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Purpose compare incidences of maternal–fetal complications during pregnancy, labor, and early puerperium according to baseline BMI in a consecutive cohort of pregnant women. Methods This retrospective cohort study compares pregnancy outcome indicators by body mass index (BMI) in 1236 pregnant women managed over the period January 2017 to May 2018. Data were collected regarding the personal history (smoking, diabetes and hypertension), obstetrics and BMI (kg/m 2 ) (normoweight 18.5–24.9, overweight 25–29.9, obese ≥ 30). Results Of the 1236 women, 354 (28.6%) were overweight and 206 (16.7%) were obese at the start of pregnancy follow-up. Mean age at this time was 33 years (SD 6). Risk factors for a cesarean-section delivery assessed through logistic regression were maternal age (OR 1.05 95% CI 2.06–6.15; p  < 0.001) and previous C-section (OR 4.21 95% CI 2.89–6.14; p  < 0.001) regardless of BMI. In a propensity score analysis, pregnancy weight gain was found lower in obese vs normoweight (− 2.73 kg 95% CI − 3.74 to − 1.72 p  < 0.001), and newborn weight higher in obese vs normoweight women (161.21 g 95% CI 57.94–264.48 p  = 0.002). Labor duration and weight gain were reduced in overweight vs normoweight subjects (− 0.72 h 95% CI − 1.27 to − 0.17 p  = 0.010 and 0.81 kg 95% CI − 1.50 to − 0.12 p  = 0.021, respectively). Conclusions In this cohort, obese women showed higher rates of prenatal complications yet obesity and overweight were not related to worse puerperium outcomes.

Photocatalysis promotes eco-friendly reactions under mild conditions, and among photocatalytic agents are dyes, which have good redox potential in their excited states. The aim of the current contribution was to design a novel series of coumarins based on DFT analysis of their photochemical properties. The coumarin amide group serves as a linking group to cinnamic acid, allowing for electron delocalization throughout the system and the stabilization of the anionic and cationic species. An electronic structure analysis was performed by calculating vertical excitations and emissions, obtaining conceptual DFT chemical descriptors and nonlinear optical parameters (e.g., first static hyperpolarizability β). The novel coumarin derivatives display a reduction in the HOMO–LUMO energy gap from 6.11 to 4.2 eV, large oscillator strength (1.93), efficient nonlinear optical behavior, and excellent redox potential. Hence, they are promising compounds for photocatalytic activity. Graphical Abstract The present work shows a series of computational parameters that can be considered for the design of a molecule with potential photocatalytic activity, evaluating in this instance a series of new coumarins, promising from the computational point of view

NOx emissions in vehicles are currently only controlled through the homologation process. There is a lack of knowledge to assess and control real NOx emissions of vehicles reliably. Even if vehicles in EU-27 are subject to Periodical Technical Inspection (PTI), NOx are not among the pollutants currently being controlled. For PTIs, tests need to be simple, quick, inexpensive, representative, and accurate. Ideally, tests need to be carried out under static conditions, without the need for a power bench or complex equipment. In this paper, a new approach for measuring NOx in PTI is proposed. The method has been developed and validated at a PTI Spanish station to ensure feasibility and repeatability. This method is based on the relationship between the “% engine load” value and exhaust NOx concentration at idle engine speed. Starting from the state of minimum possible power demand in a vehicle (idling and without any consumption), a load state with an average 98% increase in engine power demand is generated by connecting elements of the vehicle’s equipment. The relationship between power demand (through the “% engine load” value) and NOx concentration is then analyzed. The quality and representativity of this relationship have been checked with a p-value lower than 0.01. The method has been compared with a different NOx measurement technique, based on the simulation on a test bench and the ASM 2050 cycle, showing better performance in terms of repeatability and representativeness. The “% engine load” dispersion with the new approach is 7%, which ensures the reliability and repeatability of the method. The results show that the proposed method could be a valuable tool in PTI to detect high NOx emitting vehicles and to obtain information from the diesel vehicles fleet.

The measurement of NOx emissions in vehicles has so far been exclusively carried out during the type-approval process. For this purpose, high-precision gas measurement laboratory equipment and Portable Emission Measurement Systems (PEMS) are used. Both types of equipment are costly in terms of price, maintenance, complexity, and time of use (calibration and maintenance requirements). Currently, NOx emissions measurements in Periodic Technical Inspections (PTIs) are being considered, but PEMS or laboratory equipment is unsuitable for this function, and PTI-grade equipment has to be used. Although CO and O2 are currently being reliably measured with this equipment, there is not enough information about its accuracy for NOx measurements. Accordingly, in this paper, simultaneous measures have been performed over the same engine in a test cell, with a laboratory and a PTI gas analyser to assess the accuracy of the latter. When performing the test with the most similar conditions found in PTI, our results show that the PTI gas analyser shows an average deviation of 2.6 ppm and 9% rel. with respect to high-precision laboratory equipment for concentrations below 700 ppm NOx, which can be considered acceptable for periodic technical inspections.

Background Over the past two decades, most cancer vaccines have failed to be developed clinically. The lack of efficient priming with specific tumor antigens and/or weak adjuvants may explain this poor success rate. MVX-ONCO-1, a personalized cell-based vaccine, combines inactivated autologous tumor cells and encapsulated allogeneic human cells genetically engineered to produce granulocyte–macrophage colony stimulating factor (GM-CSF). This unique technology allows sustained local delivery of strong adjuvant at the vaccination site. The combination of inactivated autologous tumor cells and potent local adjuvant delivery addresses these two unmet critical steps and may recapitulate in patients the successful combination observed in experimental models. Methods The SAKK 11/16, a Phase IIa trial with Overall Survival (OS) as the primary endpoint was the first efficacy study evaluating MVX-ONCO-1. Patients with Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC) progressing after at least one line of systemic therapy were enrolled with 50% of patients alive at 26 weeks as the primary objective. Results In this hard-to-treat population, SAKK 11/16 met the primary endpoint, with 68.8% of patients alive at 6 months. The median OS was 11.4 months, with 32% of the patients alive after 18 months. Complete and partial responses were observed on MVX-ONCO-1 monotherapy. Moreover, all patients who developed a positive DTH reaction to their tumor cells upon vaccination survived at 12 months. Additionally, patients living for more than 12 months had higher circulating antibody titers against tumor-associated antigens. Explorative analysis looking at median OS from the start of anti-PD-1 therapy was 21.7 months. In addition, no new safety signals with no systemic adverse events (AE) related to the treatment and no manufacturing issues were observed in this multicenter trial. Conclusions These findings suggest that MVX-ONCO-1 can induce a coordinated immune response with clinical benefits as a standalone treatment, leading to prolonged survival. This effect may be enhanced by previous exposure to immune checkpoint inhibitors. Trial registration (ClinicalTrials.gov): NCT02999646.

5q spinal muscular atrophy (5q-SMA) is a leading genetic cause of infant mortality. Presymptomatic intervention with disease-modifying therapies significantly improves motor outcomes, but effectiveness depends on early detection through newborn screening (NBS). Despite global 5q-SMA NBS expansion and recent Brazilian federal legislation, regional disparities and a lack of systematic monitoring hinder access to timely diagnosis and care. This study addresses these gaps by evaluating a statewide pilot program in São Paulo. We used multiplex real-time PCR to detect SMN1 exon 7 deletions in dried blood spots, confirming SMN1/2 copy numbers via MLPA in positive cases. Under real-world conditions, timeliness key performance indicators were evaluated to assess operational efficiency. 194,714 newborns were screened with 14 positive cases, yielding a prevalence of 1:13,908. First-tier results and treatment initiation occurred at a median of 10.8 and 28 days of life, respectively. Notably, 78.6% of patients had two SMN2 copies, of which approximately half were symptomatic by the first evaluation, highlighting the critical need for rapid screening to prevent irreversible motor decline. Screening achieved 100% specificity. This pilot demonstrates the feasibility of 5q-SMA NBS within the Brazilian public health system, providing essential evidence to overcome logistical and socioeconomic barriers and support nationwide expansion.

Background/Objectives: Type 1 diabetes mellitus (T1D) is the most common metabolic disorder in children, with significant physical and emotional impacts. Achieving optimal glucometric control is challenging due to the complex management and limitations of insulin therapy. Advances in pharmacology and technology, including continuous glucose monitoring (CGM) systems, offer new options for diabetes management. We developed Andiacare, an open-source platform for macro/micro-management of diabetes and analyzed its application in a pediatric T1D cohort to evaluate glucometric control patterns. Methods: A retrospective cohort study was conducted in a pediatric population (<18 years old) in Andalusia, Spain. Patients treated with Multiple Daily Injections of Insulin (MDI) and FreeStyle Libre 2 System (Abbott, Spain) were included. The patient data were analyzed using the Andiacare platform, which categorizes patients based on the Advanced Technologies and Treatments for Diabetes (ATTD) panel’s targets for glucometric control. Results: The study included 2215 patients from 18 pediatric hospitals. The Andiacare platform categorized patients into four groups based on glucometric control parameters, enabling patient stratification based on their glucometric control. Only 25.8% of the cohort achieved the recommended Time in Range (TIR), and 9.5% of the patients achieved all target parameters of glucometric control. Age is a determinant factor in adherence and achievement of set goals. Conclusions: This study offers insights into glucometric control in a large pediatric population with T1D in Andalusia. Few patients achieved the recommended glucometric control targets, highlighting the need for improved management strategies. The use of digital platforms such as Andiacare might contribute to facilitating the management of large pediatric cohorts. New algorithms integrating glucometric and non-glucometric parameters are required for improved individual and cohort categorization to optimize therapeutic interventions.

Pressure ulcers represent a major current health problem and produce an important economic impact on the healthcare system. Most of studies to prevent pressure ulcers have been carried out in hospital contexts, with respect to the use of hyperoxygenated fatty acids and to date, no studies have specifically examined the use of olive oil-based substances. Main objective: To assess the effectiveness of the use of olive oil, comparing it with hyperoxygenated fatty acids, for immobilised home-care patients at risk of suffering pressure ulcers. Design: Non-inferiority, triple-blind, parallel, multicentre, randomised clinical trial. Scope: Population attending Primary Healthcare Centres in Andalusia (Spain). Sample: 831 immobilised patients at risk of suffering pressure ulcers. The follow-up period was 16 weeks. Groups were similar after randomization. In the per protocol analysis, none of the body areas evaluated presented risk differences for pressure ulcers incidence that exceeded the 10% delta value established. Sacrum: Olive Oil 8 (2.55%) vs HOFA 8 (3.08%), ARR 0.53 (-2.2 to 3.26) Right heel: Olive Oil 4 (1.27%) vs HOFA 5 (1.92)%, ARR0.65 (-1.43 to 2.73). Left heel: Olive Oil 3 (0.96%) vs HOFA 3 (1.15%), ARR0.2 (-1.49 to 1.88). Right trochanter: Olive Oil 0 (0%) vs HOFA 4 (1.54%), ARR1.54 (0.04 to 3.03). Left trochanter: Olive Oil 1 (0.32%) vs HOFA 1 (0.38%), ARR0.07 (-0.91 to 1.04). In the intention to treat analysis the lower limit of the established confidence interval was never exceeded. The results obtained confirmed that the use of topical extra-virgin olive oil to prevent PU in the home environment, for immobilised patients at high risk, is not inferior to the use of HOFA. Further studies are needed to investigate the mechanism by which olive oil achieves this outcome. Clinicaltrials.gov NCT01595347.

Timothy syndrome 1 (TS1) is a multi-organ form of long QT syndrome associated with life-threatening cardiac arrhythmias, the organ-level dynamics of which remain unclear. In this study, we developed and characterized a novel porcine model of TS1 carrying the causative p.Gly406Arg mutation in CACNA1C , known to impair Ca V 1.2 channel inactivation. Our model fully recapitulated the human disease with prolonged QT interval and arrhythmic mortality. Electroanatomical mapping revealed the presence of a functional substrate vulnerable to reentry, stemming from an unforeseen constitutional slowing of cardiac activation. This signature substrate of TS1 was reliably identified using the reentry vulnerability index, which, we further demonstrate, can be used as a benchmark for assessing treatment efficacy, as shown by testing of multiple clinical and preclinical anti-arrhythmic compounds. Notably, in vitro experiments showed that TS1 cardiomyocytes display Ca 2+ overload and decreased peak I Na current, providing a rationale for the arrhythmogenic slowing of impulse propagation in vivo.

Health related quality of life (HRQoL) is a relevant result when assessing the course of different pathologies and the efficacy of their treatments. HRQoL has been studied previously on adults born small for gestational age (SGA), both in the general population and in patients who had received recombinant human growth hormone (rhGH) treatment, with disparate results. Our study included 50 adults who had received rhGH treatment for the SGA indication in 4 Spanish hospitals. Data have been gathered retrospectively from their clinical records, current weight and height were measured, and patients have been asked to fill out SF-36 and QoLAGHDA quality of life forms, and the Graffar test to evaluate their socio-economical status. Patient’s adult height was – 1.2 ± 0.9 SD, lower than their target height of 1 ± 0.8 SD, but gaining 1.7 ± 1 SD from the beginning of the treatment. SF-36 test results showed lower scoring on Mental Health domains than on those related to Physical Health. No correlation was found between HRQoL results and final height, rhGH treatment duration or puberty. Correlation was indeed found between QoLAGHDA and several domains of SF-36, but QoLAGHDA detected fewer patients with low HRQoL than SF-36. Thus, it is concluded that SGA patient’s follow-up should include a HRQoL, neuro-cognitive and psychiatric assessment in their transition to adult age. Adult SGA patients without catch up growth have impaired HRQoL, especially in mental health domains.