The rising concern about sustainable development led most states worldwide to adopt the 2030 Agenda for Sustainable Development to achieve 17 new goals before the end of 2030. Due to the prominent ...role of urbanization, the Sustainable Development Goal (SDG) #11 was introduced to make cities and human settlements more resilient, sustainable, safe and inclusive. The frameworks built so far to assess sustainable urban development primarily focus on sustainability, disregarding inclusiveness, safety and resilience. Under the joint consideration of these four facets, this research devised a new tool to evaluate communities and cities by selecting 61 indicators from an extensive literature review, which were weighted subsequently to ensure the balance among the four sustainability dimensions, namely society, economy, environment and governance. Data extracted from international organizations and the targets of the SDGs were used to score the indicators of the system. Mexico City, as one of the most overcrowded cities in the planet, was selected as a case study to apply the proposed tool. The research determined that the minimum thresholds set for the safety, sustainability and inclusiveness domains were not reached. In contrast, the city performed over the resilience limit. Consequently, RESSICOM was revealed as a helpful framework to identify shortcomings in cities related to the achievement of SDG #11.
•A new rating tool (RESSICOM) was designed to assess urban development holistically.•RESSICOM jointly considered resilience, sustainability, safety and inclusiveness.•The indicators of RESSICOM were weighted to balance the pillars of sustainability.•The proposed framework was tested using Mexico City as a representative case study.•The results showed that Mexico City was not sustainable, safe and inclusive enough.
Reactions of dissolved organic matter (DOM) with photochemically generated reactive halogen species (RHS) may represent an important natural source of organohalogens within surface seawaters. ...However, investigation of such processes has been limited by difficulties in quantifying low dissolved organohalogen concentrations in the presence of background inorganic halides. In this work, sequential solid phase extraction (SPE) and silver-form cation exchange filtration were utilized to desalt and preconcentrate seawater DOM prior to nonspecific organohalogen analysis by ICP-MS. Using this approach, native organobromine and organoiodine contents were found to range from 3.2−6.4 × 10–4 mol Br/mol C and 1.1–3.8 × 10–4 mol I/mol C (or 19–160 nmol Br L–1 and 6–36 nmol I L–1) within a wide variety of natural seawater samples, compared with 0.6–1.2 × 10–4 mol Br/mol C and 0.6–1.1 × 10–5 mol I/mol C in terrestrial natural organic matter (NOM) isolates. Together with a chemical probe method specific for RHS, the SPE+ICP-MS approach was also employed to demonstrate formation of nanomolar levels of organobromine and organoiodine during simulated and natural solar irradiation of DOM in artificial and natural seawaters. In a typical experiment, the organobromine content of 2.1 × 10–4 mol C L–1 (2.5 mg C L–1) of Suwannee River NOM in artificial seawater increased by 69% (from 5.9 × 10–5 to 1.0 × 10–4 mol Br/mol C) during exposure to 24 h of simulated sunlight. Increasing I– concentrations (up to 2.0 × 10–7 mol L–1) promoted increases of up to 460% in organoiodine content (from 8.5 × 10–6 to 4.8 × 10–5 mol I/mol C) at the expense of organobromine formation under the same conditions. The results reported herein suggest that sunlight-driven reactions of RHS with DOM may play a significant role in marine bromine and iodine cycling.
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Maple syrup urine disease (MSUD) is a rare metabolic disorder with a worldwide prevalence of 1 in every 185,000 live births. However, certain populations display a significant ...overexpression of the disorder where incidence is reported to be 1 in every 52,541 new-borns. The first-line therapy for MSUD involves a strict dietary leucine restriction and oral supplementation of isoleucine and valine. The dose administered to patients requires strict tailoring according to age, weight and blood levels. In current clinical practice, however, practitioners still have to prepare extemporaneous formulations due to the lack of suitable oral treatments for MSUD. Herein, we evaluate the first time use of 3D printing in a hospital setting for the preparation of personalised therapies with the aim of improving safety and acceptability to isoleucine supplementation in paediatric patients suffering from MSUD. This investigation was a single-centre, prospective crossover experimental study. Four paediatric patients with MSUD (aged 3–16 years) were treated at the Clinic University Hospital in Santiago de Compostela, Spain which is a MSUD reference hospital in Europe. The primary objective was to evaluate isoleucine blood levels after six months of treatment with two types of formulations; conventional capsules prepared by manual compounding and personalised chewable formulations prepared by automated 3D printing. A secondary investigation was to evaluate patient acceptability of 3D printed formulations prepared with different flavours and colours. Isoleucine blood levels in patients were well controlled using both types of formulations, however, the 3D printed therapy showed mean levels closer to the target value and with less variability (200–400 µM). The 3D printed formulations were well accepted by patients regarding flavour and colour. The study demonstrates for the first time that 3D printing offers a feasible, rapid and automated approach to prepare oral tailored-dose therapies in a hospital setting. 3D printing has shown to be an effective manufacturing technology in producing chewable isoleucine printlets as a treatment of MSUD with good acceptability.
This study set out to assess the performance of an artificial intelligence (AI) algorithm based on clinical data and dermatoscopic imaging for the early diagnosis of melanoma, and its capacity to ...define the metastatic progression of melanoma through serological and histopathological biomarkers, enabling dermatologists to make more informed decisions about patient management. Integrated analysis of demographic data, images of the skin lesions, and serum and histopathological markers were analyzed in a group of 196 patients with melanoma. The interleukins (ILs) IL-4, IL-6, IL-10, and IL-17A as well as IFNγ (interferon), GM-CSF (granulocyte and macrophage colony-stimulating factor), TGFβ (transforming growth factor), and the protein DCD (dermcidin) were quantified in the serum of melanoma patients at the time of diagnosis, and the expression of the RKIP, PIRIN, BCL2, BCL3, MITF, and ANXA5 proteins was detected by immunohistochemistry (IHC) in melanoma biopsies. An AI algorithm was used to improve the early diagnosis of melanoma and to predict the risk of metastasis and of disease-free survival. Two models were obtained to predict metastasis (including "all patients" or only patients "at early stages of melanoma"), and a series of attributes were seen to predict the progression of metastasis: Breslow thickness, infiltrating BCL-2 expressing lymphocytes, and IL-4 and IL-6 serum levels. Importantly, a decrease in serum GM-CSF seems to be a marker of poor prognosis in patients with early-stage melanomas.
Individuals with evening chronotypes are prone to suffer chronodisruption and display worse lifestyle habits than morning-types, exhibiting higher cardiovascular diseases (CVD). However, it is ...unknown whether CVD patients, who are evening chronotypes, have higher cardiometabolic risk than morning-types. This study explored whether individual chronotypes were associated with cardiometabolic risk in patients from the CORDIOPREV study (n = 857). We also investigated whether potential associations were moderated by long-term consumption of two healthy diets (Mediterranean and Low-fat diets). This population was classified into chronotypes using the Morningness-Eveningness Questionnaire. Seven-day daily rhythms in wrist temperature (T), rest-activity (A) and position (P) were recorded in a subset of patients (n = 168), and an integrative variable TAP was determined. Metabolic Syndrome (MetS) was determined at baseline, and metabolic and inflammation markers were measured at baseline and yearly during the 4 years of follow-up. Differences in several lifestyle factors were analyzed according to chronotype. At all times, evening-types had higher triglycerides, C-reactive protein and homocysteine and lower high density lipoprotein cholesterol than morning-types (P < 0.05). Evening-types had a higher prevalence of MetS (OR 1.58 IC 95% 1.10 – 2.28, P = 0.01). Moreover, they were more sedentary, displayed less and delayed physical activity and ate and slept later. In addition, evening-types had lower amplitude, greater fragmentation, lower robustness and less stable circadian pattern at TAP (P < 0.01), all related to a less healthy circadian pattern. In conclusion, evening-types with CVD had higher cardiometabolic risk and less robust circadian-related rhythms than morning-types, regardless of the nutritional intervention.
Bevacizumab has been used in patients with GBM as a salvage therapy since its approval in the United States for recurrent GBM in 2009. In order to review the therapeutic effect of bevacizumab in the ...primary and recurrent clinical setting we have performed a systematic analysis of data from the published literature. Weighted median progression free survival and overall survival were calculated and compared to standard therapy or other experimental therapies. A qualitative analysis of the limited studies on health related quality of life and effects on steroid requirements was also undertaken. We found that the available literature supports the use of bevacizumab for prolonging PFS and OS in the recurrent setting either alone or in combination with a cytotoxic agent (P < 0.05), but does not support its use in the primary setting (P > 0.05). The survival advantage of bevacizumab compared to experimental therapy at recurrence is limited to 4 months. There is no additional benefit reported to date in health-related quality of life with the use of bevacizumab, although it may reduce steroid requirements. On average there is one side-effect event per patient and 74% of these events are grade 3 toxicity or higher. Further studies investigating the role of bevacizumab in combination with cytotoxic agents at recurrence are awaited.
•Metabolic disorders have risen in prevalence during recent years.•hiPSCs emerge as a source of cells for functional grafts in medicine.•Recent patient-derived hiPSCs could be useful for the ...discovery of new biomarkers.•hiPSCs together with GWAS allow identification of specific therapeutic drugs.
Human induced pluripotent stem cells (hiPSCs) enable in vitro high-throughput pharmacological screening assays of diseased tissue. Together with recent genome-wide association studies (GWAS), hiPSCs enable the identification of key mutations for the development of effective treatments based on precise drugs. In concert with CRISPR/Cas9 systems, hiPSC technology can reveal therapeutic targets in metabolic disorders. The ex vivo CRISPR correction of autologous patient-derived hiPSCs has led to the development of replacement cell therapies, providing better patient prognoses.
Objective
To determine if the addition of the assessment of levator ani muscle (LAM) avulsion to the measurement of the difference in the pubis‐uterine fundus distance between rest and with the ...Valsalva maneuver could increase the diagnostic capacity of ultrasound for uterine prolapse (UP).
Methods
This multicenter, observational and prospective study included 145 patients. Ultrasound assessment was performed, establishing the diagnosis of UP as a difference between the pubic‐uterine fundus distance at rest and during the Valsalva maneuver ≥15 mm (standard technique), while LAM avulsion was defined as an abnormal LAM insertion in three central slices using multislice ultrasound. A binary multivariate logistic regression model was made using nonautomated methods to predict surgical UP (general population, premenopausal, and postmenopausal patients), including the difference between the pubis‐uterine fundus distance at rest and with the Valsalva maneuver as well as LAM avulsion.
Results
A total of 143 patients completed the study. The addition of LAM avulsion criteria to the standard dynamic distance‐based protocol for the diagnosis of UP resulted in a higher sensitivity for the general population (79.7 vs 68.1%) as well as for premenopausal (89.3 vs 79.9%) and postmenopausal patients (76 vs 66.1%). In contrast, the standard technique showed a higher specificity than the model based on the standard technique associated with LAM avulsion for the general population (89.2 vs 74.3%) and premenopausal women (91.7 vs 63.2%). For postmenopausal patients, the model based on the standard technique associated with LAM avulsion had a higher sensitivity (76 vs 66.1%) and specificity (91.7 vs 86.8%) than the ultrasound diagnosis of UP.
Conclusion
The implementation of the assessment of LAM avulsion in the ultrasound diagnosis of UP is useful in postmenopausal patients, increasing sensitivity and specificity relative to the ultrasound assessment based only on the difference between the pubis‐uterine fundus distance at rest and with the Valsalva maneuver.
A clear link between ecosystem services (ES) and human well-being has been established in the recent decades. Thus, forests are recognised as extremely important ecosystems in relation to their ...capacity to provide goods and services to society. Nevertheless, this capacity greatly depends on the type of forest and on the management applied. Some types of data often used for this type of analysis, such as land use/land cover maps produced for general purposes, are not always appropriate for representing forest ecosystems and the services they offer. In this study, we used a forest map (Spanish National Forest Map: scale 1:25,000) and information describing composition and structure to assess six services closely associated with forest ecosystems in a forest-dominated zone of northwestern Spain on a regional scale. The following ES were considered: provision of food (basically fruits), provision of materials (timber and pulp), provision of biomass for energy (firewood), climate regulation (carbon storage by above-ground biomass), erosion regulation (protection against erosion), and cultural (recreational use and nature tourism). By combining information about tree species and cover with forest harvest data and other statistics, we established representative spatial models for the six ES representing different categories of the potential supply of each one. The six models were analysed by different methods (Spearman’s correlation, Moran’s I and Getis-Ord Gi*), enabling detection of hotspots and coldspots and the characteristic spatial scales for ES supply. The combined use of highly detailed map data, nonspatial databases and spatial analysis yielded accurate ES supply assessment.
•Bats serve as natural reservoirs for a variety of viruses.•Transmission of highly pathogenic viruses from bats has been suspected and linked to a spectrum of emerging infectious diseases in humans ...and animals worldwide.•Examples of such viruses include Marburg, Ebola, Nipah, Hendra, Influenza A, Dengue, Equine Encephalitis viruses, Lyssaviruses, Madariaga, and Coronaviruses, involving the now pandemic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).•Herein, we provide a comprehensive review on the diversity, reservoirs, and geographical distribution of the main bat viruses and their potential for cross-species transmission.
Bats have populated earth for approximately 52 million years, serving as natural reservoirs for a variety of viruses through the course of evolution. Transmission of highly pathogenic viruses from bats has been suspected or linked to a spectrum of potential emerging infectious diseases in humans and animals worldwide. Examples of such viruses include Marburg, Ebolavirus, Nipah, Hendra, Influenza A, Dengue, Equine Encephalitis viruses, Lyssaviruses, Madariaga and Coronaviruses, involving the now pandemic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Herein, we provide a narrative review focused in selected emerging viral infectious diseases that have been reported from bats.
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