Search

Abstract Charge Coupled Devices (CCD) are being used for reactor neutrino experiments and have already demonstrated their potential in constraining new physics models. The prospect of a Skipper-CCD experiment looking for standard and beyond standard model (BSM) physics in a nuclear reactor has been evaluated for different benchmark scenarios. Here, we report the first installation of a 2-g Skipper-CCD inside the containment building of a 2 GW th nuclear power plant and analyze its performance throughout its first 18 months of operation. The sensor was successfully deployed at Atucha II, in Argentina, 12 meters away from the center of the reactor core. We discuss the challenges involved in the commissioning of the detector and present data acquired during reactor ON and reactor OFF periods, with the sensor functioning with a sub-electron readout noise of 0.17 e−. Based on an exposure of 56.8 g day reactor ON and two reactor OFF data sets with a total exposure of 118.1 g day we characterize the system and evaluate the sensitivity to CEvNS. We achieved a background rate of 33 kdru and a low threshold of 45 eV ee . The ongoing efforts to improve sensitivities to CEvNS and BSM interaction are also discussed.

Abstract The cultivation of grapevines has spanned millennia, leading to thousands of varieties through exchanges, mutations, and crosses between genotypes, as well probably as gene flow from wild populations. These varieties are typically categorized by regional origin and primary use, either for wine production or fruit consumption. France, within the Western European group, hosts many of the world’s renowned wine grape varieties. However, the historical development of cultivated grapevines in France and in the world remains poorly understood. This study applies morphometry on 19,377 charred and waterlogged archaeological grape pips to investigate the evolutionary history of grapevine in France over the last 10,000 years. The study compares seed outlines and lengths, corrected for taphonomic distortions, with a reference collection of 80 wild and 466 modern domestic grapevine accessions. Findings reveal a shift from wild grapevine exploitation to the expansion of domestic varieties around 600–500 BCE, coinciding with Mediterranean cultural influences and the introduction of eastern grape types. The identification of the East-Table group, a group of varieties of eastern origin for fruit consumption, indicates that grapes were also grown for food, especially in Mediterranean regions and near urban areas, alongside wine production. Early French viticulture featured a notable presence of Western European wine-type grapevines. The abundance of pips with wild-like morphology suggests early cultivation involved plants at an initial domestication stage and gene flow between introduced and wild grapevines. As viticulture spread northward, wild and Eastern morphotypes declined, leading to the dominance of Western European wine types in inner France during the Middle Ages.

Abstract COSINUS is a dark matter (DM) direct search experiment that uses sodium iodide (NaI) crystals as cryogenic calorimeters. Thanks to the low nuclear recoil energy threshold and event-by-event discrimination capability, COSINUS will address the long-standing DM claim made by the DAMA/LIBRA collaboration. The experiment is currently under construction at the Laboratori Nazionali del Gran Sasso, Italy, and employs a large cylindrical water tank as a passive shield to meet the required background rate. However, muon-induced neutrons can mimic a DM signal therefore requiring an active veto system, which is achieved by instrumenting the water tank with an array of photomultiplier tubes (PMTs). This study optimizes the number, arrangement, and trigger conditions of the PMTs as well as the size of an optically invisible region. The objective was to maximize the muon veto efficiency while minimizing the accidental trigger rate due to the ambient and instrumental background. The final configuration predicts a veto efficiency of 99.63 ± 0.16% and 44.4 ± 5.6% in the tagging of muon events and showers of secondary particles, respectively. The active veto will reduce the cosmogenic neutron background rate to 0.11 ± 0.02 cts $$\cdot $$ · kg $$^{-1}\cdot $$ - 1 · year $$^{-1},$$ - 1 , corresponding to less than one background event in the region of interest for the whole COSINUS-1 $$\pi $$ π exposure of 1000 kg $$\cdot $$ · days.

Introduction The Positive and Negative Syndrome Scale (PANSS) has been used as a universal instrument for clinical assessment of psychopathology in schizophrenia. Different studies have analyzed the factorial structure of this scale and have suggested a five-factor model: positive, negative, excited, depressive, and cognitive/disorganized factors. Two of the most used models are the Marder´s solution and the Wallwork´s one. Objectives The aim of this work was to study the correlations of the two cognitive factors (Marder and Wallwork) with a cognitive assessment performed with a standard cognitive battery, in a sample of patients with first psychotic episode of schizophrenia. Methods Seventy four patients with first psychotic episode of schizophrenia (26.9, SD:7.8 years old; 70.3% male) were included. The cognitive assessment was performed with the MATRICS Consensus Cognitive Battery (MCCB). The MCCB present seven cognitive domains: Speed of processing, Working memory, Attention/Vigilance, Verbal Learning, Visual Learning, Reasoning and Problem Solving, and Social cognition). Pearson correlations were performed between MCCB scores and Marder´s PANSS cognitive factor (P2, N5, G5, G10, G11, G13, G15) and Wallwork´s one (P2, N5, G11). Results Correlation between MCCB scores and cognitive factors of Marder and Wallwork can be seen in the table. Marder´s cognitive factor Wallwork´s cognitive factor Speed of processing r = -0.461; p

Multi-objective optimization-based model calibration can be an intermediate solution between the computationally expensive probabilistic approaches and the single-objective optimization strategies that do not allow uncertainty quantification of the obtained solutions. This work addresses the multi-objective model calibration of two historic stone arch bridges using high-fidelity computational FE models. To implement the methodology, a five-step approach is proposed: experimental characterization through non-destructive testing techniques, non-parametric as-built geometric modeling, macro-finite element modeling, sensitivity analysis, and multi-objective optimization. The preferred solution among the Pareto front solutions is selected based on two different classical criteria, and the set of optimal solutions is further statistically analyzed to assess the validity of the identification process. The results show an average frequency error of 0.97 % and 0.70 % and an average MAC of 0.97 and 0.96 for each case study, respectively, thus highlighting the adequacy of the proposed methodology.

Geodiversity is recognized as one of the most important drivers of ecosystem characteristics and biodiversity globally. However, in the northern Neotropics, the contribution of highly diverse landscapes, environmental conditions, and geological history in structuring large-scale patterns of aquatic environments and aquatic species associations remains poorly understood. We evaluated the relationships among geodiversity, limnological conditions, and freshwater ostracodes from southern Mexico to Nicaragua. A cluster analysis (CA), based on geological, geochemical, mineralogical, and water-column physical and chemical characteristics of 76 aquatic ecosystems (karst, volcanic, tectonic) revealed two main limnological regions: (1) karst plateaus of the Yucatán Peninsula and northern Guatemala, and (2) volcanic terrains of the Guatemalan highlands, mid-elevation sites in El Salvador and Honduras, and the Nicaraguan lowlands. In addition, seven subregions were recognized, demonstrating a high heterogeneity of aquatic environments. Principal component analysis (PCA) identified water chemistry (ionic composition) and mineralogy as most influential for aquatic ecosystem classification. Multi-parametric analyses, based on biological data, revealed that ostracode species associations represent disjunct faunas. Five species associations, distributed according to limnological regions, were recognized. Structural equation modeling (SEM) revealed that geodiversity explains limnological patterns of the study area. Limnology further explained species composition, but not species richness. The influence of conductivity and elevation were individually evaluated in SEM and were statistically significant for ostracode species composition, though not for species richness. We conclude that geodiversity has a central influence on the limnological conditions of aquatic systems, which in turn influence ostracode species composition in lakes of the northern Neotropical region.

Nowadays, several historical masonry arch bridges present a deficient state of conservation due to degradation processes induced by natural or human actions. Usually, these constructions have significant economic, cultural, and heritage value. Therefore, they shall be thoroughly assessed to verify their structural integrity and safety condition. For this purpose, reliability-based structural assessments are typically performed. However, the associated outcomes (i.e., reliability index and probability of failure) highly rely on the accuracy of the structural parameters uncertainty quantification. This work presents a study regarding the influence of the scattering of the arches' thickness dimensions in the load-carrying capacity assessment of the Cernadela Bridge, a historical stone bridge located in Galicia, Spain. The study first involved a comprehensive experimental campaign to characterize the outer and inner bridge geometry through geomatic techniques, i.e., terrestrial laser scanning and ground penetrating radar. Subsequently, a limit analysis model was developed, considering only the arches' outer (visible) data. From this initial structural assessment, a reliability index of 2.38 was obtained. The influence of the uncertain structural parameters, both geometric features and material properties, in the collapse load was investigated through a global variance-based sensitivity analysis (i.e., Sobol' indices) complemented by a surrogate modeling strategy based on the Kriging approach. Finally, the measured inner geometry of the arches was introduced in the computational model through Bayesian inference procedures. Thus, two new structural assessments were performed: first, by considering the updated distributions of all arches thicknesses, and second, by considering only the updated distributions of the non-influential ones. Reliability indexes of 1.51 and 2.33 were derived, thus highlighting the importance of a proper uncertainty quantification process and the relevance of the sensitivity analysis outcomes to identify the critical parameters on the bridge mechanical response.

The aim of this study was to find the structural changes in the rat testis after a diazinon administration. The testis structure changes after the diazinon administration of 20 mg/kg b.w. (i.p.) and daily dose of 40 mg/l in drinking water (p.o.) were evaluated in light microscopy. 36 hours after the diazion i.p. administration, the vacuolization of the seminiferous epithelium, evacuation of germ cells into the tubule lumen, epithelium necrosis and interstitium extension were observed. After 90 days of daily oral administration, the changes in the testis were not as visible as in the acute intoxication. The germ cells released from the basal lamina and then were visible in the tubule lumen. Diazinon causes the damage of the germinal epithelium in the testes leading to the spermatogenesis failure. The infertility can then appear.

IntroductionUrachal cancer (UrC) is a rare, non-urothelial malignancy. Its natural history and management are poorly understood. Although localized to the bladder dome, the most common histological subtype of UrC is adenocarcinoma. UrC develops from an embryonic remnant, and is frequently diagnosed in advanced stage with poor prognosis. The treatment is not standardized, and based only on case reports and small series. This large retrospective multicentric study was conducted by the French Genito-Urinary Tumor Group to gain a better understanding of UrC.Material and Methodsdata has been collected retrospectively on 97 patients treated at 22 French Cancer Centers between 1996 and 2020.ResultsThe median follow-up was 59 months (range 44-96). The median age at diagnosis was 53 years (range 20-86), 45% were females and 23% had tobacco exposure. For patients with localized disease (Mayo I-II, n=46) and with lymph-node invasion (Mayo III, n=13) median progression-free-survival (mPFS) was 31 months (95% CI: 20-67) and 7 months (95% CI: 6-not reached (NR)), and median overall survival (mOS) was 73 months (95% CI: 57-NR) and 22 months (95% CI: 21-NR) respectively. For 45 patients with Mayo I-III had secondary metastatic progression, and 20 patients were metastatic at diagnosis. Metastatic localization was peritoneal for 54% of patients. Most patients with localized tumor were treated with partial cystectomy, with mPFS of 20 months (95% CI: 14-49), and only 12 patients received adjuvant therapy. Metastatic patients (Mayo IV) had a mOS of 23 months (95% CI: 19-33) and 69% received a platin-fluorouracil combination treatment.ConclusionUrC is a rare tumor of the bladder where patients are younger with a higher number of females, and a lower tobacco exposure than in standard urothelial carcinoma. For localized tumor, partial cystectomy is recommended. The mOS and mPFS were low, notably for patients with lymph node invasion. For metastatic patients the prognosis is poor and standard therapy is not well-defined. Further clinical and biological knowledge are needed.

The primary scientific objective of MexiDrill, the Basin of Mexico Drilling Program, is development of a continuous, high-resolution ∼400 kyr lacustrine record of tropical North American environmental change. The field location, in the densely populated, water-stressed Mexico City region gives this record particular societal relevance. A detailed paleoclimate reconstruction from central Mexico will enhance our understanding of long-term natural climate variability in the North American tropics and its relationship with changes at higher latitudes. The site lies at the northern margin of the Intertropical Convergence Zone (ITCZ), where modern precipitation amounts are influenced by sea surface temperatures in the Pacific and Atlantic basins. During the Last Glacial Maximum (LGM), more winter precipitation at the site is hypothesized to have been a consequence of a southward displacement of the mid-latitude westerlies. It thus represents a key spatial node for understanding large-scale hydrological variability of tropical and subtropical North America and is at an altitude (2240 m a.s.l.), typical of much of western North America. In addition, its sediments contain a rich record of pre-Holocene volcanic history; knowledge of the magnitude and frequency relationships of the area's explosive volcanic eruptions will improve capacity for risk assessment of future activity. Explosive eruption deposits will also be used to provide the backbone of a robust chronology necessary for full exploitation of the paleoclimate record. Here we report initial results from, and outreach activities of, the 2016 coring campaign.

Según la Organización de las Naciones Unidas para la Agricultura y la Alimentación, los cítricos dominan la producción mundial de todas las frutas. Por su posición geográfica, Ecuador tiene condiciones favorables de crecimiento para la producción de cítricos y la mayor parte del país tiene condiciones favorables para las plantas y sus relaciones con las condiciones ambientales. El objetivo de la presente investigación fue determinar la fenología reproductiva de la sutil de limón ( Citrus aurantifolia Swingle) bajo diferentes niveles de humedad del suelo.Un Asistente de Configuración de Base de Datos) usando un diseño de Bloque Completo Aleatorio aplicado y cuatro tratamientos y seis repeticiones se distribuyeron de la siguiente manera: tratamiento 1 [coeficiente de cultivo (Kc) 0.3], tratamiento 2 (Kc 0.5), tratamiento 3 (Kc 0,7) y tratamiento 4 (Kc 0,9). Se evaluó la calidad del fruto, peso de piel y pulpa, cantidad de semilla, contenido de jugo, grado Brix y diámetro polar y ecuatorial, y se ajustó la fenología a la codificación de la escala BBCH. No se encontraron diferencias estadísticamente significativas durante el estudio que resultaron de las lluvias que homogeneizaron todo el sustrato y mantuvieron la humedad del suelo.Establecimos que desde la fase fenológica de los primordios hasta la cosecha del fruto, hubo un intervalo de 138-140 d en el que el peso promedio del fruto (42. 62 g) fluctuó según el peso de la piel (7,65 g) , peso de la pulpa (34,73 g), número de semillas (5,05), cantidad de jugo (14,36 mL), grados Brix (5,5), diámetros polares y ecuatoriales (44,32 y 42, 12 mm, respectivamente) y la acidez titulable (6,54%). Concluimos que las Kcs propuestas en la presente investigación deben evaluarse durante la estación seca porque, en esta investigación, el riego fue inducido por Kc solo durante 2 meses después de las lluvias.

Resumen: Introducción: La información existente sobre el impacto de la gripe en la población infantil española es escasa. El presente trabajo pretende aumentar este conocimiento estudiando aspectos clave como la incidencia de hospitalización, clínica, comorbilidades y el estado vacunal en los niños hospitalizados. Métodos: Estudio retrospectivo, observacional, por revisión de historias clínicas, en menores de 15 años hospitalizados por gripe adquirida en la comunidad, confirmada microbiológicamente, durante 2 temporadas gripales (2014-2015 y 2015-2016). El estudio se realizó en 10 hospitales de 6 ciudades, que atienden aproximadamente al 12% de la población infantil española. Resultados: Fueron hospitalizados 907 niños con diagnóstico principal de gripe (447 50%) de los casos. Una gran parte de las formas graves de gripe en población infantil podrían ser evitada si se cumplieran las indicaciones actuales de vacunación. Abstract: Introduction: There are only a limited number of studies on the impact of influenza in the Spanish child population. The present work intends to increase this knowledge by studying some key aspects, such as the incidence of hospital admissions, clinic variables, comorbidities, and the vaccination status in the hospitalised children. Methods: A retrospective, observational study was conducted by reviewing the medical records of children under 15 years and hospitalised due to community acquired influenza confirmed microbiologically, during 2 ́flu seasons (2014-2015 and 2015-2016). The study was carried out in 10 hospitals of 6 cities, which represent approximately 12% of the Spanish child population. Results: A total of 907 children were admitted to hospital with main diagnosis of influenza infection (447 10 years. Admission to the PICU was required in 10% (92) of the cases, mainly due to acute respiratory failure. Conclusion: Influenza continues to be an important cause of hospitalisation in the Spanish child population. Children 50%) of the cases. Many of the severe forms of childhood influenza that occur today could be avoided if current vaccination guidelines were met.

Introduction: There are only a limited number of studies on the impact of influenza in the Spanish child population. The present work intends to increase this knowledge by studying some key aspects, such as the incidence of hospital admissions, clinic variables, comorbidities, and the vaccination status in the hospitalised children. Methods: A retrospective, observational study was conducted by reviewing the medical records of children under 15 years and hospitalised due to community acquired influenza confirmed microbiologically, during 2 ́flu seasons (2014–2015 and 2015–2016). The study was carried out in 10 hospitals of 6 cities, which represent approximately 12% of the Spanish child population. Results: A total of 907 children were admitted to hospital with main diagnosis of influenza infection (447 10 years. Admission to the PICU was required in 10% (92) of the cases, mainly due to acute respiratory failure. Conclusion: Influenza continues to be an important cause of hospitalization in the Spanish child population. Children 50%) of the cases. Many of the severe forms of childhood influenza that occur today could be avoided if current vaccination guidelines were met. Resumen: Introducción: La información existente sobre el impacto de la gripe en la población infantil española es escasa. El presente trabajo pretende aumentar este conocimiento estudiando aspectos clave como la incidencia de hospitalización, clínica, comorbilidades y el estado vacunal en los niños hospitalizados. Métodos: Estudio retrospectivo, observacional, por revisión de historias clínicas, en menores de 15 años hospitalizados por gripe adquirida en la comunidad, confirmada microbiológicamente, durante 2 temporadas gripales (2014-2015 y 2015-2016). El estudio se realizó en 10 hospitales de 6 ciudades, que atienden aproximadamente al 12% de la población infantil española. Resultados: Fueron hospitalizados 907 niños con diagnóstico principal de gripe (447 50%) de los casos. Una gran parte de las formas graves de gripe en población infantil podrían ser evitada si se cumplieran las indicaciones actuales de vacunación.

Objetivo: Describir la asociación entre el control del asma y la adherencia al tratamiento en los pacientes del Hospital Nacional Dos de Mayo en los años 2019-2020. Materiales y métodos: Se realizó un estudio cuantitativo, descriptivo y retrospectivo, de tipo clínico, durante el periodo 2019-2020, en pacientes asmáticos del Hospital Nacional Dos de Mayo (HNDM) para evaluar la relación entre control del asma y adherencia al tratamiento en los pacientes atendidos en el Consultorio de Asma del Servicio de Neumología. La información fue recolectada de las historias clínicas y los datos registrados fueron los siguientes: test de adherencia a los inhaladores (TAI), test de control de asma (ACT), edad, sexo, tratamiento instaurado, tiempo de enfermedad y la valoración nutricional, a través de la revisión de historias clínicas. El análisis estadístico se realizó con el software IBM SPSS Statistics versión 22, y para determinar la asociación se realizó la prueba estadística X2. Resultados: Se evaluaron 187 pacientes mediante historias clínicas, 84 hombres (44,92 %) y 103 mujeres (55,08 %). El promedio de edad fue de 59,42 ± 15,08 años (solo los mayores de edad fueron considerados en el estudio). Mediante el análisis de los datos de las historias clínicas, se determinó que había 86 pacientes controlados (45,99 %) y que 48 pacientes eran adherentes (25,67 %). El corticoide inhalado (CSI) fue el tratamiento más usado (50,80 %). El tipo inconsciente fue la modalidad más frecuente de paciente incumplidor (64,17 %). El promedio de tiempo de enfermedad, en años, estuvo en 21,78 ± 16,75. Conclusiones: El 75% de los pacientes asmáticos con adherencia al tratamiento controlan la enfermedad.

In present work it is pretended to estimate elastic parameters of beams through the combined use of precision geomatic techniques (laser scanning) and structural behaviour simulation tools. The study has two aims, on the one hand, to develop an algorithm able to interpret automatically point clouds acquired by laser scanning systems of beams subjected to different load situations on experimental tests; and on the other hand, to minimize differences between deformation values given by simulation tools and those measured by laser scanning. In this way we will proceed to identify elastic parameters and boundary conditions of structural element so that surface stresses can be estimated more easily.

El fútbol es un fenómeno social, cultural, mediático y económico. Existen numerosas investigaciones sobre su influencia en quiénes lo practican. No obstante, el objetivo de esta investigación fue explorar su influencia sobre valores sociales relacionados con el fair play, la igualdad de género y la relación medios-fines, en alumnado de primaria, por ser aspectos que pueden reflejarse en algunas problemáticas sociales. La población objeto de estudio fue alumnado de sexto curso. Es un estudio descriptivo correlacional transversal. Las fuentes de obtención de información utilizadas fueron, un cuestionario y un grupo de discusión. Los resultados indicaron que el sexo y la práctica de fútbol federado influyen en el fair play, afán por la victoria e igualdad de género, siendo los chicos y el alumnado practicante de fútbol más proclive a conductas anti fair play, más resultadistas y con una visión más negativa hacia la figura de la mujer en el fútbol.

We present results of analysis of biological (diatoms and ostracodes) and non-biological (Ti, Ca / Ti, total inorganic carbon, magnetic susceptibility) variables from an 8.8 m long, high-resolution (~ 20 yr sample−1) laminated sediment sequence from Lake Santa María del Oro (SMO), western Mexico. This lake lies at a sensitive location between the dry climates of northern Mexico, under the influence of the North Pacific subtropical high-pressure cell and the moister climates of central Mexico, under the influence of the seasonal migration of the intertropical convergence zone and the North American monsoon (NAM). The sequence covers the last 2000 years and provides evidence of two periods of human impact in the catchment, shown by increases in the diatom Achnanthidium minutissimum. The first from AD 100 to 400 (Early Classic) is related to the shaft and chamber tombs cultural tradition in western Mexico, and the second is related to Post-Classic occupation from AD 1100 to 1300. Both periods correspond to relatively wet conditions. Three dry intervals are identified from increased carbonate and the presence of ostracodes and aerophilous Eolimna minima. The first, from AD 500 to 1000 (most intense during the late Classic, from AD 600 to 800), correlates with the end of the shaft and chamber tradition in western Mexico after ca. AD 600. This late Classic dry period is the most important climatic signal in the Mesoamerican region during the last 2000 years, and has been recorded at several sites from Yucatan to the Pacific coast. In the Yucatan area, this dry interval has been related with the demise of the Maya culture at the end of the Classic (AD 850 to 950). The last two dry events (AD 1400 to 1550 and 1690 to 1770) correspond with the onset of, and the late, Little Ice Age, and follow largely the Spörer and Maunder minima in solar radiation. The first of these intervals (AD 1400 to 1550) shows the most intense signal over western Mexico; however this pattern is different at other sites. Dry/wet intervals in the SMO record are related with lower/higher intensity of the NAM over this region, respectively.

No abstract available. doi:10.2204/iodp.sd.14.12.2012

In this paper the availabilities of some network topologies are analyzed and calculated. Software based on exact All-terminal Graph reduction Algorithm is developed and applied. Results, conclusions and solutions are presented, demonstrated and discussed.

Resumen: Introducción: Se considera que la arteriosclerosis de las arterias extracraneales causa casi un tercio de los ictus isquémicos. El diagnóstico certero del grado de estenosis es fundamental para indicar la mejor estrategia terapéutica. Si bien la angiografía cerebral se considera la técnica de referencia, el estudio ultrasonográfico (EUS) es un procedimiento más disponible, no invasivo y bien establecido en la cuantificación de la estenosis carotídea. Sin embargo, al ser una técnica dependiente del explorador, se recomienda que cada laboratorio valide sus resultados frente a la angiografía. Objetivos: Establecer, en nuestro laboratorio, la validez del estudio neurosonológico en el diagnóstico de la enfermedad ateromatosa extracraneal y determinar su capacidad para cuantificar el grado de estenosis de la arteria carótida interna. Material y métodos: Estudio retrospectivo de los pacientes con enfermedad ateromatosa carotídea extracraneal en cuyo proceso diagnóstico se realizó tanto ultrasonografía carotídea como angiografía por sustracción digital de troncos supraaórticos. Resultados: Se evaluaron 254 carótidas clasificando el grado de estenosis en > 50%, 70-99% y 100%. Para el primer grupo el EUS obtuvo una sensibilidad del 97%, una especificidad del 90%, un valor predictivo positivo (VPP) del 94,6% y un VP negativo (VPN) del 94,2%. En el segundo grupo, se obtuvo: sensibilidad, 96,4%; especificidad, 93%; VPP, 94,4%, y VPN, 95,4%. Para la oclusión carotídea los valores respectivos fueron del 85, el 96,8, el 80 y el 97,8%. Conclusiones: Nuestros datos validan la capacidad del EUS realizado en nuestro laboratorio para el diagnóstico del grado de estenosis carotídea. Abstract: Introduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. Objetives: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. Material and methods: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. Results: A total of 254 carotids were evaluated and the degree of stenosis being classified into > 50%, 70-99% and 100%. The UST for the first group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had an Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. Conclusions: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis. Palabras clave: Angiografía cerebral, Aterosclerosis carotidea, Doppler, Estenosis extracraneal, Estudio ultrasonográfico, Keywords: Cerebral angiography, Carotid atherosclerosis carotidea, Doppler, Extracraneal stenosis, Ultrasound study

Introduction: Arteriosclerosis of the extra-cranial arteries is believed to be responsible for almost one-third of all ischaemic strokes. The sound diagnosis of the degree of stenosis is essential in deciding the best therapeutic strategy. Although cerebral angiography is considered the reference technique, ultrasound study (UST) is a more readily available, non-invasive and well-established procedure for quantifying carotid stenosis. However, on being a dependent exploratory technique, it is recommended that each laboratory validates its results against angiography. Objectives: To establish the validity of the neuro-ultrasound study in our laboratory for use in the diagnosis of extracranial atheromatous disease, and determine its capacity to quantify the degree of stenosis in the internal carotid artery. Material and methods: A retrospective study of patients with extracranial carotid atheromatous disease, in whom the diagnostic process was carried out with carotid ultrasound as well as supra-aortic trunk digital-subtraction angiography. Results: A total of 254 carotids were evaluated and the degree of stenosis being classified into >50%, 70–99% and 100%. The UST for the fi rst group had a sensitivity (Se) of 97%, a specificity (Sp) of 90%, a positive predictive value (PPV) of 94.6% and a negative predictive value (NPV) of 94.2%. The second group had a Se of 96.4%, Sp 93%; PPV 94.4% and NPV 95.4%. The respective values for carotid occlusion were, 85%, 96.8%, 80% and 97.8%. Conclusions: Our data validates the ability of UST performed in our Laboratory to diagnose the degree of carotid stenosis. Resumen: Introducción: Se considera que la arteriosclerosis de las arterias extracraneales causa casi un tercio de los ictus isquémicos. El diagnóstico certero del grado de estenosis es fundamental para indicar la mejor estrategia terapéutica. Si bien la angiografía cerebral se considera la técnica de referencia, el estudio ultrasonográfico (EUS) es un procedimiento más disponible, no invasivo y bien establecido en la cuantifi cación de la estenosis carotídea. Sin embargo, al ser una técnica dependiente del explorador, se recomienda que cada laboratorio valide sus resultados frente a la angiografía. Objetivos: Establecer, en nuestro laboratorio, la validez del estudio neurosonológico en el diagnóstico de la enfermedad ateromatosa extracraneal y determinar su capacidad para cuantificar el grado de estenosis de la arteria carótida interna. Material y métodos: Estudio retrospectivo de los pacientes con enfermedad ateromatosa carotídea extracraneal en cuyo proceso diagnóstico se realizó tanto ultrasonografía carotídea como angiografía por sustracción digital de troncos supraaórticos. Resultados: Se evaluaron 254 carótidas clasifi cando el grado de estenosis en > 50%, 70–99% y 100%. Para el primer grupo el EUS obtuvo una sensibilidad del 97%, una especificidad del 90%, un valor predictivo positivo (VPP) del 94,6% y un VP negativo (VPN) del 94,2%. En el segundo grupo, se obtuvo: sensibilidad, 96,4%; especifi cidad, 93%; VPP, 94,4%, y VPN, 95,4%. Para la oclusión carotídea los valores respectivos fueron del 85, el 96,8, el 80 y el 97,8%. Conclusiones: Nuestros datos validan la capacidad del EUS realizado en nuestro laboratorio para el diagnóstico del grado de estenosis carotídea. Keywords: Cerebral angiography, Carotid atherosclerosis carotidea, Doppler, Extracraneal stenosis, Ultrasound study, Palabras clave: Angiografía cerebral, Aterosclerosis carotidea, Doppler, Estenosis extracraneal, Estudio ultrasonográfico

Objective: to identify predictive factors of response to pegylated interferon alpha-2b and ribavirin in patients with genotype 1 chronic hepatitis C. Viral kinetics were studied in weeks 2 and 4. Methods: a prospective and consecutive study of patients with genotype 1 chronic hepatitis C referred to our Hepatology Clinic between January 2004 and October 2006 for antiviral treatment. Baseline data were recorded and viremia levels were determined hours before the weekly dose of pegylated interferon by qualitative and quantitative PCR. Results: 57 patients were included in the study, although 3 of these were excluded during follow up; 65% were male (n = 35), with a mean age of 42 (26-65) years. Baseline viremia levels were > 800,000 IU/mL in 67% (n = 36). Liver biopsy was performed in 86% (n = 46), 22% (n = 12) had advanced fibrosis. Forty were naïve, 4 relapsing and 10 non-responders. Ribavirin dose was modified in one patient alone due to adverse effects. End treatment response and sustained virological response (SVR) were 59 and 41%, respectively. A univariate analysis revealed a statistically significant association of SVR with baseline viremia (p = 0.006), baseline GGT (p = 0.025), and a reduction in viremia ≥ 2 logs at 2, 4 and 12 weeks (p = 0.001). The extent of viremia reduction at week 2 was associated with 100% SVR, and at 4 weeks the positive predictive values was 84% and the negative predictive values was 96.5%. A subanalysis of the naïve group yielded analogous results. Conclusions: in our study, a reduction in viremia ≥ 2 logs 2 weeks after treatment could ensure SVR. At 4 weeks, most non-responders could be identified.Objetivo: identificar qué factores predicen la respuesta al interferón pegilado alfa-2b y ribavirina en pacientes con hepatitis crónica C genotipo 1. Se estudió la cinética viral en la semana 2 y 4. Métodos: se evaluaron de forma prospectiva y consecutiva a los pacientes con hepatitis crónica C genotipo 1 remitidos a nuestra consulta de hepatología entre enero de 2004 y octubre de 2006, para tratamiento antiviral. Se recogieron datos basales y la viremia se determinó horas antes de la dosis semanal de interferón pegilado por PCR cualitativa y cuantitativa. Resultados: cincuenta y siete pacientes fueron incluidos aunque 3 fueron excluidos durante el seguimiento. Un 65% fueron varones (n = 35) con edad media de 42 (26-65) años. La viremia basal fue > 800.000 UI/ml en 67% (n = 36). Se realizó biopsia hepática en 86% (n = 46), 22% (n = 12) tenían fibrosis avanzada. 40 fueron naïves, 4 recidivantes y 10 no respondedores. La dosis de ribavirina se modificó por efecto secundario sólo en un paciente. La RFT y la RVS fueron de 59 y 41%, respectivamente. El análisis univariante mostró asociación estadísticamente significativa con RVS de la viremia basal (p = 0,006), GGT basal (p = 0,025) y el descenso en la viremia ≥ 2 logaritmos a las 2, 4 y 12 semanas (p = 0,001). El descenso de la viremia en la semana 2 se asoció con 100% de RVS y a las 4 semanas el VPP fue 84% y el VPN 96,5%. Se realizó un subanálisis en el grupo de pacientes naïves con resultados superponibles. Conclusiones: en nuestro estudio el descenso de la viremia ≥ 2 logaritmos a las 2 semanas de tratamiento aseguró la RVS. A las 4 semanas, identificamos a la gran mayoría de los pacientes no respondedores.

Introducción: La obesidad se ha convertido en un grave problema de salud pública, constituyendo en la actualidad una auténtica pandemia. Es, por tanto, una prioridad desarrollar estrategias destinadas a la prevención y el tratamiento de la misma, incluyendo modificaciones en el estilo de vida, intervenciones a nivel comunitario e integración de las diferentes opciones terapéuticas. En este sentido, los "sustitutos de comida", productos empleados para reemplazar una o varias comidas diarias en dietas de bajo valor energético, pueden constituir en el momento actual una opción más frente a una dieta hipocalórica convencional. Objetivo: Revisar la bibliografía sobre los sustitutos de comida y comparar la composición nutricional de distintaspresentaciones comercializadas en España. Metodología: Hemos realizado una búsqueda, tanto en farmacias, como en grandes superficies, de productos especialmente destinados a sustituir una comida. Hemos comparado su composición nutricional en relación a macronutrientes y micronutrientes de los treinta y dos productos analizados, incluyendo sus diferentes formas de presentación (barritas, polvo, bricks y crackers). Resultados: Encontramos que la forma de presentación más extendida son las barritas (23 de los 32 productos analizados), seguidas de la presentación en forma de polvo para reconstitución como batidos (6 productos), bricks (2 productos) y crackers (1 producto). En cuanto a la distribución global de macronutrientes (valores medios por comida) encontramos que contienen un 26% del VCT en forma de proteínas, un 45% de carbohidratos y una media del 29% como grasas, con un aporte medio de fibra de 4,45 gramos por comida y un aporte energético medio de 266 kcal/comida. Respecto a los micronutrientes, aunque existe una marcada variabilidad entre los diferentes productos, se supera el aporte medio global del 33% de las RDA por comida sobre todo para el hierro y las vitaminas B1, B6 y D. Sin embargo para otros micronutrientes como el calcio, el magnesio, el ácido fólico y la vitamina B12 y no llega a alcanzarse el 33% de las RDA. Conclusión: Los planes de sustitución parcial de comidas son una opción más a tener en cuenta en el tratamiento de la obesidad, especialmente por tratarse de dietas de más fácil comprensión y manejo y con más altas tasas de seguimiento a largo plazo. Creemos, por tanto, que es fundamental ampliar el conocimiento que se tiene de estos productos, así como el establecimiento de unos criterios más estrictos en lo referente a la composición de los mismos, por parte de la administración.Introduction: Obesity has become a serious health problem. It is nowadays considered a pandemia and it is therefore a priority to develop different strategies on its prevention and treatment: lifestyle changes, community interventions as well as pharmacological and non-pharmacological activities. In this way, meal replacement products (energy reduced products designed to replace one or two regular meals providing a supously nutritionally balanced low fat meal) can be an alternative to traditional reduced calorie diet. Objective: Our aim was to revise the literature on meal replacement and compare the nutritional composition and the different forms of presentation of the main meal replacement products commercialised in Spain. Methodology: We made a research in pharmacies, weight loss centers and big supermarkets of food products specially designed to replace a meal. We compared the nutritional composition regarding macronutrients and micronutrients of the thirty-two different products founded, including their different form of presentation (bars, powder, drink-shakes and crackers). In order to judge their nutritional composition, we compared one meal replaced with these products with the Recommended Dietary Allowances (RDA). Results: The most common form of meal replacement products were bars (23 of 32 analyzed products), followed by powder for making shakes (6 products), bricks (2 products) and crackers (1 product). When we analysed a single meal replaced with these products, we founded that the global distribution of macronutrients was: 45% as carbohydrates, 29% as fats, 26% as proteins, and 4.45 grams of fiber. Their average energy was 266 Kcal per meal. Regarding micronutrients (vitamins and minerals), there was a great variability among the different products, but in average their composition was above the 33% of the RDA per meal specially in iron and vitamins B1, B6 and D. Calcium, magnesium, folic acid and vitamin B12 were the micronutrients less plentiful. Conclusion: Partial meal replacement can be an alternative or a complementary therapeutic option to conventional hipocaloric diets in obesity since they appear to have an easier understanding and follow up. It is therefore important to consider them in weight management programs and more studies are required to establish strict criteria on their nutritional composition by a legal normative.

Se presentan los resultados de los estudios de paleomagnetismo (primeros 12 metros) y microfósiles (primeros 8 metros) para la secuencia lacustre del lago de Chalco. Estos se han realizado en material recobrado de cuatro perforaciones en el sector central del lago. La reconstrucción paleoambiental propuesta integra los datos de polen, diatomeas, limnología, paleomagnetismo y fechamientos de radiocarbono. La edad estimada para el fondo de la secuencia, a los 12 m, es de 25,000 años antes del presente. Los sedimentos están caracterizados por valores altos de susceptibilidad magnética, los cuales están relacionados a la ocurrencia de material volcánico (se identifican 10 tefras en esta parte de la secuencia). La paleoflora está constituida principalmente por bosques de coníferas y vegetación subacuática. Los datos limnológicos indican fluctuaciones en el nivel del lago, con correspondientes cambios en salinidad y alcalinidad. La disminución o ausencia de paleofósiles en la secuencia correlacionan con la localización de las tefras; ello sugiere una relación con la actividad volcánica. El registro de declinación magnética muestra varias anomalías, de hasta 30 - 60 grados, para aproximadamente los 5,000 años y los 14,000 años. La variación para los 5,000 años ha sido observada también en estudios de rocas volcánicas y podría reflejar una variación del campo geomagnético. El registro de inclinación magnética muestra un patrón más homogéneo, con fluctuaciones alrededor de los 32.9 grados (inclinación dipolar es de 35.3 grados). Sin embargo se tiene también una variación para los 14,000 años, que se resalta en los valores de la anomalía de inclinación. El análisis espectral de los registros de los varios parámetros magnéticos indica varios periodos dominantes. Para la intensidad se tienen del orden de 650 a 2,900 años. Para la declinación se tienen del orden de 850 a 2,900 años. Para la inclinación se tienen del orden de 1,000 a 3,800 años.

Se presentan los resultados de un estudio estratigráfico y de fechamiento radiométrico para los primeros doce metros de la secuencia volcano-sedimentaria del Lago de Chalco, en el sector sureste de la Cuenca de México. Para el estudio se ha analizado el material recuperado de cuatro perforaciones realizadas en la porción central del sector oeste de la cuenca. El modelado de las anomalías de Bouguer indica que la cuenca esta dividida en dos sub-cuencas por un alto estructural N-S que coincide con la estructura volcánica de Xico. El espesor máximo de la secuencia en la parte oeste es de 400 m y en la parte este de 300 m. Este estudio forma parte de un proyecto que incluye análisis del contenido de microfósiles, paleomagnetismo, sedimentología y limnolog1a, encaminado a documentar la evolución paleoambiental y paleoclimática de la Cuenca durante el Pleistoceno tardío y el Holoceno. Cinco unidades mayores pueden ser identificadas en los primeros 12m. intensa actividad volcánica esta representada por 10 horizontes de tefra. El control de edades se ha obtenido a partir de once determinaciones de radiocarbono. La edad a los 9 m de profundidad es alrededor de 19, 000 años. Un cambio marcado en la secuencia ocurre a los 13,000 años, indicado por los fechamientos y la presencia de una tefra y un grueso horizonte de diatomitas. Los cocientes promedio de sedimentación cambian de unos 0.80 mm/año en la parte profunda entre 3.5 y 8.13 m a unos 0.28 mm/año en la parte somera, arriba de los 3.5 m de profundidad. Análisis de las variaciones del contenido de carbón orgánico en la secuencia sugieren que entre 3 y 8 metros corresponden principalmente a un ambiente de lago somero, con acumulación alta de materia orgánica. doi: https://doi.org/10.22201/igeof.00167169p.1994.33.3.1181

Des facteurs et des moments critiques influant sur la qualité hygiénique du lait ont été examinés au Costa Rica dans une coopérative de petits éleveurs laitiers qui livraient tous leur lait à une laiterie. Le lait de toutes les vaches en lactation a été examiné avec le CMT (California Mastitis Test). Le lait positif au CMT a subi un examen bactériologique (EB). En outre, des échantillons de lait ont été prélevés dans les cuves de stockage pour le comptage des cellules somatique (CCS) et EB. Huit pour cent des échantillons positifs au CMT ont révélé la présence de S. aureus. Vingt-huit pourcent des échantillons prélevés dans les cuves de stockage contenaient S. aureus et 79 % des échantillons contenaient E. coli. Tous les échantillons pris dans les cuves de stockage de la laiterie avaient un nombre de CFU supérieurà 2.106 cellules/ml. Ce lait était fortement contaminé par des agents bactériologiques provenant de l'environnement. Le refroidissement du lait était inadéquat. La méthode de préparation des mamelles, les appareils de traite insuffisamment aseptisés et l'eau de nettoyage étaient les principales sources de contamination du lait.

Sin resumen

Los ritmos circádicos son variaciones que ocurren en un período de aproximadamente 24 horas y el más notable en nuestra especie es el ciclo sueño-vigilia. En los mamíferos dichos ritmos están controlados por un reloj maestro que se localiza en el núcleo supraquiasmático (NSQ), ubicado en el cerebro. Estos ritmos son endógenos pero necesitan sincronizarse a los ciclos externos de luz-oscuridad para que tengan una función adaptativa a los organismos. La informa- ción fótica externa es transmitida a través del tracto retinohipotalámico, una haz de fibras que va de la retina hasta el núcleo NSQ. En el presente trabajo se estudió la anatomía y el desarrollo ontogenético de dicho tracto en el conejo en dos condiciones, cuando su sincronizador principal es el alimento (día postnatal 1 y 9) y en adultos cuando su principal sincronizador es la luz, con el trazador ß toxina de cólera. El tracto está presente desde los días 1 y 9 postnatal cuando los individuos aún no abren los ojos y presenta un desarrollo gradual de inervación en el NSQ. Esto es en el día 1 se observan escasas fibras en el núcleo, pero en el día 9 ya se observa una intensa inervación, la cual es similar a la del adulto. Sin embargo se debe determinar si tanto en el día 1 y 9 dicha inervación ya es funcional, esto es, si responde a la estimulación fótica ya que el principal sincronizador de estos sujetos es el alimento y no la luz.

A 50-year-old woman presented with nephrotic proteinuria and preserved glomerular filtration rate. A renal biopsy showed focal segmental glomerulosclerosis (FSGS) and glomerular basement membrane thinning. Her brother has a long history of chronic kidney disease, formerly diagnosed with minimal change disease, and eventually received a kidney allograft, developing high-grade proteinuria and decline in kidney function. FSGS was found by biopsy. Lastly, one paternal uncle suffered from the same condition, but he declined a biopsy. A genetic test identified a novel missense mutation in LMX1B, c.349G>A:p(Gly117Ser). Thus, the present series of cases shows a familial LMX1B-associated nephropathy presenting with FSGS., (Copyright © 2024. Published by Elsevier Masson SAS.)

Introduction:  Maternal overweight and obesity during pregnancy have been shown to have multiple negative effects on the mother's health, which can even affect the infant's growth by increasing weight gain and altering various indicators, such as weight for age, length for age and weight for length. While breast milk on the other hand reduces these risks, and it's the best and most complete food for the newborn. It's a dynamic fluid capable of being modified to meet the needs of each stage of the newborn, but despite this capacity and the fact that maternal body mass index can have an impact on its components, through complex biological mechanisms, it manages to reduce the negative effects accumulated during pregnancy and even promotes a healthy state in the baby. In a country like Mexico, where overweight and obesity affect a large part of the population, it is important to study their causes and which could be the effect of this increased maternal overweight during pregnancy and lactation on newborns., Objective: Identify the alterations associated with increased maternal body mass index during pregnancy and breastfeeding on mothers' health and their possible effect on the growth of the newborn during the first six months of life., Material and Methods: This was a prospective cohort study. Forty-two healthy binomials (mother and child), without problems during delivery and without serious illnesses during the breastfeeding period, were included. Maternal body mass index at the beginning of pregnancy allowed us to create two comparison groups between mothers: one with adequate weight, another with overweight or obesity. Follow-up was carried out once a month during the first six months of life, evaluating the somatometric development of mothers and children. All mothers completed the six-month period of exclusive breastfeeding., Results:  There were differences between both groups of women. The one that included overweight and obese women compared to the group of women with adequate weight had a higher number of pregnancies, abortions, plasma glucose levels in the third trimester of pregnancy, and a lower number of prenatal control visits and plasma platelet levels (all with p<0.05). Regarding the baby's growth, there was a difference between the weight for length classification at 60-, 120-, 150- and 180-day follow-ups. The group to which the mother was assigned with respect to her body mass index at the beginning of pregnancy (adequate weight group and overweight/obese group) was the only factor associated with the risk of the baby being overweight according to weight for length indicator at the 180-day follow-up, with an OR = 5.2 (95%CI 1.02-26.59)., Conclusions: Maternal overweight and obesity during pregnancy have a negative effect on the mother's health and baby's weight gain in its weight-for-length classification during the first six months of life. Although breastfeeding has been shown to have a positive effect on the growth of the baby, exposure to a higher maternal body mass index during pregnancy triggers important metabolic alterations that promote the development of diseases. It is important to establish weight control guidelines in women who wish to become pregnant to reduce the negative effects on the mother and offspring., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee, Xalapa Regional Hospital "Dr. Luis F. Nachón" issued approval 10/21. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: Jorge Iván Zurutuza Lorméndez declare(s) a grant from Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT). This work was carried out with the support of grant No. 783848 assigned to JIZL, by the Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT). Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Zurutuza et al.)

Introduction: Manual techniques for total hip arthroplasty (THA) have been widely utilized and proven to be clinically successful. However, the use of advanced computed tomography (CT) scan-based planning and haptically-bounded reamers in robotic-arm assisted total hip arthroplasty (RTHA) holds promise for potentially limiting surrounding soft-tissue damage. This cadaver-based study aimed to compare the extent of soft-tissue damage between a robotic-arm assisted, haptically-guided THA (RTHA) and a manual, fluoroscopic-guided THA (MTHA) direct anterior approach., Materials and Methods: There were six fresh-frozen torso-to-toe cadaver specimens included, with two surgeons each performing three RTHA and three MTHA procedures. One hip underwent an RTHA and the other hip received an MTHA in each cadaver. Postoperatively, one additional surgeon, blinded to the procedures, assessed and graded damage to nine key anatomical structures using a 1 to 4 grading scale: (1) complete soft-tissue preservation to <5% of damage; (2) 6 to 25% of damage; (3) 26 to 75% of damage; and (4) 76 to 100% of damage. Kruskal-Wallis hypothesis tests were used to compare soft-tissue damage between RTHA and MTHA cases and adjusted for ties., Results: Pooled analysis of the gluteus minimus, sartorius, tensor fascia lata, and vastus lateralis muscle grades demonstrated that cadaver specimens who underwent RTHA underwent less damage to these structures than following MTHA (median, IQR: 1.0, 1.0 to 2.0 vs. 3.0, 2.0 to 3.0; p=0.003). Pooled analysis of the calculated volumetric damage (mm3) for the gluteus minimus, sartorius, tensor fascia lata, and vastus lateralis muscles demonstrated that the cadaver specimens that underwent RTHA underwent less damage to these structures than those that followed MTHA (median, IQR: 23, 2 to 586 vs. 216, 58 to 3,050; p=0.037)., Conclusion: This cadaver-based study suggests that utilizing RTHA may lead to reduced soft-tissue damage compared with MTHA, likely due to enhanced preoperative planning with robotic-arm assisted software, real-time intraoperative feedback, haptically-bounded reamer usage, reduced surgical steps, as well as ease of use with reaming. These findings should be carefully considered when evaluating the utilization of robotic-arm assisted THA in practice.

Soft-tissue balancing is an important factor in primary total knee arthroplasty (TKA), with 30 to 50% of TKA revisions attributed to technical operative factors including soft-tissue balancing. Robotic-assisted TKA (RATKA) offers opportunities for improved soft-tissue balancing methods. This study aimed to evaluate the repeatability and reproducibility of ligamentous laxity assessments during RATKA using a digital tensioner.Three experienced RATKA surgeons assessed preresection and trialing phases of 12 human cadaveric knees with varying degrees of arthritis. Ligamentous laxity was assessed with manual varus and valgus stresses in extension and flexion, with a digital tensioner providing feedback on the change of laxity displacement. Intraclass correlation coefficient (ICC) analyses were used to determine the repeatability within a single surgeon and reproducibility between the three surgeons.The results showed excellent repeatability and reproducibility in ligamentous laxity assessment during RATKA. Surgeons had excellent repeatability for preresection and trialing assessments, with median ICC values representing excellent reproducibility between surgeons. Surgeons were repeatable within 1 or 1.5 mm for preresection and trialing assessments. On average, the variation within a surgeon was 0.33 ± 0.26 mm during preresection and 0.29 ± 0.28 mm during trialing. When comparing surgeons to each other, they were reproducible within an average of 0.69 ± 0.33 mm for preresection and 0.65 ± 0.31 mm for trialing.This study demonstrated the reliability of robotic-assisted soft-tissue balancing techniques, providing control over ligamentous laxity assessments, and potentially leading to better patient outcomes. The digital tensioner used in this study provided excellent repeatability and reproducibility in ligamentous laxity assessment during RATKA, highlighting the potential benefits of incorporating robotics in TKA procedures., Competing Interests: None declared., (Thieme. All rights reserved.)

Introduction: The direct anterior (DA) approach allows for earlier mobilization and shorter length-of-stay than traditional total hip arthroplasty (THA) approaches; however, conventional techniques rely on intraoperative fluoroscopy for accurate cup placement. Robotic-assisted THA is an alternative to conventional THA procedures and utilizes preoperative computed tomography (CT) scans and intraoperative mapping for accurate component positioning. The purpose of this study was to evaluate the impact of robotic-assisted DA THA without fluoroscopy on surgical efficiency parameters when compared to conventional DA THA with fluoroscopy., Methods: There were six cadaver specimens evenly distributed between two orthopaedic surgeons, both with previous experience in conventional and robotic-assisted THA. For each cadaver, conventional DA THA with fluoroscopy was performed on the first hip, and robotic-assisted DA THA without fluoroscopy was performed on the contralateral hip. Total surgical time from skin to trials, acetabular and femoral workflow time, and the number of reamers and broaches used, were recorded for all cases. There were two-sample t -tests performed to assess statistical differences between conventional and robotic-assisted THA data., Results: Acetabular reaming took longer, on average, for conventional DA THA with fluoroscopy than robotic-assisted DA THA without fluoroscopy (2.4 ± 0.6 versus 0.4 ± 0.2 min; p  < 0.001). Surgeons using conventional THA required more acetabular reamers when compared to a single reamer used with robotic-assisted THA (2.67 ± 0.5 versus 1 ± 0; p  = 0.001). Total operative time (26.1 ± 7.0 versus 23.2 ± 5.6 min; p  = 0.452), acetabular workflow time (6.4 ± 3.1 versus 3.3 ± 1.7 min; p  = 0.07), femoral workflow time (6.5 ± 4.8 versus 5.0 ± 1.7 min; p  = 0.495), and number of femoral broaches (5.0 ± 1.8 versus 4.3 ± 2.3; p  = 0.593) were higher during conventional THA than during robotic-assisted THA., Discussion: Amidst the changing healthcare environment and focus on identifying and implementing efficiencies, these findings have important consequences for the continued and accelerated use of robotic-assisted THA in primary settings., (© 2024 Published by Elsevier B.V. on behalf of Professor P K Surendran Memorial Education Foundation.)

Chronobiology investigations have revealed much about cellular and physiological clockworks but we are far from having a complete mechanistic understanding of the physiological and ecological implications. Here we present some unresolved questions in circadian biology research as posed by the editorial staff and guest contributors to the Journal of Circadian Rhythms. This collection of ideas is not meant to be comprehensive but does reveal the breadth of our observations on emerging trends in chronobiology and circadian biology. It is amazing what could be achieved with various expected innovations in technologies, techniques, and mathematical tools that are being developed. We fully expect strengthening mechanistic work will be linked to health care and environmental understandings of circadian function. Now that most clock genes are known, linking these to physiological, metabolic, and developmental traits requires investigations from the single molecule to the terrestrial ecological scales. Real answers are expected for these questions over the next decade. Where are the circadian clocks at a cellular level? How are clocks coupled cellularly to generate organism level outcomes? How do communities of circadian organisms rhythmically interact with each other? In what way does the natural genetic variation in populations sculpt community behaviors? How will methods development for circadian research be used in disparate academic and commercial endeavors? These and other questions make it a very exciting time to be working as a chronobiologist., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Circadian Biology intersects with diverse scientific domains, intricately woven into the fabric of organismal physiology and behavior. The rhythmic orchestration of life by the circadian clock serves as a focal point for researchers across disciplines. This retrospective examination delves into several of the scientific milestones that have fundamentally shaped our contemporary understanding of circadian rhythms. From deciphering the complexities of clock genes at a cellular level to exploring the nuances of coupled oscillators in whole organism responses to stimuli. The field has undergone significant evolution lately guided by genetics approaches. Our exploration here considers key moments in the circadian-research landscape, elucidating the trajectory of this discipline with a keen eye on scientific advancements and paradigm shifts., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2024 The Author(s).)

Aims: Attendance at diabetes self-management education and support (DSMES) programmes for type 2 diabetes is associated with positive outcomes, but the impact on some outcomes is inconsistent and tends to decline over time. Understanding the active ingredients of effective programmes is essential to optimise their effectiveness. This study aimed to (1) retrospectively identify behaviour change techniques (BCTs), mechanisms of action (MoAs) and intervention functions in two DSMES programmes, the Community-Oriented Diabetes Education and the Diabetes Education and Self-Management for Ongoing and Newly Diagnosed and (2) examine variation in content between programmes., Methods: A multiple case study approach, including a documentary analysis of the programme materials, was conducted. Materials were coded using the BCT Taxonomy v1, the Mode of Delivery Ontology v1 and the Intervention Source Ontology v1. The Behaviour Change Wheel guidance and the Theory and Techniques tool were used to identify intervention functions and MoAs. Programme stakeholders provided feedback on the findings., Results: Thirty-four BCTs were identified across the programmes, with 22 common to both. The identified BCTs were frequently related to 'goals and planning', 'feedback and monitoring' and 'natural consequences'. BCTs were linked with 15 MoAs, predominantly related to reflective motivation ('beliefs about capabilities' and 'beliefs about consequences') and psychological capability ('knowledge'). BCTs served six intervention functions, most frequently 'education', 'enablement' and 'persuasion'., Conclusions: Although both programmes included several BCTs, some BCTs were rarely or never used. Additional BCTs could be considered to potentially enhance effectiveness by addressing a wider range of barriers., (© 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)

A systematic search was carried out through search platforms and specialized databases, such as Academic Google, PubMed, and Scopus, using thesauri: breast feeding, obesity, immunology, and human milk in English and Spanish, and those articles published from January 2000 to December 2021, in both languages. Only those reports that included quantitative data on immunological components in the milk of normal-weight and overweight women were considered. The PRISMA 2020 guides were used, and a total of 306 articles were reviewed, of which a total of 33 were included, according to the basic inclusion criteria. It was observed that in obese mothers, there is an increase in certain immune cells, such as B lymphocytes, cytotoxic T lymphocytes, and NK cells, and cytokines, such as IL-6 and IFN-γ; other alterations included the bacterial population and proteins with antibacterial action. Also, a decrease in growth factors such as TGF-β and IFG-1 was documented in overweight women. Immunoglobulin concentrations did not show substantial changes. This brief review shows that maternal overweight is associated with changes in the biochemical and immunological parameters of milk., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Zurutuza et al.)

Introduction: Insulin-like growth factor-II messenger RNA-binding protein-3 (IMP3) over-expression is a predictor of tumor recurrence and metastases in some types of human melanoma. Our objective was to evaluate the immunohistochemical expression of IMP3 and other molecules related to tumor prognosis in melanoma-xeno-tumors undergoing treatment. We test the effect of radiotherapy (RT) and mesenchymal stromal cells (MSCs) treatment, analyzing the tumorigenic and metastatsizing capacity in a mice melanoma xenograft model., Materials and Methods: We inoculated A375 and G361 human melanoma cell lines into NOD/SCID gamma mice (n = 64). We established a control group, a group treated with MSCs, a group treated with MSCs plus RT, and a group treated with RT. We assessed the immunohistochemical expression of IMP3, E-cadherin, N-cadherin, PARP1, HIF-1α, and the proliferation marker Ki-67. Additionally, we performed a retrospective study including 114 histological samples of patients diagnosed with malignant cutaneous superficial spreading melanoma (n = 104) and nodular melanoma (n = 10) with at least 5 years of follow-up., Results: Most morphological and immunohistochemical features show statistically significant differences between the 2 cell lines. The A375 cell line induced the formation of metastases, while the G361 cell line provoked tumor formation but not metastases. All three treatments reduced the cell proliferation evaluated by the Ki-67 nuclear antigen (p = 0.000, one-way ANOVA test) and reduced the number of metastases (p = 0.004, one-way ANOVA test). In addition, the tumor volumes reduced in comparison with the control groups, 31.74% for RT + MSCs in the A357 tumor cell line, and 89.84% RT + MSCs in the G361 tumor cell line. We also found that IMP3 expression is associated with greater tumor aggressiveness and was significantly correlated with cell proliferation (measured by the expression of Ki-67), the number of metastases, and reduced expression of adhesion molecules., Conclusions: The combined treatment of RT and MSCs on xenografted melanomas reduces tumor size, metastases frequency, and the epithelial to mesenchymal transition/PARP1 metastatic phenotype. This treatment also reduces the expression of molecules related to cellular proliferation (Ki-67), molecules that facilitate the metastatic process (E-cadherin), and molecules related with prognosis (IMP3)., (© 2023 S. Karger AG, Basel.)

Lymphoid interstitial pneumonia (LIP) is a rare form of interstitial pulmonary disease, which has been described in association with a wide range of autoimmune disorders. Although the association of this entity with Sjogren's syndrome is well known, only a few cases are reported in relation to systemic lupus erythematosus (SLE). The aim of this paper is to review the cases reported in literature to date, as well as to describe the characteristics of these patients including the new case presented herein. We will be focusing on the case of a 36-year-old female patient diagnosed with SLE on hydroxychloroquine treatment who develops pleuritic chest pain and progressive dyspnea after 3 years of follow-up. The chest CT scan showed pleural thickening and both multiple and bilateral micronodules. A lung biopsy was also performed, revealing an infiltration of lymphocytes, plasma cells, and histiocytes in the alveolar septa suggestive of LIP. After conducting a review of the literature, we identified seven other cases describing SLE in association with LIP. The majority of them were young women, and LIP tends to appear early in the course of the disease, even as a form of initial presentation in some cases. Symptoms included cough, dyspnea, and pleuritic pain, with the exception of one case which was asymptomatic. It is noteworthy that half of the patients were positive for anti-SSA/anti-SSB autoantibodies, and some of them also met criteria for Sjogren's syndrome. Treatment with steroids and other immunosuppressive agents improved symptoms in all of them., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Robotic-assisted total knee arthroplasty (TKA) has been associated with improved accuracy and precision of implant placement, protection of soft tissue, and improved patient-reported postoperative outcomes when compared to manual TKA techniques. Previous studies have highlighted the importance of surgical confidence throughout the learning curve when adopting robotic-assisted platforms. The purpose of this study was to evaluate the confidence and efficiencies of surgeons when utilizing computed tomography (CT)-based robotic TKA technology., Materials and Methods: A cross-sectional, questionnaire-based study was conducted with 20 arthroplasty-trained surgeons with prior experience in both manual TKA and robotic-assisted TKA techniques. The surgeons completed an initial learning period, with new software, during various stages of their experience. The new TKA software upgrade builds on the prior software version with new features. A Net Promoter Score (NPS), the measurement of a respondent's likelihood to recommend a product or service to others, was used during the analysis of survey questions. A NPS over 50 indicates a positive score., Results: When compared to manual TKA techniques, 95% of surgeons reported that their overall intraoperative confidence increased with the new software upgrade for CT-based robotic technology and had an average rating of 8.9 out of 10 for their intraoperative confidence with the new software upgrade. Additionally, 100% of surgeons reported that they were more confident when performing intraoperative implant adjustments with the new software upgrade when compared to manual TKA. Surgeons determined that the overall use of the new software upgrade was intuitive (8.4 of 10 average rating) and were satisfied with the overall use of the new software upgrade (9 of 10 average rating). Also, surgeons reported that they would recommend the new software upgrade for CT-based robotic technology to colleagues (NPS of 85), as well as being used as a research tool (NPS of 85) or for a training and education tool in a fellowship program (NPS of 90)., Conclusion: As new technology continues to enter the field of orthopedics, it is important to ensure upgrades and advancements continue to serve surgeons and provide efficiencies in the operating room. For established robotic surgeons, the new robotic technology assessed in this study provided increased confidence when compared to manual TKA. Based on these results, the new software upgrade demonstrated value during various stages of a TKA procedure and is highly recommended for use by others in the field of orthopedics.

Accumulation of white adipose tissue (WAT) during obesity is associated with the development of chronic low-grade inflammation, a biological process known as lipoinflammation. Systemic and central lipoinflammation accumulates pro-inflammatory cytokines including IL-6, IL-1β and TNF-α in plasma and also in brain, disrupting neurometabolism and cognitive behavior. Obesity-mediated lipoinflammation has been reported in brain regions of the mesocorticolimbic reward circuit leading to alterations in the perception and consumption of ultra-processed foods. While still under investigation, lipoinflammation targets two major outcomes of the mesocorticolimbic circuit during food reward: perception and motivation ("Wanting") and the pleasurable feeling of feeding ("Liking"). This review will provide experimental and clinical evidence supporting the contribution of obesity- or overnutrition-related lipoinflammation affecting the mesocorticolimbic reward circuit and enhancing food reward responses. We will also address neuroanatomical targets of inflammatory profiles that modulate food reward responses during obesity and describe potential cellular and molecular mechanisms of overnutrition linked to addiction-like behavior favored by brain lipoinflammation., (Copyright © 2023 IBRO. Published by Elsevier Ltd. All rights reserved.)

Objective  Nocturnal animals forage and eat during the night and sleep during the day. When food is available only for a short period during the day, animals develop a catabolic state and exhibit locomotor behavior before accessing food, termed food anticipatory activity . Consequently, there is a disruption in the sleep pattern. The present study aimed to explore how anticipatory arousal emerges under circadian exposure to a palatable meal (PM) and disrupts sleep architecture. Materials and Methods  Adult male Wistar rats were implanted with electrodes for continuous sleep recording and housed under a light/dark 12/12-hour cycle with free access to food and water. After basal recordings, the rats had access to a PM during the light period for eight days. Results  The anticipatory arousal started on the third day. On the eighth day, we found an increase in wake time and a decrease in the non-rapid eye movement sleep (NREMS) and rapid eye movement sleep (REMS) times 45 minutes before the PM compared with the basal recordings. The REMS transitions (events from NREMS to REMS) showed a significant reduction during the light period of the eighth day of PM. In contrast, the number of NREMS transitions (events from wakefulness to NREMS) remained unchanged. Conclusion  The results suggest that palatable food induces a motivational timing that leads the rat to wake by altering the sleep quota., Competing Interests: Conflict of Interests The authors have no conflict of interest to declare., (Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

BACKGROUND The incidence of glomerular disease recurrence in kidney transplant patients varies according to type of glomerulopathy; therefore, it is important to know the primary chronic kidney disease etiology. C3 glomerulopathy (C3G) is characterized by deposits of C3 in immunofluorescence and its pathogeny is based on the dysregulation of the alternative complement pathway. C3G has a high recurrence rate and, given its low prevalence, only case series have been published. A higher rate of recurrence and a more aggressive course have been described in association with monoclonal gammopathy (MG). CASE REPORT We describe the case of a 78-year-old man with chronic kidney disease of unknown etiology (no significant proteinuria) and monoclonal IgGl gammopathy with low risk of progression, who received a kidney transplant, presenting accelerated deterioration of kidney function. Histopathology showed predominant C3 deposits in immunofluorescence, compatible with C3 glomerulonephritis (C3GN). He was treated with eculizumab during 4 weeks while the study was completed. The response to treatment was not favorable and the patient remained in the dialysis program. CONCLUSIONS Further studies are needed to explain the pathogenic mechanisms of complement alternative pathway dysregulation mediated by monoclonal component in patients with C3GN and MG. Patients older than 50 years who are on a waiting list for kidney transplantation should have an MG detection study. The information provided to patients with MG on a waiting list for kidney transplantation should include not only the possibility of hematologic progression but also the recurrence/de novo appearance of associated kidney pathology.

Introduction: The consensus on recovery from alcohol use disorder (AUD) has shifted toward encompassing psychological wellbeing and quality of life dimensions. However, few studies have explored the long-term recovery process and its dimensions, timing, styles, and modes. The aim of this study was to investigate the extent, timing, and process of psychological wellbeing and quality of life recovery in alcohol use disorder (AUD) patients, as well as the relationship with classic dimensions of AUD recovery., Method: A cross-sectional study has been carried out with 348 participants with AUD, in different abstinence periods (1 month-28 years), and 171 control subjects. Participants underwent a psychological evaluation, which included self-informed measures of psychological wellbeing, quality of life, negative emotionality, and coping strategies related to alcohol consumption avoidance. Statistical analysis included linear and non-linear regression models between psychological dimensions and maintenance of abstinence, as well as matching the scores of the sample with AUD to those of controls. Scatter plots were used to explore inflection points. In addition, mean comparison tests were performed between participants with AUD and controls and by gender., Results: In general, according to the regression models, there were pronounced increases in indices of wellbeing and coping strategies (and pronounced decreases in negative emotionality) during the first 5 years of abstinence, followed by less pronounced improvements. The matching of AUD subjects in wellbeing and negative emotionality indices with controls occurs at different times: (a) 1 year or less: physical health; (b) 1-4 years: psychological health; (c) 4-10 years: social relationships, wellbeing, and negative emotionality; and (d) more than 10 years: autonomy and self-acceptance. There are statistically significant differences by gender for the negative emotionality and physical health variables., Conclusion: Recovery from AUD is a long process that involves improvements in wellbeing and quality of life. Four stages can be described in this process, with the most pronounced changes occurring during the first 5 years of abstinence. However, AUD patients take more time to obtain similar scores to controls in several psychological dimensions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Rubio, Esteban Rodríguez, Sion, Ramis Vidal, Blanco, Zamora-Bayon, Caba-Moreno, Macias-Molina, Pérez-Sánchez, Rubio-Escobar, Ruiz-Diez, Marin, Arias, Lora and Jurado-Barba.)