Optimal navigability of weighted human brain connectomes in physical space

The architecture of the human connectome supports efficient communication protocols relying either on distances between brain regions or on the intensities of connections. However, none of these protocols combines information about the two or reaches full efficiency. Here, we introduce a continuous spectrum of decentralized routing strategies that combine link weights and the spatial embedding of connectomes to transmit signals. We applied the protocols to individual connectomes in two cohorts, and to cohort archetypes designed to capture weighted connectivity properties. We found that there is an intermediate region, a sweet spot, in which navigation achieves maximum communication efficiency at low transmission cost. Interestingly, this phenomenon is robust and independent of the particular configuration of weights.Our results indicate that the intensity and topology of neural connections and brain geometry interplay to boost communicability, fundamental to support effective responses to external and internal stimuli and the diversity of brain functions.Comment: 49 pages (10 main text, 39 Supplementary Material

Evaluación de riesgos laborales en Almazaras: Limitaciones y nuevas perspectivas

Risk assessment is an essential tool to support risk decisions. However, this process may not always be applied effectively, and this can limit the quality of the preventative action. This is particularly critical in sectors that have a lot of micro and small companies, such as Olive Oil Mills (OOMs). To better understand how to improve the quality of the risk assessment at OOMs, this study aims to analyze the views of Occupational Safety and Health (OSH) practitioners on the key difficulties/limitations in this process and identify some improvements to current practices. This analysis was based on a questionnaire that was developed and given to 13 OSH practitioners working for OOMs. The results showed that the time available to perform the risk assessment is the major limitation. The need for a specific tool for risk assessment in the OOM sector was identified, and the use of accident reports from the entire sector was indicated as an alternative to the absence of data at company level.La evaluación de riesgos es una herramienta esencial para apoyar las decisiones acerca del riesgo. No obstante, este proceso puede no siempre aplicarse con eficacia, y esto puede limitar la calidad de la acción preventiva. Esto es particularmente crítico en sectores que incluyen una gran cantidad de micro y pequeñas empresas, como las Almazaras. Para comprender cómo mejorar la calidad de la evaluación de riesgos en las Almazaras, este estudio tiene como objetivo analizar los puntos de vista de los profesionales de la Prevención de Riesgos Laborales (PRL) acerca de las principales dificultades/limitaciones en este proceso e identificar algunas mejoras en las prácticas actuales. Para este análisis fue desarrollado un cuestionario que fue aplicado a 13 profesionales de la PRL con experiencia en las Almazaras. Los resultados mostraron que el tiempo disponible para el desarrollo de la evaluación del riesgos es la principal limitación. Esta investigación identificó la necesidad de una herramienta específica para la evaluación de riesgos en las Almazaras, siendo identificado el uso de informes de accidentes de todo el sector como una alternativa a la falta de datos a nivel de la empresa.(undefined

Perception of medical students about courses based on peer-assisted learning in five Peruvian universities

Objectives: Peer-assisted learning (PAL) is a supportive strategy in medical education. In Peru, this method has been implemented by few universities. However, there are no consistent studies evaluating their acceptability by medical students. The objective of this study was to evaluate the perception of medical students about PAL in five Peruvian universities. Results: A total of 79 medical students were included in the study. The mean age was 20.1 ± 1.9 years, 54% were female, and 87% were in the first 4 years of study. Most of the students were satisfied with classes and peer teachers. Similarly, most of the students agreed with the interest in developing teaching skills. It was also observed that 97% of students approved to implement PAL in medical education programs.Revisión por pare

Performance of QuantiFERON-TB Gold Plus assays in children and adolescents at risk of tuberculosis: a cross-sectional multicentre study

Introduction: The QuantiFERON-TB Gold Plus (QFT-Plus) assay, which features two antigen-stimulated tubes (TB1 and TB2) instead of a single tube used in previous-generation interferon-gamma release assays (IGRAs), was launched in 2016. Despite this, data regarding the assay’s performance in the paediatric setting remain scarce. This study aimed to determine the performance of QFT-Plus in a large cohort of children and adolescents at risk of tuberculosis (TB) in a low-burden setting. Methods: Cross-sectional, multicentre study at healthcare institutions participating in the Spanish Paediatric TB Research Network, including patients <18 years who had a QFT-Plus performed between September 2016 and June 2020. Results: Of 1726 patients (52.8% male, median age: 8.4 years), 260 (15.1%) underwent testing during contact tracing, 288 (16.7%) on clinical/radiological suspicion of tuberculosis disease (TBD), 649 (37.6%) during new-entrant migrant screening and 529 (30.6%) prior to initiation of immunosuppressive treatment. Overall, the sensitivity of QFT-Plus for TBD (n=189) and for latent tuberculosis infection (LTBI, n=195) was 83.6% and 68.2%, respectively. The agreement between QFT-Plus TB1 and TB2 antigen tubes was excellent (98.9%, κ=0.961). Only five (2.5%) patients with TBD had discordance between TB1 and TB2 results (TB1+/TB2−, n=2; TB1−/TB2+, n=3). Indeterminate assay results (n=54, 3.1%) were associated with young age, lymphopenia and elevated C reactive protein concentrations. Conclusions: Our non-comparative study indicates that QFT-Plus does not have greater sensitivity than previous-generation IGRAs in children in both TBD and LTBI. In TBD, the addition of the second antigen tube, TB2, does not enhance the assay’s performance substantially

O106 / #796 FEASIBILITY OF TRANSCUTANEOUS SPINAL CORD STIMULATION COMBINED WITH ROBOTIC-ASSISTED GAIT TRAINING (LOKOMAT) FOR GAIT REHABILITATION FOLLOWING INCOMPLETE SPINAL CORD INJURY. A CASE SERIES STUDY

Transcutaneous electrical spinal cord stimulation (tSCS) is a non-invasive technique for neuromodulation with therapeutic potential for motor rehabilitation following spinal cord injury (SCI). The aim of the present study was to analyze the feasibility of a program of 20 sessions of 30-Hz tSCS combined with robotic-assisted gait training in incomplete SCI. The results of the present work partially belong to a randomized clinical trial that is in progress

Concentration-Dependent Protection by Ethanol Extract ofPropolis against &#947;-Ray-Induced Chromosome Damage in HumanBlood Lymphocytes

[EN] Radioprotection with natural products may be relevant to the mitigation of ionizing radiation-induced damage in mammalian systems; in this sense, propolis extracts have shown effects such as antioxidant, antitumoral, anti-inflammatory, and immunostimulant. We report for the first time a cytogenetic study to evaluate the radioprotective effect, in vitro, of propolis against radiation-induced chromosomal damage. Lymphocytes were cultured with increasing concentrations of ethanol extract of propolis (EEP), including 20, 40, 120, 250, 500, 750, 1000, and 2000 ¿g mL-1 and then exposed to 2 Gy ¿-rays. A significant and concentration-dependent decrease is observed in the frequency of chromosome aberrations in samples treated with EEP. The protection against the formation of dicentrics was concentration-dependent, with a maximum protection at 120 ¿g mL-1 of EEP. The observed frequency of dicentrics is described as negative exponential function, indicating that the maximum protectible fraction of dicentrics is approximately 44. Free radical scavenging and antioxidant activities are the mechanisms that these substances use to protect cells from ionizing radiation. Copyright © 2011 A. Montoro et al.This research was supported in part by the Company Dieteticos Intersa S.A., U.P.V., and Hospital Universitario La Fe of Valencia and Consejo de Seguridad Nuclear (2696/SRO). The authors express their appreciation to Dr. Pepe Perez (Hospital Universitario La Fe) and Dr. Alberto Yuste (U.P.V.).Montoro, A.; Barquinero, J.; Almonacid, M.; Montoro, A.; Sebastià, N.; Verdú Martín, GJ.; Sahuquillo, V.... (2011). Concentration-Dependent Protection by Ethanol Extract ofPropolis against &#947;-Ray-Induced Chromosome Damage in HumanBlood Lymphocytes. Evidence-based Complementary and Alternative Medicine. 1-7. doi:10.1155/2011/174853S1

Consensus on post COVID in the Spanish national health system: Results of the CIBERPOSTCOVID eDelphi study

Background: In 2021, the Spanish Ministry of Health launched the CIBERPOSTCOVID project to establish what post COVID was. The present study reports the level of agreement among stakeholders on post COVID and its clinical and diagnostic characteristics in the Spanish health system. Methods: The agreement on post COVID among clinicians, public health managers, researchers and patients' representatives was explored in a real-time, asynchronous online Delphi. In a two-wave consensus, respondents rated from 1 (total disagreement) to 6 (total agreement) 67 statements related to terminology, duration, etiology, symptoms, impact on quality of life, severity, elements to facilitate diagnosis, applicability in the pediatric population, and risk factors. Consensus was reached when 70 % of ratings for a statement were 5 or 6, with an interquartile range equal or less than 1. Findings: A total of 333 professionals and patients participated in this eDelphi study. There was agreement that post COVID was "a set of multi-organic symptoms that persist or fluctuate after acute COVID-19 infection and are not attributable to other causes" with a minimum duration of 3 months. The highest levels of agreement were found in the most frequent symptoms and its impacts on everyday activities. Aspects related to the diagnostic process and the measurement of its severity reached a lower level of consensus. There was agreement on the need to rule out previous health problems and assess severity using validated functional scales. However, no agreement was reached on the risk factors or specific features in the pediatric population. Interpretation: This policy-based consensus study has allowed the characterization of post COVID generating collective intelligence and has contributed to an operational definition applicable in clinical practice, health services management and useful for research purposes in Spain and abroad. Agreements are consistent with existing evidence and reference institutions at European and international level.The CIBERPOSTCOVID is a commissioned project of the Spanish Ministry of Health to the Ministry of Science and Innovation, funded through the Instituto de Salud Carlos III and CIBER -Consorcio Centro de Investigación Biomédica en Red- (ES21PI01).S

Symptom-based predictive model of COVID-19 disease in children

Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is neither always accessible nor easy to perform in children. We aimed to propose a machine learning model to assess the need for a SARS-CoV-2 test in children (<16 years old), depending on their clinical symptoms. Methods: Epidemiological and clinical data were obtained from the REDCap® registry. Overall, 4434 SARS-CoV-2 tests were performed in symptomatic children between 1 November 2020 and 31 March 2021, 784 were positive (17.68%). We pre-processed the data to be suitable for a machine learning (ML) algorithm, balancing the positive-negative rate and preparing subsets of data by ageThis research has received external funding from the Fundació la Marató tv3 after being awarded in the COVID-19 research call with the expedient number 202134-30-31.Objectius de Desenvolupament Sostenible::3 - Salut i BenestarPostprint (published version

A Concerted Action of Engrailed and Gooseberry-Neuro in Neuroblast 6-4 Is Triggering the Formation of Embryonic Posterior Commissure Bundles

One challenging question in neurogenesis concerns the identification of cues that trigger axonal growth and pathfinding to form stereotypic neuronal networks during the construction of a nervous system. Here, we show that in Drosophila, Engrailed (EN) and Gooseberry-Neuro (GsbN) act together as cofactors to build the posterior commissures (PCs), which shapes the ventral nerve cord. Indeed, we show that these two proteins are acting together in axon growth and midline crossing, and that this concerted action occurs at early development, in neuroblasts. More precisely, we identified that their expressions in NB 6-4 are necessary and sufficient to trigger the formation of the PCs, demonstrating that segmentation genes such as EN and GsbN play a crucial role in the determination of NB 6-4 in a way that will later influence growth and guidance of all the axons that form the PCs. We also demonstrate a more specific function of GsbN in differentiated neurons, leading to fasciculations between axons, which might be required to obtain PC mature axon bundles

Guía de práctica clínica SENPE/SEGHNP/SEFH sobre nutrición parenteral pediátrica

Introduction: Parenteral nutrition (PN) in childhood is a treatment whose characteristics are highly variable depending on the age and pathology of the patient. Material and methods: The Standardization and Protocols Group of the Spanish Society for Parenteral and Enteral Nutrition (SENPE) is an interdisciplinary group formed by members of the SENPE, the Spanish Society of Gastroenterology, Hepatology and Pediatric Nutrition (SEGHNP) and the Spanish Society of Hospital Pharmacy (SEFH) that intends to update this issue. For this, a detailed review of the literature has been carried out, looking for the evidences that allow us to elaborate a Clinical Practice Guide following the criteria of the Oxford Center for Evidence-Based Medicine. Results: This manuscript summarizes the recommendations regarding indications, access routes, requirements, modifications in special situations, components of the mixtures, prescription and standardization, preparation, administration, monitoring, complications and home NP. The complete document is published as a monographic number. Conclusions: This guide is intended to support the prescription of pediatric PN. It provides the basis for rational decisions in the context of the existing evidence. No guidelines can take into account all of the often compelling individual clinical circumstances.Introducción: la nutrición parenteral (NP) en la infancia es un tratamiento cuyas características son muy variables en función de la edad y la patología que presente el paciente. Material y métodos: el grupo de Estandarización y Protocolos de la Sociedad Española de Nutrición Parenteral y Enteral (SENPE) es un grupo interdisciplinar formado por miembros de la SENPE, Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP) y Sociedad Española de Farmacia Hospitalaria (SEFH) que pretende poner al día este tema. Para ello, se ha realizado una revisión pormenorizada de la literatura buscando las evidencias que nos permiten elaborar una Guía de Práctica Clínica siguiendo los criterios del Oxford Centre for Evidence-Based Medicine. Resultados: este manuscrito expone de forma resumida las recomendaciones en cuanto a indicaciones, vías de acceso, requerimientos, modificaciones en situaciones especiales, componentes de las mezclas, prescripción y estandarización, preparación, administración, monitorización, complicaciones y NP domiciliaria. El documento completo se publica como número monográfico. Conclusiones: esta guía pretende servir de apoyo para la prescripción de la NP pediátrica. Constituye la base para tomar decisiones en el contexto de la evidencia existente. Ninguna guía puede tener en cuenta todas las circunstancias clínicas individuale