Search Results (505)

Leptospirosis is a zoonotic disease caused by Leptospira spp., with over 250 serovars classified into 24 serogroups. Control measures depend on understanding serovar-specific epidemiology, yet the microscopic agglutination test (MAT) is only serogroup specific, and classification is complicated by cross-reactivity. While MAT is the reference standard for leptospirosis serodiagnosis and seroepidemiological studies, factors influencing serogroup cross-reactivity remain poorly characterized. We investigated the relationship between age, antibody titer, and serogroup diversity among seropositive individuals in a population-based serosurvey in the Dominican Republic. Between June and October 2021, we conducted a multistage national serosurvey, enrolling 6683 participants across 134 clusters. MAT was performed on sera from 2091 participants in two provinces using a 20-serovar panel. MAT positivity was defined as titers ≥ 1:100. Generalized Additive Models were used to assess associations between age, maximum titer, and serogroup diversity. Of 2091 tested samples, 237 (11.3%) were seropositive. Older individuals and those with higher titers reacted to a greater number of serogroups (p = 0.005 and p < 0.0001, respectively). However, mean maximum titer decreased with age, suggesting that broader serogroup reactivity in older individuals reflects cumulative exposure rather than higher titers. Maximum titer was the strongest predictor of serogroup breadth, while gender, study region, and urban/rural setting were not significant. Overall, our findings demonstrate that serogroup cross-reactivity in MAT was significantly influenced by antibody titer and prior exposure, with older individuals displaying broader serogroup reactivity despite lower titers. These findings highlight key considerations for interpreting MAT results in seroepidemiological studies and underscore the limitations of MAT in serogroup-level classification. Full article

In Latin American cities, violence against women (VAW) remains critical for public health, well-being, and safety. This phenomenon is influenced by social, political, and environmental drivers. VAW is not randomly distributed; built environments—geography, ambient population, and street networks—influence criminal through spatial dependence across multiple scales. Despite growing interest in the spatial distribution of crime, few studies have explicitly explored the spatiotemporal dimensions of VAW in Monterrey. This study explores spatio-temporal patterns of VAW in Monterrey, Mexico, based on the analysis of 27,036 georeferenced and verified emergency reports from the 911 system (2019–2022). The study applies kernel density estimation (KDE), the Getis–Ord G_i* statistics, the Local Moran I index, and space–time cube analysis to identify spatial and temporal clusters of VAW. The results show concentrations of incidents during nighttime and weekends, particularly in northern and eastern sectors in Monterrey. The analysis reveals clusters in areas of high socioeconomic vulnerability. VAW in Monterrey follows predictable and cyclical patterns. These insights contribute to the design of tailored public policies and actions to improve women’s health, well-being, and safety in critical zones and timeframes. The findings also enhance international understanding of gender-based spatial violence patterns in the rapidly urbanizing contexts of the Global South. Full article

Background: Huntington’s disease (HD) causes progressive motor dysfunction, with chorea as its hallmark symptom. Vesicular monoamine transporter 2 (VMAT 2) inhibitors (tetrabenazine, deutetrabenazine, valbenazine) are established symptomatic therapies, while dopamine stabilizers (pridopidine, ordopidine) are emerging therapies, but their net benefit and safety remain uncertain. Methods: Seven databases were searched through May 2025 following PRISMA guidelines. Random effects meta-analyses calculated mean differences (MDs) for the Unified Huntington Disease Rating Scale total motor score (UHDRS TMS) and total maximal chorea score (TMC), plus risk ratios (RRs) for adverse events (AEs). Trial Sequential Analysis (TSA) applied a Lan DeMets O’Brien Fleming α spending function with 80% power. Results: Seven randomized trials (1431 participants) met inclusion criteria. VMAT 2 inhibitors significantly improved motor outcomes versus placebo (UHDRS TMS: MD −3.80, 95% CI −5.76 to −1.83; TMC: MD −3.05, 95% CI −3.84 to −2.26; both I² = 0%). Dopamine stabilizers produced no meaningful change (UHDRS TMS: MD −0.98, 95% CI −2.48 to 0.51; I² = 32%). Neither class increased total AEs (VMAT 2: RR 1.21, 95% CI 0.99 to 1.48; dopamine stabilizers: RR 1.05, 95% CI 0.92 to 1.20; both I² = 0%). TSA confirmed robust evidence for VMAT 2 benefits on TMC but indicated additional data are required to verify dopamine stabilizer effects on UHDRS TMS. Trial sequential analysis confirmed the reliability of VMAT2 for TMC; however, the sample size was insufficient to draw conclusions about the effects of dopamine stabilizers on UHDRS TMS or their safety outcomes, indicating that additional data are needed. Conclusions: VMAT-2 inhibitors may suggest potential improvements in motor symptoms in Huntington’s disease, while current evidence does not demonstrate a significant benefit of dopamine stabilizers. The safety profiles of both treatments appear generally comparable to placebo. Further rigorous and long-term studies are required to better establish their efficacy and safety. Full article

This study analyzed the implementation of a problem-solving method based on Pólya’s proposal, complemented by accessible technological resources such as the Arduino board, sensors, and STEM educational cards, in engineering and nursing students from public universities in Peru. A quasi-experimental design with pre- and post-test was used, employing a quantitative approach and intentional non-probabilistic sampling. The participants were 98 first-year students who developed formative research projects contextualized to their local reality, using the visual programming environment mBlock. The results show significant development of research competencies in both majors, especially in the solution review phase, evidencing critical thinking and reflective evaluation. No significant differences were found between the majors regarding the use of educational technology, reinforcing its cross-disciplinary applicability. It is concluded that the combination of Pólya’s method and the use of accessible technologies strengthens active, reflective, and contextualized learning in higher education. Full article

With the ever-growing reliance on digital communication networks in microgrids equipped with digital control systems and highly distributed energy resources, the threat of cyberattacks is more present than ever. Therefore, a robust cybersecurity response framework could be in place to secure smart grids, including microgrids, against cyberattacks. Adaptive protection systems, which are crucial for microgrid reliability and resilience, are also vulnerable. On the other hand, multi-agent systems are often employed in microgrid adaptive protection, providing a decentralized and cooperative framework where intelligent agents can monitor system conditions, exchange information, and detect anomalies. Many researchers in the literature have focused on addressing microgrid protection with multi-agent systems against physical faults in scenarios with various degrees of distributed energy resource penetration. Other research efforts have leveraged multi-agent systems, as well as technologies such as artificial intelligence, machine learning, advanced encryption, and authentication, to enhance the capabilities of microgrids for maintaining resilient operation under cyberattacks. However, both physical and cybersecurity anomalies have rarely been tackled in the same scheme. This paper aims to provide a systematic review of the use of cybersecurity strategies for multi-agent-based adaptive protection schemes. From the results of this study, it was found that most research efforts do not address microgrid protection with an integrated approach, considering both physical and cybersecurity threats, as well as the application of established industry communication and cybersecurity standards. All of this, while maintaining scalability and performance, is crucial. Full article

Background: Vaccination against SARS-CoV-2 has been pivotal in controlling the COVID-19 pandemic. However, understanding vaccine-induced immunity in immunocompromised individuals remains critical, particularly how prior exposure to other coronaviruses modulates immune responses. The influence of previous infections with endemic human coronaviruses (HCoVs), such as OC43, on SARS-CoV-2 immunity is not fully understood. This study evaluates antibody responses to COVID-19 vaccination in hemodialysis patients (HD), transplant recipients (TR), and healthy controls (CO), accounting for prior SARS-CoV-2 infection and baseline human coronavirus (HCoV) reactivity. Methods: We obtained longitudinal antibody measurements from 70 subjects (CO: n = 33; HD: n = 13; TR: n = 24) and assessed antibody kinetics across multiple post-vaccination time points using multivariate linear mixed modeling (MLMM). Results: Limited but measurable cross-reactivity was observed between SARS-CoV-2 and endemic HCoVs, particularly the $\beta$-coronavirus OC43. Pre-existing immunity in healthy individuals modestly enhanced vaccine-induced anti-spike (S) IgG responses, supported by post-vaccination increases in SARS-CoV-2 IgG. Prior SARS-CoV-2 infection significantly influenced anti-S and nucleocapsid (N) IgG responses but had limited impact on endemic HCoVs responses. Vaccine type and immune status significantly affected antibody kinetics. mRNA vaccination (BNT162b2) elicited stronger and more durable SARS-CoV-2 anti-S IgG responses than the inactivated CoronaVac vaccine, especially in immunocompetent individuals. Immunocompromised groups showed delayed or attenuated responses, with modest anti-S IgG cross-reactive boosting. Elevated anti-N IgG in CoronaVac recipients raised questions about its origin—infection or vaccine effects. MLMM identified key immunological and clinical predictors of antibody responses, emphasizing the critical role of host immune history. Conclusions: These findings highlight a constrained but meaningful role for HCoV cross-reactivity in SARS-CoV-2 immunity and vaccine responsiveness, underscore the need for infection markers unaffected by vaccination, and support development of broadly protective pan-coronavirus vaccines and tailored strategies for at-risk populations. Full article

Background: Chemical burns represent a persistent global health challenge due to their high prevalence, causing lifelong disabilities and socioeconomic burdens. Although research on chemical burns has expanded over the past century, no comprehensive study has mapped the intellectual structure, global collaboration patterns, and thematic evolution of scientific production on chemical burns to determine how research in the area has evolved and the existence of gaps or imbalances that need to be addressed. Objective: The aim was to analyze the scientific production on chemical burns using bibliometric methods, identifying key contributors, evolving themes, and research gaps. Methods: Eligible documents contained the MeSH descriptor and were listed both in PubMed (1946 to 2024) and in the Web of Science Core Collection. The documents were analyzed with Bibliometrix version 5.0 and VOSviewer version 1.6.20. The metrics included were annual productivity, citation networks, co-authorship patterns, and keyword co-occurrence. Results: The analysis included 3943 articles from 757 journals. The annual average was 25.8 articles, with a growth rate of 0.65% from 1946 to 2024. The USA produced the most articles (n = 1547), followed by China (n = 890). The USA also led in international collaboration, working with 26 countries. Harvard University was the leading institution (n = 325) and Burns the leading journal (n = 306), followed by Cornea (n = 132). The most common subject category of the research was surgery (n = 1185 docs) and ophthalmology (n = 984). Reim M. was the most prolific author (n = 35), while Basu S. had the most citations (n = 1159). The main clinical MeSH descriptors were “Eye burns” (n = 1158), “Esophageal stenosis” (n = 683), and “Caustics” (n = 659). Conclusions: The results show slight growth in scientific production on chemical burns. The USA and China are leading research in this field, and the main reported finding was eye burns. Full article

This systematic review examines the methodologies and applications of integrated risk indicators in positron emission tomography (PET) radiopharmaceutical production, focusing on occupational, technological, and environmental risks. Conducted in accordance with PRISMA 2020 guidelines and utilizing the Ryyan software 2023 for article screening, the review synthesizes findings from 70 studies published between 2020 and 2025 in English and Spanish, including articles, conference papers, and reviews. The review was registered on PROSPERO (CRD420251078221). Key disciplines contributing to risk assessment frameworks include environmental science, occupational health and safety, civil engineering, mining engineering, maritime safety, financial/economic risk, and systems engineering. Predominant risk assessment methods identified are probabilistic modeling (e.g., Monte Carlo simulations), machine learning (e.g., neural networks), multi-criteria decision-making (e.g., AHP and TOPSIS), and failure mode and effects analysis (FMEA), each offering strengths, such as uncertainty quantification and systematic hazard identification, alongside limitations like data dependency and subjectivity. The review explores how frameworks from other industries can be adapted to address PET-specific risks, such as radiation exposure to workers, equipment failure, and waste management, and how studies integrate these factors into unified risk indicators using weighted scoring, probabilistic methods, and fuzzy logic. Gaps in the literature include limited stakeholder engagement, lack of standardized frameworks, insufficient real-time monitoring, and under-represented environmental risks. Future research directions propose developing PET-specific tools, integrating AI and IoT for real-time data, establishing standardized frameworks, and expanding environmental assessments to enhance risk management in PET radiopharmaceutical production. This review highlights the interdisciplinary nature of risk assessment and the critical need for comprehensive, tailored approaches to ensure safety and sustainability in this field. Full article

Hispanic populations in the U.S. have a high prevalence of type 2 diabetes and its complications. It has been proposed that interventions targeting multiple levels and domains of influence are needed to address health disparities, but more evidence is needed regarding the most effective approaches. We aimed to review the effects of non-pharmacological interventions on glycemic control among Hispanic persons with diabetes, overall and by level and domain of intervention. A systematic review (PubMed, Scopus, PsycInfo, CINAHL; 1985–2019) identified randomized trials reporting HbA1c outcomes for Hispanic populations. Article review, data extraction, and risk of bias assessment were completed by independent reviewers. Level and domain of intervention were assigned based on the National Institute on Minority Health and Health Disparities Research Framework. Random-effects meta-analyses estimated pooled effect sizes. Quality of evidence was rated based on the GRADE framework. Forty-eight trials met inclusion criteria, representing various Hispanic populations (n = 18 Mexican, n = 5 Puerto Rican, n = 1 Dominican, n = 4 multiple, n = 20 unspecified) and enrolling 9185 total participants. Overall, interventions decreased HbA1c by −0.32% (95% CI: −0.44% to −0.20%, I² = 68%, strength of evidence: moderate). Multi-level, multi-domain interventions decreased HbA1c by −0.41% (−0.61% to −0.21%, I² = 74%, strength of evidence: moderate). Few interventions addressed community (n = 3), society (n = 0), or physical/built environment (n = 1). Non-pharmacological interventions have modestly decreased HbA1c among Hispanic persons with diabetes. Multi-level, multi-domain interventions are promising, but more research is needed on interventions that target social and environmental structures. Full article

Capsaicin, the main pungent component of chili peppers, exhibits several bioactive properties, such as modulation of adipogenesis and inhibition of liver steatosis by reducing cytoplasmic lipid accumulation. However, no evidence is currently available regarding its effect on the membrane fatty acid remodeling. In this work, we focused on the HepG2 cell model, commonly employed for hepatotoxicity, to examine the lipidome changes after treatment with capsaicin (10 µM), and its combination with oleic acid (100 µM), following the effects after 1.5, 3, and 24 h. In addition, cell viability, lipid accumulation, and secretion of inflammatory mediators were assessed. Notably, the combination of capsaicin with oleic acid completely reverted the correlation between cytokine/chemokine levels and omega-6/omega-3 fatty acids compared to capsaicin alone. Additionally, the combined treatment influenced the protective effect of capsaicin against polyunsaturated fatty acids, as investigated through biomimetic experiments. Full article

The use of orthodontic aligners has increased significantly due to their convenience and esthetic advantages. However, understanding their microbiological behavior and cytotoxicity is essential. This study aimed to evaluate the metabolic activity (MA) and proliferation of different bacterial strains—assessed through colony-forming unit (CFU) counts—as well as the cytotoxicity of three widely used aligner systems: Spark, Invisalign, and Smile. Wettability and surface free energy (both dispersive and polar components) were determined using the sessile drop technique. The bacterial strains Streptococcus oralis, Actinomyces viscosus, Streptococcus gordonii, Enterococcus faecalis, and Porphyromonas gingivalis were cultured, and their behavior on the aligner surfaces was assessed under simulated oral cavity conditions in both aerobic and anaerobic environments using a bioreactor. Cytocompatibility was evaluated with HFF-1 human fibroblasts. Distinct strain-specific behaviors were observed. For Spark aligners, the contact angle was 70.5°, Invisalign 80.6°, and Smile 91.2°, and the surface free energy was 60.8, 66.7, and 74. 2 mJ/m², respectively, highlighting the high polar component of the Spark aligner of 31.9 mJ/m² compared to 19.3 and 20.2 mJ/m² for Invisalign and Smile, respectively. The Spark aligner exhibited the lowest metabolic activity for Streptococcus oralis (23.1%), Actinomyces viscosus (43.2%), Porphyromonas gingivalis (17.7%), and biofilm formation (2.4%), likely due to its higher hydrophilicity. The Smile aligner showed the lowest metabolic activity for Streptococcus gordonii (23.6%) and Enterococcus faecalis (51.1%), attributed to its low polar surface free energy component. CFU counts were minimal for all aligners and bacterial strains, including biofilm. All aligners demonstrated cytocompatibility above 70% (Spark: 71.0%, Invisalign: 75.7%, and Smile: 75.6%). These findings highlight the importance of considering aligner material properties in clinical practice and underscore the need for proper oral hygiene and aligner maintenance. Full article

Hispanic breast cancer survivors reported worse quality of life, and fatalism is considered one of the mediators for this disparity. This study aimed to identify the factors associated with fatalism within a diverse Hispanic population. Hispanic origin was self-reported, and the Multidimensional Fatalism Measure questionnaire, a validated tool that measures fatalism across multiple dimensions, was used to assess fatalism. A total of 390 women, consisting of 210 Puerto Ricans, 34 Colombians, 29 Dominicans, 25 Cubans, 24 Venezuelans, 22 Mexicans, and 46 individuals of other Hispanic backgrounds, completed the fatalism assessment. The mean fatalism score was 16.4 (95% CI = 15.8–17.0), characterized by a high internal locus of control and strong religious beliefs, along with moderate beliefs in luck and a low external locus of control. The higher fatalism scores were reported in Dominican, Mexican, and Venezuelan groups, while Colombians reported the lowest score. Multivariable analysis showed that Colombians (β = −4.0), individuals with higher household incomes (β = −2.3 for USD 20,000–USD 75,000, β = −2.4 for ≥75,000), higher education levels (β = −1.9), and those using English more frequently at home (β = −2.0) reported lower fatalism compared to their reference group. To enhance the quality of life for these survivors, culturally tailored interventions should focus on improving perceived control and mitigating fatalism. Full article

Creativity is the primary driver of our cultural evolution. The astonishing potential of artificial intelligence (AI) and its possible application in the creative process poses an urgent and dramatic challenge for humanity; how can we maximize the benefits of AI while minimizing the associated risks? In this article, we identify all forms of human–AI collaboration in this realm as cyber-creativity. We introduce the following two forward-looking scenarios: a utopian vision for cyber-creativity, in which AI serves to enhance and not replace human creativity, and a dystopian view associated with the pre-emption of all human creative agency caused by the rise of AI. In our view, the scientific community is called to bring its contribution, however small, to help humanity make steps towards the utopian scenario, while avoiding the dystopian one. Here, we present a decalogue of research challenges identified for this purpose, touching upon the following dimensions: (1) the theoretical framework for cyber-creativity; (2) sociocultural perspectives; (3) the cyber-creative process; (4) the creative agent; (5) the co-creative team; (6) cyber-creative products; (7) cyber-creative domains; (8) cyber-creative education; (9) ethical aspects; and (10) the dark side of cyber-creativity. For each dimension, a brief review of the state-of-the-art is provided, followed by the identification of a main research challenge, then specified into a list of research questions. Whereas there is no claim that this decalogue of research challenges represents an exhaustive classification, which would be an impossible objective, it still should serve as a valid starting point for future (but urgent) research endeavors, with the ambition to provide a significant contribution to the understanding, development, and alignment of AI to human values the realm of creativity. Full article

Our study was conducted in the Valle Nuevo National Park and included four habitat classes: tussock grass (Sabapa), pine forest (Pinoc), broadleaf forest (Boslat), and agricultural ecosystem (Ecoag). We had two main objectives: to comparatively describe millipede communities and to determine the relationships between population density/diversity and soil physicochemical variables. The research was cross-sectional and non-manipulative, with a descriptive and correlational scope; sampling followed a stratified systematic design, with eight transects and 32 quadrats of 1 m², covering 21.7 km. We found a sandy loam soil with an extremely acidic pH. The highest population density of millipedes was recorded in Sabapa, and the lowest in Ecoag. The highest alpha diversity was shared between Boslat (Margalef = 1.72) and Pinoc (Shannon = 2.53); Sabapa and Boslat showed the highest Jaccard similarity (0.56). The null hypothesis test using the weighted Shannon index revealed a statistically significant difference in diversity between the Boslat–Sabapa and Pinoc–Sabapa pairs. Two of the species recorded highly significant indicator values (IndVal) for two habitat classes. We found significant correlations (p < 0.05) between various soil physicochemical variables and millipede density and diversity. Full article

Background: Western dietary patterns worldwide are increasingly dominated by energy-dense, nutrient-deficient industrial foods, often identified as ultra-processed foods (UPFs). Such products may have detrimental health implications, particularly if nutritionally inadequate. This study aimed to examine the intake of unhealthy UPFs among children and adolescents from five Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) involved in the DELICIOUS project and to assess the association with dietary quality indicators. Methods: A survey was conducted with a sample of 2011 parents of children and adolescents aged 6 to 17 years to evaluate their dietary habits. Diet quality was assessed using the Youth Healthy Eating Index (Y-HEI), the KIDMED index to determine adherence to the Mediterranean diet, and compliance with national dietary guidelines. Results: Increased UPF consumption was not inherently associated with healthy or unhealthy specific food groups, although children and adolescents who consumed UPF daily were less likely to exhibit high overall diet quality and adherence to the Mediterranean diet. In all five countries, greater UPF intake was associated with poorer compliance with dietary recommendations concerning fats, sweets, meat, and legumes. Conclusions: Increased UPF consumption among Mediterranean children and adolescents is associated with an unhealthy dietary pattern, possibly marked by a high intake of fats, sweets, and meat, and a low consumption of legumes. Full article