Ana G. Mendez University System

Few adult patients with cancer enroll in oncology clinical trials. A rate-limiting step to trial enrollment is prescreening, involving clinical research staff manually abstracting unstructured health records to identify patients who meet eligibility criteria. Prescreening is time-consuming, labor-intensive, and prone to human error, resulting in under-identification of eligible patients. Neurosymbolic AI language models may approximate or improve the accuracy of prescreening through automated abstraction of enrollment criteria from longitudinal unstructured patient charts. We conduct a randomized noninferiority trial using retrospectively collected clinical charts to compare the accuracy and efficiency of prescreening by trained research staff alone (Human-alone) vs. augmented with a pre-trained language model (Human+AI), among a cohort of 355 patients with non-small cell lung or colorectal cancer. Sample size is determined from analyses of a preliminary dataset as well as a prespecified, interim dataset of 74 charts. Chart-level accuracy, the primary endpoint of Human+AI prescreening is noninferior and superior to Human-alone (76.5% vs. 71.1%). However, efficiency is unchanged with similar average time per chart review, the secondary endpoint, (37.4 vs. 37.8 min). AI-assisted abstraction most improves accuracy for biomarker, staging, and response criteria. Performance is limited in some domains due to automation bias. Although improvements are modest, this large randomized trial evaluating a human-AI framework for oncology prescreening shows that AI language models can approximate and augment human-driven prescreening to enhance identification of trial-eligible patients, potentially increasing enrollment. The trial is registered on ClinicialTrials.gov (NCT06561217).

Stress exposure can disrupt fear extinction, which is a hallmark of some stress-related disorders. The underlying molecular mechanisms of impaired extinction, especially in females, remain poorly understood. In this study, we investigated proteomics changes in the infralimbic cortex, a region critical for fear suppression, in female rats exposed to single prolonged stress (SPS). One week after SPS exposure, adult female rats underwent auditory fear conditioning and extinction training and were classified as susceptible or resilient based on their extinction performance. Quantitative proteomics using tandem mass tag labeling combined with bioinformatics analysis identified distinct proteins and pathways differentiating the groups. Susceptible rats displayed unique proteomic profiles in the infralimbic cortex. Several of the 53 differentially expressed proteins are associated with synaptic plasticity and memory, including neurogranin and microtubule-associated protein tau (MAPT). Pathway enrichment analysis identified alterations in synaptogenesis, clathrin-mediated endocytosis, calcium signaling, and chaperone-mediated autophagy. Functional validation using AAV-shRNA knockdown of neurogranin or MAPT in CAMKIIα-expressing neurons of the infralimbic cortex improved extinction memory in SPS-exposed animals. Our findings suggest that dysregulated protein expression in the infralimbic cortex contributes to impaired extinction memory and traumatic stress susceptibility in female rats, offering insight into the neurobiological mechanisms underlying vulnerability to stress-related disorders.

Pneumonia and invasive pneumococcal disease are associated with high morbidity and mortality, underscoring the importance of vaccination as a preventive strategy. In Argentina, since 2017, a sequential vaccination schedule with the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been recommended for adults aged 65 years and older, as well as for younger adults with comorbidities. The introduction of the 20-valent pneumococcal conjugate vaccine (PCV20) to replace the sequential scheme, has not only the purpose to simplify vaccination schedules but also improve adherence.The aim of this study was to describe the pneumococcal vaccination status among hospitalized adults in a Hospital in Buenos Aires, Argentina. An observational, descriptive, cross-sectional study was conducted among individuals aged 18 years and older with an indication for vaccination between November 2024 and February 2025. Patients were classified into three groups: complete vaccination (VC), incomplete vaccination (VI), and unvaccinated (NV).A total of 137 patients were analyzed; 56.9% were male, and the mean age was 74.3 years. Of them, 88.3% were older than 65 years; among younger patients, the predominant comorbidities were diabetes, smoking, HIV, and cancer. Overall, 46 patients (33.5%) had complete vaccination, 14 (10.2%) had an incomplete schedule, and 77 (56.2%) had not received any dose. None had received PCV20, as it was not available at our center during the study period.Our findings suggest that pneumococcal vaccination coverage remains suboptimal. It is essential to obtain data from local healthcare centers to develop targeted strategies to improve it.

Negative pressure wound therapy (NPWT) has revolutionised the management of complex wounds via mechanisms such as microdeformation, angiogenesis and exudate control. However, its clinical effect has historically only been evaluated by qualitative and visual parameters. This study integrates near-infrared spectroscopy (NIRS) as a biofeedback tool to quantify physiological response to NPWT in real time. This study aimed to quantitatively demonstrate the physiological and structural changes induced by an NPWT system in patients with complex wounds, measured using NIRS. A prospective real-world observational study was conducted with a cohort of 23 patients with 33 wounds. Structural and physiological parameters were documented before and after NPWT treatment. Random-intercept mixed-effect statistical models and pre-post comparison tests were used to assess clinical and physiological significance. The data showed a progressive reduction in wound area and volume, accompanied by an increase in tissue oxygen saturation and a sustained decrease in deoxygenated haemoglobin. These findings, objectively quantified through NIRS as a real-time biofeedback tool, highlight the improvement in oxygenation and wound-bed perfusion and support the hypothesis of tissue biomodulation induced by NPWT. The integration of NIRS redefines the clinical role of NPWT, allowing therapy to be customised based on specific physiological data. This combination represents a new frontier in precision wound medicine. The results of this study provide a foundation for a new generation of clinical decisions in advanced wound management.

Extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitors show therapeutic potential in triple-negative breast cancer (TNBC), but resistance through compensatory signaling limits their efficacy. We previously identified the secretory carrier membrane protein 3 (SCAMP3) as a regulator of TNBC progression and ERK1/2 activation. Here, we investigated the role of SCAMP3 in ERK1/2 signaling and therapeutic response using TMT-based LC-MS/MS phosphoproteomics of wild-type (WT) and SCAMP3 knockout (SC3KO) SUM-149 cells under basal conditions, after epidermal growth factor (EGF) stimulation, and during ERK1/2 inhibition with MK-8353. A total of 4408 phosphosites were quantified, with 1093 significantly changed. SC3KO abolished residual ERK activity under MK-8353 and affected the compensatory activation of oncogenic pathways observed in WT cells. SC3KO reduced the phosphorylation of ERK feedback regulators RAF proto-oncogene serine/threonine-protein kinase Raf-1 (S43) and the dual-specificity mitogen-activated protein kinase kinase 2 (MEK2) (T394), affected other ERK targets, including nucleoporins, transcription factors, and metabolic enzymes triosephosphate isomerase (TPI1) (S21) and ATP-citrate lyase (ACLY) (S455). SCAMP3 loss also impaired the mammalian target of rapamycin complex I (mTORC1) signaling and disrupted autophagic flux, evidenced by elevated sequestosome-1 (SQSTM1/p62) and microtubule-associated protein light chain 3 (LC3B-II) with reduced levels of the autophagosome lysosome maturation marker, Rab7A. Beyond ERK substrates, SC3KO affected phosphorylation events mediated by other kinases. These findings position SCAMP3 as a central coordinator of ERK signaling and autophagy. Our results support SCAMP3 as a potential therapeutic target to enhance ERK1/2 inhibitor clinical efficacy and overcome adaptive resistance mechanisms in TNBC.

Research capturing the experiences of disabled people in physical education (PE) is on the rise. However, the available literature has given less consideration to disabled people representing various racial and ethnic groups. As such, the purpose of this study was to examine the intersubjective experiences of inclusion of Latina and Latino blind and visually impaired students in PE and the meanings ascribed to those experiences. The research approach was interpretative phenomenological analysis. Seven adults (two females and five males; 18–29 years of age) who identified as Latina or Latino, blind or visually impaired, and had previous experiences in integrated PE in the United States or its territories participated in this study. The analytical thematic development followed a four-step approach informed by the research design. Based on the analysis, the following three interrelated themes were constructed: (a) “They didn’t know what to do with me”: Teachers as barriers to feelings of inclusion, (b) “I wanted to be part of the group”: Social interactions, peer relationships, and sense of belonging, and (c) “Making my life easier is the best option”: Self-agency and empowerment to experience inclusion. The findings reported in this retrospective study are consistent with those in other geographical regions. Nonetheless, one key aspect is that some participants demonstrated resistance toward their experiences of exclusion, leading to a self-agency to demonstrate their presence in PE.

This article explores the creation of microgrids using photovoltaic systems installed on residential rooftops in Puerto Rico, comparing their performance and benefits with those of the existing electrical grid. Using the island's abundant solar energy potential, residential rooftops were analyzed using Google Earth and PVWatts software to identify feasible photovoltaic installations. The findings reveal that rooftop systems can generate 2 to 3 times more energy than residential consumption, allowing excess energy to be shared with the central grid or neighboring users. To design the microgrids, various software tools, including the Microgrid Design Toolkit (MDT), were utilized to achieve a balance between technical performance and economic feasibility. This study highlights how these microgrids could enhance grid resilience, reduce dependence on fossil fuels, and lower greenhouse gas emissions. Future work will further quantify the economic and environmental benefits of implementing these systems, supporting Puerto Rico's transition to a sustainable energy model.

The widespread presence of pesticides-especially malathion-in aquatic environments presents a major obstacle to conventional remediation strategies, while the ongoing global energy crisis underscores the urgency of developing renewable energy sources such as hydrogen. In this context, photocatalytic water splitting emerges as a promising approach, though its practical application remains limited by poor charge carrier dynamics and insufficient visible-light utilization. Herein, we report the design and evaluation of a series of TiO2-based ternary nanocomposites comprising commercial P25 TiO2, reduced graphene oxide (rGO), and molybdenum disulfide (MoS2), with MoS2 loadings ranging from 1% to 10% by weight. The photocatalysts were fabricated via a two-step method: hydrothermal integration of rGO into P25 followed by solution-phase self-assembly of exfoliated MoS2 nanosheets. The composites were systematically characterized using X-ray diffraction (XRD), Raman spectroscopy, transmission electron microscopy (TEM), UV-Vis diffuse reflectance spectroscopy (DRS), and photoluminescence (PL) spectroscopy. Photocatalytic activity was assessed through two key applications: the degradation of malathion (20 mg/L) under simulated solar irradiation and hydrogen evolution from water in the presence of sacrificial agents. Quantification was performed using UV-Vis spectroscopy, gas chromatography-mass spectrometry (GC-MS), and thermal conductivity detection (GC-TCD). Results showed that the integration of rGO significantly enhanced surface area and charge mobility, while MoS2 served as an effective co-catalyst, promoting interfacial charge separation and acting as an active site for hydrogen evolution. Nearly complete malathion degradation (~100%) was achieved within two hours, and hydrogen production reached up to 6000 µmol g-1 h-1 under optimal MoS2 loading. Notably, photocatalytic performance declined with higher MoS2 content due to recombination effects. Overall, this work demonstrates the synergistic enhancement provided by rGO and MoS2 in a stable P25-based system and underscores the viability of such ternary nanocomposites for addressing both environmental remediation and sustainable energy conversion challenges.

Introducción. La artritis reumatoide (AR) es una enfermedad crónica que lleva a discapacidad y afecta la productividad laboral. Se encontró escasa información sobre adaptaciones al medio laboral en estos pacientes. Objetivos. 1) Obtener cuestionarios para el reporte de dificultades laborales y adaptaciones en el ámbito laboral para pacientes con AR laboralmente activos; 2) identificar factores asociados a las dificultades laborales y al uso de modificaciones y adaptaciones en el ámbito laboral reportadas por pacientes con AR. Material y métodos. Se incluyeron 123 pacientes con diagnóstico de AR laboralmente activos. Se desarrollaron dos cuestionarios para autoadministración. DificuLtAR: dificultades laborales (11 preguntas con 4 opciones de respuesta) y ModAL: modificaciones y adaptaciones laborales (9 preguntas con 3 opciones de respuesta). Confiabilidad con α de Cronbach: DificuLtAR = 0,90 y ModAL = 0,83; valores de Eigenvalue para un único factor y coeficientes de correlaciones mayores a 0,40 para todas las preguntas de ambos cuestionarios. Luego de la rotación varimax: DificuLtAR = 0,91 y ModAL = 0,75 y validez de constructo mediante factor análisis. Se calcularon coeficientes de correlación de Spearman. Valor de p ≤0,05. Resultados. DificuLtAR mediana de 4 (25-75, RIC 2-9) y correlación con HAQ (r = 0,73; p ≤0,001), ModAL (r = 0,70; p ≤0,001), pérdida de productividad laboral (r = 0,65;p ≤0,001), DAS28 (r = 0,49; p ≤0,001) y EVA fatiga (r = 0,50; p ≤0,001). ModAL mediana de 3 (rango intercuartílico [RIC]: 1-5) y correlación significativa con HAQ (r = 0,60; p ≤0,001), pérdida de productividad laboral (r = 0,57; p ≤0,001) y DAS28 (r = 0,47; p ≤0,001). Conclusiones. Se lograron cuestionarios para detectar dificultades y modificaciones laborales con aceptable confiabilidad.