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Background Kawasaki disease (KD) is an acute self-limited systemic vasculitis of unknown etiology. Intravenous immunoglobulin (IVIG) is an effective treatment and decreases the risk of cardiac complications to less than 5%. In spite of its effectiveness, some children do not respond to this therapy and still develop coronary aneurysms (CAA). The optimal treatment for IVIG non-responsive patients remains controversial although corticoids have been suggested to be an effective treatment in some patients. For those patients still resistant to IVIG and corticoids, interleukin-1 receptor antagonists (IL-1RA) such anakinra could be an alternative. Case presentation We present a 3 year-old Caucasian patient with KD without cardiac complications but with important resistance to treatment. After becoming resistant to IVIG and corticoids, anakinra proved to be an effective treatment. Conclusions To our knowledge, this is the first report of the utility of IL-1RA in refractory KD without coronary impairment. The patient fulfilled the classical criteria for KD and, after becoming resistant to first and second line treatments, anakinra proved to be an effective treatment. Further studies are required to determine if this is an effective treatment option for other cases of resistant Kawasaki disease.

With proper management, the modernization of irrigation systems makes it possible to improve the efficiency of application and use of water at the cost of an increase in pumping needs and, therefore, an increment of the energy consumed. The recent drastic price increase for energy put the viability of many farms at risk. In this context, using photovoltaic solar energy to power pumping stations has become an increasingly attractive alternative and a cheap and reliable option. The dimensioning of pumping systems powered by photovoltaic solar energy must be done considering the variability of solar radiation to take advantage of the available photovoltaic energy, especially during periods of less irradiation. By investigating a particular case, this paper studies the effect of increasing the number of pumps in parallel while maintaining the total power, as well as the relationship between the installed photovoltaic capacity and the power of the pumping system, to meet pumping requirements throughout the year. The pumped volume increased as the number of pumps installed in parallel increased for the same photovoltaic power generator. Although this increment has a limit, beyond which no greater significant rise in volume is achieved, installation costs increase. In addition, for the same pumping power installed, the required photovoltaic generator power decreases as the number of pumps in parallel increases. In the case studied, a 27% increase in the annual pumped volume was achieved by incrementing the number of pumps in parallel from one to five, thus leading to a 44.1% reduction in the size of the photovoltaic generator and a 13.3% reduction in the cost of installation compared with a system with only one pump. The procedure used to determine the most appropriate number of pumps to install in parallel when pumping water between two tanks, which minimizes the photovoltaic generator's size while guaranteeing pumping requirements, is easily generalizable for sizing isolated photovoltaic water pumping systems.

Polymer–ceramic composites are favourite candidates when aiming to replace bone tissue. We present here scaffolds made of polycaprolactone-hydroxyapatite (PCL-HAp) composites, and investigate in vitro mineralisation of the scaffolds in SBF after or without a nucleation treatment. In vitro bioactivity is enhanced by HAp incorporation as well as by nucleation treatment, as demonstrated by simulated body fluid (SBF) mineralization. Surprisingly, we obtained a hybrid interconnected organic-inorganic structure, as a result of micropore invasion by biomimetic apatite, which results in a mechanical strengthening of the material after two weeks of immersion in SBF×2. The presented scaffolds, due to their multiple qualities, are expected to be valuable supports for bone tissue engineering.

The ability to stabilize the gun is crucial for performance in Olympic pistol shooting and is thought to be related to the shooters muscular strength. The present study examines the relation between performance and finger flexor force as well as shoulder abduction isometric force in senior male air pistol shooting. 46 Spanish national level shooters served as test subjects of the study. Two maximal force tests were carried out recording handgrip and deltoid force data under competition conditions, during the official training time at national Spanish championships. Performance was measured as the total score of 60 shots at competition. Linear regressions were calculated to examine the relations between performance and peak and average finger flexor forces, peak and average finger flexor forces relative to the BMI, peak and average shoulder abduction isometric forces, peak shoulder abduction isometric force relative to the BMI. The connection between performance and other variables such as age, weight, height, BMI, experience in years and training hours per week was also analyzed. Significant correlations were found between performance at competition and average and peak finger flexor forces. For the rest of the force variables no significant correlations were found. Significant correlations were also found between performance at competition and experience as well as training hours. No significant correlations were found between performance and age, weight, height or BMI. The study concludes that hand grip strength training programs are necessary for performance in air pistol shooting.

The aim of this research work is to build a regression model of air quality by using the multivariate adaptive regression splines (MARS) technique in the Oviedo urban area (northern Spain) at a local scale. To accomplish the objective of this study, the experimental data set made up of nitrogen oxides (NO x ), carbon monoxide (CO), sulfur dioxide (SO 2 ), ozone (O 3 ), and dust (PM 10 ) was collected over 3 years (2006–2008). The US National Ambient Air Quality Standards (NAAQS) establishes the limit values of the main pollutants in the atmosphere in order to ensure the health of healthy people. Firstly, this MARS regression model captures the main perception of statistical learning theory in order to obtain a good prediction of the dependence among the main pollutants in the Oviedo urban area. Secondly, the main advantages of MARS are its capacity to produce simple, easy-to-interpret models, its ability to estimate the contributions of the input variables, and its computational efficiency. Finally, on the basis of these numerical calculations, using the MARS technique, conclusions of this research work are exposed.

Heavy vehicles present high aerodynamic drag. This results in significant fuel consumption and, consequently, high emissions of harmful substances. This study examines the variation in aerodynamic drag in a European-type truck with different trailer configurations. Passive flow control by geometry modifications of the rear part of the trailer and active flow control using the Coanda effect were tested, with the aim of improving the aerodynamic efficiency of the vehicle. To achieve this, a modular structure of a 1:30 scaled truck was designed to enable different trailer configurations. Drag measurements were performed with a two-component external balance, and PIV tests were conducted to correlate the drag reduction with the aerodynamic changes behind the trailer. Passive control reduced drag by up to 5.7%, and active flow control reduced it by up to 12.6% compared to the unmodified base trailer. PIV flow visualization confirms that blowing effectively reduces the recirculation zone behind the trailer.

Large-scale sequencing of RNA from individual cells can reveal patterns of gene, isoform and allelic expression across cell types and states 1 . However, current short-read single-cell RNA-sequencing methods have limited ability to count RNAs at allele and isoform resolution, and long-read sequencing techniques lack the depth required for large-scale applications across cells 2 , 3 . Here we introduce Smart-seq3, which combines full-length transcriptome coverage with a 5′ unique molecular identifier RNA counting strategy that enables in silico reconstruction of thousands of RNA molecules per cell. Of the counted and reconstructed molecules, 60% could be directly assigned to allelic origin and 30–50% to specific isoforms, and we identified substantial differences in isoform usage in different mouse strains and human cell types. Smart-seq3 greatly increased sensitivity compared to Smart-seq2, typically detecting thousands more transcripts per cell. We expect that Smart-seq3 will enable large-scale characterization of cell types and states across tissues and organisms. Smart-seq3 enables isoform- and allele-specific reconstruction of RNA molecules.

IntroductionDifferent mental health care provision models coexist in prisons in Spain. The Ministry of Interior applies a traditional model to secure mental health care to 83% of the country imprisoned population. Three autonomous regions with acquired competencies for health care provision (17% of the imprisoned population) are implementing innovative care models.ObjectivesTo explore the views of healthcare professionals on models of mental health care provision for imprisoned persons with a serious mental illness (SMI) in Spain.Methods21 healthcare professionals (13 physicians, 5 nurses, 3 pharmacists) working in prisons, penitentiary psychiatric hospitals and a psychiatric in-prison unit took part in 5 online, 2 hours focus groups and one in-deep interview between 31st May and 20th July 2022. The moderator used open-ended questions to research into the characteristics of mental health care models and on the challenges for implementation. Focus groups were audiotape recorded and transcribed. Transcripts were analysed applying thematic analysis.ResultsHealthcare professionals reported that within the traditional model of healthcare provision, the psychiatric care of SMI imprisoners relies on correctional general practitioner physicians (GP). Psychiatrists act as external care providers. There are two psychiatric penitentiary hospitals with a strong correctional character for in-hospital care. Acute psychiatric care happens in prisons or at the local general hospital. Healthcare records remain within the penitentiary organization and outside the accesible healthcare information system. In consequence, there is fragmentation and delocalization of mental health care. An innovative approach consists of a dedicated mental healthcare unit within the prison with continuous psychiatric supervision of imprisoners with SMI and good quality psychiatric care. Schizophrenia and hyperactive attention deficit disorder persons benefit the most. Continued mental health care in the community remains a challenge. Another model of care is centred in the SMI imprisoned person. Acute and rehabilitation psychiatric penitentiary units operate within a network of mental health and social care resources in the community, coordinated by a liaison nurse. Individualised care plans keep SMI persons in their social environment. Costs of implementation are high. Clear definition of roles; investment in dedicated staff and shared information systems are challenges to overcome.ConclusionsInnovative models of mental health care are needed to benefit imprisoned persons with a SMI in Spain. A decided national and regional will is paramount to overcome challenges.Disclosure of InterestNone Declared

Background:In 2021 we described the baseline clinical information about 887 FMF patients enrolled in the Eurofever registry since 2009.Objectives:We describe now first longitudinal data about these patients.Methods:Patients with FMF enrolled in Eurofever registry with at least one follow-up visit were included in a longitudinal study. Demographic and clinical data were analyzed. Disease activity and maximum dose of colchicine were defined according to the 2016 EULAR recommendation [1].Results:1104 patients with FMF are enrolled in Eurofever registry in November 2023, 574 males and 530 females. The median age at disease onset was 3.8 (0.4 - 28.1); the median diagnostic delay was 2.4 (0.1 – 28.7); the median age at enrollment was 7.9 (1.7 – 50.8). Follow-up information was available in 497 patients, with a mean number of follow-up visits of 2.2 (25th-75th centile 1-4) and a mean duration of follow-up of 5.4 years (range 2.2 – 8.2). At the last follow-up around half of patients in the longitudinal cohort were in complete remission, 34.9% experienced some disease activity (<1 episode/month) while only 9.2% experienced ≥ 1 episode/month and are therefore considered resistant to treatment according to the 2016 EULAR Guidelines (Table 1).At last follow-up visit 85.9% of patients of the longitudinal cohort were receiving colchicine, with a median duration of treatment of 4.4 years (0.4 – 15.4). Among resistant patients only 1 reached maximum recommended dose per age of colchicine according EULAR Guidelines (2 patients in partial remission, only 3 patients in complete remission). 8.2% of patients were on canakinumab while 0.4% were receiving anakinra. Among patients receiving biological treatments, 35 (81.4%) were receiving a combination of colchicine and biologics. Rate of withdrawal for colchicine were 10.3%, for canakinumab 6.5% while for anakinra was higher (61.1%). Reasons for withdrawal of treatment are detailed in Table 2.Conclusion:This study analyzes the initial data concerning the natural history of the Eurofever FMF cohort. At the last follow-up less than 50% of the patients have achieved complete disease control. Colchicine is the most used treatment. Among biologic drugs, IL-1 inhibitors are the most frequently used, with a good treatment retention rate at the last follow-up, especially for anti-IL-1 monoclonal antibody.REFERENCES:[1] S. Ozen et al., “EULAR recommendations for the management of familial Mediterranean fever,” doi: 10.1136/annrheumdis-2015-208690.Acknowledgements:This study is supported by a research collaboration agreement with Novartis.Disclosure of Interests:Marta Bustaffa: None declared, Gayane Amaryan: None declared, Romina Gallizzi: None declared, Efimia Papadopoulou-Alataki: None declared, Maria Carrabba: None declared, Jordi Antón: None declared, Gabriele Simonini: None declared, Maria Alessio: None declared, Luciana Breda: None declared, Jasmin B. Kuemmerle-Deschner: None declared, Donato Rigante: None declared, Laura Obici: None declared, Antonella Insalaco: None declared, Elizabeth Legger: None declared, Roberta Caorsi: None declared, Nicolino Ruperto Abbvie, Aclaris, Amgen, AstraZeneca, Aurinia, BMS, Boehringer Ingelheim, Eli Lilly, Galapagos, Guidepoint, Janssen, Novartis, Pfizer, Sanofi, Marco Gattorno Novartis, Sobi, Seza Ozen: None declared.

The purpose of this study was compare the effects of a traditional and an instability resistance circuit training program on upper and lower limb strength, power, movement velocity and jumping ability. Thirty-six healthy untrained men were assigned to two experimental groups and a control group. Subjects in the experimental groups performed a resistance circuit training program consisting of traditional exercises (TRT, n = 10) or exercises executed in conditions of instability (using BOSU® and TRX®) (IRT, n = 12). Both programs involved three days per week of training for a total of seven weeks. The following variables were determined before and after training: maximal strength (1RM), average (AV) and peak velocity (PV), average (AP) and peak power (PP), all during bench press (BP) and back squat (BS) exercises, along with squat jump (SJ) height and counter movement jump (CMJ) height. All variables were found to significantly improve (p <0.05) in response to both training programs. Major improvements were observed in SJ height (IRT = 22.1%, TRT = 20.1%), CMJ height (IRT = 17.7%, TRT = 15.2%), 1RM in BS (IRT = 13.03%, TRT = 12.6%), 1RM in BP (IRT = 4.7%, TRT = 4.4%), AP in BS (IRT = 10.5%, TRT = 9.3%), AP in BP (IRT = 2.4%, TRT = 8.1%), PP in BS (IRT=19.42%, TRT = 22.3%), PP in BP (IRT = 7.6%, TRT = 11.5%), AV in BS (IRT = 10.5%, TRT = 9.4%), and PV in BS (IRT = 8.6%, TRT = 4.5%). Despite such improvements no significant differences were detected in the posttraining variables recorded for the two experimental groups. These data indicate that a circuit training program using two instability training devices is as effective in untrained men as a program executed under stable conditions for improving strength (1RM), power, movement velocity and jumping ability. Key PointsSimilar adaptations in terms of gains in strength, power, movement velocity and jumping ability were produced in response to both training programs.Both the stability and instability approaches seem suitable for healthy, physically-active individuals with or with limited experience in resistance training.RPE emerged as a useful tool to monitor exercise intensity during instability strength training.