Prognostic value of the 5-SENSE Score to predict focality of the seizure-onset zone as assessed by stereoelectroencephalography: a prospective international multicentre validation study.

Introduction: Epilepsy surgery is the only curative treatment for patients with drug-resistant focal epilepsy. Stereoelectroencephalography (SEEG) is the gold standard to delineate the seizure-onset zone (SOZ). However, up to 40% of patients are subsequently not operated as no focal non-eloquent SOZ can be identified. The 5-SENSE Score is a 5-point score to predict whether a focal SOZ is likely to be identified by SEEG. This study aims to validate the 5-SENSE Score, improve score performance by incorporating auxiliary diagnostic methods and evaluate its concordance with expert decisions. Methods and analysis: Non-interventional, observational, multicentre, prospective study including 200 patients with drug-resistant epilepsy aged ≥15 years undergoing SEEG for identification of a focal SOZ and 200 controls at 22 epilepsy surgery centres worldwide. The primary objective is to assess the diagnostic accuracy and generalisability of the 5-SENSE in predicting focality in SEEG in a prospective cohort. Secondary objectives are to optimise score performance by incorporating auxiliary diagnostic methods and to analyse concordance of the 5-SENSE Score with the expert decisions made in the multidisciplinary team discussion. Ethics and dissemination: Prospective multicentre validation of the 5-SENSE score may lead to its implementation into clinical practice to assist clinicians in the difficult decision of whether to proceed with implantation. This study will be conducted in accordance with the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (2014). We plan to publish the study results in a peer-reviewed full-length original article and present its findings at scientific conferences. Trial registration number: NCT06138808.

Present and future of new systemic therapies for early and intermediate stages of hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a high mortality neoplasm which usually appears on a cirrhotic liver. The therapeutic arsenal and subsequent prognostic outlook are intrinsically linked to the HCC stage at diagnosis. Notwithstanding the current deployment of treatments with curative intent (liver resection/local ablation and liver transplantation) in early and intermediate stages, a high rate of HCC recurrence persists, underscoring a pivotal clinical challenge. Emergent systemic therapies (ST), particularly immunotherapy, have demonstrate promising outcomes in terms of increase overall survival, but they are currently bound to the advanced stage of HCC. This review provides a comprehensive analysis of the literature, encompassing studies up to March 10, 2024, evaluating the impact of novel ST in the early and intermediate HCC stages, specially focusing on the findings of neoadjuvant and adjuvant regimens, aimed at increasing significantly overall survival and recurrence-free survival after a treatment with curative intent. We also investigate the potential role of ST in enhancing the downstaging rate for the intermediate-stage HCC initially deemed ineligible for treatment with curative intent. Finally, we critically discuss about the current relevance of the results of these studies and the encouraging future implications of ST in the treatment schedules of early and intermediate HCC stages.

Lightweight Mortar Incorporating Expanded Perlite, Vermiculite, and Aerogel: A Study on the Thermal Behavior.

Climate change is compelling countries to alter their construction and urbanization policies to minimize their impact on the environment. The European Union has set a goal to reduce greenhouse gas emissions by 55%, recognizing that 50% of its emissions originate from maintaining thermal comfort within buildings. As a response, the EU has developed comprehensive legislation on energy efficiency. In this article, special mortars using aerogel, perlite, and vermiculite as lightweight aggregates were prepared and studied to enhance the thermal properties of the mortar. Their thermal properties were examined and, using a solar simulator for both hot and cold conditions, it was found that varying proportions of these lightweight aggregates resulted in a mortar that provided insulation from the exterior up to 7 °C more than the reference mortar in warm conditions and up to 4.5 °C in cold conditions.

Current characteristics of patients with hepatitis C virus: results from an automated alert system.

Alert systems are proving to be useful to increase hepatitis C virus (HCV) diagnoses and facilitating access to antiviral treatment. Since 2020, our health department has had a fully automated alert system set up at the Microbiology Department. In this study, we present the results of the 2022-2023 period to assess the current characteristics of HCV diagnosed patients. In addition, we analyzed, through a comparison, whether a limitation that we noticed during the 2020-2021 period (whose results were published) is still present. This limitation consists of that 24.2% (34/134) of those candidates for antiviral treatment were not treated because they could not be located or refused treatment. During the 2022-2023 period, 188 new cases were diagnosed, and 75% (141/188) were treated. The comparison of both periods showed that in 2022-2023, the rate of treatment rejection by the patient was significantly lower (1.4% vs 14.5%, p < 0.05) and, therefore, the rate of antiviral treatment increased (75% vs 58.9%, p < 0.05). These results suggest that our alert system is useful and efficient for the diagnosis and treatment of HCV.

Hepatitis B virus reactivation after ibrutinib treatment.

New immunosuppressive and antineoplastic drugs are becoming both more numerous and more widely used, even during several years. Most of them present a low-moderate risk of hepatitis B virus (HBV) reactivation in HBsAg-negative and anti-HBc-positive patients. However, their reactivation capacity has not been clearly studied. We present the clinical case of a patient with these serological characteristics who, after 5 years of treatment with ibrutinib for chronic lymphocytic leukaemia, developed VHB reactivation, which was controlled with tenofovir. The occurrence of this event with drugs such as ibrutinib may lead to changes in HBV reactivation prophylaxis.

Impact of antiseizure medication with a very long half-life on long term video-EEG monitoring in focal epilepsy.

PURPOSE: To assess the impact of antiseizure medications (ASMs) with a very long half-life on long term video-EEG monitoring (LTM) in people with focal epilepsy (FE). METHODS: In this retrospective cohort study, we searched our local database for people with FE who underwent ASM reduction during LTM at the University Hospital of 'La Fe', Valencia, from January 2013 to December 2019. Taking into account the half-life of the ASM, people with FE were divided into two groups: Group A contained individuals who were taking at least one ASM with a very long half-life at admission, and Group B consisted of those not taking very long half-life ASMs. Using multivariable analysis to control for important confounders, we compared the following outcomes between both groups: seizure rates per day, time to first seizure, and LTM duration. RESULTS: Three hundred seventy individuals were included in the study (154 in Group A and 216 in Group B). The median recorded seizure rates (1.3 seizures/day, range 0-15.3 vs.1.3 seizures/day, range 0-9.3, p-value=0.68), median time to the first seizure (24 h, range 2-119 vs. 24 h, range 2-100, p-value=0.92), and median LTM duration (4 days, range 2-5 vs. 4 days, range 2-5, p-value=0.94) were similar in both groups. Multivariable analysis did not reveal any significant differences in the three outcomes between the two groups (all p-values>0.05). CONCLUSION: ASMs with a very long half-life taken as co-medication do not significantly affect important LTM outcomes, including recorded seizure rates, time to the first seizure, or LTM duration. Therefore, in general, there is no need to discontinue ASMs with a very long half-life prior to LTM.

Ejercicios físicos como tratamiento para lesiones de la columna vertebral, en estudiantes universitarios

Elevar la calidad de vida de estudiantes en todas las carreras universitarias es uno de los retos más importantes para los especialistas de Educación Física, y la terapéutica en particular; sin embargo, cuando los beneficiarios presentan lesiones en la columna vertebral, necesitan una adecuada rehabilitación física y mental. Se planteó como objetivo desarrollar ejercicios físicos como tratamiento para compensar el tiempo de recuperación de los estudiantes con lesiones en la columna vertebral que asisten al área terapéutica de la Universidad de Oriente, a través de las clases de Educación Física. En la investigación, se utilizaron métodos de nivel teórico y empírico, para conocer el estado real del problema, además de las técnicas para recoger y procesar información. Los ejercicios físicos propuestos están dirigidos fundamentalmente a estudiantes que presentan escoliosis, y de forma profiláctica-terapéutica se ofrece tratamiento para compensar y/o prevenir el tiempo de aparición del dolor que permita su recuperación inmediata e incorporación al proceso de enseñanza-aprendizaje dentro de las clases de Educación Física. Se tuvo en cuenta una estructura y ordenamiento metodológico de los contenidos en cuatro etapas escalonadas durante la aplicación del tratamiento, en correspondencia con las características individuales de la muestra. Los especialistas que valoraron la propuesta lo consideraron factible para su aplicación y de utilidad.

Elevar a qualidade de vida dos estudantes em todas as carreiras universitárias é um dos desafios mais importantes para os especialistas em Educação Física e, em particular, para a terapia; Contudo, quando os beneficiários apresentam lesões na medula espinhal, necessitam de reabilitação física e mental adequada. O objetivo foi desenvolver exercícios físicos como tratamento para compensar o tempo de recuperação de alunos com lesões medulares que frequentam a área terapêutica da Universidade de Oriente, por meio de aulas de Educação Física. Na pesquisa foram utilizados métodos teóricos e empíricos para conhecer o real estado do problema, além das técnicas para coletar e processar informações. Os exercícios físicos propostos são direcionados fundamentalmente aos alunos portadores de escoliose, e de forma profilático-terapêutica é oferecido tratamento para compensar e/ou prevenir o momento do aparecimento da dor que permite recuperação imediata e incorporação no processo de ensino-aprendizagem dentro do aulas de educação física. Foi considerada uma estrutura e ordenação metodológica dos conteúdos em quatro etapas escalonadas durante a aplicação do tratamento, em correspondência com as características individuais da amostra. Os especialistas que avaliaram a proposta consideraram-na viável e útil para sua aplicação.

Raising the quality of life of students in all university careers is one of the most important challenges for Physical Education specialists, and therapy in particular; however, when beneficiaries have spinal cord injuries, they need adequate physical and mental rehabilitation. The objective was to develop physical exercises as a treatment to compensate for the recovery time of students with spinal cord injuries who attend the therapeutic area of the Universidad de Oriente, through Physical Education classes. In the research, theoretical and empirical methods were used to know the real state of the problem, in addition to the techniques to collect and process information. The physical exercises proposed are fundamentally aimed at students who have scoliosis, and in a prophylactic-therapeutic way, treatment is offered to compensate and/or prevent the time of onset of pain that allows immediate recovery and incorporation into the teaching-learning process within the physical education classes. A structure and methodological ordering of the contents was taken into account in four staggered stages during the application of the treatment, in correspondence with the individual characteristics of the sample. The specialists who evaluated the proposal considered it feasible for its application and useful.

Stabilization of Enzymes by Using Thermophiles.

Manufactured steroid compounds have many applications in the pharmaceutical industry. Due to the chemical complexity and chirality of steroids, there is an increasing demand for enzyme-based bioconversion processes to replace those based on chemical synthesis. In this context, thermostability of the involved enzymes is a highly desirable property as both the increased half-life of the enzyme and the enhanced solubility of substrates and products will improve the yield of the reactions. Metagenomic libraries from thermal environments are potential sources of thermostable enzymes of prokaryotic origin, but the number of expected hits could be quite low for enzymes handling substrates such as steroids, rarely found in prokaryotes. An alternative to metagenome screening is the selection of thermostable variants of well-known steroid-processing enzymes. Here we review and detail a protocol for such selection, where error-prone PCR (epPCR) is used to introduce random mutations into a gene to create a variants library for further selection of thermostable variants in the thermophile Thermus thermophilus. The method involves the use of folding interference vectors where the proper folding of the enzyme of interest at high temperature is linked to the folding of a reporter encoding a selectable property such as thermostable resistance to kanamycin, leading to a life-or-death selection of variants of reinforced folding independently of the activity of the enzyme.

Concepción teórico-metodológica para el desarrollo de la coordinación en educandos con discapacidad intelectual leve

La discapacidad intelectual leve provoca un lento aprendizaje de las habilidades motrices, en particular de la coordinación, y se considera que esta problemática precisa de atención. En las clases de Educación Física se observó que los educandos con discapacidad intelectual leve presentaron alteraciones en las capacidades coordinativas motoras, posturales, sensoriales y en las conductas de adaptación a los diferentes contextos como la casa, la institución educativa y la comunidad; por lo que se planteó como objetivo desarrollar la coordinación en los educandos de siete a ocho años, mediante juegos motrices en las clases de Educación Física. El estudio que se presenta, se sustentó en la complementariedad metodológica al combinarse los enfoques cualitativo y cuantitativo; se emplearon métodos teóricos como el analítico-sintético, el sistémico-estructural-funcional, el histórico-lógico y el inductivo-deductivo y métodos empíricos como la observación, la entrevista, la encuesta y el experimento. Como resultado, se realizó la sistematización teórica, el diagnóstico y la propuesta de juegos motrices acorde con la edad y la discapacidad intelectual leve que se manifiesta en el desarrollo de la conducta motriz y en las relaciones de actuación de los educandos. De manera general, se constató una mejor coordinación y desarrollo de las habilidades para realizar los diferentes ejercicios y juegos motrices en las clases de Educación Física.

A deficiência intelectual leve causa uma aprendizagem lenta das habilidades motoras, particularmente da coordenação, e considera-se que esse problema precisa de atenção. Nas aulas de Educação Física, observou-se que os alunos com deficiência intelectual leve apresentavam alterações nas habilidades de coordenação motora, postural e sensorial e no comportamento de adaptação a diferentes contextos, como a casa, a instituição de ensino e a comunidade; portanto, o objetivo foi desenvolver a coordenação em alunos de sete a oito anos de idade, por meio de jogos motores nas aulas de Educação Física. O estudo aqui apresentado baseou-se na complementaridade metodológica, combinando abordagens qualitativas e quantitativas; foram utilizados métodos teóricos como o analítico-sintético, o sistêmico-estrutural-funcional, o histórico-lógico e o indutivo-dedutivo, bem como métodos empíricos como observação, entrevista, pesquisa e experimento. Como resultado, foram realizados a sistematização teórica, o diagnóstico e a proposta de jogos motores de acordo com a idade e a deficiência intelectual leve que se manifesta no desenvolvimento do comportamento motor e nas relações de desempenho dos alunos. Em geral, observou-se uma melhor coordenação e desenvolvimento de habilidades para realizar os diferentes exercícios e jogos motores nas aulas de Educação Física.

Mild intellectual disability causes slow learning of motor skills, particularly coordination, and this problem is considered to require attention. In Physical Education classes, it was observed that students with mild intellectual disabilities presented alterations in motor, postural, sensory coordinative capacities and in adaptation behaviors to different contexts such as home, the educational institution and the community; for this reason, the objective was to develop coordination in students from seven to eight years of age, through motor games in Physical Education classes. The study presented was based on methodological complementarity by combining the qualitative and quantitative approaches; theoretical methods such as the analytical-synthetic, the systemic-structural-functional, the historical-logical and the inductive-deductive and empirical methods such as observation, interview, survey and experiment were used. As a result, the theoretical systematization, the diagnosis and the proposal of motor games according to age and mild intellectual disability that manifests itself in the development of motor behavior and in the relations of action of the students were carried out. In general, there was a better coordination and development of skills to perform the different exercises and motor games in Physical Education classes.

Educational intervention for the main caregiver of primiparous women to promote breastfeeding and the association between prolactin and nutritional parameters.

Background: In the last two years, breastfeeding rates have experienced a notable decline worldwide. Only 46% of women breastfeed their children, the figure being much lower in primiparous women. Breastfed milk is the ideal food for babies; its benefits for the health of mothers and babies are scientifically proven. Several studies show that babies who are not breastfed have a higher risk of getting sick. This fact gives rise to an important public health problem. The aim of this paper is to describe the association between presence of the caregiver in health education and increasing rates of breastfeeding. Methods: We conducted an observational study (cohort) in a population of primiparous pregnant women (n = 88), and their main caregivers belonging to a region of central Spain. The development, content and implementation of the intervention consisted of: 1) obtaining the blood levels of pregnant women (prolactin, folic acid, vitamin B12 and transferrin) before health education (13-26 weeks of pregnancy), 2) carry out health education with two groups: A (44 pregnant women with caregivers) and B (44 without caregivers), 3) obtain the same blood levels as in the first intervention, 15 days after delivery, and finally the evaluation of the intervention with breastfeeding rates. Results: The levels of prolactin (288.57 ± 107.46 nanogrammes per millilitre (ng / ml)), folic acid (16.93 ± 4.09 ng / ml), vitamin B12 (505.05 ± 213.97 picogrammes (pg) / ml) and transferrin (296.82 ± 67.61 milligrammmes per decilitre (mg / dl)) were higher in pregnant women who attended the health education program with a caregiver than in pregnant women who attended alone: prolcoactin (103.61 ± 45.48 ng / ml), folic acid (7.16 ± 5.88 ng / ml), vitamin B12 (160.59 ± 36.92 pg / ml) and transferrin (223.86 ± 44.14 mg / dl). Of the sample size of 44 primiparous people who attended the talks with caregivers, 35 (79.54%) breastfed their babies, while the other 44 primiparous women who attended alone, only seven (15.91%) established breastfeeding successfully. Conclusions: The implications for public health research are that the presence of a caregiver in health education programs modifies levels of prolactin, folic acid, vitamin B12, and transferrin, as well as increasing breastfeeding rates.

Improved rock phosphate dissolution from organic acids is driven by nitrate assimilation of bacteria isolated from nitrate and CaCO3-rich soil.

Until now, the solubilization capacities of insoluble mineral P by soil microorganisms have been screened in vitro with media containing NH4+ as a nitrogen source. This presence of NH4+ will lead to an acidification of the medium responsible for the solubilization of the insoluble P. However, besides proton release, the production of organic acids can play a very important role in the release of free P. This physiological mechanism can largely depend on the source of nitrogen (NH4+vs NO3-) assimilated by the bacteria but the influence of the N source on the production of organic acids has yet to be studied. Our aim was to investigate if the N source assimilated by bacteria and the soil characteristics such as the dominant N source (NH4+vs NO3-) and CaCO3 contents might influence the bacterial capacities to solubilize rock phosphate. To fill this objective, we screened the capacity of bacteria isolated from 3 soils to solubilize rock phosphate in vitro in presence of NH4+or NO3-. Then, we selected the most efficient bacterial strains to identify and quantify the release of organic anions into the medium. Among the two hundred and forty-three bacterial strains isolated from the 3 soils, nine and seven isolates were identified with the highest % rock phosphate-solubilization values with NH4+ or NO3- as the sole N-source. Only one strain was able to release free Pi with NH4+ or NO3- as the sole N-source. The most predominant organic acids released by almost all isolates were gluconic acid, lactic acid, glycolic acid, acetic acid, formic acid and pyruvic acid regardless the N-source. However, with NO3- as source of N, the highest concentrations on those acids were found together with the highest release of free Pi into the medium. Molecular analysis of 16S rRNA indicated that almost all strains belonged to Bacillus and Paenibacillus genera. The PCA analysis between soil properties and bacterial capacities to release organic acids and free Pi also revealed that soil factors such as CaCO3 and soil NO3- content positively influenced the release of organic acids by bacteria grown in vitro. Our results concluded that the bacterial rock phosphate-solubilization was intimately related to organic acids production which in turn seemed to be driven by the assimilation of NO3- by bacteria. Therefore, the N-source might be considered a key factor to take into consideration during the screening and selection of suitable strains involved in the P-solubilization.

Consumers' willingness to pay for health claims during the COVID-19 pandemic: A moderated mediation analysis.

The COVID-19 pandemic has posed a substantial threat to people's lives and raised health concerns. This research explores the mediating role of consumers' attitudes towards health claims in the relationship between consumers' interest in health claims and their willingness to pay (WTP) for health claims in extra virgin olive oil (EVOO). Additionally, we examine the moderation effect of COVID-19 risk perception in the relationship between consumers' interest in and attitudes towards health claims. Data were collected through an online survey in three countries: Spain, the UK and Chile. Findings confirm the mediating role of consumers' attitudes towards health claims. Furthermore, the relationship between consumers' interest and their attitudes towards health claims was stronger when COVID-19 risk perception was higher.

Best methods for urine sample collection for diagnostic accuracy in women with urinary tract infection symptoms: a systematic review.

BACKGROUND: Most guidelines recommend a midstream urine (MSU) or a midstream clean-catch (MSCC) sample for urinalysis. However, whether this sample is better than others is still controversial. OBJECTIVES: To assess the most adequate non-invasive method to collect a urine specimen for diagnosing urinary tract infections (UTI) in symptomatic non-pregnant women. METHODS: This review was conducted according to the Systematic Reviews of Diagnostic Test Accuracy guidelines (PROSPERO CRD42021241758). PubMed was searched paired sample studies and controlled trials. Studies comparing MSCC, MSU without cleaning, first-void urine, and random voiding samples were considered. Studies evaluating invasive methods were excluded. The main outcome was diagnostic accuracy of urine cultures. Contamination rates were evaluated. The risk of bias tool for systematic reviews on diagnostic accuracy (QUADAS-2) was assessed. RESULTS: Six studies including 1,010 patients were evaluated. Only two studies used paired samples. No study was considered as having low risk of bias. There was no difference in contamination for MSU specimens collected with or without cleansing and between random void urine collection and MSCC. In one study comparing first-void urine with MSU samples, the contamination rate was lower in the latter, but the gold standard of urine culture was only used for one sampling collection. CONCLUSIONS: To the best of our knowledge, this systematic review is the first to assess the evidence available from different exclusively non-invasive urine sampling. Despite being widely recommended, our review did not find consistent evidence that asking women to provide midstream samples with or without cleansing is better.

Urine is one type of specimen that can be easily collected from a patient. Urinalysis testing can give the doctor valuable information about the presence of an infection in the urine and the type of microorganism causing this infection. The physician can also use the information from urine testing to diagnose and treat other diseases. The collection of the mid-stream of the urination has always been advocated. However, this recommendation has never been proven with good quality studies, and the results of the studies carried out so far have been controversial. In a systematic review, we recently determined that the use of any specimen during urination is as good as midstream collection when patients are requested to provide a urine sample and in terms of quality even specimens collected without proper cleansing are also comparable to mid-stream collection with cleansing. In the present systematic review, we evaluated the most adequate non-invasive method to collect a urine specimen for diagnosing urinary tract infections in symptomatic non-pregnant women. We identified only six studies comparing different urine sampling techniques and we did not observe any difference regarding the quality of the urine between them.