multistrap: boosting phylogenetic analyses with structural information.

In a phylogeny, trustworthy reliability branch support estimates are as important as the tree itself. We show that reliability support values based on bootstrapping can be improved by combining sequence and structural information from proteins. Our approach relies on the systematic comparison of homologous intra-molecular structural distances.

Accuracy of pulse wave velocity for screening coronary artery disease: a systematic review and meta-analysis.

Coronary artery disease (CAD) is the leading cause of cardiovascular events and showed high prevalence and healthcare costs in 2019. However, CAD screening for cardiovascular event prevention is invasive and expensive. This study aims to estimate the ability of a noninvasive method, pulse wave velocity (PWV), to detect the presence or absence of coronary artery disease in patients with suspected CAD.

The exposome impact on hair health: non-pharmacological management. Part II.

Hair holds a significance that surpasses mere aesthetics, as it plays a pivotal role in our social interactions and contributes significantly to the definition of our self-esteem. Central to this understanding is the concept of the exposome, which encompasses intrinsic elements like genetics and physiological changes, as well as extrinsic factors such as UV radiation, pollution, lifestyle choices, and chemical treatments. These factors may significantly impact hair health and hair aging.

Newly identified cell types crucial for gut commensal tolerance.

The generation of regulatory T cells (Tregs) through interactions with antigen-presenting cells (APCs) is essential for establishing tolerance to gut commensals. Recent findings highlight the critical role of RORγt-lineage APCs, especially in gut-associated lymphoid tissues, in the induction of microbiota-specific peripheral Tregs and maintaining gut immune homeostasis.

A Systematic Review of Evaluated Labor Market Initiatives Addressing Precarious Employment: Findings and Public Health Implications.

Precarious employment (PE) is a major determinant of population health and contributor to health and social inequities. The purpose of this article is to synthesize and critically appraise available evidence on labor market initiatives addressing PE identified through a systematic review. Of the 21 initiatives reviewed, grouped into four categories-labor market policies, legislation, and reforms; union strategies; apprenticeships and other youth programs; social protection programs-10 showed consistently positive outcomes and 11 a combination of negative, mixed, or inconclusive outcomes.

Explainable deep neural networks for predicting sample phenotypes from single-cell transcriptomics.

Recent advances in single-cell RNA-Sequencing (scRNA-Seq) technologies have revolutionized our ability to gather molecular insights into different phenotypes at the level of individual cells. The analysis of the resulting data poses significant challenges, and proper statistical methods are required to analyze and extract information from scRNA-Seq datasets. Sample classification based on gene expression data has proven effective and valuable for precision medicine applications.

The effect of brief, repetitive balance training on balance and fall risk in older people with stroke: A randomized controlled trial.

Objective: To evaluate the effect of integrating a specific balance-training program focused on static balance to the conventional rehabilitation program on dynamic balance, risk of falls, and activities of daily living (ADLs) in older adults post-stroke.

Design: A single-blinded randomized controlled trial.

Setting: Institutional Intermediate Care Hospital.

Surgical Bailout in Patients Undergoing Transfemoral Transcatheter Aortic Valve Replacement: Incidence, Trends, and Clinical Outcomes.

Background: Transcatheter aortic valve replacement (TAVR) harbors the risk of periprocedural complications that require emergent cardiac surgery, or "surgical bailout." Surgical bailout intends to be lifesaving but is associated with high mortality. This has given rise to discussion on the necessity of surgical backup during TAVR.

Clinical Characteristics and Outcomes of Patients Undergoing 3 Aortic Valve Interventions: The THIRD Multicenter Registry.

Background: Lifetime treatment of aortic valve disease is a matter of increasing debate. Although the risks of a second aortic valve intervention are recognized, little attention has been given to the challenges of a third.

Objectives: This study delves into the clinical characteristics, indications, and outcomes of patients undergoing 3 aortic valve interventions.

Initial Decline in Glomerular Filtration Rate With Finerenone in HFmrEF/HFpEF: A Prespecified Analysis of FINEARTS-HF.

Background: An initial decline in estimated glomerular filtration rate (eGFR) often leads to reluctance to continue life-saving therapies in patients with heart failure (HF).

Objectives: The goal of this study was to describe the association between initial decline in eGFR and subsequent clinical outcomes in patients randomized to placebo or finerenone.

Methods: In this prespecified analysis of FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure), we examined the association between initial decline in eGFR (≥15%) from randomization to 1 month and subsequent outcomes in patients assigned to finerenone or placebo.

Effectiveness of the Triple P Procedure and its modifications on reducing the blood loss and peripartum hysterectomy rates in women with Placenta Accreta Spectrum (PAS): a review of published literature.

Background: Placenta Accreta Spectrum (PAS) disorders has been reported to be associated with a maternal mortality rate of 7-10%, worldwide, and many women who survive, experience life changing morbidity. Triple P procedure (- perioperative placental localization and incision on the myometrium above the upper border of the placenta; - pelvic devascularisation; and -placental non-separation and myometrial excision) was developed in 2010 as a novel conservative alternative to peripartum hysterectomy to avoid severe maternal morbidity and mortality). There have been several modifications to the original Triple P Procedure to achieve "pelvic devascularisation" based on locally available resources.

Palliative care training in Spanish medical schools: student assessment.

Objectives: This study investigates the status of end-of-life (EOL) care and palliative care (PC) training in Spanish medical schools and assesses students' perspectives.

Methods: The research employs a quantitative cross-sectional survey and a systematic review of curricula including schools to which the respondent students belonged to.

Results: A systematic review reveals that only 12 out of 39 universities offer mandatory PC or EOL care subjects, often integrated with other areas.

Clinical expression of radiographic axial spondyloarthritis and its association with HLA-B27 in European and Ibero-American populations.

Objective: To compare the clinical and sociodemographic characteristics of Ibero-American patients with radiographic axial spondyloarthritis (r-axSpA) to those of European patients, with a particular focus on the influence of HLA-B27.

Methods: This was an observational, cross-sectional, and multicentre study of patients who fulfilled the European Spondyloarthropathy Study Group (ESSG) criteria for SpA from the REGISPONSER and RESPONDIA registries. Univariate and multivariate analyses between European and Ibero-American populations stratified by HLA-B27 status were conducted.

Baricitinib dose reduction in patients with rheumatoid arthritis achieving sustained disease control: Final results from the RA-BEYOND study.

Objective: This study examines the impact of dose step-down in patients with rheumatoid arthritis (RA) who achieved sustained disease control with baricitinib 4-mg once-daily up to 96-weeks.

Methods: Patients who completed a baricitinib phase 3 study could enter a long-term extension (LTE). In the LTE, patients who received baricitinib 4-mg for ≥15 months and maintained clinical disease activity index (CDAI) low disease activity (LDA) or remission (REM) were blindly randomized to continue 4-mg or taper to 2-mg.

Disease activity indices used in axial spondyloarthritis perform similarly in real-life clinical settings.

Objective: Monitoring of axial spondyloarthritis (axSpA) activity using validated indices (BASDAI/ASDAS) is widely recommended but rarely followed in practice. The reasons, although varied, may be found in the scarcity of studies comparing the performance of these indices in daily practice. Here we compare the performance of activity indices in clinical practice.

Mortality in patients with Sjögren Disease: A Prospective Cohort Study Identifying Key Predictors.

Objective: To quantify the mortality risk in a large, well-characterized cohort of Sjögren's disease (SjD) patients and to identify independent predictors of mortality in this population.

Methods: We included 314 patients diagnosed with SjD according to the 2002 American-European Consensus Group criteria from a prospective, multicenter SjögrenSER-PROS cohort. Detailed data on systemic manifestations, serological markers, disease activity, and mortality was collected after 9 years of follow up.

Can thermoregulatory response to heat stress be improved in lactating dairy cows? Insights from counter-current heat transfer systems impacting reproduction.

Climate change has caused heat stress (HS) to become an increasingly severe problem for high-producing dairy herds. Although cooling systems allow milk production to remain nearly constant throughout the year, fertility decreases during summer. Physiological counter-current heat transfer mechanisms maintaining brain/hypothalamic and reproductive functions in cattle are vulnerable to HS.

Development of a StIW111C-based bioresponsive pore-forming conjugate for permeabilizing the endosomal membrane.

Gene expression manipulation is pivotal in therapeutic approaches for various diseases. Non-viral delivery systems present a safer alternative to viral vectors, with reduced immunogenicity and toxicity. However, their effectiveness in promoting endosomal escape, a crucial step in gene transfer, remains limited.

The impact of blood eosinophil count and FeNO on benralizumab effectiveness in clinical practice: An ORBE II subanalysis.

Background: The ORBE II study showed the real-world effectiveness of benralizumab in severe eosinophilic asthma (SEA). This subgroup analysis aimed to characterize patients and outcomes based on baseline blood eosinophil count (BEC) and/or fractional exhaled nitric oxide (FeNO) levels.

Methods: In this analysis of the ORBE II retrospective study, SEA patients receiving benralizumab were categorized into subgroups based on individual or combined BEC/FeNO levels, according to the following thresholds: high BEC (hiBEC): ≥300 cells/μL; low BEC (loBEC): <300 cells/μL; high FeNO (hiFeNO): ≥50 ppb; low FeNO (loFeNO): <50 ppb.

Empirical antibiotic therapy improves outcomes in mechanically ventilated patients with COVID-19: An emulated targeted trial within a prospective, multicentre cohort study.

Background: Bacterial pulmonary superinfections develop in a substantial proportion of mechanically ventilated COVID-19 patients and are associated with prolonged mechanical ventilation requirements and an increased mortality. Albeit recommended, evidence supporting the use of empirical antibiotics at intubation is weak and of low quality. The aim of this study was to elucidate the effect of empirical antibiotics, administered within 24hours of endotracheal intubation, on superinfections, duration of mechanical ventilation, and mortality in mechanically ventilated patients with COVID-19.

Call to action for Clinicians in the South-East Asian Regions on Primary Prevention of Diabetes in people with Prediabetes- A Consensus statement.

Primary prevention of diabetes still remains as an unmet challenge in a real world setting. While, translational programmes have been successful in the developed nations, the prevailing social and economic inequities in the low and middle income countries, fail to integrate diabetes prevention into their public health systems. The resulting exponential increase in the prevalence of diabetes and the cost of treatment has put primary prevention in the back seat.

A catalytic perspective to nanomaterials reactivity-based toxicity; implications for single- and multiple-component nanomaterials (nanocomposites).

The extended use of a given product normally precedes concerns about it. The reactivity-based nanotoxicity is a major concern that must be tackled from its fundamental understanding to its regulatory management. Moreover, concepts and ideas must seamlessly flow between relevant performers.