borne disease and if symptoms occur, could appear suddenly, characterized by biphasic fever, headache, retroocular pain, pain in various parts of the body, prostration and rash. It has also been described that the Dengue virus can also cause liver dysfunction that could vary from mild injury to severe hepatocyte injury, commonly in tropical and subtropical climates. We report the case of a 24-year-old female who came to the emergency room due to fever and myalgia, in the context of a recent trip to Cuba. Physical examination included positive tourniquet test and laboratory findings showed anaemia and thrombocytopenia, as well as elevated transaminase levels. Serologic tests for dengue virus are requested and a positive result of specific antibodies-IgM classified the patient as presumptive being necessary to confirm authorities the outbreak and explain the patient it requires a close monitoring. Abdominal ultrasound showed mild splenomegaly. Because of progressive analytical normalization, the patient asked for outpatient care.

Revisión histórica, distribución potencial y estado de conservación de la rata endémica de México Xenomys nelsoni (Rodentia: Cricetidae) / Historical review, potential distribution, and conservation of the Mexican endemic rat Xenomys nelsoni (Rodentia: Cricetidae)

Resumen Introducción: La Rata de Magdalena, Xenomys nelsoni, es un roedor endémico de México, de distribución restringida a las selvas bajas caducifolias densas, en una pequeña región de la costa del Pacífico mexicano. Es una especie poco conocida, catalogada como "En Peligro" de acuerdo con la Unión Internacional para la Conservación de la Naturaleza (IUCN). Este desconocimiento unido a la alta tasa de deforestación de su hábitat hace que su conservación sea prioritaria. Objetivo: Realizar un recuento histórico de los registros depositados en las colecciones científicas, generar mapas de distribución potencial y analizar el estado de conservación de la especie. Método: Los datos de ocurrencia de las especies se obtuvieron de la literatura y bases de datos digitales y se analizaron por décadas. Se utilizaron los programas GARP y MaxEnt para generar los modelos de nicho ecológico. La importancia de las variables en el modelo se estimó mediante un análisis Jackknife. Resultados: A lo largo de 129 años 19 recolectores registraron 69 ejemplares, de los cuales 65 están depositados en siete colecciones internacionales y una nacional. Aunque la especie sólo se ha recolectado en Jalisco y Colima, la distribución potencial de X. nelsoni incluye también el estado de Michoacán. De esta área estimada, sólo el 1.5 % se encuentra dentro de un Área Natural Protegida. Conclusiones: Los resultados de la distribución potencial podrían ser utilizados para verificar la presencia de la especie en lugares donde no ha sido recolectada como el norte de la Reserva de la Biosfera Chamela-Cuixmala y en algunas zonas de la provincia fisiográfica Costas del Sur en el estado de Michoacán. Es necesario incrementar los muestreos en regiones poco estudiadas predichas por el modelo y aumentar el área de protección.

Abstract Introduction: The Magdalena Rat, Xenomys nelsoni, is a rodent endemic to Mexico, whose distribution is restricted to dense tropical dry forests in a small region on the Pacific coast of Mexico. It is a poorly known species categorized as "Endangered" by the International Union for Conservation of Nature (IUCN). This lack of knowledge and the high rates of deforestation of its habitat makes its conservation a priority. Objective: To summarize the historical records deposited in scientific collections, to create potential distribution maps, and to analyze the conservation status of the species. Methods: We obtained species occurrence data from literature and digital databases, analyzing them by the decade. We used GARP and MaxEnt software to generate the ecological niche models. The importance of the variables in the model was estimated using the Jackknife technique. Results: Over 129 years, 19 collectors registered 69 specimens, of which 65 are deposited in one national and seven international collections. Although the species has only been collected in Jalisco and Colima, the potential distribution for X. nelsoni also includes the state of Michoacán. Of this estimated area, only 1.5 % is in a Protected Natural Area. Conclusions: The results of the potential distribution could be used to verify the presence of the species in places where it has not been collected, such as the northern part of the Chamela-Cuixmala Biosphere Reserve and in some areas of the physiographic province Costas del Sur in the state of Michoacán. It is needed to increase samplings in the least studied regions predicted by the model and expand the area of protection.

[Autoimmunity and Freiburg classification in common variable immunodeficiency]. / Autoinmunidad y clasificación de Freiburg en pacientes con inmunodeficiencia común variable.

Introduction: Up to 25% of patients with common variable immunodeficiency (CVID) debut with autoimmunity, which is related to the Freiburg classification, which is based on flow cytometry. Objective: to determine the frequency and type of autoimmune diseases and their association with the Freiburg classification in adults with CVID. Methods: A cross-sectional, analytical and observational study was carried out with 33 patients belonging to the Primary Immunodeficiency Clinic of a third level hospital, with a diagnosis of CVID. They were divided into 3 phenotypes according to the Freiburg classification. Results: Of the 33 patients studied, 66.6% presented autoimmune diseases, 19 of them (86.3%) had cytopenia; 42.1% belonged to Freiburg group Ia, 36.8% to Ib and 21% to phenotype II. In 36.6% of the patients, autoimmune cytopenia were the first manifestation of CVID; and up to 70% of them belong to the Freiburg phenotype Ia (p = 0.086). Patients with autoimmune cytopenia had a lower percentage of isotype-switched memory B cells (p = 0.018), no higher percentage of CD21low B cells (p = 0.226). Conclusions: Classification by CVID phenotypes allows the identification of the patient's profile according to the percentage of memory B cells with isotype change, which is useful to intentionally search for non-infectious complications of the disease.

Introducción: hasta el 25% de los pacientes con inmunodeficiencia común variable (IDCV) debutan con autoinmunidad, la cual guarda relación con la clasificación de Freiburg, que se basa en la citometría de flujo. Objetivo: determinar la frecuencia y tipo de enfermedades autoinmunes y su asociación con la clasificación de Freiburg en adultos con IDCV. Métodos: se realizó un estudio transversal, analítico y observacional con 33 pacientes pertenecientes a la Clínica de Inmunodeficiencias Primarias de un hospital de tercer nivel con diagnóstico de IDCV. Se dividieron en tres fenotipos según la clasificación de Freiburg. Resultados: de los 33 pacientes estudiados, el 66.6% presentó enfermedades autoinmunes, de ellos 19 (86.3%) tuvieron citopenias. El 42.1% se clasificó en el grupo Ia de Freiburg, el 36.8% en el grupo Ib y el 21% en el fenotipo II. En el 36.6% de los pacientes las citopenias autoinmunes fueron la primera manifestación de IDCV, y hasta el 70% de ellos pertenecen al fenotipo Ia de Freiburg (p = 0.086). Los pacientes con citopenias autoinmunes tuvieron un menor porcentaje de células B de memoria con cambio de isotipo (p = 0.018), sin mayor porcentaje de células B CD21low (p = 0.226). Conclusiones: la clasificación por fenotipos en IDCV permite identificar el perfil del paciente y el tipo de manifestaciones asociadas, lo que es útil para buscar de manera intencionada complicaciones no infecciosas propias de la enfermedad.

Hepatosplenic schistosomiasis: an uncommon cause of liver disease in developed countries.

Schistosomiasis is a parasitic infection caused by trematode species of the genus Schistosoma. It is prevalent in tropical regions of Africa, Asia and South America, being rare in Europe, where it is usually diagnosed in immigrants and tourists from endemic areas. It has different clinical forms of presentation. Hepatosplenic schistosomiasis produces periportal fibrosis, which can progress to presinusoidal portal hypertension, with all its associated complications. We present the case of a 43-year-old female patient from the Philippines who was referred to gastroenterology consultation due to liver enzyme alteration with a predominantly cholestatic pattern. An aetiological study was performed, with negative results. An abdominal ultrasound revealed signs of chronic liver disease, with transient elastography of 9.5 kPa. A percutaneous liver biopsy was performed, with histological findings consistent with infestation by schistosome eggs, receiving treatment with praziquantel and subsequently verifying its eradication with a stool test.

Effect of Conservative Rehabilitation Interventions on Health-Related Quality of Life in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Systematic Review.

Breast cancer-related lymphedema (BCRL) of the upper limb is a very common condition in women undergoing breast cancer treatment; it can cause considerable alterations in the daily life of patients and a decrease in their health-related quality of life (HRQoL). Currently, there are many conservative therapies that try to palliate the symptoms, but the results are still controversial and there are still no globally accepted treatments. The purpose of this article is to determine the effect, according to the current available evidence, on HRQoL of different conservative interventions in the rehabilitation of BCRL in the upper limb in women. Eighteen articles that compared the effects of standard treatments, such as manual lymphatic drainage-based decongestive therapy or compression measures, and other newer treatments, including new technologies and other types of treatment programs, were reviewed. According to the results of this review, the most recommended modality for the improvement of HRQoL would be a complex decongestive technique without manual lymphatic drainage. Although there are clinical trials that have demonstrated the effectiveness of various treatments, the results of the positive effects on HRQoL remain highly controversial. There is a need to continue to develop studies to help guide therapeutic decisions that can promote HRQoL in women affected by upper limb BCRL.

Treatment and Improvement of Healing after Surgical Intervention.

The development of abnormal scars has a great impact on people's well-being, and improving scarring outcomes after surgery is a field that currently lacks consensus. This review aims to identify newly researched approaches to improving the quality of surgical scars. A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted between 13 May 2023 and 17 May 2023, in accordance with the recommendations of the PRISMA Statement. Study selection and analysis of methodological quality were performed in parts, independently and blindly, based on eligibility criteria. The 21 prospective, comparative, and randomized studies reviewed included 1057 subjects and studied approaches such as topical applications of creams with herbal extracts and silicone gels, growth factors, negative pressure dressings, oligonucleotides, intralesional injection of compounds such as botulinum toxin, skin closure techniques such as suturing and tissue adhesive, and laser treatments. There are recent research techniques that generate good results and are really promising to improve the results of surgical scars; however, the available evidence is extremely limited in some cases, and it is necessary to deepen its analysis to obtain reliable action protocols in each type of surgery.

Innovations in surgical training: exploring the role of artificial intelligence and large language models (LLM).

The landscape of surgical training is rapidly evolving with the advent of artificial intelligence (AI) and its integration into education and simulation. This manuscript aims to explore the potential applications and benefits of AI-assisted surgical training, particularly the use of large language models (LLMs), in enhancing communication, personalizing feedback, and promoting skill development. We discuss the advancements in simulation-based training, AI-driven assessment tools, video-based assessment systems, virtual reality (VR) and augmented reality (AR) platforms, and the potential role of LLMs in the transcription, translation, and summarization of feedback. Despite the promising opportunities presented by AI integration, several challenges must be addressed, including accuracy and reliability, ethical and privacy concerns, bias in AI models, integration with existing training systems, and training and adoption of AI-assisted tools. By proactively addressing these challenges and harnessing the potential of AI, the future of surgical training may be reshaped to provide a more comprehensive, safe, and effective learning experience for trainees, ultimately leading to better patient outcomes. .

Role of EpCAM+ CD133+ extracellular vesicles in steatosis to steatohepatitis transition in NAFLD.

BACKGROUND AND AIMS: Extracellular vesicles (EVs) have emerged as a potential source of circulating biomarkers in liver disease. We evaluated circulating AV+ EpCAM+ CD133+ EVs as a potential biomarker of the transition from simple steatosis to steatohepatitis. METHODS: EpCAM and CD133 liver proteins and EpCAM+ CD133+ EVs levels were analysed in 31 C57BL/6J mice fed with a chow or high fat, high cholesterol and carbohydrates diet (HFHCC) for 52 weeks. The hepatic origin of MVs was addressed using AlbCrexmT/mG mice fed a Western (WD) or Dual diet for 23 weeks. Besides, we assessed plasma MVs in 130 biopsy-proven NAFLD patients. RESULTS: Hepatic expression of EpCAM and CD133 and EpCAM+ CD133+ EVs increased during disease progression in HFHCC mice. GFP+ MVs were higher in AlbCrexmT/mG mice fed a WD (5.2% vs 12.1%) or a Dual diet (0.5% vs 7.3%). Most GFP+ MVs were also positive for EpCAM and CD133 (98.3% and 92.9% respectively), suggesting their hepatic origin. In 71 biopsy-proven NAFLD patients, EpCAM+ CD133+ EVs were significantly higher in those with steatohepatitis compare to those with simple steatosis (286.4 ± 61.9 vs 758.4 ± 82.3; p < 0.001). Patients with ballooning 367 ± 40.6 vs 532.0 ± 45.1; p = 0.01 and lobular inflammation (321.1 ± 74.1 vs 721.4 ± 80.1; p = 0.001), showed higher levels of these EVs. These findings were replicated in an independent cohort. CONCLUSIONS: Circulating levels of EpCAM+ CD133+ MVs in clinical and experimental NAFLD were increased in the presence of steatohepatitis, showing high potential as a non-invasive biomarker for the evaluation and management of these patients.

Linking the shifts in the metabolically active microbiota in a UASB and hybrid anaerobic-aerobic bioreactor for swine wastewater treatment.

Due to the high concentration of pollutants, swine wastewater needs to be treated prior to disposal. The combination of anaerobic and aerobic technologies in one hybrid system allows to obtain higher removal efficiencies compared to those achieved via conventional biological treatment, and the performance of a hybrid system depends on the microbial community in the bioreactor. Here, we evaluated the community assembly of an anaerobic-aerobic hybrid reactor for swine wastewater treatment. Sequencing of partial 16S rRNA coding genes was performed using Illumina from DNA and retrotranscribed RNA templates (cDNA) extracted from samples from both sections of the hybrid system and from a UASB bioreactor fed with the same swine wastewater influent. Proteobacteria and Firmicutes were the dominant phyla and play a key role in anaerobic fermentation, followed by Methanosaeta and Methanobacterium. Several differences were found in the relative abundances of some genera between the DNA and cDNA samples, indicating an increase in the diversity of the metabolically active community, highlighting Chlorobaculum, Cladimonas, Turicibacter and Clostridium senso stricto. Nitrifying bacteria were more abundant in the hybrid bioreactor. Beta diversity analysis revealed that the microbial community structure significantly differed among the samples (p < 0.05) and between both anaerobic treatments. The main predicted metabolic pathways were the biosynthesis of amino acids and the formation of antibiotics. Also, the metabolism of C5-branched dibasic acid, Vit B5 and CoA, exhibited an important relationship with the main nitrogen-removing microorganisms. The anaerobic-aerobic hybrid bioreactor showed a higher ammonia removal rate compared to the conventional UASB system. However, further research and adjustments are needed to completely remove nitrogen from wastewater.

Uncommon etiology of Cullen´s sign and Grey Turner sign.

Cullen´s sign and Grey Turner sign are, respectively, the cutaneous ecchymoses located in periumbilical region and tissues flanks along the lower portion of the abdomen. Both have been observed in <1% of individuals with acute pancreatitis, suggesting poor prognosis in terms of gravity and mortality. However, these signs are not exclusive for acute pancreatitis, as they can appear in other identities such as: ruptured ectopic pregnancy, aortic aneurysm, rectus abdominis muscle hematoma, perforated duodenal ulcer, common bile duct rupture and biliary peritonitis, idiopathic perirenal hemorrhage, infectious mononucleosis with splenic rupture, metastatic esophageal and thyroid cancer, non-Hodgkin lymphoma, amoebic liver abscess, portal hypertension, and liver tumor disease. Based on the review of the literature, it is patent that Cullen´s sign and Grey Turner sign are neither sensitive nor specific for acute pancreatitis, therefore it may be best to relate these findings in the physical examination to conditions associated with abdominal pathology and retroperitoneal hemorrhage. We report the case of a 60-year-old Spanish female, with previous history of squamous small cell neuroendocrine lung carcinoma with hepatic extension in follow-up by palliative care services. Due to disease progression after two palliative chemotherapy sessions, the patient came to the emergency room with jaundice and abdominal pain in superior regions. On physical examination, notable findings included ecchymoses in the right flank and periumbilical region. Laboratory findings showed elevated bilirubin and transaminase levels, as well as a small increase in the serum amylase and lipase levels. Cholangioresonance was performed to discard acute biliary pancreatitis. The imaging revealed no enlargement of the pancreas, dilatation of the common bile duct without visible stone, and a liver full of new cancerous liver implants. These findings were consistent with diffuse distribution metastases lesions, concluding the progression of liver disease.

Cost-effective screen printing approach for Ce/Nd-doped ZnAl2O4 films: tuning crystallinity induced by the substrate.

Near-infrared (NIR) emitting phosphors are currently receiving considerable attention owing to their high demand in various applications, such as light detection and ranging (LiDAR), short-range communications, security, biosensing and night vision lighting applications. The miniaturization of photonic components demands the integration of thin films into exploitable devices. In this context, NIR emitting ZnAl2O4:Ce/Nd films of hundreds of nanometer thickness are synthesized using a scalable and cost-efficient approach to screen printing. Cerium co-doping is responsible for the Nd emission in the NIR through energy transfer by exciting the films under UV excitation at around 360 nm. Through the proper design of ink, dense Nd/Ce doped ZnAl2O4 ceramic films were produced using polycrystalline alumina. The use of polycrystalline alumina substrates opens up new opportunities because this ceramic is a cheap and well-known substrate for optoelectronic packaging. During manufacturing, as a direct effect of predominant crystal growth over the polycrystalline alumina substrate, an increase in emission intensity is achieved. The results obtained by X-ray photoelectron (XPS) and X-ray absorption near edge spectroscopy (XANES) serve to determine the oxidation state of Ce. The findings of this study indicate that a higher concentration of Ce4+ promotes NIR emission. This study may contribute to a better understanding of film production processes of films based on the ZnAl2O4 matrix and guide future studies on films for NIR emitters.

Decidual cells and decidualization in the carnivoran endotheliochorial placenta.

Decidualization is considered a distinctive feature of eutherian pregnancy, and has appeared during evolution along with the development of invasive forms of placentation, as the endotheliochorial placenta. Although decidualization is not massive in carnivores, as it is in most species developing hemochorial placentas, isolated or grouped cells regarded as decidual have been documented and characterized, mainly in bitches and queens. For the majority of the remaining species of the order, data in the bibliography are fragmentary. In this article, general morphological aspects of decidual stromal cells (DSCs), their time of appearance and lasting, data about the expression of cytoskeletal proteins and molecules considered as markers of decidualization were reviewed. From the data reviewed, it follows that carnivoran DSCs take part either in the secretion of progesterone, prostaglandins, relaxin, among other substances, or at least in the signaling pathways triggered by them. Beyond their physiological roles, some of those molecules are already being used, or are yet under study, for the non-invasive endocrine monitoring and reproductive control of domestic and wild carnivores. Only insulin-like growth factor binding protein 1, among the main decidual markers, has been undoubtedly demonstrated in both species. Laminin, on the contrary, was found only in feline DSCs, and prolactin was preliminary reported in dogs and cats. Prolactin receptor, on the other hand, was found in both species. While canine DSCs are the only placental cell type expressing the nuclear progesterone receptor (PGR), that receptor has not been demonstrated neither in feline DSCs, nor in any other cell in the queen placenta, although the use of PGR blockers leads to abortion. Against this background, and from the data gathered so far, it is unquestionable that DSCs in carnivorans do play a pivotal role in placental development and health. The knowledge about placental physiology is critical for medical care and breeding management, primarily in domestic carnivores; it is also absolutely crucial for a conservation approach in the management of endangered carnivore species.

A Cross-Sectional Study: Determining Factors of Functional Independence and Quality of Life of Patients One Month after Having Suffered a Stroke.

(1) Background: loss of quality of life (QoL) and functional independence are two of the most common consequences of suffering a stroke. The main objective of this research is to study which factors are the greatest determinants of functional capacity and QoL a month after suffering a stroke so that they can be considered in early interventions. (2) Methods: a cross-sectional study was conducted which sample consisted of 81 people who had previously suffered a stroke. The study population was recruited at the time of discharge from the Neurology Service and Stroke Unit of the hospitals of Burgos and Córdoba, Spain, through a consecutive sampling. Data were collected one month after participants experienced a stroke, and the main study variables were quality of life, measured with the Stroke-Specific Quality of Life Measure (NEWSQOL), and functional independence, measured with the Functional Independence Measure-Functional Assessment Measure (FIM-FAM). (3) Results: the factors associated with a worse QoL and functional capacity one month after having suffered a stroke were living in a different dwelling than the usual flat or house (p < 0.05), a worse cognitive capacity (p < 0.001) and a worse functional capacity of the affected upper limb (p < 0.001). A higher age was related to a worse functional capacity one month after suffering a stroke (p = 0.048). (4) Conclusions: the type of dwelling, age, cognitive ability and functional capacity of the affected upper limb are determining aspects in functional independence and QoL during the first weeks after a stroke.

Pancreas fat content, insulin homeostasis and circulating endothelial microparticles in male essential hypertensive patients.

The pancreas fat content has been poorly investigated in essential hypertension. The authors aim to relate pancreas and liver fat content with parameters measuring insulin resistance, beta-cell function and also with markers of endothelial dysfunction and platelet or endothelial cell destruction. The authors studied a group of 40 male hypertensive patients with well-controlled blood pressure, maintaining a stable weight, and having not changed their medication during the last year. Pancreas fat content was correlated with HOMA-IR (r = .616, p < .001), HOMA-S (r = -.439, p < .005), beta cell function parameter (r = .457, p < .005), and QUICKI (r = .412, p < .01), whereas liver fat was not patients in the highest quartile of pancreas fat content had more circulating endothelial microparticles than patients in the other quartiles (median 129 [94.3-200] vs. 60.9 [49.4-88.8], p = .002). However, patients in the highest quartile of the pancreas fat content distribution did not differ from the lowest in hyperemic response after ischemia nor circulating platelet microparticles count. Liver fat content was not related to any of the parameters studied. In a multivariate stepwise binary logistic regression analysis (Wald Method) circulating endothelial microparticles remain significantly associated with pancreas fat content after adjusting for confounding factors, such as tobacco, diabetes mellitus, hypercholesterolemia, or metabolic syndrome. Our results reflect that in essential hypertension, pancreas fat content is superior to liver fat to study beta-cell functionality and insulin resistance. Moreover, the authors described for the first time that pancreas fat content is related to endothelial cell destruction. Further studies are needed to confirm this point.

Innovations in surgical training: exploring the role of artificial intelligence and large language models (LLM) / Inovações no treinamento cirúrgico: explorando o papel da inteligência artificial e dos grandes modelos de linguagem (LLM)

ABSTRACT The landscape of surgical training is rapidly evolving with the advent of artificial intelligence (AI) and its integration into education and simulation. This manuscript aims to explore the potential applications and benefits of AI-assisted surgical training, particularly the use of large language models (LLMs), in enhancing communication, personalizing feedback, and promoting skill development. We discuss the advancements in simulation-based training, AI-driven assessment tools, video-based assessment systems, virtual reality (VR) and augmented reality (AR) platforms, and the potential role of LLMs in the transcription, translation, and summarization of feedback. Despite the promising opportunities presented by AI integration, several challenges must be addressed, including accuracy and reliability, ethical and privacy concerns, bias in AI models, integration with existing training systems, and training and adoption of AI-assisted tools. By proactively addressing these challenges and harnessing the potential of AI, the future of surgical training may be reshaped to provide a more comprehensive, safe, and effective learning experience for trainees, ultimately leading to better patient outcomes. .

RESUMO O cenário do treinamento cirúrgico está evoluindo rapidamente com o surgimento da inteligência artificial (IA) e sua integração na educação e simulação. Este artigo explora as aplicações e benefícios potenciais do treinamento cirúrgico assistido por IA, em particular o uso de modelos de linguagem avançados (MLAs), para aprimorar a comunicação, personalizar o feedback e promover o desenvolvimento de habilidades. Discutimos os avanços no treinamento baseado em simulação, ferramentas de avaliação impulsionadas por IA, sistemas de avaliação baseados em vídeo, plataformas de realidade virtual (RV) e realidade aumentada (RA), e o papel potencial dos MLAs na transcrição, tradução e resumo do feedback. Apesar das oportunidades promissoras apresentadas pela integração da IA, vários desafios devem ser abordados, incluindo precisão e confiabilidade, preocupações éticas e de privacidade, viés nos modelos de IA, integração com os sistemas de treinamento existentes, e treinamento e adoção de ferramentas assistidas por IA. Ao abordar proativamente esses desafios e aproveitar o potencial da IA, o futuro do treinamento cirúrgico pode ser remodelado para proporcionar uma experiência de aprendizado mais abrangente, segura e eficaz para os aprendizes, resultando em melhores resultados para os pacientes.