This bibliographic study addresses key aspects related to fishing, product safety, and climate change in the Adriatic Sea region. The examination of product safety focuses on the assessment of contaminants originating from human activities such as industry, mining, agriculture, and household waste disposal. The contamination of the aquatic environment has emerged as a pressing global concern, extending to the Adriatic basin. Aquatic organisms, including fish, are prone to accumulating pollutants directly from polluted water sources and indirectly through the food web. The bio-accumulation of potentially hazardous substances, particularly heavy metals, pesticides, PCBs, PAHs, and antibiotic resistance in aquatic organisms, poses a significant threat to human health. Climate change effects will deplete our seafood supply in terms of quantity and safety owing to negative consequences such as higher levels of pollution, parasites, viruses, infections, acidification, and toxicities such as shellfish poisoning. Global food safety strategies should be developed to reduce greenhouse gas emissions and promote environmentally friendly technology, which indirectly affects seafood quality and microbiological safety, especially for the Adriatic Sea, which is part of the Mediterranean Sea, characterized by the most polluted waters in the world. Full article

In this study, we introduced the chaos game optimization-artificial neural network (CGO-ANN) model as a novel approach for predicting peak particle velocity (PPV) induced by mine blasting. The CGO-ANN model is compared with other established methods, including the particle swarm optimization-artificial neural network (PSO-ANN), the genetic algorithm-artificial neural network (GA-ANN), single ANN, and the USBM empirical model. The aim is to demonstrate the superiority of the CGO-ANN model for PPV prediction. Utilizing a dataset comprising 180 blasting events from the Tonglushan Copper Mine in China, we investigated the performance of each model. The results showed that the CGO-ANN model outperforms other models in terms of prediction accuracy and robustness. This study highlights the effectiveness of the CGO-ANN model as a promising tool for PPV prediction in mining operations, contributing to safer and more efficient blasting practices. Full article

In this paper, we constructed a new and robust fixed point iterative scheme called the UO iterative scheme for the approximation of a contraction mapping. The scheme converges strongly to the fixed point of a contraction mapping. A rate of convergence result is shown with an example, and our scheme, when compared, converges faster than some existing iterative schemes in the literature. Furthermore, the stability and data dependence results are shown. Our new scheme is applied in the approximation of the solution to the oxygen diffusion model. Finally, our results are applied in the approximation of the solution to the boundary value problems using Green’s functions with an example. Full article

The aim of this study was to determine the associations between the front and back squat, countermovement jump (CMJ) and deep squat jump (DSJ) force–time metrics, and weightlifting performance in top-level weightlifters. Thirteen top-level weightlifters who classified for the World Championship 2023 participated. The heaviest successful snatch and clean and jerk were recorded within a preparation session as performance indicators. The front and back squat one-repetition maximums (1RMs) were evaluated in separate training sessions. The average of three maximum CMJs and DSJs were recorded using a force plate, and jump height, propulsive net impulse, and peak power were calculated for further analysis. Pearson’s correlation coefficients were used to determine the associations between variables. Statistical significance was set at p ≤ 0.05. The front and back squat 1RMs were significant and nearly perfectly associated with weightlifting performance (p < 0.001, r = 0.98–0.99). CMJ and DSJ propulsive net impulse displayed nearly perfect associations with weightlifting performance (p < 0.001, r = 0.96–0.99), while jump height is a less promising metric to assess the weightlifters’ ballistic capabilities. This study reinforces that lower body maximum strength and ballistic capabilities are closely associated with top-level weightlifters’ performance and are of practical importance to monitor their neuromuscular function. Full article

We review the role of the spectral condition as a characteristic of Minkowski, de Sitter, and anti-de Sitter quantum field theories. We also discuss the role of plane waves that are compatible with the relevant analyticity domains linked to the spectral condition(s) and discuss harmonic analysis in terms of them. Full article

The article discusses the importance of accurately distinguishing HER2-low from HER2-negative breast cancer, as novel ADCs have demonstrated activity in a large population of patients with HER2-low-expressing BC. While current guidelines recommend a dichotomous classification of HER2 as either positive or negative, the emergence of the HER2-low concept calls for standardization of HER2 testing in breast cancer, using currently available assays to better discriminate HER2 levels. This review covers the evolution and latest updates of the ASCO/CAP guidelines relevant to this important biomarker in breast cancer, including still-evolving concepts such as HER2 low, HER2 heterogeneity, and HER2 evolution. Our group presents the latest Mexican recommendations for HER2 status evaluation in breast cancer, considering the ASCO/CAP guidelines and introducing the HER2-low concept. In the era of personalized medicine, accurate HER2 status assessment remains one of the most important biomarkers in breast cancer, and the commitment of Mexican pathologists to theragnostic biomarker quality is crucial for providing the most efficient care in oncology. Full article

Microplastics (MPs) are now ubiquitous environmental contaminants that lead to unavoidable human exposure; they have received increasing attention in recent years and have become an emerging area of research. The greatest concern is the negative impacts of MPs on marine, fresh-water, and terrestrial ecosystems, as well as human health, to the extent that the World Health Organization (WHO) calls for increased research and standardized methods to assess exposure to MPs. Many countries and international organizations are implementing or proposing legislation in this regard. This review aims to summarize the current state of legislation, indoor and outdoor contamination, and potential human health risk due to exposure to airborne MPs, considering that occupational exposure to MPs is also becoming a growing area of concern. Even though research regarding MPs has continuously increased in the last twenty years, the effects of MPs on human health have been scarcely investigated, and toxicity studies are still limited and not directly comparable, due to the lack of standardized studies in this field. Full article

This study proposes a new computational framework for the multi-objective topology optimization of conjugate heat transfer systems using a continuous adjoint approach. It relies on a monolithic solver for the coupled steady-state Navier–Stokes and heat equations, which combines finite elements stabilized by the variational multi-scale method, level set representations of the fluid–solid interfaces and immersed modeling of heterogeneous materials (fluid–solid) to ensure that the proper amount of heat is exchanged to the ambient fluid by solid objects in arbitrary geometry. At each optimization iteration, anisotropic mesh adaptation is applied in near-wall regions automatically captured by the level set. This considerably cuts the computational effort associated with calling the finite element solver, in comparison to traditional topology optimization algorithms operating on isotropic grids with a comparable refinement level. Given that we operate within the constraint of a specified number of nodes in the mesh, this allows not only to improve the accuracy of interface representation and motion but also to retain the high fidelity of the numerical solutions at the grid points just adjacent to the interface. Finally, the remeshing and resolution steps both run within a highly parallel environment, which makes it possible for the proposed algorithm to tackle large-scale problems in three dimensions with several tens of millions of state degrees of freedom. The developed solver is validated first by minimizing dissipation in a flow splitter device, for which the method delivers relevant optimal designs over a wide range of volume constraints and flow rate distributions over the multiple outlet orifices but yields better accuracy compared to reference data from literature obtained using uniform meshes (in the sense that the layouts are more smooth, and the solutions are better resolved). The scheme is then applied to a two-dimensional heat transfer problem, using bi-objective cost functionals combining flow resistance and thermal recoverable power. A comprehensive parametric study reveals a complex arrangement of optimal solutions on the Pareto front, with multiple branches of symmetric and asymmetric designs, some of them previously unreported. Finally, the algorithmic developments are substantiated with several three-dimensional numerical examples tackled under fixed weights for heat transfer and flow resistance, for which we show that the optimal layouts computed at low Reynolds number, that are intrinsically relevant to a broad range of microfluidic application, can also serve as smooth solutions to high-Reynolds-number engineering problems of practical interest. Full article

Mild Cognitive Impairment (MCI) is a cognitive state frequently observed in older adults, characterized by significant alterations in memory, thinking, and reasoning abilities that extend beyond typical cognitive decline. It is worth noting that around 10–15% of individuals with MCI are projected to develop Alzheimer’s disease, effectively positioning MCI as an early stage of Alzheimer’s. In this study, a novel approach is presented involving the utilization of eXtreme Gradient Boosting to predict the onset of Alzheimer’s disease during the MCI stage. The methodology entails utilizing data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Through the analysis of longitudinal data, spanning from the baseline visit to the 12-month follow-up, a predictive model was constructed. The proposed model calculates, over a 36-month period, the likelihood of progression from MCI to Alzheimer’s disease, achieving an accuracy rate of 85%. To further enhance the precision of the model, this study implements feature selection using the Recursive Feature Elimination technique. Additionally, the Shapley method is employed to provide insights into the model’s decision-making process, thereby augmenting the transparency and interpretability of the predictions. Full article

This study aimed to investigate the gradient properties of bamboo at the microscopic level and provide a basis for improving the utilization rate of bamboo. Using moso bamboo (Phyllostachys edulis (Carrière) J. Houz.) as a research subject, the variation of vascular bundle area percentage, chemical content, relative crystallinity (CR), mechanical properties of different bamboo slivers, and correlation between those parameters were analyzed. From the bamboo green layer (BGL) to the bamboo yellow layer (BYL), the distribution of vascular bundles changed from dense to sparse. Cellulose and lignin mass content decreased gently, and hemicellulose mass content showed gradual increases. The CR showed an order of bamboo middle layer (BML) > BGL > BYL. The tensile modulus of elasticity, tensile strength, bending modulus of elasticity, and bending strength decreased from BGL to BYL. The order of influence degree on mechanical properties of moso bamboo was vascular bundle area, hemicellulose content, lignin mass content, density, and CR, and these factors correlated with mechanical properties at a significant level (p < 0.05). Vascular bundle area had a decisive effect on the mechanical properties of bamboo. The vascular bundle area and density were linearly correlated with mechanical properties, while the lignin mass content and CR were curve-linearly correlated with mechanical properties. Full article

Background and Objectives: Leukemia, characterized by abnormal leukocyte production, exhibits clonal origin from somatic mutations. Globally, it ranked 15th in cancer incidence in 2020, with higher prevalence in developing countries. In Mexico, it was the ninth most frequent cancer. Regional registries are vital for understanding its epidemiology. This study aims to analyze the prevalence and age-standardized incidence rates of leukemias in a tertiary care hospital in the Mexican Bajio region. Materials and Methods: Leukemia cases from 2008–2018 were analyzed, and 535 medical records were included in this study. The prevalence, distribution, and age-specific incidence rate of different types and subtypes of leukemia were determined according to sex and age groups. Results: Overall, 65.79% consisted of lymphocytic leukemia, 33.64% of myeloid leukemia, and 0.56% of monocytic leukemia. No significant sex-based differences were found, but age-specific patterns were observed. Leukemia distribution by age revealed significant associations. Lymphocytic leukemia dominated in the pediatric population, particularly acute lymphocytic leukemia, while myeloid leukemia shifted towards adulthood. Age-specific incidence patterns showed, first, that lymphocytic leukemia is the most common leukemia in pediatric ages, and second, there is a shift from acute lymphocytic leukemia dominance in pediatric ages to myeloid leukemia incidence in late adulthood, emphasizing nuanced epidemiological dynamics. Conclusions: Acute leukemia cases occurred with high prevalence in our study population, with a high incidence in pediatric and adulthood populations, especially for acute lymphocytic leukemia, showing a (<18 years) 153.8 age-standardized incidence rate in the pediatric group, while in the adult population, the age-standardized rate was 59.84. In the age-specific analysis, we found that the childhood group (5–9 years) were the most affected by acute lymphocytic leukemia in the pediatric population, while in the adult population, the early-adulthood group (15–29 years) were the most affected age group. In contrast, chronic myeloid leukemia affected both adults and the pediatric populations, while chronic lymphocytic leukemia and monocytic leukemia were exclusive to adults. The study underscores the need for tailored diagnostic, treatment, and preventive strategies based on age, contributing valuable insights into the leukemia epidemiology of the Bajio region. Full article

Female genital tract infections (FGTIs) include vaginal infections (e.g., bacterial vaginosis [BV]), endometritis, pelvic inflammatory disease [PID], and chorioamnionitis [amniotic fluid infection]. They commonly occur in women of reproductive age and are strongly associated with multiple adverse health outcomes including increased risk of HIV/sexually transmitted infection acquisition and transmission, infertility, and adverse birth outcomes such as preterm birth. These FGTIs are characterized by a disruption of the cervicovaginal microbiota which largely affects host immunity through the loss of protective, lactic acid-producing Lactobacillus spp. and the overgrowth of facultative and strict anaerobic bacteria. Prevotella species (spp.), anaerobic Gram-negative rods, are implicated in the pathogenesis of multiple bacterial FGTIs. Specifically, P. bivia, P. amnii, and P. timonensis have unique virulence factors in this setting, including resistance to antibiotics commonly used in treatment. Additionally, evidence suggests that the presence of Prevotella spp. in untreated BV cases can lead to infections of the upper female genital tract by ascension into the uterus. This narrative review aims to explore the most common Prevotella spp. in FGTIs, highlight their important role in the pathogenesis of FGTIs, and propose future research in this area. Full article

The gas-liquid flow and oxygen content in a pressurized leaching stirred tank significantly influence the chemical reaction rates, while the specific dynamics of gas-liquid flow in the sulfuric acid system remain largely unexplored. In this study, a mathematical model of gas-liquid flow within a stirred tank is developed using the Euler-Euler approach, with the turbulence and drag force models being validated against experimental data. Utilizing this validated and reliable model, this study investigates the impacts of the sulfuric acid concentration, baffles, air inlet velocity, and bubble diameter on the flow field and gas holdup in a two-phase system consisting of a sulfuric acid solution and oxygen. The findings indicate that introducing a specific concentration of sulfuric acid decreases the solution velocity and increases the gas holdup within the tank. However, once the sulfuric acid concentration reaches a certain threshold, further increases have a diminished effect on the gas-liquid phases. The installation of baffles enhances the turbulent kinetic energy and increases the gas holdup while only resulting in a minimal 1.2% increase in power consumption. Additionally, the inlet velocity and bubble diameter have a relatively minor impact on the tank’s flow field. However, increasing the inlet velocity significantly boosts the gas holdup, whereas an increase in the bubble diameter marginally reduces it. Furthermore, introducing a sulfuric acid solution into the tank can enhance the gas holdup when the gas inlet velocity is low. Conversely, when the gas inlet velocity is high, the addition of sulfuric acid results in a decrease in the gas holdup. The conclusions from this study contribute to enhancing the mixing effectiveness and oxygen content within the tank, providing a substantial theoretical basis for optimizing the design and operating conditions of pressurized leaching stirred tanks. Full article

Gridded precipitation (PRP) data have been largely used in diagnostic studies on the climate variability in several time scales, as well as to validate model results. The three most used gauge-based PRP datasets are from the Global Precipitation Climatology Centre (GPCC), University of Delaware (UDEL), and Climate Research Unit (CRU). This paper evaluates the performance of these datasets in reproducing spatiotemporal PRP climatological features over the entire South America (SA) for the 1901–2015 period, aiming to identify the differences and similarities among the datasets as well as time intervals and areas with potential uncertainties involved with these datasets. Comparisons of the PRP annual means and variances between the 1901–2015 period and the non-overlapping 30-year subperiods of 1901–1930, 1931–1960, 1961–1990, and the 25-year subperiod of 1991–2015 for each dataset show varying means of the annual PRP over SA depending on the subperiod and dataset. Consistent patterns among datasets are found in most of southeastern SA and southeastern Brazil, where they evolved gradually from less to more rainy conditions from 1901–1930 to the 1991–2015 subperiod. All three datasets present limitations and uncertainties in regions with poor coverage of gauge stations, where the differences among datasets are more pronounced. In particular, the GPCC presents reduced PRP variability in an extensive area west of 50° W and north of 20° S during the 1901–1930 subperiod. In monthly time scale, PRP time series in two areas show differences among the datasets for periods before 1941, which are likely due to spurious or missing data: central Bolivia (CBO), and central Brazil (CBR). The GPCC has less monthly variability before 1940 than the other two datasets in these two areas, and UDEL presents reduced monthly variability before 1940 and spurious monthly values from May to September of the years from 1929 to 1941 in CBO. Thus, studies with these three datasets might lead to different results depending on the study domain and period of analysis, in particular for those including years before 1941. The results here might be relevant for future diagnostic and modelling studies on climate variability from interannual to multidecadal time scales. Full article

The treatment of DeBakey type I aortic dissection remains a major challenge in the field of aortic surgery. To upgrade the standard of care hemiarch replacement, a novel device called an “Ascyrus Medical Dissection Stent” (AMDS) is now available. This hybrid device composed of a proximal polytetrafluoroethylene cuff and a distal non-covered nitinol stent is inserted into the aortic arch and the descending thoracic aorta during hypothermic circulatory arrest in addition to hemiarch replacement. Due to its specific design, it may result in a reduced risk for distal anastomotic new entries, the effective restoration of branch vessel malperfusion and positive aortic remodeling. In this narrative review, we provide an overview about the indications and the technical use of the AMDS. Additionally, we summarize the current available literature and discuss potential pitfalls in the application of the AMDS regarding device failure and aortic re-intervention. Full article

Phytoplasmas are insect-transmitted bacterial pathogens associated with diseases in a wide range of host plants, resulting in significant economic and ecological losses. Perennial deciduous trees in the genus Paulownia are widely planted for wood harvesting and ornamental purposes. Paulownia witches’ broom (PaWB) disease, associated with a 16SrI-D subgroup phytoplasma, is a destructive disease of paulownia in East Asia. The PaWB phytoplasmas are mainly transmitted by insect vectors in the Pentatomidae (stink bugs), Miridae (mirid bugs) and Cicadellidae (leafhoppers) families. Diseased trees show typical symptoms, such as branch and shoot proliferation, which together are referred to as witches’ broom. The phytoplasma presence affects the physiological and anatomical structures of paulownia. Gene expression in paulownia responding to phytoplasma presence have been studied at the transcriptional, post-transcriptional, translational and post-translational levels by high throughput sequencing techniques. A PaWB pathogenic mechanism frame diagram on molecular level is summarized. Studies on the interactions among the phytoplasma, the insect vectors and the plant host, including the mechanisms underlying how paulownia effectors modify processes of gene expression, will lead to a deeper understanding of the pathogenic mechanisms and to the development of efficient control measures. Full article

Background: The prevalence of obesity and overweight in children is increasing in industrialized countries. Monitoring the evolution of these phenomena is essential for understanding prevention and health promotion programs. This study aims to present the analysis of anthropometric data collected by school nurses from the School Health Service of Geneva (Service de santé de l’enfance et de la jeunesse) for children aged 5 to 6 years during the 2021–2022 school year, as well as describe the trends in overweight and obesity from 2003–2004 to 2021–2022. Risk factors were also assessed in the 2021–2022 sample. Methods: This study included a random sample of 958 (479 girls and 479 boys) primary school pupils aged 5 to 6 years in Geneva. Data on weight, height and socioeconomic status were collected. BMI was analyzed using the Cole standard. A multivariate analysis was conducted to assess the influence of socioeconomic factors on overweight and obesity. We compared these results with BMI trends in students of the same age since 2003. Results: In 2021–2022, overall prevalence of overweight was 12.73%, and obesity was 5.64%. Girls had higher rates of overweight (14.20%) and obesity (6.68%) compared to boys (11.27% and 4.59%, respectively) (p < 0.0001). Overweight in boys significantly increased since the 2013–2014 and 2019–2020 measurements (p = 0.003). The trend for girls was similar but not statistically significant. Obesity rates have not significantly increased since 2019–2020 in both genders, but there is a significantly increasing trend for girls since 2013–2014 p = 0.045). Socioeconomic factors, particularly the socioeconomic class of parents, played a predictive role in overweight and obesity. Conclusions: The School Health Service of Geneva and the Directorate General of Health have a crucial role in monitoring and preventing childhood obesity. The prevalence of overweight and obesity has remained high since 2010, justifying continuous efforts for prevention. A significant increase in prevalence has been observed since 2020, particularly among overweight boys, and could be related to COVID-19 confinement measures. Full article

Flash droughts tend to cause severe damage to agriculture due to their characteristics of sudden onset and rapid intensification. Early detection of the response of vegetation to flash droughts is of utmost importance in mitigating the effects of flash droughts, as it can provide a scientific basis for establishing an early warning system. The commonly used method of determining the response time of vegetation to flash drought, based on the response time index or the correlation between the precipitation anomaly and vegetation growth anomaly, leads to the late detection of irreversible drought effects on vegetation, which may not be sufficient for use in analyzing the response of vegetation to flash drought for early earning. The evapotranspiration-based (ET-based) drought indices are an effective indicator for identifying and monitoring flash drought. This study proposes a novel approach that applies cross-spectral analysis to an ET-based drought index, i.e., Evaporative Stress Anomaly Index (ESAI), as the forcing and a vegetation-based drought index, i.e., Normalized Vegetation Anomaly Index (NVAI), as the response, both from medium-resolution remote sensing data, to estimate the time lag of the response of vegetation vitality status to flash drought. An experiment on the novel method was carried out in North China during March–September for the period of 2001–2020 using remote sensing products at 1 km spatial resolution. The results show that the average time lag of the response of vegetation to water availability during flash droughts estimated by the cross-spectral analysis over North China in 2001–2020 was 5.9 days, which is shorter than the results measured by the widely used response time index (26.5 days). The main difference between the phase lag from the cross-spectral analysis method and the response time from the response time index method lies in the fundamental processes behind the definitions of the vegetation response in the two methods, i.e., a subtle and dynamic fluctuation signature in the response signal (vegetation-based drought index) that correlates with the fluctuation in the forcing signal (ET-based drought index) versus an irreversible impact indicated by a negative NDVI anomaly. The time lag of the response of vegetation to flash droughts varied with vegetation types and irrigation conditions. The average time lag for rainfed cropland, irrigated cropland, grassland, and forest in North China was 5.4, 5.8, 6.1, and 6.9 days, respectively. Forests have a longer response time to flash droughts than grasses and crops due to their deeper root systems, and irrigation can mitigate the impacts of flash droughts. Our method, based on cross-spectral analysis and the ET-based drought index, is innovative and can provide an earlier warning of impending drought impacts, rather than waiting for the irreversible impacts to occur. The information detected at an earlier stage of flash droughts can help decision makers in developing more effective and timely strategies to mitigate the impact of flash droughts on ecosystems. Full article

Preclinical testing of medical devices is an essential step in the product life cycle, whereas testing of cardiovascular implants requires specialised testbeds or numerical simulations using computer software Ansys 2016. Existing test setups used to evaluate physiological scenarios and test cardiac implants such as mock circulatory systems or isolated beating heart platforms are driven by sophisticated hardware which comes at a high cost or raises ethical concerns. On the other hand, computational methods used to simulate blood flow in the cardiovascular system may be simplified or computationally expensive. Therefore, there is a need for low-cost, relatively simple and efficient test beds that can provide realistic conditions to simulate physiological scenarios and evaluate cardiovascular devices. In this study, the concept design of a novel left ventricular simulator made of latex rubber and actuated by pneumatic artificial muscles is presented. The designed left ventricular simulator is geometrically similar to a native left ventricle, whereas the basal diameter and long axis length are within an anatomical range. Finite element simulations evaluating left ventricular twisting and shortening predicted that the designed left ventricular simulator rotates approximately 17 degrees at the apex and the long axis shortens around 11 mm. Experimental results showed that the twist angle is 18 degrees and the left ventricular simulator shortens 5 mm. Twist angles and long axis shortening as in a native left ventricle show it is capable of functioning like a native left ventricle and simulating a variety of scenarios, and therefore has the potential to be used as a test platform. Full article

Agricultural water rights trading has become an effective means to solve the shortage of agricultural water. However, in the context of uncertainty, the key elements of the water rights trading system and their interactions remain unclear. Therefore, this study constructs a multi-dimensional collaborative optimization model for agricultural water rights based on water price reform under a changing environment. The model quantitatively characterizes the synergistic effects of resource, economic, social, environmental, and ecological objectives on initial water rights allocation and trading. At the same time, the model uses a system dynamics model and intuitionistic fuzzy number to reflect the impact of a changing environment and uncertainty of the management system on water rights allocation and trading. The results show that through water rights trading, the overall coordinated development of farms has been improved, and the economic benefits and water resources utilization efficiency have been improved. Full article

The use of antimicrobials in swine production is an issue that concerns the whole world due to their impact on animal and public health. This study aimed to verify the antimicrobial use in 29 commercial full-cycle farms in the midwestern region of the state of Minas Gerais, since this region is a hub of intensive pig farming in Brazil, as well as the possible correlations between the use of antimicrobials, biosecurity, and productivity. A total of 28 different drugs used for preventive purposes were described. On average, the herds used seven drugs, exposing the piglets for 116 days and totaling 434.17 mg of antimicrobials per kilogram of pig produced. Just eight active ingredients made up 77.5% of the total number of drugs used on the studied herds. Significant differences were found between the variables, biosecurity score and number of sows, antimicrobial amount and number of drugs, number of drugs and number of sows, and between productivity and biosecurity scores. The use of antimicrobials was considered excessive in the swine farms in the state of Minas Gerais compared to what was reported in Brazil and in other countries. Educational measures and better control should be proposed to reduce the preventive use of antimicrobials. Full article

Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. IgAN causes end-stage kidney disease (ESKD) in 30–40% of all cases. The activation of the complement system by pathological circulating IgAs, which is often associated with low serum C3 levels (LowC3), seems to play a crucial role. Previous studies have shown an association between histological evidence of TMA, which is the result of alternative complement activation, and poor outcomes. However, it is not known to what extent the decrease in serum C3 levels reflects ongoing TMA injury. Our study aimed at assessing the association between LowC3 and ESKD and whether this association reflects ongoing TMA. Methods: We enrolled all patients with biopsy-proven IgAN and followed-up patients until their last visit, ESKD, or death. Results: Of the 56 patients included in the study, 12 (21%) presented low serum C3 (LowC3) at the time of renal biopsy. TMA was significantly more frequent in the LowC3 group [7/12 (58%) vs. 9/44 (20%), p = 0.02]. After adjusting for potential confounders, LowC3 was strongly associated with an increased hazard of ESKD (hazard ratio [HR]: 5.84 [95%CI: 1.69, 20.15; p = 0.005). The association was not affected by adjusting for TMA. The estimated overall proportion of the relation between C3 and ESKD mediated by TMA was low and not statistically significant. Conclusions: Our study provides evidence that C3 hypocomplementemia is associated with an increased risk of ESKD through mechanisms that are largely independent from TMA. Full article