Epidemiological and Clinical Aspects of Cutaneous and Mucosal Leishmaniases in Portugal: Retrospective Analysis of Cases Diagnosed in Public Hospitals and Reported in the Literature between 2010 and 2020

Leishmania infantum, a zoonotic vector-born parasite, is endemic in the Mediterranean region, presenting mostly as visceral (VL), but also as cutaneous (CL) and mucosal leishmaniasis (ML). This study aimed to describe the epidemiological and clinical aspects of the CL and ML cases diagnosed in mainland Portugal between 2010 and 2020. Collaboration was requested from every hospital of the Portuguese National Health System. Cases were screened through a search of diagnostic discharge codes or positive laboratory results for Leishmania infection. Simultaneously, a comprehensive literature search was performed. Descriptive statistics and hypothesis testing were performed using IBM® SPSS® Statistics. A total of 43 CL and 7 ML cases were identified, with a predominance of autochthonous cases (86%). In CL, immunosuppressed individuals constituted a significant proportion of patients (48%), and in this group, disseminated CL (22%) and simultaneous VL (54%) were common. In autochthonous cases, lesions, mostly papules/nodules (62%), were frequently observed on the head (48%). The approach to treatment was very heterogeneous. ML cases were all autochthonous, were diagnosed primarily in older immunosuppressed individuals, and were generally treated with liposomal amphotericin B. The findings suggest a need for enhanced surveillance and reporting, clinical awareness, and diagnostic capacity of these forms of leishmaniasis to mitigate underdiagnosis and improve patient outcomes. A holistic One Health approach is advocated to address the multifaceted challenges posed by leishmaniases in Portugal and beyond.

Predicting post-discharge complications in cardiothoracic surgery: A clinical decision support system to optimize remote patient monitoring resources

Cardiac surgery patients are highly prone to severe complications post-discharge. Close follow-up through remote patient monitoring can help detect adverse outcomes earlier or prevent them, closing the gap between hospital and home care. However, equipment is limited due to economic and human resource constraints. This issue raises the need for efficient risk estimation to provide clinicians with insights into the potential benefit of remote monitoring for each patient. Standard models, such as the EuroSCORE, predict the mortality risk before the surgery. While these are used and validated in real settings, the models lack information collected during or following the surgery, determinant to predict adverse outcomes occurring further in the future. This paper proposes a Clinical Decision Support System based on Machine Learning to estimate the risk of severe complications within 90 days following cardiothoracic surgery discharge, an innovative objective underexplored in the literature. Health records from a cardiothoracic surgery department regarding 5 045 patients (60.8% male) collected throughout ten years were used to train predictive models. Clinicians' insights contributed to improving data preparation and extending traditional pipeline optimization techniques, addressing medical Artificial Intelligence requirements. Two separate test sets were used to evaluate the generalizability, one derived from a patient-grouped 70/30 split and another including all surgeries from the last available year. The achieved Area Under the Receiver Operating Characteristic curve on these test sets was 69.5% and 65.3%, respectively. Also, additional testing was implemented to simulate a real-world use case considering the weekly distribution of remote patient monitoring resources post-discharge. Compared to the random resource allocation, the selection of patients with respect to the outputs of the proposed model was proven beneficial, as it led to a higher number of high-risk patients receiving remote monitoring equipment.

miRNAs in Heart Development and Disease

Cardiovascular diseases (CVD) are a group of disorders that affect the heart and blood vessels. They include conditions such as myocardial infarction, coronary artery disease, heart failure, arrhythmia, and congenital heart defects. CVDs are the leading cause of death worldwide. Therefore, new medical interventions that aim to prevent, treat, or manage CVDs are of prime importance. MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression at the posttranscriptional level and play important roles in various biological processes, including cardiac development, function, and disease. Moreover, miRNAs can also act as biomarkers and therapeutic targets. In order to identify and characterize miRNAs and their target genes, scientists take advantage of computational tools such as bioinformatic algorithms, which can also assist in analyzing miRNA expression profiles, functions, and interactions in different cardiac conditions. Indeed, the combination of miRNA research and bioinformatic algorithms has opened new avenues for understanding and treating CVDs. In this review, we summarize the current knowledge on the roles of miRNAs in cardiac development and CVDs, discuss the challenges and opportunities, and provide some examples of recent bioinformatics for miRNA research in cardiovascular biology and medicine.

Relationship between Physicochemical and Cooking Quality Parameters with Estimated Glycaemic Index of Rice Varieties

Rice is a significant staple food in the basic diet of the global population that is considered to have a high glycaemic index. The study of the physical and chemical parameters in rice that are related to the starch digestion process, which allows us to quickly predict the glycaemic index of varieties, is a major challenge, particularly in the classification and selection process. In this context, and with the goal of establishing a relationship between physicochemical properties and starch digestibility rates, thus shedding light on the connections between quality indicators and their glycaemic impact, we evaluated various commercial rice types based on their basic chemical composition, physicochemical properties, cooking parameters, and the correlations with digestibility rates. The resistant starch, the gelatinization temperature and the retrogradation (setback) emerge as potent predictors of rice starch digestibility and estimated glycaemic index, exhibiting robust correlations of r = -0.90, r = -0.90, and r = -0.70 (p ≤ 0.05), respectively. Among the rice types, Long B and Basmati stand out with the lowest estimated glycaemic index values (68.44 and 68.10), elevated levels of resistant starch, gelatinization temperature, and setback values. Furthermore, the Long B showcases the highest amylose, while the Basmati with intermediate, revealing intriguingly strong grain integrity during cooking, setting it apart from other rice varieties.

Ambivalence Resolution in Meaning Reconstruction Grief Therapy: An Exploratory Study

In psychotherapy, ambivalence may be conceptualized as a conflict between two distinct motivations: one that is favorable to change (pro-change) and another that favors the maintenance of a problematic pattern (pro status quo). Previous studies identified two processes by which clients resolve this conflict: imposing the innovative part and silencing the problematic one (dominance), and establishing negotiations between the innovative and the pro status quo parts (negotiation). The present exploratory study examined ambivalence resolution in a sample of clients diagnosed with complicated grief. Results revealed that, in recovered cases, negotiation increases and dominance decreases from the beginning until the middle sessions of therapy and the opposite tendency is observed from the middle to the final sessions. Unchanged cases reveal an overall high proportion of dominance and an overall low proportion of negotiation. These results are partially divergent from those reported in previous studies with samples of clients diagnosed with major depression.

Is the quality of therapeutic collaboration associated with the assimilation of problematic experiences progress? A comparison of two cases

OBJECTIVE

How are collaborative interactions associated with clients' progress in therapy? This study addressed this question, by assessing the quality of therapeutic collaboration and comparing it passage by passage with the clients' assimilation of problematic experiences in two cases of major depression treated with Cognitive Behavioral Therapy, one recovered and one improved-but-not-recovered.

METHOD

We used the Therapeutic Collaboration Coding System to code collaborative work and the Assimilation of Problematic Experiences Scale (APES) to rate clients' progress. In both cases, for the distribution of specific collaborative therapeutic exchanges, we tested for the difference of empirical means between lower and higher APES levels.

RESULTS

Both cases progress in APES, but in contrast with Annie (Improved-but-not-recovered), Kate (Recovered) achieved higher levels of change in last sessions. In addition, we found significant differences in the types of collaborative therapeutic exchanges associated with lower and higher APES levels.

CONCLUSION

Ambivalent therapeutic exchanges distinguished the recovered case from the not recovered case highlighting a source of difficulties in facilitating therapeutic change in CBT. In addition, observations in these cases supported the theoretical suggestion that supporting interventions would be better accepted at lower APES levels, whereas challenging interventions would be better accepted at higher APES levels.

Trapping Microparticles in a Structured Dark Focus

We experimentally demonstrate stable trapping and controlled manipulation of silica microspheres in a structured optical beam consisting of a dark focus surrounded by light in all directions-the dark focus tweezer. Results from power spectrum and potential analysis demonstrate the nonharmonicity of the trapping potential landscape, which is reconstructed from experimental data in agreement to Lorentz-Mie numerical simulations. Applications of the dark tweezer in levitated optomechanics and biophysics are discussed.

Fall risk stratification of community-living older people. Commentary on the world guidelines for fall prevention and management

The Task Force on Global Guidelines for Falls in Older Adults has put forward a fall risk stratification tool for community-dwelling older adults. This tool takes the form of a flowchart and is based on expert opinion and evidence. It divides the population into three risk categories and recommends specific preventive interventions or treatments for each category. In this commentary, we share our insights on the design, validation, usability and potential impact of this fall risk stratification tool with the aim of guiding future research.

Urinary continence recovery after Retzius-sparing robot-assisted radical prostatectomy in relation to surgeon experience

Urinary incontinence is one of the main concerns for patients after radical prostatectomy. Differences in surgical experience among surgeons could partly explain the wide range of frequencies observed. Our aim was to evaluate the association between the surgeons` experience and center caseload with relation to urinary continence recovery after Retzius-sparing robot-assisted radical prostatectomy (RS-RARP). Prospective observational single-center study. Five surgeons consecutively operated 405 patients between July 2017 and February 2022. Continence recovery was evaluated with pad count and by employing the short form of the International Consultation on Incontinence Questionnaire (ICIQ-SF), pre- and postoperatively at 1 year. Non-parametric tests were used. Median age was 63 years, 30% of patients presented with local advanced disease; the positive surgical margin rate (over 3 mm length) was 16%. Complication rate was 1% (Clavien-Dindo > II). One year after surgery, continence was assessed in 282 patients, of whom 87% were pad free and 51% never leaked (ICIQ-SF = 0). With respect to the mean annual number of procedures per surgeon, divided in < 20, 20-39 and ≥ 40, pad-free rates were achieved in 93%, 85%, and 84% and absence of urine leak rates in 47%, 62% and 48% of patients, respectively. Postoperative median ICIQ-SF was five. We acknowledge the limitation of a 12-month follow-up and the fact that we are a medium-volume center. There is no statistically significant association between continence recovery, surgeon's experience and center caseload. Continence recovery at 1 year after surgery is adequate and robust to surgeon's experience.

The importance, prevalence and determination of vitamins B6 and B12 in food matrices: A review

Vitamins are a vast group of fundamental organic compounds, which are not produced by the human body but are essential for the living organisms' good health. Vitamins B6 and B12 belong to the same group of hydrophilic vitamins. Structurally unrelated, they share the same purpose as essential components for normal cellular operation, growth and development. Vitamin B6 is an enzymatic co-factor that is vital for countless biochemical reactions, and is also important in sugar and fatty acid metabolization. It encompasses three natural and inter-convertible pyridine-derivatives: pyridoxine, pyridoxal and pyridoxamine. Vitamin B12 is a cobalt organometallic complex also indispensable in numerous human physiological functions. It has four bioactive forms: cyanocobalamin, methylcobalamin, hydroxocobalamin and 5'-deoxyadenosylcobalamin, and only a few prokaryotes have the ability to biosynthesize cobalamin. This work reviews the significant aspects of vitamins B6 and B12: their vital roles, consequences of deficit; food sources; and methods of determination and respective matrices, with heavy emphasis on chromatographic techniques developed within the last two decades.

Minding your steps: a cross-sectional pilot study using foot-worn inertial sensors and dual-task gait analysis to assess the cognitive status of older adults with mobility limitations

BACKGROUND

Cognitive impairment is a critical aspect of our aging society. Yet, it receives inadequate intervention due to delayed or missed detection. Dual-task gait analysis is currently considered a solution to improve the early detection of cognitive impairment in clinical settings. Recently, our group proposed a new approach for the gait analysis resorting to inertial sensors placed on the shoes. This pilot study aimed to investigate the potential of this system to capture and differentiate gait performance in the presence of cognitive impairment based on single- and dual-task gait assessments.

METHODS

We analyzed demographic and medical data, cognitive tests scores, physical tests scores, and gait metrics acquired from 29 older adults with mobility limitations. Gait metrics were extracted using the newly developed gait analysis approach and recorded in single- and dual-task conditions. Participants were stratified into two groups based on their Montreal Cognitive Assessment (MoCA) global cognitive scores. Statistical analysis was performed to assess differences between groups, discrimination ability, and association of gait metrics with cognitive performance.

RESULTS

The addition of the cognitive task influenced gait performance of both groups, but the effect was higher in the group with cognitive impairment. Multiple dual-task costs, dual-task variability, and dual-task asymmetry metrics presented significant differences between groups. Also, several of these metrics provided acceptable discrimination ability and had a significant association with MoCA scores. The dual-task effect on gait speed explained the highest percentage of the variance in MoCA scores. None of the single-task gait metrics presented significant differences between groups.

CONCLUSIONS

Our preliminary results show that the newly developed gait analysis solution based on foot-worn inertial sensors is a pertinent tool to evaluate gait metrics affected by the cognitive status of older adults relying on single- and dual-task gait assessments. Further evaluation with a larger and more diverse group is required to establish system feasibility and reliability in clinical practice.

TRIAL REGISTRATION

ClinicalTrials.gov (identifier: NCT04587895).

As trials go by: Effects of 2-AFC item repetition on statistical learning performance

One of the most popular tasks used to test statistical learning (SL) involves asking participants to identify which of two stimuli, a triplet presented during the previous familiarization phase versus a new sequence made of the same stimuli never presented together, is more familiar based on the stream presented before, that is, to perform a two-alternative forced-choice (2-AFC) task. Despite the widespread use of this task, it has come under increasing criticism in current cognitive research due to psychometric flaws. A common practice to improve SL measurement involves increasing the number of 2-AFC trials by presenting the same items (triplets and foils) several times during the test phase. This work aimed to directly analyze the effect that this practice entails by examining how the proportion of correct discriminations of three-syllable nonsense words presented during the familiarization phase of an auditory triplet embedded task changed as the number of 2-AFC item repetitions increased. We also tested whether this effect was modulated by the predictability of the "words" embedded in the auditory streams (high and low) and the conditions under which they were presented to participants (implicit and explicit). Results showed that 2-AFC item repetitions had indeed detrimental effects on SL measurement, as indexed by a significant decrease in the proportion of correct discriminations as the number of items repetitions increased, both in the 2-AFC task performed under implicit and explicit conditions, although, in the first case, only for low-predictable "words." These findings recommend caution when using this strategy to improve SL measurement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes

Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) has emerged as a surgical option for patients with prostatic cancer in high-volume centers. The objective is to assess oncological and functional outcomes when implementing RS-RARP in a medium-volume center without previous experience of robotic surgery. This is a prospective observational single-center study. Patients operated between July 2017 and April 2020 were divided into two consecutive groups, A and B, each with 104 patients. The surgeons had prior experience in laparoscopic surgery and underwent robotic training. Positive surgical margin (PSM) status, urinary continence, and erectile function projected by Kaplan-Meier curves, together with patient reported quality of life outcomes at 12 months post-surgery were documented. Median patient age was 63 years (IQR = 59-67), overall PSM rate were 33%, 28% for pT2 disease. Pre-operative values showed no significant difference between both groups. The rate of urinary continence dropped from 81 to 78% (SE = 5.7) (Group A) and from 90 to 72% (SE = 6.3) (Group B) using the International Consultation on Incontinence Questionnaire-Short Form. Baseline sexual function was regained in 41% (Group A) and 47% (Group B) of patients. The median Expanded Prostate Index Composite-26 total score decreased from 86 to 82. These outcomes relate favorably to prior reports. There was a clinically significant decrease in median operative time in the successive groups with post-operative complications occurring in less than 2% of surgical procedures overall. A 12-month follow-up suggests that RS-RARP may be safely introduced in a medium-volume center without previous experience of robotic surgery.

Using shoe-mounted inertial sensors and stepping exergames to assess the motor-cognitive status of older adults: A correlational study

Objective

Stepping exergames designed to stimulate physical and cognitive skills can provide important information concerning individuals’ performance. In this study, we investigated the potential of stepping and gameplay metrics to assess the motor-cognitive status of older adults.

Methods

Stepping and gameplay metrics were recorded in a longitudinal study involving 13 older adults with mobility limitations. Game parameters included games’ scores and reaction times. Stepping parameters included length, height, speed, and duration, measured by inertial sensors placed on the shoes while interacting with the exergames. Parameters measured on the first gameplay were correlated against standard cognitive and mobility assessments, including the Montreal Cognitive Assessment (MoCA), gait speed, and the Short Physical Performance Battery. Based on MoCA scores, patients were then stratified into two groups: cognitively impaired and healthy controls. The differences between the two groups were visually inspected, considering their within-game progression over the training period.

Results

Stepping and gameplay metrics had moderate-to-strong correlations with cognitive and mobility performance indicators: faster, longer, and higher steps were associated with better mobility scores; better cognitive games’ scores and reaction times, and longer and faster steps were associated with better cognitive performance. The preliminary visual analysis revealed that the group with cognitive impairment required more time to advance to the next difficulty level, also presenting slower reaction times and stepping speeds when compared to the healthy control group.

Conclusion

Stepping exergames may be useful for assessing the cognitive and motor status of older adults, potentially allowing assessments to be more frequent, affordable, and enjoyable. Further research is required to confirm results in the long term using a larger and more diverse sample.

Innovative moments in recovered cases treated with the unified protocol for transdiagnostic treatment of emotional disorders

OBJECTIVE

Innovative moments (IMs) are moments in which the previous problematic pattern of meaning is challenged. Studies have shown that IMs are associated with good psychotherapy outcomes. A three-level hierarchy of IMs was observed in recent studies, with level 1 IMs being more elementary and levels 2 and 3 being more complex and associated with treatment success. However, studies with manualized protocol treatments are thus far lacking. This study analyzed the longitudinal progression of IMs in the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) and explored its associations with changes in psychological distress.

METHODS

Data were collected from a Portuguese university-based outpatient clinic and included 18 cases with positive outcomes. Nine sessions of each case were coded with the IM coding system (N=162).

RESULTS

Multilevel analyses showed a significant increase in all IM levels across treatments. The decrease in psychological distress predicted an increase in level 2 IMs in the same session.

CONCLUSION

The evolution of IMs is similar to what was found previously in other studies. Contrary to what was found in previous studies, IMs did not predict outcomes in the following session, whereas the reduction in psychological distress predicted the emergence of level 2 IMs.

Promoter Demethylation Upregulates STEAP1 Gene Expression in Human Prostate Cancer: In Vitro and In Silico Analysis

The Six Transmembrane Epithelial Antigen of the Prostate (STEAP1) is an oncogene overexpressed in several human tumors, particularly in prostate cancer (PCa). However, the mechanisms involved in its overexpression remain unknown. It is well known that epigenetic modifications may result in abnormal gene expression patterns, contributing to tumor initiation and progression. Therefore, this study aimed to analyze the methylation pattern of the STEAP1 gene in PCa versus non-neoplastic cells. Bisulfite amplicon sequencing of the CpG island at the STEAP1 gene promoter showed a higher methylation level in non-neoplastic PNT1A prostate cells than in human PCa samples. Bioinformatic analysis of the GEO datasets also showed the STEAP1 gene promoter as being demethylated in human PCa, and a negative association with STEAP1 mRNA expression was observed. These results are supported by the treatment of non-neoplastic PNT1A cells with DNMT and HDAC inhibitors, which induced a significant increase in STEAP1 mRNA expression. In addition, the involvement of HDAC in the regulation of STEAP1 mRNA expression was corroborated by a negative association between STEAP1 mRNA expression and HDAC4,5,7 and 9 in human PCa. In conclusion, our work indicates that STEAP1 overexpression in PCa can be driven by the hypomethylation of STEAP1 gene promoter.

Premature termination of the unified protocol for the transdiagnostic treatment of emotional disorders: The role of ambivalence towards change

Ambivalence towards change is an expected, recurrent process in psychological change. However, the prolonged experience of ambivalence in psychotherapy contributes to client disengagement, which could result in treatment dropout. Considering the negative effects of premature termination of therapy and the convenience of the identification of clients who are at risk of dropping out before achieving good-outcome, the current study explored the predictive power of ambivalence for premature therapy termination using a multilevel time-backwards model (i.e., considering the session of the dropout as session zero and then modelling what occurred from the dropout until session 1). Participants included a total of 96 psychotherapy clients (38 dropouts) treated in a university-based clinic following the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Multilevel modelling using a time-backwards model to analyse dropout data provided evidence of the predictive power of ambivalence evolution throughout treatment on the decision to prematurely discontinue treatment (p < .0001; R² _adj  = .29). Specifically, good-outcome dropouts presented a decreasing ambivalence trend throughout treatment, whereas poor-outcome dropouts tended to experience the same levels of ambivalence before deciding to drop out (time × dropout; β₁₁  = .64, p = .014). Additionally, poor-outcome dropouts presented higher levels of ambivalence (β₀₁  = 9.92, p < .0001) in the last session. The results suggest that the pattern of client ambivalence towards change is a predictor of premature termination of therapy. Implications for clinical and research contexts are discussed.

Enhancing knowledge on low-value fishing species: the distinct reproductive strategy of two gurnard species

The depletion and overexploitation of several fish stock demands for a valorisation of non-target and discarded species. Nonetheless, such species are often poorly studied, and information on their biological parameters must be gathered for effective population management. For 1 year, the reproductive strategy of the piper gurnard Trigla lyra and the red gurnard Chelidonichthys cuculus was studied by monthly samples obtained from commercial boats operating on western Portuguese coast. Both species showed a biased sex ratio towards females, especially for larger length classes. Length at first maturity could be estimated only for red gurnard (22.1 and 19.9 cm for females and males, respectively) because all piper gurnard individuals caught were mature. Piper gurnard showed determinate fecundity and a short spawning season, from November to February with a peak in January, whereas red gurnard showed indeterminate fecundity and a wide spawning season, from late December to May. The relative annual fecundity estimated for red gurnard (1893 ± 728 oocytes × g^-1 eviscerated weight [EW]) was higher than the one estimated for piper gurnard (1018 ± 250 oocytes×g^-1 EW). Although important information for understanding the species dynamics is presented in this study, additional information on other life-history parameters and of species landings is required.

Improving B 1 + parametric estimation in the brain from multispin-echo sequences using a fusion bootstrap moves solver

PURPOSE

To simultaneously estimate the B 1 + field (along with the T₂ ) in the brain with multispin-echo (MSE) sequences and dictionary matching.

METHODS

T₂ mapping provides clinically relevant information such as in the assessment of brain degenerative diseases. It is commonly obtained with MSE sequences, and accuracy can be further improved by matching the MSE signal to a precomputed dictionary of echo-modulation curves. For additional T₁ quantification, transmit B 1 + field knowledge is also required. Preliminary work has shown that although simultaneous brain B 1 + estimation along with T₂ is possible, it presents a bimodal distribution with the main peak coinciding with the true value. By taking advantage of this, the B 1 + maps are expected to be spatially smooth by applying an iterative method that takes into account each pixel neighborhood known as the fusion bootstrap moves solver (FBMS). The effect of the FBMS on B 1 + accuracy and piecewise smoothness is investigated and different spatial regularization levels are compared. Total variation regularization was used for both B 1 + and T₂ simultaneous estimation because of its simplicity as an initial proof-of-concept; future work could explore non edge-preserving regularization independently for B 1 + .

RESULTS

Improvements in B 1 + accuracy (up to 45.37% and 16.81% B 1 + error decrease) and recovery of spatially homogeneous maps are shown in simulations and in vivo 3.0T brain data, respectively.

CONCLUSION

Accurate B 1 + estimated values can be obtained from widely available MSE sequences while jointly estimating T₂ maps with the use of echo-modulation curve matching and FBMS at no further cost.

tRNA-modifying enzyme mutations induce codon-specific mistranslation and protein aggregation in yeast

Protein synthesis rate and accuracy are tightly controlled by the cell and are essential for proteome homoeostasis (proteostasis); however, the full picture of how mRNA translational factors maintain protein synthesis accuracy and co-translational protein folding are far from being fully understood. To address this question, we evaluated the role of 70 yeast tRNA-modifying enzyme genes on protein aggregation and used mass spectrometry to identify the aggregated proteins. We show that modification of uridine at anticodon position 34 (U34) by the tRNA-modifying enzymes Elp1, Elp3, Sml3 and Trm9 is critical for proteostasis, the mitochondrial tRNA-modifying enzyme Slm3 plays a fundamental role in general proteostasis and that stress response proteins whose genes are enriched in codons decoded by tRNAs lacking mcm5U34, mcm5s2U34, ncm5U34, ncm5Um34, modifications are overrepresented in protein aggregates of the ELP1, SLM3 and TRM9 KO strains. Increased rates of amino acid misincorporation were also detected in these strains at protein sites that specifically mapped to the codons sites that are decoded by the hypomodified tRNAs, demonstrating that U34 tRNA modifications safeguard the proteome from translational errors, protein misfolding and proteotoxic stress.

tRNAs as a Driving Force of Genome Evolution in Yeast

Transfer RNAs (tRNAs) are widely known for their roles in the decoding of the linear mRNA information into amino acid sequences of proteins. They are also multifunctional platforms in the translation process and have other roles beyond translation, including sensing amino acid abundance, interacting with the general stress response machinery, and modulating cellular adaptation, survival, and death. In this mini-review, we focus on the emerging role of tRNA genes in the organization and modification of the genomic architecture of yeast and the role of tRNA misexpression and decoding infidelity in genome stability, evolution, and adaption. We discuss published work showing how quickly tRNA genes can mutate to meet novel translational demands, how tRNAs speed up genome evolution, and how tRNA genes can be sites of genomic instability. We highlight recent works showing that loss of tRNA decoding fidelity and small alterations in tRNA expression have unexpected and profound impacts on genome stability. By dissecting these recent evidence, we hope to lay the groundwork that prompts future investigations on the mechanistic interplay between tRNAs and genome modification that likely triggers genome evolution.

Neonatal Screening for MPS Disorders in Latin America: A Survey of Pilot Initiatives

Newborn screening enables the diagnosis of treatable disorders at the early stages, and because of its countless benefits, conditions have been continuously added to screening panels, allowing early intervention, aiming for the prevention of irreversible manifestations and even premature death. Mucopolysaccharidoses (MPS) are lysosomal storage disorders than can benefit from an early diagnosis, and thus are being recommended for newborn screening. They are multisystemic progressive disorders, with treatment options already available for several MPS types. MPS I was the first MPS disorder enrolled in the newborn screening (NBS) panel in the USA and a few other countries, and other MPS types are expected to be added. Very few studies about NBS for MPS in Latin America have been published so far. In this review, we report the results of pilot studies performed in Mexico and Brazil using different methodologies: tandem mass spectrometry, molecular analysis, digital microfluidics, and fluorimetry. These experiences are important to report and discuss, as we expect to have several MPS types added to NBS panels shortly. This addition will enable timely diagnosis of MPS, avoiding the long diagnostic odyssey that is part of the current natural history of this group of diseases, and leading to a better outcome for the affected patients.

Technological Solution for Pervasive Fall Risk Assessment

Falls are a well-known danger for older adults. With the worldwide population aging, there has been an increasing interest in assessing the risk of falling. This work presents a novel algorithm for continuous fall risk assessment, relying on a linear regression model whose inputs consist of both measured and self-reported risk factors. Two models were conceived and compared, following two distinct approaches, a theoretical and an empirical one. The system is pervasive and was tested in free-living unsupervised conditions. The results of our fall risk scoring system unveiled a strong correlation with the output of the clinical functional tests POMA and TUG (90% and 89%, respectively), which was deemed a promising outcome concerning the feasibility of pervasive monitoring for fall risk assessment in daily living.

Diagnostic challenges in paediatric foreign body aspiration: a case report

Introduction: Foreign body aspiration (FBA) is a potentially fatal paediatric emergency. Our objective was to highlight the importance of a multidisciplinary approach to difficult/doubtful diagnosis. Case Report: 34-month-old girl referred for urgent rigid bronchoscopy after suspected metallic blade ingestion (found chewing on it). She had a previous recurrent history of wheezing. The physical examination revealed face/lip wounds, traces of powder on her teeth but no breathing difficulty. The plain X-Ray revealed radiopaque images of the upper pulmonary field and gastric chamber. In the absence of FBA clinical signs but considering a previous history of bronchial hyperresponsiveness, a direct digital radiographic study was performed. There were no images compatible with foreign bodies: the results were interpreted as artefacts and no bronchoscopy was performed. Conclusions: A careful pre-anaesthetic evaluation, a high level of suspicion and excellent multidisciplinary communication led to the recognition of false radiologic findings. A conservative approach was followed and invasive procedures in a remote location, with high anaesthetic risk for the paediatric population were avoided.

What is the effect of emotional processing on depression? A longitudinal study

Emotional processing is an empirically established predictor of pre-post therapy improvement in depression. However, its relationship to symptom alleviation over time requires clarification. To clarify the contribution of emotional processing to gradual symptom improvement, we explored both (1) the effect of emotional processing on pre-post therapy changes in depressive symptoms (final outcome) and (2) its association with the intensity of clinical symptoms across sessions (session-by-session outcome). These relationships were estimated in a sample of 50 depressed clients treated with cognitive-behavioral therapy (CBT) or emotion-focused therapy (EFT). Emotional processing was measured by the Experiencing Scale during Emotion Episodes in five sessions taken across therapy. As expected, we found that a greater increase in emotional processing during treatment predicted a greater pre-post therapy improvement in depressive symptoms. Higher levels of emotional processing predicted next-session lower intensity on clinical symptoms, but the intensity of symptoms contributed to explaining the subsequent level of emotional processing achieved. Our observations suggest that clients' capabilities to process their emotions may both facilitate and be promoted by gradual improvement in symptoms. These results suggest the reciprocal predictive influence of emotional processing and symptoms on the therapeutic change in depression.

A Review of Capture-recapture Methods and Its Possibilities in Ophthalmology and Vision Sciences

Epidemiological information is expected to be used to develop key aspects of eye care such as to control and minimise the impact of diseases, to allocate resources, to monitor public health actions, to determine the best treatment options and to forecast the consequence of diseases in populations. Epidemiological studies are expected to provide information about the prevalence and/or incidence of eye diseases or conditions. To determine prevalence is necessary to perform a cross-sectional screening of the population at risk to ascertain the number of cases. The aim of this review is to describe and evaluate capture-recapture methods (or models) to ascertaining the number of individuals with a disease (e.g. diabetic retinopathy) or condition (e.g. vision impairment) in the population. The review covers the fundamental aspects of capture-recapture methods that would enable non-experts in epidemiology to use it in ophthalmic studies. The review provides information about theoretical aspects of the method with examples of studies in ophthalmology in which it has been used. We also provide a problem/solution approach for limitations arising from the lists obtained from registers or other reliable sources. We concluded that capture-recapture models can be considered reliable to estimate the total number of cases with eye conditions using incomplete information from registers. Accordingly, the method may be used to maintain updated epidemiological information about eye conditions helping to tackle the lack of surveillance information in many regions of the globe.

Time-motion analysis of competitive surfers: Portuguese championship

BACKGROUND

Time-motion analysis has been used to provide detailed insight into surfers' performance. This study evaluated surfers' activity times at the Portuguese surfing championship in order to account for the time spent in each surfing activity.

METHODS

Eighty-seven individually recorded videos of surfers were analyzed, showing their activity over the entire heat, and video analysis software was used to obtain each surfer's activity profile in the competition.

RESULTS

The results breakdown by time percentage show that the surfers were paddling 50.9% of the time, sprint paddling for wave 1.9%, were stationary 34.1% of the time, wave riding 3.7%, and involved in miscellaneous activities (e.g., duck diving, board recovery, etc.) 9.4% of the total time. Average times spent in each surfing activity were 18.6 seconds for paddling, 2.9 seconds for sprint paddling for a wave, 21.7 seconds for the stationary period, 11.5 seconds for wave riding, and 6.9 seconds for miscellaneous activities.

CONCLUSIONS

The data revealed that the most performed heat activity was paddling, allowing us to conclude that surfing is basically a long-arm paddling activity and that this activity constitutes a specific surfing competition demand, which in turn means that individual surfer's data can be used as a starting point for the development of tailored conditioning training programs.

Ambivalence Predicts Symptomatology in Cognitive-Behavioral and Narrative Therapies: An Exploratory Study

Background: The identification of poor outcome predictors is essential if we are to prevent therapeutic failure. Ambivalence - defined as a conflictual relationship between two positions of the self: one favoring change and another one favoring problematic stability - has been consistently associated with poor outcomes. However, the precise relationship between ambivalence and clients' symptomatology remains unclear. Objective: This study aims at assessing ambivalence's power to predict symptomatology, using a longitudinal design. Methods: The complete 305 sessions of 16 narrative and cognitive-behavioral cases have been analyzed with the Ambivalence Coding System and outcome measures have been used for each session. Results: Ambivalence emerged as a significant predictor of subsequent symptomatology suggesting that ambivalence is not only related to treatment outcomes, but that it represents a strong predictor of subsequent symptomatology. Discussion: The implications of ambivalence's power to predict outcomes for research and clinical practice are discussed.

Correlation structure in hierarchical linear modelling: An illustration with the therapeutic alliance

Previous studies have found an association between therapeutic alliance and treatment outcome, but only recently have researchers begun to analyse time-lagged relationships between session-to-session measures of alliance and outcomes with hierarchical linear modelling (HLM). HLM assumes simple correlation structures between any two measurements from the same client. In this paper, we suggest that this assumption might be problematic. Session-to-session measurements of outcomes (Outcome Questionnaire-10.2) and alliance (Working Alliance Inventory) in a sample (N = 63) were used to perform HLM analyses to test time-lagged (lag +1) relations between outcomes and alliance in both directions. A first set of analyses replicated the models consistently used in the literature, whereas a second set of models considered a correlation structure as a function of time. A correlation independent of time distance resulted in a bidirectional influence between alliance and outcomes (the model commonly used in the literature), but when considering a correlation structure as a function of time, only the outcomes were predictive of alliance. Considering a more complex correlation structure as a function of time seems to be an important analytical strategy for addressing the issue of variability in within-client measurements over time. This study highlights how the misspecification of a statistical model, namely, not considering a time-dependent correlation structure of the response variable, may lead to misleading findings in HLM studies. This is particularly relevant in process-outcome research, such as studies analysing the impact of therapeutic alliance on clinical outcomes.