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\"This continuing series of handpicked stories is chock-full, featuring 176 pages of comedic gems in a high quality trade paperback format that includes a pullout paper craft that will allow the reader to recreate the second in a series of Springfield's favorite landmarks. Join the fun as Bart meets his double-crossing doppelgèanger, Homer proves there IS cause to be alarmed at the nuclear power plant, Moe and the barflies invent a popular beer-flavored donut, the whole family makes itself busy as bees while trying to make money in the honey business, and Bartman faces his deadliest foe of all ... the Bartman of the Future! And much, much more! Then build your very own replica of one Homer Simpsons' favorite nightspot, Moe's Tavern, with your very own two hands!\" -- from publisher's web site.

Introduction The role of kindness in healthcare is receiving increased attention. Indeed, international research shows that a culture of kindness has a positive impact on healthcare organizations, healthcare staff members, and patients. Benefits include better patient outcomes, as well as a humanized work environment, which helps to prevent stress and burnout among healthcare workers. Studies across different settings suggest that healthcare managers need to foster not only technical and organizational skills, but also social skills such as empathy and kindness. The purpose of this scoping review is to provide an overview of the current research landscape regarding initiatives based on acts of kindness in healthcare organizations. We will also explore whether this is a topic of interest to academics, which countries have conducted the most research on the subject, the practical implications for healthcare management, and potential directions for future research. Methods This scoping review was conducted using the Arksey and O’Malley framework. A search was performed in the electronic databases ScienceDirect, Pubmed and Web of Science, to identify studies published in English between 1994 and 2023 describing or evaluating kindness-based interventions in the healthcare context. Based on the predefined eligibility criteria, screening and studies selection were performed. Data were extracted and analyzed descriptively to summarize the evidence. Results 19 studies were analyzed and included in the review. The article assessment revealed four categories: 1) organizational culture; 2) burnout reduction and staff well-being; 3) staff education / training; and 4) communication and patient experience. Kindness in healthcare is a relatively new topic, but of great scientific interest. The countries most interested in the topic are English speaking (with a particular interest in category 2) and Western European, and the methodology most commonly used to investigate this topic is qualitative. Conclusions The need for additional research on kindness in healthcare arises from a complex and dynamic healthcare environment, where the concept of kindness holds the potential to revolutionize the quality of care and the well-being of healthcare providers. The interest of the various countries in the 4 thematic categories proposed by the study and the performance results of healthcare organizations promoting kindness compared to others without this focus also bear further consideration.

There is an important relationship between probiotics, psychobiotics and cognitive and behavioral processes, which include neurological, metabolic, hormonal and immunological signaling pathways; the alteration in these systems may cause alterations in behavior (mood) and cognitive level (learning and memory). Psychobiotics have been considered key elements in affective disorders and the immune system, in addition to their effect encompassing the regulation of neuroimmune regulation and control axes (the hypothalamic-pituitary-adrenal axis or HPA, the sympathetic-adrenal-medullary axis or SAM and the inflammatory reflex) in diseases of the nervous system. The aim of this review is to summarize the recent findings about psychobiotics, the brain-gut axis and the immune system. The review focuses on a very new and interesting field that relates the microbiota of the intestine with diseases of the nervous system and its possible treatment, in neuroimmunomodulation area. Indeed, although probiotic bacteria will be concentrated after ingestion, mainly in the intestinal epithelium (where they provide the host with essential nutrients and modulation of the immune system), they may also produce neuroactive substances which act on the brain-gut axis.

Introduction Alzheimer’s disease (AD) is the most frequent cause of cognitive impairment. Improving knowledge of dementia management through health education for health professionals can improve clinical and community care in home and specialist settings. It is important to guarantee good dementia knowledge in health students, and it is necessary to evaluate it with a good standardized tool. The aim of the current study was to assess the psychometric properties of the DKAS-S with cohorts of Ecuadorian health students, to compare these results with a former validation in Spanish health students and to analyse the level of knowledge according to different variables. Methods We performed a cross-sectional study to assess the validity, reliability and feasibility of the DKAS-S by comparing two different cohorts of health students (nursing and psychologists). Results A total of 659 students from Spain ( n  = 233) and Ecuador ( n  = 426) completed the DKAS-S (mean age 24.02 (6.35) years old), and 52.80% were nursing students. The DKAS-S showed good internal consistency in the Ecuadorian cohort (Cronbach’s α = 0.76). No significant difference was found between Spanish and Ecuadorian students ( p  = 0.767) in the global scale score, but there were differences in some subscales. Psychologist students scored significantly higher on the global scale than nursing students (32.08 (9.51) vs. 27.49 (7.15); p  < 0.001)). Students with a family history of cognitive impairment scored higher on the global scale, and those who had contact with people with dementia obtained better results on the global scale. Conclusions We confirmed that the DKAS-S is an adequate and useful instrument to measure levels of knowledge about dementia among health students in Spanish-speaking communities. It is a reliable and valid measure with good psychometric properties. Understanding health students’ knowledge about dementia will allow better adaptation of academic plans to train better health professionals.

Aim Anticipating the ultimate fraction of a landscape that might be susceptible to invasion is challenging as several species are able to expand the range of environmental conditions used over invasion. Despite its relevance, the more proximate processes underlying observed shifts are not sufficiently understood. Habitat selection theory predicts that as population density increases, individuals start using sub‐optimal resources to compensate for the limitation of the preferred ones. However, niche shifts might also occur as result of changes in habitat preferences over time. Here, we tested these alternative hypotheses by investigating nesting resource use and selection over a biological invasion and the relative effect of density‐dependence on such patterns. Location Barcelona, Spain. Methods We take advantage of a large dataset recording the occurrence of the invasive monk Parakeet, Myiopsitta monachus in Barcelona in the period 1975–2015. We apply generalized linear models to analyse changes in nesting habitat preferences and its interactive effect with conspecific presence. Results Temporal changes in nesting habitat use occurred. Palm species were the most commonly used nesting substrate since the beginning of the invasion but the diversity and frequency of use of other nesting substrates increased over time. Changes in nesting substrate use were consistent with a change in habitat selection, when accounting for habitat availability. Although a general role of conspecific aggregation on occupation patterns was found, it was mostly additive. That is, shifts in nesting substrate did not structure in relation to conspecific distribution. Conclusions Shifts in nesting resource selection can occur during the spread stage of biological invasions, probably related to innovation and learning, rather than to optimal habitat selection. These shifts present a significant challenge for forecasting efforts and management. However, changes do not happen rapidly over time, highlighting that there is a management opportunity window before significant shifts occur.

As part of the EU-funded Project INTEGRATE, the research sought to develop an evidence-based understanding of the key dimensions and items of integrated care associated with successful implementation across varying country contexts and relevant to different chronic and/or long-term conditions. This paper identifies the core dimensions of integrated care based on a review of previous literature on the topic. The research reviewed literature evidence from the peer-reviewed and grey literature. It focused on reviewing research articles that had specifically developed frameworks on integrated care and/or set out key elements for successful implementation. The search initially focused on three main scientific journals and was limited to the period from 2006 to 2016. Then, the research snowballed the references from the selected published studies and engaged leading experts in the field to supplement the identification of relevant literature. Two investigators independently reviewed the selected articles using a standard data collection tool to gather the key elements analyzed in each article. A total of 710 articles were screened by title and abstract. Finally, 18 scientific contributions were selected, including studies from grey literature and experts' suggestions. The analysis identified 175 items grouped in 12 categories. Most of the key factors reported in the literature derive from studies that developed their frameworks in specific contexts and/or for specific types of conditions. The identification and classification of the elements from this literature review provide a basis to develop a comprehensive framework enabling standardized descriptions and benchmarking of integrated care initiatives carried out in different contexts.

To carry out a systematic review and meta-analysis to verify the effects of different exercise training types on body composition and physical performance in older adults with sarcopenic obesity (SO). Systematic review and meta-analysis. Older adults (≥60 years). Database searches were performed in MEDLINE (via PubMed), EMBASE, Cochrane Library, Web of Science, SCOPUS, and LILACS on January 10th, 2023. We included: randomized and/or controlled clinical trials; physical exercise as an intervention; analysis of body composition and/or muscle function; and sarcopenic obesity diagnosis. We used the Risk of Bias 2 tool and PEDro scale. The GRADE certainty of evidence was also performed. Fourteen studies were included in the systematic review and nine studies in the meta-analysis. A decrease in body fat (%) favoring the exercise group was identified (SMD: −0.34 [95% CI: −0.53 to −0.16]; p=0.0003) (GRADE: ⊕⊕⊕○ Moderate). Only resistance training showed fat reduction (SMD: −0.27 [95% CI: −0.48 to −0.06]; p=0.01). Increases in upper (SMD: 0.41 [95% CI: 0.04 to 0.78]; p=0.03) (GRADE: ⊕⊕○○ Low) and lower (SMD: 0.80 [95% CI: 0.22 to 1.39]; p=0.007) (GRADE: ⊕⊕⊕⊕ High) limb strength was identified with exercise. Chair stand test showed increases with exercise (SMD: 0.73 [95% CI: 0.40 to 1.07]; p<0.0001) (GRADE ⊕⊕⊕⊕ High), especially for resistance training (SMD: 0.62 [95% CI: 0.21 to 1.02]; p=0.003) and combined training (SMD: 0.99 [95% CI: 0.40 to 1.57]; p=0.0005). The PEDro scale for the studies in our review ranged from 3 to 8 (mean = 5.8 (1.6)), meaning fair methodological quality, and most studies were overall judged with at least low/some concerns in terms of risk of bias. Overall, moderate to high certainty of evidence was found for body fat, lower limb strength, and chair stand test. On the other hand, low certainty of evidence was found for upper limb strength. Resistance, combined, and aerobic training evoked divergent results between the variables analyzed. Although promising, our results should be considered sparingly, but may guide additional exercise recommendations to improve specific health parameters in older adults with SO.

For centuries, humans occupying arid regions of North America have maintained an intricate relationship with Agave (Agavoideae, Asparagaceae). Today Agave cultivation, primarily for beverage production, provides an economic engine for rural communities throughout Mexico. Among known dryland-farming methods, the use of rock piles and cattle-grazed areas stand out as promising approaches for Agave cultivation. Identifying new cultivation areas to apply these approaches in Arizona, USA and Sonora, Mexico warrants a geographic assessment of areas outside the known ranges of rock piles and grasslands. The objective of this study was to predict areas for dryland-farming of Agave and develop models to identify potential areas for Agave cultivation. We used maximum entropy (MaxEnt) ecological-niche-modeling algorithms to predict suitable areas for Agave dryland farming. The model was parameterized using occurrence records of Hohokam rock piles in Arizona and grassland fields cultivated with Agave in Sonora. Ten environmental-predictor variables were used in the model, downloaded from the WorldClim 2 climate database. The model identified potential locations for using rock piles as dryland-farming methods from south-central Arizona to northwestern Sonora. The Agave -grassland model indicated that regions from central to southern Sonora have the highest potential for cultivation of Agave , particularly for the species Agave angustifolia . Results suggest that there are many suitable areas where rock piles can be used to cultivate Agave in the Sonoran Desert, particularly in the border of southeastern Arizona and northwest Sonora. Likewise, cattle-grazing grasslands provide a viable environment for cultivating Agave in southern Sonora, where the expanding bacanora-beverage industry continues to grow and where different Agave products (e.g., syrups, fructans, saponins, and medicinal compounds) can potentially strengthen local economies.

Malaria is one of the most devastating parasitic diseases worldwide. Plasmodium drug resistance remains a major challenge to malaria control and has led to the re-emergence of the disease. Chloroquine (CQ) and artemisinin (ART) are thought to exert their anti-malarial activity inducing cytotoxicity in the parasite by blocking heme degradation (for CQ) and increasing oxidative stress. Besides the contribution of the CQ resistance transporter (PfCRT) and the multidrug resistant gene (pfmdr), CQ resistance has also been associated with increased parasite glutathione (GSH) levels. ART resistance was recently shown to be associated with mutations in the K13-propeller protein. To analyze the role of GSH levels in CQ and ART resistance, we generated transgenic Plasmodium berghei parasites either deficient in or overexpressing the gamma-glutamylcysteine synthetase gene (pbggcs) encoding the rate-limiting enzyme in GSH biosynthesis. These lines produce either lower (pbggcs-ko) or higher (pbggcs-oe) levels of GSH than wild type parasites. In addition, GSH levels were determined in P. berghei parasites resistant to CQ and mefloquine (MQ). Increased GSH levels were detected in both, CQ and MQ resistant parasites, when compared to the parental sensitive clone. Sensitivity to CQ and ART remained unaltered in both pgggcs-ko and pbggcs-oe parasites when tested in a 4 days drug suppressive assay. However, recrudescence assays after the parasites have been exposed to a sub-lethal dose of ART showed that parasites with low levels of GSH are more sensitive to ART treatment. These results suggest that GSH levels influence Plasmodium berghei response to ART treatment.