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This article reports the geographical and host distribution of the flea Stenoponia tripectinata on the Canary Islands. S. tripectinata is widely distributed throughout the Mediterranean and North Africa as a parasite of Muridae rodents. To date, Gran Canaria is the only island of the archipelago where S. tripectinata had been found. In this report, S. tripectinata has appeared parasitizing 116 specimens of Mus musculus out of a total of 660, and only 2 Rattus rattus of 215 captured. All the trapped Muridae hosts found to be parasitized by S. tripectinata came from humid biotopes. The results showed that S. tripectinata is present on all the western Canary Islands and on one of the eastern islands, Gran Canaria, the only island already reported. The detection of S. tripectinata on El Hierro, La Palma, La Gomera and Tenerife represents the first records of this flea species on those Canary Islands.

The number of described species on the planet is about 1.9 million, with ca. 17,000 new species described annually, mostly from the tropics. However, taxonomy is usually described as a science in crisis, lacking manpower and funding, a politically acknowledged problem known as the Taxonomic Impediment. Using data from the Fauna Europaea database and the Zoological Record, we show that contrary to general belief, developed and heavily-studied parts of the world are important reservoirs of unknown species. In Europe, new species of multicellular terrestrial and freshwater animals are being discovered and named at an unprecedented rate: since the 1950s, more than 770 new species are on average described each year from Europe, which add to the 125,000 terrestrial and freshwater multicellular species already known in this region. There is no sign of having reached a plateau that would allow for the assessment of the magnitude of European biodiversity. More remarkably, over 60% of these new species are described by non-professional taxonomists. Amateurs are recognized as an essential part of the workforce in ecology and astronomy, but the magnitude of non-professional taxonomist contributions to alpha-taxonomy has not been fully realized until now. Our results stress the importance of developing a system that better supports and guides this formidable workforce, as we seek to overcome the Taxonomic Impediment and speed up the process of describing the planetary biodiversity before it is too late.

Cross-national research is plagued by many obstacles. This article focuses on one of these obstacles: the fact that research in more than one country usually involves respondents with different native languages. We investigated whether the language of the questionnaire influences response patterns. More specifically we tested whether responding in a common language (English) leads to a homogenization of responses across countries, hence obscuring national differences. We tested this hypothesis with a sample of 3419 undergraduate students in 24 countries. Half the students in each country received an English-language questionnaire, while the other half received the same questionnaire in their native language. Three types of questions were included in the questionnaire: questions about cultural norms and values, questions about characteristics of the ideal type of jobs that students would prefer after graduation, and questions about the reasons for choosing particular electives in their studies. Differences across countries were considerably smaller for nearly all questions when the English-language questionnaire was used. Consequences and recommendations for cross-national research and management are discussed.

Social anxiety is one of the most prevalent disorders among adolescents (Stein et al., 2017). The main aim of this study was to analyze the equivalence of scores on the Social Anxiety Scale for Adolescents (SAS-A) using structural equation modeling and identify differences in latent means of social anxiety in China, Spain, and the USA. Random sampling was used to recruit participants, which included 536 Chinese (46% girls), 1,178 Spanish (55.3% girls) and 866 North American (55.1% girls) adolescents. The participants' ages ranged between 14 and 17 years old. The SAS-A three-factor correlated model of social anxiety remained invariant between the Spanish and North American adolescents, but results could not be replicated in the Chinese adolescents [M2 = ΔS-Bχ² (Δdf, p) = 4732.56 (36, < .01)]. Analyses of latent differences between Spain and the USA showed that Spanish adolescents had higher scores than North Americans for Fear of Negative Evaluation (TS = -9.630; d = .44) and for Social Avoidance and General Anxiety towards people (TS = -2.717; d = .12). The results are interpreted according to the cultural traits of individualism-collectivism and self-construal, and practical implications are discussed.

Obesity hypoventilation syndrome is commonly treated with continuous positive airway pressure or non-invasive ventilation during sleep. Non-invasive ventilation is more complex and costly than continuous positive airway pressure but might be advantageous because it provides ventilatory support. To date there have been no long-term trials comparing these treatment modalities. We therefore aimed to determine the long-term comparative effectiveness of both treatment modalities. We did a multicentre, open-label, randomised controlled trial at 16 clinical sites in Spain. We included patients aged 15–80 years with untreated obesity hypoventilation syndrome and an apnoea-hypopnoea index of 30 or more events per h. We randomly assigned patients, using simple randomisation through an electronic database, to receive treatment with either non-invasive ventilation or continuous positive airway pressure. Both investigators and patients were aware of the treatment allocation. The research team was not involved in deciding hospital treatment, duration of treatment in the hospital, and adjustment of medications, as well as adjudicating cardiovascular events or cause of mortality. Treating clinicians from the routine care team were not aware of the treatment allocation. The primary outcome was the number of hospitalisation days per year. The analysis was done according to the intention-to-treat principle. This study is registered with ClinicalTrials.gov, number NCT01405976. From May 4, 2009, to March 25, 2013, 100 patients were randomly assigned to the non-invasive ventilation group and 115 to the continuous positive airway pressure group, of which 97 patients in the non-invasive ventilation group and 107 in the continuous positive airway pressure group were included in the analysis. The median follow-up was 5·44 years (IQR 4·45–6·37) for all patients, 5·37 years (4·36–6·32) in the continuous positive airway pressure group, and 5·55 years (4·53–6·50) in the non-invasive ventilation group. The mean hospitalisation days per patient-year were 1·63 (SD 3·74) in the continuous positive airway pressure group and 1·44 (3·07) in the non-invasive ventilation group (adjusted rate ratio 0·78, 95% CI 0·34–1·77; p=0·561). Adverse events were similar between both groups. In stable patients with obesity hypoventilation syndrome and severe obstructive sleep apnoea, non-invasive ventilation and continuous positive airway pressure have similar long-term effectiveness. Given that continuous positive airway pressure has lower complexity and cost, continuous positive airway pressure might be the preferred first-line positive airway pressure treatment modality until more studies become available. Instituto de Salud Carlos III, Spanish Respiratory Foundation, and Air Liquide Spain.

Tools for the evaluation of COVID-19 severity would help clinicians with triage decisions, especially the decision whether to admit to ICU. The aim of this study was to evaluate SeptiCyte RAPID, a host immune response assay (Immunexpress, Seattle USA) as a triaging tool for COVID-19 patients requiring hospitalization and potentially ICU care. SeptiCyte RAPID employs a host gene expression signature consisting of the ratio of expression levels of two immune related mRNAs, PLA2G7 and PLAC8, measured from whole blood samples. Blood samples from 146 adult SARS-CoV-2 (+) patients were collected within 48 h of hospital admission in PAXgene blood RNA tubes at Hospital del Mar, Barcelona, Spain, between July 28th and December 1st, 2020. Data on demographics, vital signs, clinical chemistry parameters, radiology, interventions, and SeptiCyte RAPID were collected and analyzed with bioinformatics methods. The performance of SeptiCyte RAPID for COVID-19 severity assessment and ICU admission was evaluated, relative to the comparator of retrospective clinical assessment by the Hospital del Mar clinical care team. In conclusion, SeptiCyte RAPID was able to stratify COVID-19 cases according to clinical severity: critical vs. mild (AUC = 0.93, p  < 0.0001), critical vs. moderate (AUC = 0.77, p  = 0.002), severe vs. mild (AUC = 0.85, p  = 0.0003), severe vs. moderate (AUC = 0.63, p  = 0.05). This discrimination was significantly better (by AUC or p -value) than could be achieved by CRP, lactate, creatine, IL-6, or D-dimer. Some of the critical or severe cases had “early” blood draws (before ICU admission; n = 33). For these cases, when compared to moderate and mild cases not in ICU (n = 37), SeptiCyte RAPID had AUC = 0.78 ( p  = 0.00012). In conclusion, SeptiCyte RAPID was able to stratify COVID-19 cases according to clinical severity as defined by the WHO COVID-19 Clinical Management Living Guidance of January 25th, 2021. Measurements taken early (before a patient is considered for ICU admission) suggest that high SeptiScores could aid in predicting the need for later ICU admission.

Triple-negative breast cancer (TNBC) lacks prognostic and predictive markers. Here, we use high-throughput phosphoproteomics to build a functional TNBC taxonomy. A cluster of 159 phosphosites is upregulated in relapsed cases of a training set ( n  = 34 patients), with 11 hyperactive kinases accounting for this phosphoprofile. A mass-spectrometry-to-immunohistochemistry translation step, assessing 2 independent validation sets, reveals 6 kinases with preserved independent prognostic value. The kinases split the validation set into two patterns: one without hyperactive kinases being associated with a >90% relapse-free rate, and the other one showing ≥1 hyperactive kinase and being associated with an up to 9.5-fold higher relapse risk. Each kinase pattern encompasses different mutational patterns, simplifying mutation-based taxonomy. Drug regimens designed based on these 6 kinases show promising antitumour activity in TNBC cell lines and patient-derived xenografts. In summary, the present study elucidates phosphosites and kinases implicated in TNBC and suggests a target-based clinical classification system for TNBC. Triple-negative breast cancer (TNBC) lacks prognostic and predictive markers. Here, the authors use phosphoproteomics to define kinases with distinct activity profiles in TNBC, demonstrating their prognostic value as well as their utility for simplifying TNBC classification and designing drug regimens.

BackgroundObesity hypoventilation syndrome (OHS) is treated with either non-invasive ventilation (NIV) or CPAP, but there are no long-term cost-effectiveness studies comparing the two treatment modalities.ObjectivesWe performed a large, multicentre, randomised, open-label controlled study to determine the comparative long-term cost and effectiveness of NIV versus CPAP in patients with OHS with severe obstructive sleep apnoea (OSA) using hospitalisation days as the primary outcome measure.MethodsHospital resource utilisation and within trial costs were evaluated against the difference in effectiveness based on the primary outcome (hospitalisation days/year, transformed and non-transformed in monetary term). Costs and effectiveness were estimated from a log-normal distribution using a Bayesian approach. A secondary analysis by adherence subgroups was performed.ResultsIn total, 363 patients were selected, 215 were randomised and 202 were available for the analysis. The median (IQR) follow-up was 3.01 (2.91–3.14) years for NIV group and 3.00 (2.92–3.17) years for CPAP. The mean (SD) Bayesian estimated hospital days was 2.13 (0.73) for CPAP and 1.89 (0.78) for NIV. The mean (SD) Bayesian estimated cost per patient/year in the NIV arm, excluding hospitalisation costs, was €2075.98 (91.6), which was higher than the cost in the CPAP arm of €1219.06 (52.3); mean difference €857.6 (105.5). CPAP was more cost-effective than NIV (99.5% probability) because longer hospital stay in the CPAP arm was compensated for by its lower costs. Similar findings were observed in the high and low adherence subgroups.ConclusionCPAP is more cost-effective than NIV; therefore, CPAP should be the preferred treatment for patients with OHS with severe OSA.Trial registration number NCT01405976

Various surface modifications to increase the lifespan of cobalt–chromium (CoCr) joint prostheses are being studied to reduce the wear rate in bone joint applications. One recently proposed modification involves depositing graphene oxide functionalized with hyaluronic acid (a compound present in joints) on CoCr surfaces, which can act as a solid lubricant. This paper analyzes the biological alterations caused by wear–corrosion phenomena that occur in joints, both from the perspective of the worn surface (in vitro model) and the particles generated during the wear processes (in vivo model). The analysis of the inflammatory response of macrophage was performed on CoCr surfaces modified with graphene oxide and functionalized with hyaluronic acid (CoCr-GO-HA), before and after wear–corrosion processes. The wear particles released during the wear–corrosion tests of the CoCr-GO-HA/CoCr ball pair immersed in 3 g/L hyaluronic acid were intra-articularly injected into the experimental animals. The hematological analysis in vivo was made considering a murine model of intra-articular injection into the left knee in male adult Wistar rats, at increasing concentrations of the collected wear particles dispersed in 0.9% NaCl. Non-significant differences in the inflammatory response to unworn CoCr-GO-HA surfaces and control (polystyrene) were obtained. The wear–corrosion of the CoCr-GO-HA disk increased the inflammatory response at both 72 and 96 h of material exposure compared to the unworn CoCr-GO-HA surfaces, although the differences were not statistically significant. The pro-inflammatory response of the macrophages was reduced on the worn surfaces of the CoCr modified and functionalized with graphene oxide (GO) and hyaluronic acid (HA), compared to the worn surfaces of the unmodified CoCr. The hematological analysis and tissue reactions after intra-articular injection did not reveal pathological damage, with average hematological values recorded, although slight reductions in creatinine and protein within non-pathological ranges were found. Some traces of biomaterial particles in the knee at the highest concentration of injected particles were only found but without inflammatory signs. The results show the potential benefits of using graphene in intra-articular prostheses, which could improve the quality of life for numerous patients.

This study assessed the technological potential and bioactive compounds present in purple yampee (Dioscorea trifida L.f.) lyophilized powder, peeled and whole flour, as well as the tuber peel, starch residual fiber, and wastewater mucilage. Although most values approached neutrality, flour showed a lower pH and high density, while greater acidity was observed in the mucilage. Color differed statistically and perceptibly between all samples, with similar values of °hue to purple flours from other sources, and the maximum chroma was found in lyophilized pulp and lightness in fiber. Average moisture levels around 7.2% and water activity levels of 0.303 (0.194 for whole flour) in fractions suggested favorable storability, while the interaction of the powders with water was similar to other root and tuber powdered derivatives. Yampee periderm had the highest swelling power, oil absorption capacity, water holding capacity, and absorption index and capacity. Mucilage had a higher solubility index and outstanding emulsion activity, greater than 90%. Twelve anthocyanins, with new reports of petunidin derivatives for the species, and more than 30 phytochemicals were identified through advanced liquid chromatography techniques. The greatest amounts of pinitol and myo-inositol were found in the mucilage, and sucrose, glucose, and fructose prevailed in the other powders. Successfully characterized yampee fractions showed high potential as functional food ingredients.