Implications of two-component systems EnvZ/OmpR and BaeS/BaeR in in vitro temocillin resistance in Escherichia coli.

BACKGROUND: BaeS/BaeR is a two-component system of Escherichia coli that controls the expression of porins and efflux pumps. Its role in beta-lactam resistance is limited. OBJECTIVES: To study the role of baeS/baeR two-component system in temocillin resistance in E. coli. METHODS: E. coli strain BW25113 and single-gene deletion mutants related to two-component systems were collected from the KEIO collection. Double-gen deletion mutants were generated. Temocillin-resistant mutant frequencies were determined at 32 mg/L. E. coli BW25113 mutants were selected by selective pressure from serial passages. Biological costs were analysed by growth curves. Genomes of the generated mutants were sequenced. The expression level of the mdtA, mdtB, mdtC, acrD and tolC in the ΔbaeS mutant was determined by RT-PCR (with/without temocillin exposure). RESULTS: The frequency of temocillin mutants ranged from 2.12 × 10-8 to 4.51 × 10-8 in single-porin mutants. No mutants were recovered from E. coli BW25113 (>10-9). Selection of temocillin-resistant variants by serial passage yielded mutants up to 128 mg/L. Mutations were found in the baeS gene. Temocillin MICs ranged from 4 to 32 mg/L (highest MICs for ΔbaeS and ΔompR). The efflux pumps mdtA, mdtB, mdtC and acrD pumps were overexpressed 3-10-fold in the presence of temocillin in ΔbaeS compared to control. CONCLUSIONS: Mutations in the sensor histidine kinase, baeS, may be involved in temocillin resistance through the expression of the efflux pumps mdtABC and acrD. In addition, the low mutation rate may be a good predictor of temocillin activity.

Evaluation of temocillin efficacy against KPC-2-producing Klebsiella pneumoniae isolates in a hollow-fibre infection model.

BACKGROUND: Temocillin is an old antimicrobial that is resistant to hydrolysis by ESBLs but has variable activity against carbapenemase-producing Enterobacteriaceae. The current EUCAST susceptibility breakpoints for Enterobacterales are set at ≤16 mg/L (susceptible with increased exposure) based on a dose of 2 g q8h, but there is limited information on the efficacy of this dose against temocillin-susceptible carbapenemase-producing Klebsiella pneumoniae isolates. OBJECTIVES: To evaluate the efficacy of this dose using a hollow-fibre infection model (HFIM) against six KPC-2-producing clinical isolates of K. pneumoniae. METHODS: The isolates were characterized by WGS and temocillin susceptibility was determined using standard and high inoculum temocillin. Mutant frequencies were estimated and temocillin activity was tested in time-kill assays and in the HFIM. At standard conditions, three of the isolates were classified as susceptible (MIC ≤ 16 mg/L) and three as resistant (MIC > 16 mg/L). The HFIM was performed over 3 days to mimic human-like pharmacokinetics of 2 g q8h. Bacterial counts were performed by plating on Mueller-Hinton agar (MHA) and MHA containing 64 mg/L temocillin to detect resistant subpopulations. RESULTS: All isolates showed a reduction in bacterial population of at least 3 log cfu/mL within the first 8 h of simulated treatment in the hollow-fibre assay. Regrowth was observed for the three resistant isolates and one of the susceptible ones. The MIC value for these isolates was higher by at least two dilutions compared with their initial values. CONCLUSIONS: These data suggest that an optimized pharmacokinetic regimen may be of clinical interest for the treatment of KPC-2-producing K. pneumoniae susceptible to temocillin. These data showed activity of temocillin against KPC-2-producing K. pneumoniae susceptible to temocillin; however, a dose of 2g q8h administered over 30 min may be inadequate to prevent the emergence of resistant variants.

Health systems and quality of healthcare: bringing back missing discussions about gender and sexuality.

Gender and sexuality are recognised as social determinants of health. While gender and sexuality are becoming important frameworks guiding many disciplines and studies, discussions about quality of healthcare (QHC) lack a sufficient focus on these. When QHC studies have considered gender and sexuality the primary focus tends to be on the practice of individual professionals, patients' differential health seeking behaviours or outcomes. This commentary eapplies a gender and sexuality lens to Donabedian's framework to further understand the influence of gender and sexuality in shaping QHC. The framework illustrates how the very foundations of QHC (institutional structures, processes and outcomes), can increase or reduce inequalities in QHC linked to gender, sexuality (as well as other factors). The commentary suggests practices that would reduce these inequalities. In the context of present debates over inequality in medicine, science and global health , this commentary is a reminder that health systems have a critical role to play in ensuring that QHC does not perpetuate them. .

Penicillin-Binding Protein Occupancy Dataset for 18 ß-Lactams and 4 ß-Lactamase Inhibitors in Neisseria gonorrhoeae.

The lack of effective first-line antibiotic treatments against Neisseria gonorrhoeae, and the worldwide dissemination of resistant strains, are the main drivers of a worsening global health crisis. ß-lactam antibiotics have been the backbone of therapeutic armamentarium against gonococci. However, we are lacking critical insights to design rationally optimized therapies. In the present work, we generated the first PBP-binding data set on 18 currently available and clinically relevant ß-lactams and 4 ß-lactamase inhibitors in two N. gonorrhoeae ATCC type collection strains, 19424 and 49226 (PBP2 type XXII and A39T change in mtrR). PBP binding (IC50) was determined via the Bocillin FL binding assay in isolated membrane preparations. Three clusters of differential PBP IC50s were identified and were mostly consistent across both strains, but with quantitative differences. Carbapenems were coselective for PBP2 and PBP3 (0.01 to 0.03 mg/L). Third- and fourth-generation cephalosporins cefixime, cefotaxime, ceftazidime, cefepime, and ceftriaxone showed the lowest IC50 values for PBP2 (0.01 mg/L), whereas cefoxitin, ceftaroline, and ceftolozane required higher concentrations (0.04 to >2 mg/L). Aztreonam was selective for PBP2 in both strains (0.03 to 0.07 mg/L); amdinocillin bound this PBP at higher concentrations (1.33 to 2.94 mg/L). Penicillins specifically targeted PBP2 in strain ATCC 19424 (0.02 to 0.19 mg/L) and showed limited inhibition in strain ATCC 49226 (0.01 to >2 mg/L). Preferential PBP2 binding was observed by ß-lactam-based ß-lactamase inhibitors sulbactam and tazobactam (1.07 to 6.02 mg/L); meanwhile, diazabicyclooctane inhibitors relebactam and avibactam were selective for PBP3 (1.27 to 5.40 mg/L). This data set will set the bar for future studies that will help the rational use and translational development of antibiotics against multidrug-resistant (MDR) N. gonorrhoeae. IMPORTANCE The manuscript represents the first N. gonorrhoeae PBP-binding data set for 22 chemically different drugs in two type strains with different genetic background. We have identified three clusters of drugs according to their PBP binding IC50s and highlighted the binding differences across the two strains studied. With the currently available genomic information and the PBP-binding data, we have been able to correlate the target attainment differences and the mutations that affect the drug uptake with the MIC changes. The results of the current work will allow us to develop molecular tools of great practical use for the study and the design of new rationally designed therapies capable of combating the growing MDR gonococci threat.

Effect of Glycerol on Fosfomycin Activity against Escherichia coli.

Fosfomycin is an antimicrobial that inhibits the biosynthesis of peptidoglycan by entering the bacteria through two channels (UhpT and GlpT). Glycerol is clinically used as a treatment for elevated intracranial pressure and induces the expression of glpT in Escherichia coli. Glycerol might offer synergistic activity by increasing fosfomycin uptake. The present study evaluates the use of glycerol at physiological concentrations in combination with fosfomycin against a collection of isogenic mutants of fosfomycin-related genes in E. coli strains. Induction of fosfomycin transporters, susceptibility tests, interaction assays, and time-kill assays were performed. Our results support the notion that glycerol allows activation of the GlpT transporter, but this induction is delayed over time and is not homogeneous across the bacterial population, leading to contradictory results regarding the enhancement of fosfomycin activity. The susceptibility assays showed an increase in fosfomycin activity with glycerol in the disk diffusion assay but not in the agar dilution or broth microdilution assays. Similarly, in the time-kill assays, the effect of glycerol was absent by the emergence of fosfomycin-resistant subpopulations. In conclusion, glycerol may not be a good candidate for use as an adjuvant with fosfomycin.

Dental Age Estimation Using Multiphoton Microscopy: A Potential Tool for Forensic Science.

Normal aging affects the different structures of teeth, in particular, the dentine. These changes are useful in forensic disciplines as a tool for age estimation. Although multiphoton (MP) microscopy has been used to explore dental pieces, a relationship between age and MP response of the human dentine has not been proposed yet. The relationship between MP signals and natural dentine aging is investigated herein. An index of age (INAG) combining two-photon excitation fluorescence (TPEF) and second harmonic generation (SHG) images has been used to quantify these changes. The results show that the INAG significantly decreases with age. Moreover, peritubular dentine size and collagen internal properties are also modified with age. This information confirms the usefulness of this technique in forensic age estimation after disasters (natural or manmade) with a lack of comprehensive fingerprint database. Courts and other government authorities might also benefit from this tool when the official age of individuals under special circumstances is required for legal or medical reasons.

Factors That Affect the Accumulation of Strecker Aldehydes in Standardized Wines: The Importance of pH in Oxidation.

Strecker aldehydes (SA) can be formed in wine from the degradation of Strecker and, to a lesser degree, via the oxidation of higher alcohols. The objective of this article is to assess the magnitude of the differences introduced by wine compositional factors other than amino acids and Fe, in the accumulation of SA during oxidation. Eight red, two rosé and two white wines were oxidized. The accumulation of SA was analyzed. Whites and rosés presented negative accumulations for isobutyraldehyde, and in general, these wines accumulated smaller concentrations of the other SA than red wines. Only methional and phenylacetaldehyde were accumulated in all of the wines during oxidation. 2-methylbutanal and 3-methylbutanal were accumulated in 9 out of the 12 wines, whereas isobutyraldehyde was accumulated only in 5 out of the 12. 2-methylbutanal was, on average, the least accumulated aldehyde. Methional was the aldehyde formed most homogenously. Most of the observed differences can be attributed to three factors: the pH, oxidation time and native levels of Strecker aldehydes. The influence of pH was particularly intense in the cases of phenylacetaldehyde and methional. An independent test using synthetic wines with Strecker amino acids and 4-methylcatechol with different pHs (4.2, 3.5 and 2.8) was carried out in order to verify the higher pH value, the greater accumulation in SA after oxidation process. The results strongly suggest the important role played by pH in the accumulation of SA in wine oxidation.

Maturation of Moristel in Different Vineyards: Amino Acid and Aroma Composition of Mistelles and Wines with Particular Emphasis in Strecker Aldehydes.

The aim of this article was to assess the influence of the harvest date on the composition of amino acids and derived aromatic compounds in grape-mistelle and wine of the Moristel variety, in different vineyards. Two vineyards were sampled in 2016 and another one in 2017. At each sampling point, grapes were collected, destemmed, crushed and divided into four aliquots. The first three were fermented, and the latter was treated with ethanol, to produce 1-week macerates containing 15% ethanol (v/v)-mistelles. Overall, 10 mistelles and 33 wines were produced. Amino acids, Strecker aldehydes and aroma compounds were analysed. Amino acid profiles are characteristic of the vineyard and level of ripeness, converging with maturation. In fermentation, major amino acids, except proline, are consumed at a relatively fixed and specific tax, while consumption of 13 amino acids is determined by the ratios of alanine, glutamic acid, serine and threonine, with γ-aminobutyric acid. After fermentation, amino acid precursors to Strecker aldehydes are maxima in unripe and overripe samples, while Strecker aldehydes are maxima in unripe wines. No direct correlations between precursor amino acids in mistelle and aromatic compounds in wine have been found. Nevertheless, must amino acid profiles could determine wine aroma composition.

The impact of the COVID-19 lockdown on depression sufferers: a qualitative study from the province of Zaragoza, Spain.

BACKGROUND AND PURPOSE: The impact of COVID-19 and its control measures have exacerbated existing mental health conditions. Although the deleterious effects of mental health problems are well known, fewer studies have examined the links between the Social Determinants of Health (SDHs) and depression. This study provides insights into the relationship between SDHs and depression during the first strict lockdown in Spain, which lasted for a period of 7 weeks. METHODS: Fifty-two structured interviews were conducted with people diagnosed with depression during June 2020 in the province of Zaragoza (Spain). Interviews were conducted by telephone due to lockdown constraints. Inductive thematic content analysis was used to explore, develop, and define emergent categories of analysis, which were mapped against the SDH framework. RESULTS: Listening to people's experiences of living with depression during lockdown provided insights into their concerns and coping strategies, which are greatly influenced by the conditions in which they live, their job and their age. Examples of these factors include access to and quality of physical spaces, including housing conditions and public spaces for socialising, social support, adverse working conditions which include caring responsibilities, and access to digital technologies and healthcare services. CONCLUSION: SDHs have played a fundamental role in shaping people's health and well-being during the COVID-19 pandemic, and this study has shown that they have a considerable effect on depression outcomes. Governments should consider implementing social welfare programs to tackle both psychosocial problems and material need during crisis situations.

Validación de la versión en español de la Feminism and the Women's Movement Scale en estudiantes universitarios / Validation of the spanish version of Feminism and the Women's Movement Scale in university students

Objetivo: Existe evidencia de que la orientación feminista de las personas es un predictor significativo de la concienciación ante la violencia de género y la capacidad de intervenir. El objetivo de este estudio es validar la versión en español de laFeminism and the Women's Movement Scale (FWMS), que evalúa la orientación feminista. Método: Se administró la FWMS a 407 estudiantes universitarios/as de Ciencias de la Salud y de Trabajo Social. Se realizó un análisis factorial confirmatorio y se examinó el ajuste del modelo mediante ecuaciones estructurales. Resultados: Los resultados mostraron un alfa de Cronbach de 0,869 y un KMO de 0,923, con Barttlet <0,001. El modelo factorial detectó un único factor que agrupó los 10 ítems en una variable latente denominada «movimiento feminista», que explicaba el 99,15% de la varianza total. El modelo factorial arrojó un factor que explicó el 99,15% de la varianza. Las cargas factoriales de los ítems superaron el 0,837. Conclusiones:Los resultados confirman la validez de la versión española de la FWMS. (AU)

Objective: There is strong evidence that individuals' feminist orientation is a significant predictor of gender-based violence awareness and capability to intervene. The objective of this study is to validate the Spanish version of the Feminism and the Women's Movement Scale (FWMS) that assesses the feminist orientation. Method: A cross-sectional descriptive study was carried out, administering the FWMS to 407 university students of Health Sciences and Social Work. A confirmatory factor analysis was carried out and the adjustment of the model was examined through confirmatory factor analysis, analyzing structural equations. Results: The results revealed Cronbach's alpha=0.869 and KMO=0.923; Bartlett <0.001. The factorial model found a sole factor that merged the 10 items into a latent variable called feminist movement and explained 99.15% of the total variance. The factorial model yielded one factor that explained 99.15% of the variance. The factorial loads of the items exceeded 0.837. Conclusions: These results confirm the validity of the Spanish version of FWMS questionnaire. (AU)

An Index for Wine Acetaldehyde Reactive Potential (ARP) and Some Derived Remarks about the Accumulation of Acetaldehyde during Wine Oxidation.

The amount of acetaldehyde accumulated during wine oxidation was very small, far less than expected. The existence of polyphenols specifically reactive to acetaldehyde was postuled. In order to assess the acetaldehyde reactive potential (ARP) of wines, different reactive conditions have been studied: acetaldehyde concentration, temperature and pH. The evaluation/validation of developed ARP assay was made with 12 wines. Results have shown that high temperatures cannot be used to estimate wine ARP. In fact, at 70 °C acetaldehyde reacts strictly proportionally to wine total polyphenols. A reproducible index by letting wine at pH 2 react with 35 mgL-1 of acetaldehyde for 7 days was obtained and applied to 12 wines. Rosés did not consume any, whites consumed 8% and reds between 18 and 38% of their total acetaldehyde content. After pH correction, whites ARP can be similar to low ARP reds. Basic kinetic considerations derived from the measurement of ARP were applied to interpret observed acetaldehyde accumulation and consumption during the forced oxidation of the 12 wines. It is concluded that wine ARPs cannot explain the huge fraction of acetaldehyde presumably consumed by wine and the fraction of H2O2 produced during oxidation and not consumed by SO2 has to oxidize majorly wine components other than ethanol.

GroundsWell: Community-engaged and data-informed systems transformation of Urban Green and Blue Space for population health - a new initiative.

Natural environments, such as parks, woodlands and lakes, have positive impacts on health and wellbeing. Urban Green and Blue Spaces (UGBS), and the activities that take place in them, can significantly influence the health outcomes of all communities, and reduce health inequalities. Improving access and quality of UGBS needs understanding of the range of systems (e.g. planning, transport, environment, community) in which UGBS are located. UGBS offers an ideal exemplar for testing systems innovations as it reflects place-based and whole society processes , with potential to reduce non-communicable disease (NCD) risk and associated social inequalities in health. UGBS can impact multiple behavioural and environmental aetiological pathways. However, the systems which desire, design, develop, and deliver UGBS are fragmented and siloed, with ineffective mechanisms for data generation, knowledge exchange and mobilisation. Further, UGBS need to be co-designed with and by those whose health could benefit most from them, so they are appropriate, accessible, valued and used well. This paper describes a major new prevention research programme and partnership, GroundsWell, which aims to transform UGBS-related systems by improving how we plan, design, evaluate and manage UGBS so that it benefits all communities, especially those who are in poorest health. We use a broad definition of health to include physical, mental, social wellbeing and quality of life. Our objectives are to transform systems so that UGBS are planned, developed, implemented, maintained and evaluated with our communities and data systems to enhance health and reduce inequalities. GroundsWell will use interdisciplinary, problem-solving approaches to accelerate and optimise community collaborations among citizens, users, implementers, policymakers and researchers to impact research, policy, practice and active citizenship. GroundsWell will be shaped and developed in three pioneer cities (Belfast, Edinburgh, Liverpool) and their regional contexts, with embedded translational mechanisms to ensure that outputs and impact have UK-wide and international application.

Can aldehyde accumulation rates of red wines undergoing oxidation be predicted in accelerated conditions? The controverted role of aldehyde-polyphenol reactivity.

BACKGROUND: The accumulation of acetaldehyde and Strecker aldehydes during wine oxidation is detrimental to quality and often determines wine shelf-life. Knowing in advance the specific tendency of a wine to accumulate these compounds would help decision making during winemaking. An accelerated test based on a forced oxidation procedure at 45 °C (5 days) to measure aldehyde accumulation rates (AARs) is proposed and assessed by comparing results with those obtained by oxidation at 25 °C (36 days). Reactivities of aldehydes in those same wines stored in anoxia at both temperatures were also measured. RESULTS: Wine oxygen consumption rates at 25 °C are poorly correlated with those observed at 45 °C. By contrast, AARs of methional and of 2- and 3-methylbutanals measured during wine oxidation at 25 °C are equivalent to those measured at 45 °C. AARs from isobutanal and acetaldehyde are also correlated, while AARs from phenylacetaldehyde are not. Partial least squares models explaining AARs show intriguing differences regarding the apparent limiting role played by wine anthocyanins and other polyphenols in the ability of wines to accumulate aldehydes. Measured differences in aldehyde pattern are similar to those of the other Strecker aldehydes. CONCLUSION: The proposed assay makes it possible to obtain a reasonable estimate of a wine's tendency to accumulate aldehydes, with the exception phenylacetaldehyde, in 5 days. Neither differences in aldehyde reactivity between wines nor the change in reactivities with temperature support a major role for reactivity in differentially limiting AARs during wine oxidation. © 2021 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

[Validation of the Spanish version of Feminism and the Women's Movement Scale in university students]. / Validación de la versión en español de la Feminism and the Women's Movement Scale en estudiantes universitarios.

OBJECTIVE: There is strong evidence that individuals' feminist orientation is a significant predictor of gender-based violence awareness and capability to intervene. The objective of this study is to validate the Spanish version of the Feminism and the Women's Movement Scale (FWMS) that assesses the feminist orientation. METHOD: A cross-sectional descriptive study was carried out, administering the FWMS to 407 university students of Health Sciences and Social Work. A confirmatory factor analysis was carried out and the adjustment of the model was examined through confirmatory factor analysis, analyzing structural equations. RESULTS: The results revealed Cronbach's alpha=0.869 and KMO=0.923; Bartlett <0.001. The factorial model found a sole factor that merged the 10 items into a latent variable called feminist movement and explained 99.15% of the total variance. The factorial model yielded one factor that explained 99.15% of the variance. The factorial loads of the items exceeded 0.837. CONCLUSIONS: These results confirm the validity of the Spanish version of FWMS questionnaire.

Role of Grape-Extractable Polyphenols in the Generation of Strecker Aldehydes and in the Instability of Polyfunctional Mercaptans during Model Wine Oxidation.

Polyphenolic fractions from Garnacha, Tempranillo, and Moristel grapes were reconstituted to form model wines of identical pH, ethanol, amino acid, metal, and varietal polyfunctional mercaptan (PFM) contents. Models were subjected to a forced oxidation procedure at 35 °C and to an equivalent treatment under strict anoxia. Polyphenolic profiles significantly determined oxygen consumption rates (5.6-13.6 mg L-1 day-1), Strecker aldehyde (SA) accumulation (ratios max/min around 2.5), and levels of PFMs remaining (ratio max/min between 1.93 and 4.53). By contrast, acetaldehyde accumulated in small amounts and homogeneously (11-15 mg L-1). Tempranillo samples, with highest delphinidin and prodelphinidins and smallest catechin, consume O2 faster but accumulate less SA and retain smallest amounts of PFMs under anoxic conditions. Overall, SA accumulation may be related to polyphenols, producing stable quinones. The ability to protect PFMs as disulfides may be negatively related to the increase in tannin activity, while pigmented tannins could be related to 4-methyl-4-mercaptopentanone decrease.

Sensory Relevance of Strecker Aldehydes in Wines. Preliminary Studies of Its Removal with Different Type of Resins.

The orthonasal quality of two synthetic contexts of wine (young wine and oaked wine) spiked with six different levels of the Strecker aldehydes (isobutyraldehyde, 2-methylbutanal, 3-methylbutanal, methional and phenylacetaldehyde) was evaluated by a panel of wine experts. The aldehyde levels simulated the concentrations present in wines protected from oxidation during production and storage and after severe oxidation. Significant quality detriments were observed at concentrations of 13 µg/L of methional, 49 µg/L of phenylacetaldehyde, 17 µg/L of isobutyraldehyde, 12 µg/L of 2-methylbutanal and 24 µg/L of 3-methylbutanal. The presence of these levels of aldehyde concentrations induced the reduction of fruitiness in young wines and of woody notes in oaked wines as well as the appearance of the typical attributes that define wine oxidation. More than 75% of recently opened commercial wines contain total levels of Strecker aldehydes higher than those, however their effect is not always noticeable as they are forming inodorous adducts with SO2. Nevertheless, this content is a potential risk for the shelf life of the wine, as once SO2 is depleted, these aldehydes could release back into their odour-active forms. Thus, in order to reduce the presence of Strecker aldehydes, eight different resins were studied (two scavengers, four mixed-mode anion exchange and two pure anion exchange) in white wine at two levels of SO2. After 24-h contact, the mixed mode Strata X-A resin was able to significantly reduce aldehydes' percentages: between 11% for isobutyraldehyde and 86% for phenylacetaldehyde. On the other hand, wine colour was affected and therefore the applicability of the treatment should be further studied. However, this work can be considered a starting point to solve the technological challenge involved in the elimination of aldehydes from wine.

Development of a Third Trimester Contingent Prognostic Prediction Scheme for Suspected Early-Onset Pre-Eclampsia.

INTRODUCTION: Short-term prediction of pre-eclampsia (PE) using soluble FMS-like tyrosine kinase-1 (sFlt-1)/ placental growth factor (PlGF) ratio has high false-positive rate. Therefore, we developed a prognostic prediction tool that predicts early-onset PE leading to delivery within 1 week on pregnancies with an sFlt-1/PlGF ratio above 38 and compared it with an analogous model based on sFlt-1/PlGF ratio and with the 655 sFlt-1/PlGF ratio cutoff. METHODS: Cohort study of 363 singleton pregnancies with clinical suspicion of PE before 34 weeks of gestation, allowing repeated assessments (522). 213 samples with an sFlt-1/PlGF ratio above 38 were assessed to construct and identify the best-fit linear mixed model. N-terminal pro-B-type natriuretic peptide (NT-proBNP), sFlt-1 MoM, PlGF MoM, and sFlt-1/PlGF ratio combined with gestational age (GA) were assessed. RESULTS: None of the pregnancies with an sFlt-1/PlGF ratio of 38 or below developed early-onset PE (309 samples from 240 pregnancies). Conversely, 47 women of 213 assessments (22.1%) with an sFlt-1/PlGF ratio above 38 developed the assessed outcome. The selected model included sFlt-1 MoM, NT-proBNP, and GA. Differences in area under the curve were observed between the selected model and the GA + sFlt-1/PlGF model (p = 0.04). At an sFlt-1/PlGF ratio cutoff of 655, detection rate was 31.9% (15/47), while the selected model detection was 55.3% (26/47) (p = 0.008). DISCUSSION: Considering repeated assessments, the sFlt-1/PlGF ratio of 38 or below adequately ruled out early-onset PE, leading to delivery within 1 week. However, when sFlt-1/PlGF ratio is above 38, the prediction tool derived from linear mixed model based on GA, NT-proBNP, and sFlt-1 MoM, provided a better prognosis prediction than the sFlt-1/PlGF ratio.

The Relationship Between Confidence and Conformity in a Non-routine Counting Task With Young Children: Dedicated to the Memory of Purificación Rodríguez.

Counting is a complex cognitive process that is paramount to arithmetical development at school. The improvement of counting skills of children depends on their understanding of the logical and conventional rules involved. While the logical rules are mandatory and related to one-to-one correspondence, stable order, and cardinal principles, conventional rules are optional and associated with social customs. This study contributes to unravel the conceptual understanding of counting rules of children. It explores, with a developmental approach, the performance of children on non-routine counting detection tasks, their confidence in their answers (metacognitive monitoring skills), and their ability to change a wrong answer by deferring to the opinion of a unanimous majority who justified or did not justify their claims. Hundred and forty nine children aged from 5 to 8 years were randomized to one of the experimental conditions of the testimony of teachers: with (n = 74) or without justification (n = 75). Participants judged the correctness of different types of counting procedures presented by a computerized detection task, such as (a) pseudoerrors that are correct counts where conventional rules are violated (e.g., first counting six footballs, followed by other six basketballs that were interspersed along the row), and (b) compensation errors that are incorrect counts where logical rules were broken twice (e.g., skipping the third element of the row and then labeling the sixth element with two number words, 5 and 6). Afterwards, children rated their confidence in their detection answer with a 5-point scale. Subsequently, they listened to the testimony of the teachers and showed either conformity or non-conformity. The participants considered both compensation errors and pseudoerrors as incorrect counts in the detection task. The analysis of the confidence of children in their responses suggested that they were not sensitive to their incorrect performance. Finally, children tended to conform more often after hearing a justification of the testimony than after hearing only the testimonies of the teachers. It can be concluded that the age range of the evaluated children failed to recognize the optional nature of conventional counting rules and were unaware of their misconceptions. Nevertheless, the reasoned justifications of the testimony, offered by a unanimous majority, promoted considerable improvement in the tendency of the children to revise those misconceptions.