Search

Abstract Background Xylazine is a α2-adrenergic receptor agonist, used for sedation in veterinary contexts. Although it is increasingly found in overdose deaths across North America, the clinical management of xylazine-involved overdoses has not been extensively studied, especially in community-based harm reduction settings. Here we present a clinical series of xylazine-involved overdose and share the clinical approach and lessons learned by a community overdose response team in Tijuana, Mexico amidst the arrival of xylazine. Case Presentation We present three cases describing the clinical management of patients with xylazine-involved overdoses that occurred in close proximity to the Prevencasa community harm reduction clinic. The long period of post-naloxone sedation in xylazine overdoses is a unique clinical feature. The first case is a 61-year-old man with longstanding opioid and methamphetamine use disorder found hypoxic, who received 4.0 mg of intranasal naloxone, and quickly began respirating well. He remained unconscious for 20 min, and upon awakening, experienced withdrawal symptoms, agitation and confusion, and exposed himself to considerable physical danger by entering a local roadway. The second is a 28-year-old man who primarily uses stimulants, who overdosed while trying “China White”. His oxygen saturation improved from 81 to 100% with supplemental oxygen and field management, and he did not require naloxone administration. He recovered consciousness after 40 min. The third patient is a 36-year-old male who was found down, saturating at 20%, who received 0.4 mg intramuscular naloxone, was placed in recovery position, and remained unconscious for 12 min before making a complete recovery. The first and third patients provided urine and drug samples that tested positive for xylazine and fentanyl. Conclusions We describe insights about the clinical management of combined xylazine-fentanyl involved overdoses in the field, from a community harm reduction context where xylazine arrived suddenly spurring a large number of overdoses. In response to the long period of post-naloxone sedation inherent to xylazine overdoses, the clinical team learned to center oxygenation—not consciousness—as the key parameter of interest for the titration of naloxone, increase emphasis on field airway management, portable oxygen administration, and scene safety, and employ xylazine testing strips for urine and direct substance analysis to educate the patient population about health risks.

En este artículo, se examinaron los estereotipos de género en la adolescencia, su influencia en la formación de identidades y la internalización de roles. Además, se contextualizó la problemática y analizó su impacto en la vida de los adolescentes. El objetivo del estudio se enfocó en identificar y analizar los estereotipos de género internalizados por una muestra de adolescentes, así como explorar los factores relacionados con su formación y manifestación. Se empleó un enfoque cuantitativo con una muestra de 236 estudiantes, quienes oscilaban entre los 11 y 16 años de edad. Se utilizó la escala de estereotipos de género para recopilar datos sobre las creencias y percepciones de género. Los resultados revelaron una alta interiorización de estereotipos de género en las dimensiones de expresión afectiva y comportamiento social, y una baja interiorización en aspectos relacionados con el cuerpo y la responsabilidad social. También, se observaron diferencias significativas entre hombres y mujeres, con una mayor tendencia en los hombres a reproducir creencias estereotipadas en la mayoría de las dimensiones analizadas. Estos hallazgos subrayan la necesidad de intervenciones educativas que promuevan la igualdad de género y reduzcan los estereotipos. Estos resultados pueden guiar el diseño de programas y políticas dirigidas a disminuir los estereotipos de género y fomentar la igualdad de género en la adolescencia.

Endophytic fungi play a crucial role in the survival and adaptation of their host plants. In recent decades, unprecedented diversity of endophytic fungi has been reported in angiosperms, but knowledge about this diversity in tropical gymnosperms is lacking. Among gymnosperms, cycads (Cycadales) are important components of Neotropical forests with high levels of endemism in Central and South America. We used a combination of axenic culture and Sanger sequencing to isolate and identify leaf endophytes of two endemic cycads from humid forests of Panama, Zamia nana and Z. pseudoparasitica. The latter is the only known epiphytic gymnosperm. In Z. pseudoparasitica, 50 morphotypes were isolated from El Copé, 58 from Santa Fe, and 22 from Cerro Marta. We sampled one wild population of Z. nana (El Valle de Antón), from which we recovered 74 morphotypes. We also sampled Z. nana from the International Garden of Cycads in Panama City. Sequencing of 69 cultures with the ITS rRNA locus identified several ascomycetes: Colletotrichum, Cercophora, Hypoxylon, Phyllosticta, Xylaria, and a basidiomycete: Tritirachium. This is one of the first studies to document the diversity of endophytic fungi in a Neotropical gymnosperm and provides a window into the endophytic fungi that inhabit the leaves of tropical plants.

BackgroundMental health treatment is hindered by the limited number of mental health care providers and the infrequency of care. Digital mental health technology can help supplement treatment by remotely monitoring patient symptoms and predicting mental health crises in between clinical visits. However, the feasibility of digital mental health technologies has not yet been sufficiently explored. Rhythms, from the company Health Rhythms, is a smartphone platform that uses passively acquired smartphone data with artificial intelligence and predictive analytics to alert patients and providers to an emerging mental health crisis. ObjectiveThe objective of this study was to test the feasibility and acceptability of Rhythms among patients attending an academic psychiatric outpatient clinic. MethodsOur group embedded Rhythms into the electronic health record of a large health system. Patients with a diagnosis of major depressive disorder, bipolar disorder, or other mood disorder were contacted online and enrolled for a 6-week trial of Rhythms. Participants provided data by completing electronic surveys as well as by active and passive use of Rhythms. Emergent and urgent alerts were monitored and managed according to passively collected data and patient self-ratings. A purposively sampled group of participants also participated in qualitative interviews about their experience with Rhythms at the end of the study. ResultsOf the 104 participants, 89 (85.6%) completed 6 weeks of monitoring. The majority of the participants were women (72/104, 69.2%), White (84/104, 80.8%), and non-Hispanic (100/104, 96.2%) and had a diagnosis of major depressive disorder (71/104, 68.3%). Two emergent alerts and 19 urgent alerts were received and managed according to protocol over 16 weeks. More than two-thirds (63/87, 72%) of those participating continued to use Rhythms after study completion. Comments from participants indicated appreciation for greater self-awareness and provider connection, while providers reported that Rhythms provided a more nuanced understanding of patient experience between clinical visits. ConclusionsRhythms is a user-friendly, electronic health record–adaptable, smartphone-based tool that provides patients and providers with a greater understanding of patient mental health status. Integration of Rhythms into health systems has the potential to facilitate mental health care and improve the experience of both patients and providers.

The Arab American community has faced a history of racialization dating back to the late 19th century. The events of 9/11 and the heightened rhetoric of hate during the Trump presidency encouraged anti-Muslim sentiment and increased racial profiling and harassment. This community-based participatory research (CBPR) project uses Photovoice as a methodology to better understand the lived experiences and narratives of Arab Americans in the post-Trump1 era and as a tool for advocacy. The findings from the photo sharing sessions underscore the continued challenge of identity and representation, (in)visibility, and pushing back against anti-Arab/Muslim racism. The findings also highlight religion as a protective factor against structural and systemic racism. Overall, the participants in this study demonstrated their community resilience and navigational capital as they survived and thrived amid racializing experiences and microaggressions. Implications of this work include the need for increased consciousness raising about the lived experiences of the Arab American community and opportunities for allyship and advocacy.

PURPOSEHereditary cancer syndromes (HCS) explain 5%-10% of all cancer cases. Patients with more than one germline pathogenic variant (GPV) result in a clinical syndrome known as multilocus inherited neoplasia allele syndrome (MINAS). In recent years, an increasing number of MINAS cases have been reported. This study aims to identify the prevalence of MINAS and determine the effect of two GPVs in HCS on patients from Northern Mexico.METHODSPatients (N = 2,282) were recruited from four public oncology centers and two private institutions with hereditary cancer detection programs in Nuevo León, México. A medical geneticist collected all the patient's clinical data and gave genetic counseling. Patients with MINAS were detected using multigene panels to detect GPVs; findings were classified according to American College of Medical Genetics and Genomics guidelines. The genetic data of patients with MINAS were evaluated by their frequency and combination.RESULTSWe found 386 (16.9%) patients with one or more variants and 23 (5.9%) MINAS patients (all females). The most frequent diagnosis was breast cancer (BC) in 20 (86.95%) cases, whereas 16 (69.56%) had triple-negative BC. We found 13 patients with BRCA1 GPVs (56.52%) as the most frequent, followed by MUTYH with five cases (21.73%). The combinations of BRCA1/CHEK2, BRCA1/CDKN2A, and BRCA1/BRCA2 were the most frequent. We found no atypical presentation in the cohort.CONCLUSIONThis is the first Mexican MINAS report and the largest Latin American cohort. We detected a higher prevalence of MINAS than other populations (5.9%). We found a tendency for additive phenotypical effect and, in some MINAS combinations, a modification in the age of diagnosis.

IntroductionThis study evaluated the relationship between total plasma and free kidney concentrations of amphotericin B (AmB) in healthy and C. albicans-infected Wistar rats using microdialysis and has the potential to significantly impact future research in this field and promote the development of antifungal drugs. The findings of this study, which show that plasma levels are a good predictor for AmB kidney concentrations and can be used to optimize its dosing regimen, underscore the importance of this research.MethodsMicrodialysis probe recovery rates were determined by dialysis and retrodialysis in vitro, as well as by retrodialysis in vivo. The intravenous (i.v.) administration of 2.5 × 106 CFU/mL of C. albicans ATCC induced the infection. A 2.5 mg/kg i.v. bolus was used in healthy and C. albicans-infected rats (n = 6/group). Plasma and microdialysate samples were analyzed using HPLC-diode-array detection. AmB tissue penetration was analyzed using the ratio between the total plasma and kidney concentrations and population pharmacokinetics (PopPK) to assess the impact of the infection on the pharmacokinetic parameters. The chosen flow rate was set to 1.5 μL/min, and there was no statistical difference between the relative recovery values when changing AmB concentrations.Results and DiscussionThe in vivo relative recovery was determined to be 10.9% ± 3.7%. The antifungal tissue penetration was 0.77 and 0.71 for the healthy and infected animals, respectively. The structural PK model with two compartments and linear elimination describes the concentration versus time profile of AmB simultaneously in the plasma and tissue. Infection by C. albicans does not interfere with AmB kidney penetration. AmB protein binding is demonstrated to be nonlinear and dependent on the AmB concentration in the plasma of healthy and infected animals.

In this study, gold and silver were recovered through a bioleaching process conducted at room temperature over 11 days. Native bacteria and varying ratios of mineral pulp to culture medium (20/80, 37.5/62.5, and 50/50 %) from a mining operation in Zacatecas, Mexico, were evaluated. The mineral was crushed to a particle size of 0.125 inches or smaller, containing gold and silver concentrations of 0.609 g/ton and 138.89 g/ton, respectively. Four native microorganisms were identified using molecular biology techniques and a 16S rRNA gene fragment: Acidovorax citrulli, Brevundimonas albigilva, Sphingomonas korenensis, and Methylobacterium organophilum. The bioleaching system achieved metal extractions of 84.12 % and 63.93 % for gold and silver, respectively. Different microorganisms were identified at various processing times: Sphingomonas korenensis (days 1, 2, 5, 8, and 11), Methylobacterium organophilum (days 1 and 2), Paenibacillus dongdonensis (days 1 and 2), Brevundimonas albigilva (day 5), Ureibacillus manganicus (day 5), Peribacillus simplex (day 8), Niallia circulans (day 8), Massilia atriviolacea (day 11), and Bacillus licheniformis (day 11). The dominant bacterium throughout the process was Sphingomonas korenensis, which appeared at all stages of the experiment.

Purpose: To compare the acute effects on mechanical, metabolic, neuromuscular, and muscle contractile responses to different velocity-loss (VL) thresholds (20% and 40%) under distinct blood-flow conditions (free [FF] vs restricted [BFR]) in full squat (SQ). Methods: Twenty strength-trained men performed 4 SQ protocols with 60% 1-repetition maximum that differed in the VL within the set and in the blood-flow condition (FF20: FF with 20% VL; FF40: FF with 40% VL; BFR20: BFR with 20% VL; and BFR40: BFR with 40% VL). The level of BFR was 50% of the arterial occlusion pressure. Before and after the SQ protocols, the following tests were performed: (1) tensiomyography, (2) blood lactate, (3) countermovement jump, (4) maximal voluntary isometric SQ contraction, and (5) performance with the load that elicited a 1 m·s−1 at baseline measurements in SQ. Results: No "BFR × VL" interactions were observed. BFR protocols resulted in fewer repetitions and lower increases in lactate concentration than FF protocols. The 40% VL protocols completed more repetitions but resulted in lower mechanical performance and electromyography median frequency during the exercise than the 20% VL protocols. At postexercise, the 40% VL protocols also experienced greater blood lactate concentrations, higher alterations in tensiomyography-derived variables, and accentuated impairments in SQ and countermovement-jump performances. The 20% VL protocols showed an increased electromyography median frequency at postexercise maximal voluntary isometric contraction. Conclusions: Despite BFR-accelerated fatigue development during exercise, a given VL magnitude induced similar impairments in the distinct performance indicators assessed, regardless of the blood-flow condition. [ABSTRACT FROM AUTHOR]

Coronal mass ejections (CMEs) erupting from the host star are expected to affect the atmospheric erosion processes of planets. For planets with a magnetosphere, the embedded magnetic field in the CMEs is thought to be the most important parameter to affect planetary mass-loss. In this work, we investigate the effect of different magnetic field structures of stellar CMEs on the atmosphere of a hot Jupiter with a dipolar magnetosphere. We use a time-dependent 3D radiative magnetohydrodynamic (MHD) atmospheric escape model that self-consistently models the outflow from hot Jupiter's magnetosphere and its interaction with stellar CMEs. For our study, we consider three configurations of magnetic field embedded in CMEs – (a) northward |$B_z$| component, (b) southward |$B_z$| component, and (c) radial component. We find that both the CMEs with northward |$B_z$| and southward |$B_z$| increase the planetary mass-loss rate when the CME arrives from the stellar side, with the mass-loss rate remaining higher for the CME with northward |$B_z$| until it arrives on the opposite side. The largest magnetopause is found for the CME with a southward |$B_z$| component. During the passage of a CME, the planetary magnetosphere goes through three distinct changes – (1) compressed magnetosphere, (2) enlarged magnetosphere, and (3) relaxed magnetosphere for all three CME configurations. The computed synthetic Ly  |$\alpha$| transit absorption generally increases when the CME is in interaction with the planet for all magnetic configurations but the maximum Ly  |$\alpha$| absorption is found for the case of radial CME with the most compressed magnetosphere. [ABSTRACT FROM AUTHOR]

The 5G network was developed to push the capabilities of wireless networks to previously unseen performance limits, e.g., transmission rates of several gigabits per second, latency of less than a millisecond, and millions of devices connected at the same time. To meet these requirements, it is necessary to access new spectrum (the so-called millimeter waves) and use techniques such as Massive MIMO (Multiple-Input Multiple-Output) and beamforming. This required the design of a new radio interface, known as 5G NR, that includes improvements to its physical components and new protocols. The performance of the 5G network will depend heavily on the behavior of these new protocols under certain configuration parameters, traffic conditions, device density, and network architecture. This paper introduces an analytical model for the performance evaluation of 5G NR. The developed model describes the behavior of the different layer 1 and 2 protocols involved in 5G radio communication. Using the model, it is possible to evaluate the performance of 5G NR in terms of throughput and latency, two key performance metrics used to describe QoS (Quality of Service) thresholds of different applications. The protocol layer approach gives the model sufficient granularity to identify critical behaviors that significantly impact performance. This can help focus efforts on improving these key points or propose improvements/modifications to the operation of network protocols or devices. The use of this model for performance evaluation is exemplified by studying a Remote Driving scenario operated over 5G. This scenario has very stringent delay requirements, which, according to the model's results, can be satisfied if the network conditions are adequate. This model and its results can be used as a starting point for performance evaluations of application involving end-to-end (E2E) communications. [ABSTRACT FROM AUTHOR]

Background: Xylazine is a α2-adrenergic receptor agonist, used for sedation in veterinary contexts. Although it is increasingly found in overdose deaths across North America, the clinical management of xylazine-involved overdoses has not been extensively studied, especially in community-based harm reduction settings. Here we present a clinical series of xylazine-involved overdose and share the clinical approach and lessons learned by a community overdose response team in Tijuana, Mexico amidst the arrival of xylazine. Case Presentation: We present three cases describing the clinical management of patients with xylazine-involved overdoses that occurred in close proximity to the Prevencasa community harm reduction clinic. The long period of post-naloxone sedation in xylazine overdoses is a unique clinical feature. The first case is a 61-year-old man with longstanding opioid and methamphetamine use disorder found hypoxic, who received 4.0 mg of intranasal naloxone, and quickly began respirating well. He remained unconscious for 20 min, and upon awakening, experienced withdrawal symptoms, agitation and confusion, and exposed himself to considerable physical danger by entering a local roadway. The second is a 28-year-old man who primarily uses stimulants, who overdosed while trying "China White". His oxygen saturation improved from 81 to 100% with supplemental oxygen and field management, and he did not require naloxone administration. He recovered consciousness after 40 min. The third patient is a 36-year-old male who was found down, saturating at 20%, who received 0.4 mg intramuscular naloxone, was placed in recovery position, and remained unconscious for 12 min before making a complete recovery. The first and third patients provided urine and drug samples that tested positive for xylazine and fentanyl. Conclusions: We describe insights about the clinical management of combined xylazine-fentanyl involved overdoses in the field, from a community harm reduction context where xylazine arrived suddenly spurring a large number of overdoses. In response to the long period of post-naloxone sedation inherent to xylazine overdoses, the clinical team learned to center oxygenation—not consciousness—as the key parameter of interest for the titration of naloxone, increase emphasis on field airway management, portable oxygen administration, and scene safety, and employ xylazine testing strips for urine and direct substance analysis to educate the patient population about health risks. [ABSTRACT FROM AUTHOR]

Over the past century, colorectal cancer (CRC) has become one of the most devastating cancers impacting the human population. To gain a deeper understanding of the molecular mechanisms driving this solid tumor, researchers have increasingly turned their attention to the tumor microenvironment (TME). Spatial transcriptomics and proteomics have emerged as a particularly powerful technology for deciphering the complexity of CRC tumors, given that the TME and its spatial organization are critical determinants of disease progression and treatment response. Spatial transcriptomics enables high-resolution mapping of the whole transcriptome. While spatial proteomics maps protein expression and function across tissue sections. Together, they provide a detailed view of the molecular landscape and cellular interactions within the TME. In this review, we delve into recent advances in spatial biology technologies applied to CRC research, highlighting both the methodologies and the challenges associated with their use, such as the substantial tissue heterogeneity characteristic of CRC. We also discuss the limitations of current approaches and the need for novel computational tools to manage and interpret these complex datasets. To conclude, we emphasize the importance of further developing and integrating spatial transcriptomics into CRC precision medicine strategies to enhance therapeutic targeting and improve patient outcomes. [ABSTRACT FROM AUTHOR]

This article presents the first systematic review and meta-analysis of the prevalence and correlates of different forms of intimate partner violence (IPV) among women and men in Mexico. To identify studies, a comprehensive search strategy was developed and executed across 11 databases (Academic Search Complete, APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, International Bibliography of the Social Sciences, LILACS, MEDLINE, SciELO, Sociological Abstracts, Web of Science). From the 1,746 studies screened, 155 full-text articles were reviewed, and this systematic review included 27 studies involving 249,557 participants to determine the prevalence of physical, psychological, sexual, threats, and other forms of IPV, according to gender and other sociodemographic characteristics. Overall IPV prevalence was 16.4%, with significant differences across pregnant and non-pregnant women. Physical IPV prevalence was 14.7%, revealing higher rates in men (29.5%) compared to women (14.2%). Psychological IPV prevalence was 27.3% and sexual IPV was at 6.6%, with differences across evaluation periods. Threats and other IPV forms showed a prevalence rate of 14.2% and 21.5%. Meta-regression analyses included gender, education, marital status, rural residency, pregnancy, age, and evaluation period. This study demonstrates that IPV is a critical public health concern in Mexico, impacting both women and men. It shows the vulnerability of rural residents, youth, and pregnant women. However, understanding IPV complexities in Mexico requires nuanced considerations of demographic and situational contexts. Urgent initiatives from municipal, state, and federal governments are needed to combat IPV, focusing on prevention and support for affected individuals. [ABSTRACT FROM AUTHOR]

Critical analysis of studies with high level of evidence has relied on the significance set by the reported P values. However, this strategy steers readers toward categorical interpretation of the data; therefore, a more comprehensive approach of data analysis is warranted. The continuous fragility index (CFI) allows for frailty interpretation of any given study's continuous outcome results.To calculate the CFI of high-level quality studies reporting significant continuous outcomes on comparison of treatment modalities for management of femoroacetabular impingement syndrome.Meta-analysis; Level of evidence, 2.Three databases (PubMed, Embase, Cochrane) were queried from inception to February 2024 utilizing Boolean operators to combine variations of the following search terms: “femoroacetabular impingement, randomized controlled trials or prospective cohort.” Studies were included if level of evidence 1 or 2, and a statistically significant outcome was reported for any continuous outcome. CFI calculation was performed for all significant outcomes to obtain a study-specific mean CFI and also for the primary outcome of each study. Mean CFI was also calculated for outcomes reported to be significant in >3 studies. Additionally, multivariable linear regression was utilized for assessment of variables associated with achievement of a higher CFI.Thirteen studies totaling 1316 patients were included for analysis: 11 level of evidence 1 and 2 level of evidence 2 studies. A total of 48 outcomes reaching significance were extracted, with 8 representing primary outcomes. Study-specific mean (SD) CFI was 8 (9.3), whereas primary outcome mean CFI was 12.5 (12). In 4 of the 13 studies, the number of hips lost to follow-up was greater than the study CFI. Outcome-specific mean CFI was obtained for 5 outcomes reported in >3 studies. Multivariable linear regression revealed that larger sample size and greater journal impact factor had a significant positive association with a higher overall CFI value (P < .05).The mean (SD) number of patient outcome events needed to reverse the significance of a continuous outcome (ie, CFI) was 8.0 (9.3). Nearly one-third of studies had a CFI less than the reported loss to follow-up, reflecting the need for better patient compliance to attain less fragile statistical results. Larger sample size and greater journal impact factor were both predictive of a higher CFI. [ABSTRACT FROM AUTHOR]

In the present study, the nematicidal and fungicidal activity of the biosurfactant (BS) produced by the strain Serratia ureilytica UTS was evaluated. The highest mortality of J2 juveniles of the nematode Nacobbus aberrans was 92.3% at a concentration of 30 mg/mL. Among the phytopathogenic fungi, the concentration of 1.0% of the crude extract of the biosurfactant was the one that obtained the highest percentage inhibition against the phytopathogens Fusarium oxysporum 72.2%, Fusarium sp., 80.2% and Alternaria solani 100% at 168 h of incubation. Analysis of the BS by GC-MS revealed the presence of the three amino acids alanine, homocystine and valine in its composition. As well as the presence of fatty acids: stearic acid, lauric acid and palmitic acid. With nuclear magnetic resonance (NMR) and mass spectrophotometry (MS) analysis, the crude extract was found to have the structure of a quaternary ammonium salt derived from stearic fatty acid, which is a component of the biosurfactant. Based on this evidence, it is suggested that the BS produced by S. ureilytica has a lipopeptide-like chemical structure and possesses nematicidal and fungicidal activity, and is therefore proposed for potential use and application as a biopesticide for the benefit of regenerative and sustainable agriculture., Competing Interests: Declarations. Conflict of interests: On behalf of all authors, the corresponding author states that there is no conflict of interest., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)