Search

Economic inequality is associated with preferences for smaller, immediate gains over larger, delayed ones. Such temporal discounting may feed into rising global inequality, yet it is unclear whether it is a function of choice preferences or norms, or rather the absence of sufficient resources for immediate needs. It is also not clear whether these reflect true differences in choice patterns between income groups. We tested temporal discounting and five intertemporal choice anomalies using local currencies and value standards in 61 countries (N = 13,629). Across a diverse sample, we found consistent, robust rates of choice anomalies. Lower-income groups were not significantly different, but economic inequality and broader financial circumstances were clearly correlated with population choice patterns. Ruggeri et al. find in a study of 61 countries that temporal discounting patterns are globally generalizable. Worse financial environments, greater inequality and high inflation are associated with extreme or inconsistent long-term decisions.

Introduction Femoral neck fractures in the young patient present a unique challenge. Most surgeons managing these injuries prefer a fixed angle implant, however these devices are fraught with problems. A dynamic hip screw (DHS) is one such fixed angle device that risks malreduction through rotational torque during screw insertion. To avoid this risk some surgeons utilize a dynamic helical hip system (DHHS), however little is known about the complication profile of this device. We hypothesized that the complication rate between these two devices would be similar. Patients and Methods All patients presenting to a single tertiary referral center with a femoral neck fracture were identified from a prospectively collected trauma database over an 11-year period. Patients were included if they were less than 60 years of age, treated with a DHS or DHHS, and had at least 6 months of follow-up. Demographic data, injury characteristics, and post-operative complications were obtained through chart review. Standard statistical comparisons were made between groups. A total of 77 patients met inclusion criteria. Results Average age of patients was 38 years (range: 18–59) and 56 (73%) were male. The DHS was used in 37 (48%) patients and the DHHS was used in 40 (52%) patients. Demographic data including average age, gender, body mass index, and smoking status did not differ between the groups. There were 29 (39%) total complications of interest (femoral neck shortening >5 mm, non-union requiring osteotomy, conversion to THA, and osteonecrosis. There were 19 (51%) complications in the DHS group and 10 (25%) in the DHHS group (p = 0.01, risk difference 25%, 95% CI 7–43). Comparisons of the individual complications about the DHS and DHHS cohort did not reach statistical significance for non-union (8% vs 3%) or THA (16% vs 13%) (p = 0.33, p = 0.64, respectively) but a difference was detected in the rate of shortening (27% vs 10%; p = 0.05). Conclusion This study demonstrates a high risk of complication when managing young femoral neck fractures in line with prior literature. The major complication rate of non-union requiring osteotomy or fixation failure resulting in THA was no different between the two groups, but the rate of shortening was greater the DHS group. This data suggests the DHHS may be a suitable device to manage the young femoral neck fracture and without increased risk of complication.

Healthcare logistics play an important role in management, being attributed the activities of acquisition, distribution and movement of materials, professionals and patients. This work aims to develop a study, using the healthcare logistics in the movement of patients in the third health region of Paraná, proposing a linear programming problem that will pass through a computational simulation, considering the existing demands and constraints in the system, aiming to optimize the flow of patients from this region. The present study developed four mathematical models, based on demands and constraints followed by linear programming in order to find the best possible solution for the flow of patients from the third health region of the state of Paraná. The study developed reached its goal of optimization, generating an economy in the transportation of patients. Through the analysis of the results, it is concluded that the model that best suits the presented problem is the one of costs minimization, since the one of vehicles presented higher costs. Possibly the model that minimizes the vehicles would bring better results if the vehicles were not outsourced, but of the Ponta Grossa City Hall (PMPG). Was possible to verify the importance of the theme, especially when referring to the flow of patients in the health services due to the lack of studies with this specific approach. Even with the scarcity of data, it is possible to notice the potential for improvements on this patient transport system.

PurposeThis study analyses the sequence of actions carried out by successful enterprises in the agricultural sector and aims to understand the logic followed with such actions and the differences related to the types of families that develop them.Design/methodology/approachThrough a multiple case study approach, the business and family trajectories of 14 successful agricultural enterprises in Mexico were analysed. The actions carried out by enterprises are conceptualized as strategic movements and are classified into seven categories: (1) growth and intensification, (2) reconversion, (3) diversification, (4) integration, (5) differentiation, (6) outsourcing and (7) digitization. Depending on their relationship with agriculture, entrepreneurial families are classified into three categories: (1) continuing families, (2) returning families and (3) incoming families.FindingsThe entrepreneurship logic follows three stages: evaluation, expansion and consolidation, through which different activities are tested, then the one that produces the best results is expanded and adopted as the main activity, and finally the expansion of the main activity and its evaluation are combined by comparing and complementing it with other agricultural activities. The difference is that continuing families adhere more to the traditional productivist model based on growth in scale and improved productivity of primary production. On the other hand, actions that imply a distinction in the quality of production such as integration and differentiation and that require links with other organizations such as outsourcing are more frequently carried out by returning and incoming families.Research limitations/implicationsThe findings obtained through case studies cannot be statistically generalized to a specific population, however, our perspective can be transferred to other cases to obtain analogous findings.Originality/valueThe study is a unique piece in terms of the analysis of how families with different degrees of proximity to agriculture develop successful enterprises.

This paper presents the development and evaluation of an in-class intervention based on persona cards, an accessibility kit created to introduce users with diverse needs to postsecondary students and motivate them to adopt accessibility guidelines. The cards created include 16 profiles of users with visual, hearing, motor, cognitive, and multiple impairments. To assess the effect of the intervention on the students’ knowledge about accessibility, five in-class interventions with 134 students were conducted in the USA and in Spain. The intervention aimed at encouraging the discussion about how future designers can make interactive solutions more accessible for users with diverse needs. To assess the acceptability of the intervention materials among instructors, an online survey was utilized, and 30 respondents rated the usefulness, impact, ease of use, and their willingness to adopt the cards. They also provided suggestions to facilitate adoption. The statistical analysis of the results using Mann–Whitney tests indicates that the usage of personas during the intervention had a positive effect, improving the students’ understanding about accessibility. Instructors who responded to the survey considered the persona cards to be easy to use, diverse, and useful. The intervention increased the students’ interest and motivation to apply accessibility principles in their work practices and employ universal design in their lives. Also, instructors reported a positive acceptance regarding the adoption of the cards in their technology-related courses.

Introduction Spinal cord stimulation (SCS) is a commonly utilized therapy for the treatment of neuropathic pain conditions. The Neurostimulation Appropriateness Consensus Committee (NACC) has recommended that the placement of percutaneous SCS leads be performed in an awake patient capable of providing feedback. It is not currently known how commonly this recommendation is adhered to by physicians in clinical practice. This article presents the findings of a survey designed to answer this important question. Methods We conducted a survey of the active membership of the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the Spine Intervention Society (SIS) regarding practice patterns with SCS therapy. We analyzed the percent of respondents who indicated that they use deep sedation and general anesthesia during SCS placement as well as any reported complications. Results Many practitioners frequently utilize deep sedation as well as general anesthesia when performing SCS implants. Our findings demonstrate that 77% of physicians reported that they utilize deep sedation for permanent SCS implants at times, and 45% of physicians reported the use of general anesthesia for 10 kHz implants. Additionally, 94% of physicians reported that they have never had a complication related to the use of general anesthesia for a spinal cord stimulator placement. Conclusions This survey provides initial data on SCS practices among a large cohort of clinicians who utilize SCS. SCS lead placement under deep sedation and general anesthesia appears to be common practice for many physicians who perform implants. This survey should stimulate further research on this topic, given that the current safety guidelines and the rate of physicians reporting the use of deep sedation and general anesthesia for spinal cord stimulator placement remain at odds.

Volatility proxies like Realised Volatility (RV) are extensively used to assess the forecasts of squared financial return produced by Autoregressive Conditional Heteroscedasticity (ARCH) models. But are volatility proxies identified as expectations of the squared return? If not, then the results of these comparisons can be misleading, even if the proxy is unbiased. Here, a tripartite distinction between strong, semi-strong and weak identification of a volatility proxy as an expectation of squared return is introduced. The definition implies that semi-strong and weak identification can be studied and corrected for via a multiplicative transformation. Well-known tests can be used to check for identification and bias, and Monte Carlo simulations show they are well-sized and powerful -- even in fairly small samples. As an illustration, twelve volatility proxies used in three seminal studies are revisited. Half of the proxies do not satisfy either semi-strong or weak identification, but their corrected transformations do. Correcting for identification does not always reduce the bias of the proxy, so there is a tradeoff between the choice of correction and the resulting bias.

Background. The influence of HLA class I and II loci on the susceptibility to melanoma remains an area of intense debate. This study aimed to examine whether the HLA system was related to melanoma susceptibility and prognosis in a southern Spanish population. Methods. In this study, HLA class I and class II genotyping were performed using polymerase chain reaction sequence-specific oligonucleotides (PCR-SSO) in 237 Spanish melanoma patients and 636 ethnically matched controls. Data were analyzed according to the clinical characteristics of the defined subgroups. Results. Compared to the control group, DRB1 ∗ 16:01 (4% vs. 1.3%, p = 0.001 , Pc = 0.035, OR = 3.28) and DQB1 ∗ 05:02 (4.9% vs. 2%, p = 0.001 , Pc = 0.017, OR = 2.54) were positivity associated with the susceptibility to melanoma. Both DRB1 ∗ 16:01 (5.4% vs. 1.3%, p = 0.001 , Pc = 0.035, OR = 4.46) and DQB1 ∗ 05:02 (6.5% vs. 2%, p = 0.001 , Pc = 0.017, OR = 3.44) also showed a positive correlation with Breslow thickness >1.5 mm, most notably at an early age of diagnosis (≤58 years), DRB1 ∗ 16:01 (4.2% vs. 1.3%, p = 0.001 , Pc = 0.035, OR = 3.41) and DQB1 ∗ 05:02 (5.4% vs. 2%, p = 0.002 , Pc = 0.034, OR = 2.86). Conclusion. These findings established HLA-DRB1 ∗ 16:01 and HLA-DQB1 ∗ 05:02 loci as melanoma risk factors in the southern Spanish population.

Cerebral oedema develops after anoxic brain injury. In two models of asphyxial and asystolic cardiac arrest without resuscitation, we found that oedema develops shortly after anoxia secondary to terminal depolarizations and the abnormal entry of CSF. Oedema severity correlated with the availability of CSF with the age-dependent increase in CSF volume worsening the severity of oedema. Oedema was identified primarily in brain regions bordering CSF compartments in mice and humans. The degree of ex vivo tissue swelling was predicted by an osmotic model suggesting that anoxic brain tissue possesses a high intrinsic osmotic potential. This osmotic process was temperature-dependent, proposing an additional mechanism for the beneficial effect of therapeutic hypothermia. These observations show that CSF is a primary source of oedema fluid in anoxic brain. This novel insight offers a mechanistic basis for the future development of alternative strategies to prevent cerebral oedema formation after cardiac arrest.

VLCD (dieta de muito baixa caloria) são definidas como dietas de baixa caloria que fornecem entre 450 a 800 kcal por dia e, dada a relevância do VLCD no contexto da obesidade, este estudo realizou uma análise comparativa de pacientes que usaram a dieta VLCD (Dietkcal®) antes e após um período de dois meses, sobre seus parâmetros antropométricos. Trata-se de um estudo descritivo, retrospectivo, quantitativo, com utilização do método de pesquisa documental. Os resultados mostraram que uma perda de peso média correspondente a 7,4 kg pode ser observada no período de dois meses, apresentando significância estatística entre os pesos inicial e final. Em relação aos valores obtidos a partir do percentual de gordura, observamos uma perda total estatisticamente significante de 4,53% no período de dois meses. Em relação à diferença apresentada na circunferência da cintura dos pacientes, observou-se diminuição de 2,5 cm no total de dois meses, o que é estatisticamente significativo. O presente estudo contribui trazendo resultados em que uma dieta VLCD pode resultar em perda acentuada de peso, podendo favorecer o perfil metabólico dos pacientes, como a diminuição do percentual de gordura corporal e circunferência da cintura, uma melhora na saúde e qualidade de vida desses pacientes também pode ser destacada.

Agribusiness firms, with an eye toward increasing population and evolving weather patterns, are investing heavily into developing new varieties of staple crops that can provide higher yields and are robust to weather fluctuations. In this paper, we describe a multiyear effort at Dow Agrosciences (now Corteva) to manage its seed corn portfolio, which includes several hundred seeds and is valued at more than $1 billion. The effort had two mutually interacting parts: (1) developing a decision-analytic theory to estimate the production yield distributions for new seed varieties from discrete quantile judgments provided by plant biology experts and (2) developing an optimization protocol to determine Dow's annual production plan for the seed portfolio with the flexibility of backup production in South America, under production yield uncertainty. The first part, owned by the research and development (R&D) function, provides yield probability distributions as inputs to the optimization protocol of the second part, which the production function owns. The results of the optimization problem, which include information about the attractiveness of specific future varieties, are returned to R&D. Both parts incorporate contextual details specific to this industry. In this paper, we show the optimality of linear policies for both problems. Additionally, the linear policies have many attractive structural properties that continue to hold for the more complex instances of the problems. A major strength of the theory we developed is that it is implementable in a transparent fashion, providing managers with a user-friendly, real-time decision support tool. The implementation of the theory developed has led to significant monetary and managerial benefits at Dow.

Acute Lymphoblastic Leukemia (ALL) is the most frequent cancer in pediatric population. Although the treatment has improved and almost 85% of the children are cured about 20% suffer relapse, therefore finding molecules that participate in the pathogenesis of the disease for the identification of relapse and patients at risk is an urgent unmet need. Class I myosins are molecular motors involved in membrane tension, endocytosis, phagocytosis and cell migration and recently they have been shown important for development and aggressiveness of diverse cancer types, however Myo1g an hematopoietic specific myosin has not been studied in cancer so far. We evaluated the expression of Myo1g by qRT-PCR, Immunocytochemistry and Immunofluorescence in a cohort of 133 ALL patients and correlated the expression at diagnosis and after treatment with clinical features and treatment outcomes. We found high expression levels of Myo1g in Peripheral Blood Mononuclear Cells (PBMCs) from patients with ALL at diagnosis and those levels decreased after complete remission; furthermore, we found an increase in Myo1g expression on patients with 9:22 translocation and those who relapse. This study show that Myo1g is over expressed in ALL and that may participate in the pathogenesis of the disease specially in high-risk patients.

Aim: We aimed to verify the frequency of CD8+ T cell subsets in patients with acute form and chronic form of paracoccidioidomycosis. Material & Methods: Mononuclear cells from paracoccidioidomycosis patients and healthy donors were isolated and phenotyped by flow cytometry. Dendritic cells were pulsed with Paracoccidioides brasiliensis yeast and co-cultures with lymphocytes. Cytokine production was measured by ELISA. Results: Acute form patients present a higher frequency of Tc1 and Tc10 cells, while chronic form patients have more Tc1 and Tc21 cells, compared with healthy controls. In vitro assays showed that P. brasiliensis induced polarization to the Tc17/Tc22 subsets. Conclusion: Our results suggest that CD8+ T cells can respond in a similar way to P. brasiliensis infection, regardless of the clinical presentation of the disease.

With a relatively high energy density, hydrogen is attracting increasing attention in research, commercial and political spheres, specifically as a fuel for residential heating, which is proving to be a difficult sector to decarbonise in some circumstances. Hydrogen production is dependent on the power system so any scale use of hydrogen for residential heating will impact various aspects of the power system, including electricity prices and renewable generation curtailment (i.e. wind, solar). Using a linearised optimal power flow model and the power infrastructure on the island of Ireland this paper examines least cost optimal investment in electrolysers in the presence of Ireland's 70% renewable electricity target by 2030. The introduction of electrolysers in the power system leads to an increase in emissions from power generation, which is inconsistent with some definitions of green hydrogen. Electricity prices are marginally higher with electrolysers whereas the optimal location of electrolysers is driven by a combination of residential heating demand and potential surplus power supplies at electricity nodes.

This systematic review and meta-analysis aimed to determine the effectiveness of brentuximab vedotin (BV) in relapsed/refractory classical Hodgkin lymphoma (R/R cHL) in the clinical practice setting using most recent results. A total of 32 observational studies reporting on treatment patterns, overall response rate (ORR), complete response (CR) rate, progression-free survival (PFS), overall survival (OS), and adverse events were found. After four cycles, a random-effect model yielded pooled ORR and CR rates of 62.6% (95% confidence interval (CI): 56.0-68.9; I-2 = 9.7%) and 32.9% (95% CI, 20.8-46.3, I-2 = 64.8%), respectively. Regarding survival, 1-year, 2-year, and 5-year PFS ranged from 52.1% to 63.2%, 45.2% to 56.2%, and 31.9% to 33.0%, respectively. OS rates were 68.2-82.7%, 58.0-81.9%, and 58.0-62.0%, respectively. Most common adverse events were hematological toxicities (neutropenia: 13.3-23%, anemia: 8.8-39.0%, and thrombocytopenia: 4-4.6%), and grade >= 3 peripheral neuropathy (3.3-7.3%). This study supports the effectiveness and safety of BV in R/R cHL patients in the real-world setting.

Background Extensive malaria control measures have been implemented on Bioko Island, Equatorial Guinea over the past 16 years, reducing parasite prevalence and malaria-related morbidity and mortality, but without achieving elimination. Malaria vaccines offer hope for reducing the burden to zero. Three phase 1/2 studies have been conducted successfully on Bioko Island to evaluate the safety and efficacy of whole Plasmodium falciparum (Pf) sporozoite (SPZ) malaria vaccines. A large, pivotal trial of the safety and efficacy of the radiation-attenuated Sanaria® PfSPZ Vaccine against P. falciparum is planned for 2022. This study assessed the incidence of malaria at the phase 3 study site and characterized the influence of socio-demographic factors on the burden of malaria to guide trial design. Methods A cohort of 240 randomly selected individuals aged 6 months to 45 years from selected areas of North Bioko Province, Bioko Island, was followed for 24 weeks after clearance of parasitaemia. Assessment of clinical presentation consistent with malaria and thick blood smears were performed every 2 weeks. Incidence of first and multiple malaria infections per person-time of follow-up was estimated, compared between age groups, and examined for associated socio-demographic risk factors. Results There were 58 malaria infection episodes observed during the follow up period, including 47 first and 11 repeat infections. The incidence of malaria was 0.25 [95% CI (0.19, 0.32)] and of first malaria was 0.23 [95% CI (0.17, 0.30)] per person per 24 weeks (0.22 in 6–59-month-olds, 0.26 in 5–17-year-olds, 0.20 in 18–45-year-olds). Incidence of first malaria with symptoms was 0.13 [95% CI (0.09, 0.19)] per person per 24 weeks (0.16 in 6–59-month-olds, 0.10 in 5–17-year-olds, 0.11 in 18–45-year-olds). Multivariate assessment showed that study area, gender, malaria positivity at screening, and household socioeconomic status independently predicted the observed incidence of malaria. Conclusion Despite intensive malaria control efforts on Bioko Island, local transmission remains and is spread evenly throughout age groups. These incidence rates indicate moderate malaria transmission which may be sufficient to support future larger trials of PfSPZ Vaccine. The long-term goal is to conduct mass vaccination programmes to halt transmission and eliminate P. falciparum malaria.

PurposeLittle is known regarding triggers in the adoption of governance practices within family businesses. Enterprises can implement governance practices to avoid re-arising conflicts lived in the past. Moreover, the type of conflicts experienced can determine the order in which different types of governance practices are adopted, another issue that requires further investigation. To address these knowledge gaps, this study gathers evidence into how the adoption of governance practices is linked to the conflicts experienced in family businesses and how this adoption evolves.Design/methodology/approachA multiple case study was conducted with 15 family businesses in the agricultural sector. The conflicts experienced throughout the enterprises' trajectories and the governance practices adopted were analysed and classified according to their relationship with the family, business and ownership subsystems.FindingsThe study shows that there is no direct link between the conflicts experienced and the governance practices adopted in family businesses. The most recurrent conflicts have to do with the relationship between family and ownership; however, the adoption of governance practices is centred on the relationship between business and ownership. The practices that mediate the relationship between family and business are adopted second, and the practices that mediate the relationship between family and ownership are adopted last.Originality/valueThe study applies a classification of conflicts and governance practices that adjusts to the complexity of the family business. The research contributes to the field by providing an understanding of the integration of knowledge about the family business, governance systems and conflict.

To address diverse interaction needs of heterogeneous users' groups, user interfaces must be flexible to accommodate for customization that are specific to each user profile. Although, existing web interfaces provide some flexibility, some problems still remain: a) manual adjustments carried out by end users are required for each web application; b) the flexibility provided by current web interfaces is insufficient to address diverse interaction needs of various users' profiles and c) few users are aware about such options to customize the presentation of web interfaces. To contribute to the customization of user interface according to the needs of diverse users, in this work we asses the suitability of a tool that customize web interfaces based on the needs and preferences of end users. UIFlex is a web-based browser plugin that enables users to define their interaction profile. In this task, users are supported by fifteen web-based design rules that were extracted from the literature and the knowledge of authorities. To customize the presentation of web interfaces, UIFlex relies on a set of rules defined for each individual user and "injects" JavaScript codes, Cascading Style Sheets (CSS) and in some cases HyperText Markup Language (HTML) codes in any page that follows W3C standards. UIFlex was evaluated by 104 users of diverse interaction profiles. The results obtained are promising and suggest that the solution improves the perception that the interactive system performs as desired by users.

Recurrent pericarditis affects 15-30% of patients after acute pericarditis. A large number of the patients with recurrent pericarditis can become corticosteroid dependent, leading to disease chronicity and drug dependence, with additional morbidity from long-term steroid use. Recent randomized trials indicate the efficacy of the interleukin-1 inhibitors anakinra and rilonacept in recurrent pericarditis, including colchicine-resistant and corticosteroid-dependent cases. In particular, rilonacept was assessed in the RHAPSODY clinical trial and found to be a potential treatment option that would decrease recurrent episodes, enabling patients to be weaned off steroids. Additionally, new data indicate that rilonacept should be considered as an option for patients with recurrent pericarditis, as add-on therapy to colchicine and nonsteroidal anti-inflammatory drugs, in place of steroids. We review the current management options for recurrent pericarditis as well as rilonacept as a prospective new addition to our armamentarium.

Introduction: Multiple sclerosis (MS) is a chronic, demyelinating, autoimmune disease of the central nervous system causing neuroinflammation. Experimental autoimmune encephalitis (EAE) is a model of the disease. MS is classically treated with interferon beta (IFN-β) and glatiramer acetate (GA). Melatonin (MLT) has been reported to modulate immune system responses. The aim of the present study is to analyse the effects of MLT administration in comparison with the first-line treatments for MS (IFN-β and GA). Methods: EAE was induced in male Sprague-Dawley rats; the animals subsequently received either IFN-β, GA, or MLT. Cerebrospinal fluid (CSF) samples were analysed by multiplex assay to determine the levels of proinflammatory cytokines. The neurological evaluation of EAE was also recorded. Results: All immunised animals developed EAE. We evaluated the first relapse-remission cycle, observing that IFN-β and GA had better results than MLT in the clinical evaluation. Neither EAE nor any of the treatments administered modified CSF IL-1β and IL-12p70 concentrations. However, IFN-β and MLT did decrease CSF TNF-α concentrations. Conclusion: Further studies are needed to evaluate the molecular mechanisms involved in the behaviour of MLT in EAE, and to quantify other cytokines in different biological media in order for MLT to be considered an anti-inflammatory agent capable of regulating MS. Resumen: Introducción: La esclerosis múltiple (EM) es una enfermedad crónica desmielinizante autoinmune del sistema nervioso central (SNC) que produce neuroinflamación, un modelo es la encefalitis autoinmune experimental (EAE). La EM ha sido tratada con interferón beta (IFN-beta) y acetato de glatiramero (AG). Se ha descrito que la melatonina (MLT) modula la respuesta del sistema inmune. El objetivo de este estudio fue observar el efecto de la administración de melatonina contra los tratamientos de primera línea utilizados en la EM (IFN-β y AG). Métodos: A ratas macho Sprague Dawley se les indujo EAE y se administraron IFN-β, AG o MLT. Se colectó líquido cefalorraquídeo y se midieron citocinas proinflamatorias por multiplex, además del registro de la evaluación neurológica de la EAE. Resultados: Todos los animales inmunizados establecieron la EAE. Se evaluó el primer ciclo de recaída-remisión, observando que IFN-β y AG tienen mejores resultados que MLT en la evaluación clínica. La concentración en el LCR tanto de IL-1β e IL-12p70 no se vio modificada por el modelo o por los tratamientos administrados. EL TNF-α se vio disminuido en el LCR por el IFN-β y MLT bajo el modelo de MS. Conclusiones: Es necesario realizar estudios posteriores para evaluar los mecanismos moleculares involucrados en el comportamiento de la MLT en la EAE, así como la cuantificación de otras citocinas en diferentes matrices biológicas para poder considerar a la MLT como un agente antiinflamatorio regulador de la EM.

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, constituting 80% of all acute leukemias in minors. Despite the increase in the success of therapies, disease-free survival is over 80% in most cases. For the remaining 20% of patients, new strategies are needed to allow us to know and select those at greatest risk of relapse. We evaluated by immunohistochemistry the expression of the transcription factor YY1 and found that it is overexpressed in peripheral blood leukemia cells of pediatric patients with ALL with Pro-B and T phenotype compared to control samples. Over expression of YY1 was associated with a significantly lower chance of survival. We also evaluated by RT-PCR in bone marrow samples from ALL pediatric patients the association of YY1 expression with the percentage of blasts. High levels of YY1 were present in samples with higher percent of blasts in these patients. In addition, ALL pediatric patients with a poor response to therapy had higher levels at the nuclear level of YY1 than those who responded well to chemotherapy. In conclusion, our data suggest that YY1 could serve in pediatric ALL as markers of evolution and response for this disease, mainly in patients with pro-B and T immunophenotype. It is also suggested that YY1 is implicated in the expanse of blast in these patients.

This study compares outcomes of patients admitted for atrial fibrillation (AF) with and without coexisting systemic lupus erythematosus (SLE). The primary outcome was inpatient mortality. Hospital length of stay (LOS), total hospital charges, odds of undergoing ablation, pharmacologic cardioversion and electrical cardioversion were secondary outcomes of interest. Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 database. The NIS was searched for adult hospitalizations with AF as principal diagnosis with and without SLE as secondary diagnosis using International Classification of Diseases, Tenth Revision, Clinical Modification codes. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. There were over 71 million discharges included in the combined 2016 and 2017 NIS database. 821,630 hospitalizations were for adult patients, who had a principal diagnosis of AF, out of which, 2645 (0.3%) had SLE as secondary diagnosis. Hospitalizations for AF with SLE had similar inpatient mortality (1.5% vs 0.91%, adjusted OR (AOR): 1.0, 95% CI 0.47 to 2.14, p=0.991), LOS (4.2 vs 3.4 days, p=0.525), total hospital charges ($51,351 vs $39,121, p=0.056), odds of undergoing pharmacologic cardioversion (0.38% vs 0.38%, AOR: 0.90, 95% CI 0.22 to 3.69, p=0.880) and electrical cardioversion (12.9% vs 17.5%, AOR 0.87, 95% CI 0.66 to 1.15, p=0.324) compared with those without SLE. However, SLE group had increased odds of undergoing ablation (6.8% vs 4.2%, AOR: 1.9, 95% CI 1.3 to 2.7, p

El estudio se basa en los resultados del análisis acerca del servicio al cliente, la gestión por procesos y la comunicación interna; igualmente, en los conocimientos y resultados obtenidos que contribuyen a mejorar la información, formas de transmitirlos y los niveles organizacionales: inferior y jerárquico en la gestión de procesos; y, asimismo, en el conocimiento de la aplicación del proceso de investigación científica en tal problemática. El objetivo general es determinar cómo influye la comunicación interna y la gestión por procesos en el servicio al cliente en la empresa Nick Manager Solutions SAC, distrito de San Miguel, 2020. La muestra fue de 90 personas (45 clientes y 45 trabajadores). Los principales resultados fueron que los valores Ji cuadrado 25,160 y p=0,000 < α, los cuales indican que la variable servicio al cliente depende de las variables comunicación interna y gestión de procesos, es decir, las variables no son autónomas, por lo que existe sumisión de una variables en las otras. Se concluye que existe influencia positiva entre la comunicación interna y la gestión por procesos en el servicio al cliente, pues el valor de R2, es de 0,788, es decir el modelo explica en un 78,8% a la variable real.

An organizational business strategy's primary purpose is to achieve good financial performance, commitment to customer satisfaction, and competitive business performance to sustain the enterprise's profitability and business continuity effectively. This study aims to determine the strategic management system components in predicting financial performance, commitment to customer satisfaction, and competitive business performance. The method used was the descriptive quantitative type of research employing the structured survey questionnaire to apply the Likert Scale. To the study's answer, survey questionnaires were distributed to the respondents, namely business owners, CEOs, managers, engineers, working professionals, and rated them using the Likert Scale. They were asked to rate the following independent variables as planning, risk analyzing, organizing, performing, evaluating, realigning related to the strategic management system for financial performance and commitment to customer satisfaction competitive business performance. Based on the result and findings, the effect of the variables performing, evaluating, and realigning financial performance is significant: F=86.338; (p=0.001, 0.005, and 0.001). Therefore, the strategic management system components, namely performing, evaluating, and realigning, are useful predictors of financial performance. The influence of the variables planning, evaluating, and realigning on the commitment to customer satisfaction is significant, and these are F=76.308; (p=0.001, 0.025, 0.000) respectively. It can be concluded that the strategic management system components, namely planning, evaluating, and realigning, are useful predictors of commitment to customer satisfaction. The four combinations of independent variables, namely risk analyzing, organizing, performing, and evaluating competitive, are significant to competitive business performance: F= 94.82: (p= 0.000, 0.001, 0.001, 0.000). The four variables account for 84%, which indicates high accuracy prediction from the four variables. Finally, strategic management system components, namely, planning, risk analyzing, organizing, performing, evaluating, and realigning, can effectively predict financial performance, commitment to customer satisfaction, and competitive business performance. Therefore, it is recommended to use the PROPER strategy components by all business owners and practitioners to effectively execute their operations and activities on whatever business model or venture they wanted to start by creating appropriate policies and procedures to ensure its business continuity, profitability, sustainability, and growth.

Trazodone (TRZ) is a commonly prescribed antidepressant with significant off-label use for insomnia. A recent drug screening revealed that TRZ interferes with sterol biosynthesis, causing elevated levels of sterol precursor 7-dehydrocholesterol (7-DHC). Recognizing the well-documented, disruptive effect of 7-DHC on brain development, we designed a study to analyze TRZ effects during pregnancy. Utilizing an in vivo model and human biomaterial, our studies were designed to also account for drug interactions with maternal or offspring Dhcr7 genotype. In a maternal exposure model, we found that TRZ treatment increased 7-DHC and decreased desmosterol levels in brain tissue in newborn pups. We also observed interactions between Dhcr7 mutations and maternal TRZ exposure, giving rise to the most elevated toxic oxysterols in brains of Dhcr7+/− pups with maternal TRZ exposure, independently of the maternal Dhcr7 genotype. Therefore, TRZ use during pregnancy might be a risk factor for in utero development of a neurodevelopmental disorder, especially when the unborn child is of DHCR7+/− genotype. The effects of TRZ on 7-DHC was corroborated in human serum samples. We analyzed sterols and TRZ levels in individuals with TRZ prescriptions and found that circulating TRZ levels correlated highly with 7-DHC. The abundance of off-label use and high prescription rates of TRZ might represent a risk for the development of DHCR7 heterozygous fetuses. Thus, TRZ use during pregnancy is potentially a serious public health concern.

Plasmodium falciparum sporozoite (PfSPZ) Vaccine (radiation-attenuated, aseptic, purified, cryopreserved PfSPZ) and PfSPZ-CVac (infectious, aseptic, purified, cryopreserved PfSPZ administered to subjects taking weekly chloroquine chemoprophylaxis) have shown vaccine efficacies (VEs) of 100% against homologous controlled human malaria infection (CHMI) in nonimmune adults. Plasmodium falciparum sporozoite-CVac has never been assessed against CHMI in African vaccinees. We assessed the safety, immunogenicity, and VE against homologous CHMI of three doses of 2.7 × 106 PfSPZ of PfSPZ Vaccine at 8-week intervals and three doses of 1.0 × 105 PfSPZ of PfSPZ-CVac at 4-week intervals with each arm randomized, double-blind, placebo-controlled, and conducted in parallel. There were no differences in solicited adverse events between vaccinees and normal saline controls, or between PfSPZ Vaccine and PfSPZ-CVac recipients during the 6 days after administration of investigational product. However, from days 7–13, PfSPZ-CVac recipients had significantly more AEs, probably because of Pf parasitemia. Antibody responses were 2.9 times higher in PfSPZ Vaccine recipients than PfSPZ-CVac recipients at time of CHMI. Vaccine efficacy at a median of 14 weeks after last PfSPZ-CVac dose was 55% (8 of 13, P = 0.051) and at a median of 15 weeks after last PfSPZ Vaccine dose was 27% (5 of 15, P = 0.32). The higher VE in PfSPZ-CVac recipients of 55% with a 27-fold lower dose was likely a result of later stage parasite maturation in the liver, leading to induction of cellular immunity against a greater quantity and broader array of antigens.

In order to aid professionals in disaster management, efficient procedures and technologies are developed and adopted. This paper intends to present the results of a literature review on the use of...

Background Alcohol septal ablation (ASA) in patients with hypertrophic cardiomyopathy (HCM) can lead to heart rhythm disturbances including complete heart block (CHB) and atrial and ventricular arrhythmias. Objective We aimed to evaluate the utility of long-term arrhythmia monitoring with an implantable cardiac monitor (ICM) after ASA. Methods Between February 2014 and March 2019, 56 patients with HCM undergoing ASA were enrolled in a prospective study and underwent ICM implantation. Kaplan-Meier survival analysis was used to assess the rate of ICM-detected arrhythmic events. Results The mean age was 59 ± 11 years, and 20 (36%) were women. The median (25th, 75th percentile) resting left ventricular outflow tract gradient obtained by echocardiography was 43 (22, 81) mm Hg. Greater than 1 septal perforating artery was injected in 48 patients (86%). The Kaplan-Meier cumulative rate of ICM-detected arrhythmic events at 18 months of follow-up was 71%, with an event rate of 43% occurring within 3 months of ASA. The cumulative rate of the ICM-detected first atrial fibrillation event at 18 months was 37%, and the corresponding rate of CHB was 19%. All atrial fibrillation and CHB events were actionable, leading to the initiation of anticoagulation and pacemaker implantation, respectively. No baseline demographic or procedural variables were identified as independent predictors of an increased risk of developing ICM-detected arrhythmic events. Conclusion After ASA, ICM is effective in capturing clinically actionable arrhythmic events in patients with HCM regardless of patient's baseline risk factors.

The Philippines is one of the most hazard prone and vulnerable countries in the world to climate change effects due to its geographical location. Climate change is already happening and affecting many places causing huge problems to coastal ecosystems. Vulnerability and disaster assessment and mapping in coastal areas are essential tasks and undertakings for coastal disaster risk management. The objectives of this study were to assess the climate change vulnerability and disaster risks in the four municipalities (Sta. Cruz, Candelaria, Masinloc and Palauig) of Zambales and to determine the climate change community-based adaptation (CBA) and ecosystem-based adaptation (EBA) strategies. Remote sensing, GIS, secondary data gathering and key informant interview were used to assess vulnerability and disaster risks and mapping in the four municipalities. Survey questionnaire, focus group discussion and key informant interview were utilized in gathering data for the determination of climate change adaptation strategies. Using remote sensing technology, it was revealed that coastline changes have occurred in the shorelines of the four coastal municipalities after a decade. Sea level rise happened in Sta. Cruz and Masinloc, Zambales while there was build-up of soil in the coastline of Candelaria and Palauig, Zambales. Twelve hazard maps, 12 vulnerability maps and 12 disaster risk maps were generated for the three major disasters (flood, landslide, storm surge) in the four coastal municipalities. Based on the flood vulnerability and disaster risk assessment, the municipality of Palauig was found to be the most prone to flooding while the municipality of Candelaria was found to be the most vulnerable to landslide compared to other municipalities. All coastal barangays in the four municipalities were susceptible to storm surge. The four coastal municipalities were conducting community-based adaptation (CBA) and ecosystem-based adaptation (EBA) approaches in order to protect their coastal resources from the damaging impacts of climate change and improve the resilience of their local communities.

Chikungunya virus (CHIKV) is a global emergent arthritogenic alphavirus transmitted by anthropophilic Stegomyia mosquitoes. Chikungunya fever may evolve to chronic arthralgia in 57–80% of infected patients. This study was developed to identify possibly fast, simple low-cost biomarkers to monitor chronic CHIKV-induced articular disease. Between 2017 and 2018, we analyzed clinical data of patients meeting the criteria established by standard protocols to define chronic chikungunya articular disease. Patients were classified according to the disease activity scores, inflammatory biomarkers (erythrocyte sedimentation rate [ESR], ferritin, and C-reactive protein [CRP] serum), positive rheumatoid factor, comorbidities, smoking, and previous use of corticosteroids determined before beginning therapy. Of 106 patients, 98 (92.5%) were women with mean age of 52 ± 13 years, 6.8 ± 4.4 months of illness duration at the first medical appointment, and 6.7 ± 4.5 affected joints. Mean ESR (26 ± 19), CRP (2.6 ± 3.6), and stratified ferritin (144 ± 115) levels were normal according to reference values. There was no significance in comparing the levels of inflammatory biomarkers and the additional variables analyzed in the presence of moderate chronic joint disease in the study population. However, we identified a negative correlation between disease activity measures and duration of disease at the first medical evaluation after initial infection (P < 0.001), corroborating data observed in the literature.

High intake of omega-3 fatty acids has been associated with synaptic plasticity, neurogenesis and memory in several experimental models. To assess the efficacy of fish oil supplementation on oxidative stress markers in patients diagnosed with probable Alzheimer´s disease (AD) we conducted a double blind, randomized, placebo controlled clinical trial. AD patients who met the inclusive criteria were given fish oil (containing 0.45 g eicosapentaenoic acid and 1 g docosahexaenoic acid) or placebo daily for 12 months. Oxidative stress markers [lipoperoxides, nitric oxide catabolites levels, oxidized/reduced glutathione ratio, and membrane fluidity] and fatty acid profile in erythrocytes were assessed at enrollment, and 6 and 12 months after the start of the testing period. At the end of the trial, in patients who received fish oil, we detected a decrease in the omega 6/omega 3 ratio in erythrocyte membrane phospholipids. This change was parallel with decreases in plasma levels of lipoperoxides and nitric oxide catabolites. Conversely, the ratio of reduced to oxidized glutathione was significantly increased. In addition, membrane fluidity was increased significantly in plasma membrane samples. In conclusion fish oil administration has a beneficial effect in decreasing the levels of oxidative stress markers and improving the membrane fluidity in plasma. El alto consumo de ácidos grasos omega-3 se asocia con la plasticidad sináptica, neurogénesis y memoria en varios modelos experimentales. Para evaluar la eficacia de la suplementación con aceite de pescado en los marcadores de estrés oxidativo en pacientes con diagnóstico de la enfermedad de Alzheimer (EA) probable realizamos un ensayo clínico doble ciego, aleatorizado, controlado con placebo. A los pacientes con la EA que cumplían los criterios de inclusión se les administró aceite de pescado (que contenía 0,45 g de ácido eicosapentaenoico y 1 g de ácido docosahexaenoico) o placebo diariamente durante 12 meses. Los marcadores de estrés oxidativo plasmático [niveles de lipoperóxidos y catabolitos del óxido nítrico, cociente de glutatión reducido a glutatiónoxidado) y fluidez de la membrana] y el perfil de ácidos grasos en los eritrocitos se evaluaron al inicio, 6 meses y alos 12 meses. Al final del ensayo, en pacientes que recibieron aceite de pescado detectamos una disminución en el cociente de ácidos grasos omega 6/omega 3 en los fosfolípidos de la membrana eritrocitaria. Este cambio ocurrió en paralelo a la disminución de los niveles plasmáticos de lipoperóxidos y catabolitos del óxido nítrico. Por el contrario, el cociente de glutatión reducido a glutatión oxidado se incrementó significativamente. Además, la fluidez de la membrana aumentó significativamente en las muestras analizadas. En conclusión, la administración de aceite de pescado tiene un efecto beneficioso al disminuir los niveles de marcadores de estrés oxidativo plasmático y mejorar la fluidez de la membrana plasmática.

Prenatal insults during fetal development result in increased likelihood of developing chronic disease. Obesity, the biggest risk factor for the development of metabolic disease, is affected by several genetic and environmental factors. High-fat diet (HFD) consumption is usually linked with the development of obesity. The main goal of this study was to analyze the impact of the exposure to a HFD in prenatally stressed animals. For this purpose, we subjected pregnant BALB/c mice to restraint stress for 2 h a day between gestational day (GD) 14 and GD 21. Prenatally stressed and control offspring of both sexes were postnatally exposed to a HFD for 24 weeks. We found that prenatal stress (PS) per se produced disturbances in males such as increased total blood cholesterol and triglycerides, with a decrease in mRNA expression of sirtuin-1. When these animals were fed a HFD, we observed a rise in glucose and insulin levels and an increase in visceral adipose tissue gene expression of leptin, resistin, and interleukin-1 beta. Although females proved to be more resilient to PS consequences, when they were fed a HFD, they showed significant metabolic impairment. In addition to the changes observed in males, females also presented an increase in body weight and adiposity and a rise in cholesterol levels.

Purpose. Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD. Methods. An observational, cross-sectional, descriptive, and analytical study was conducted to evaluate patients with early PD from the Parkinsons Progression Markers Initiative. We utilized the Scales for Outcomes in Parkinsons Disease-Autonomic dysfunction questionnaire to determine the prevalence and frequencies of autonomic symptomatology. The cohort was grouped into high and low dysautonomic scores. A regression model identified variables that independently explained dysautonomic scores in our early PD cohort. Results. 414 PD patients had a mean age of 61.1 (SD 9.7) years at diagnosis and mean disease duration of 6.7 (SD 6.6) months. Among all patients, 43.7% (181/414) had high dysautonomic scores. Urinary and gastrointestinal symptoms were the most prevalent and frequently reported dysautonomic symptoms. Patients with fatigue (beta = 4.28, p < 0.001 ), probable rapid eye movement sleep behavior disorder (beta = 2.71, p < 0.001 ), excessive daytime sleepiness (beta = 1.88, p = 0.039 ), impulsivity and compulsivity (beta = 2.42, p < 0.001 ), and increasing age (beta = 1.05, p < 0.001 ) were more likely to have high dysautonomic scores. Conclusion. Lower urinary tract and gastrointestinal symptoms are prevalent and frequent in early PD patients. Fatigue, sleep disorders, impulsivity and compulsivity, and age are predictors of autonomic dysfunction. Autonomic symptoms predominated in this group of early PD patients in the disease course and were associated with more severe disease.

Aim: The aim of this study was to analyze the prognostic value of integrin subunit β1 and laminin γ1 chain in patients with cervical cancer (CC). Materials & methods: The study included 96 samples. Cytological diagnosis, human papillomavirus (HPV) genotyping, HPV integration status and integrin subunit β1 and laminin γ1 chain expressions were performed or determined using Papanicolaou smear, INNO-LiPA® Genotyping Extra Kit, in situ hybridization, and immunocytochemistry, respectively. The association between variables was calculated using chi-squared and Fisher’s exact test; logistic regression analysis was performed to calculate odds ratios and CI at 95%. Results: Our results show that integrin subunit β1 and laminin γ1 chain expressions increase according to tumor progression. Integrin subunit β1 and laminin γ1 chain expressions are associated with cytological diagnosis (p

La agricultura es la base de la alimentación, se desarrolla en suelo e hidroponía. La hidroponía se explica cómo cultivos sin suelo, en soluciones nutritivas, para el caso del tomate y del pepino es en sustrato. Los sustratos han incrementado la productividad, con uso eficiente de agua y fertilizantes. Si la agricultura consume 70% de agua y en gasto 30% es fertilizantes, el objetivo de este trabajo fue utilizar hidrogel de acrilato de potasio por su capacidad de disminuir la pérdida de fertilizantes como ser reserva de agua, permitiendo mantener la producción de tomate y pepino. La investigación se realizó en Querétaro en 2017. Se evaluó diferentes capacidades de saturación del hidrogel para sus propiedades, la mezcla de sustrato y el rendimiento de tomate y pepino, encontrando diferencias significativas.

Thispaperstudies theharmonic distortion (or non-linearity) of vertically stacked SOI nanowireswith differ-ent fin widths and channel lengths. The total harmonic distor-tion and third order harmonic distortion areused as figuresof meritin this work. The harmonicdistortion analysis is per-formed taking in consideration the differences between transis-tor’s intrinsic voltage gain and transconductance over drain current ratio. 15 1 5

This paper reports the results of a 2-year-long imagery analysis about microcephaly in Latin America from the perspective of caregivers. The content analysis included 500 images associated with the hashtag microcefalia posted on Instagram in 2017 and 2018. Microcephaly affected more than 4,000 babies in Latin America in a few years, and the quick outbreak of the epidemic made Instagram an accessible tool for caregivers to express their thoughts, feelings, raise funds and awareness, exchange information about the condition, and find peer support. Most publications are managed by the mother of female patients seeking to celebrate milestones, exchange information, and find social support. The comprehensive analysis of the contents posted elicits the caregivers’ perspectives about microcephaly besides also clarifying how Instagram empowers them to raise awareness and communicate about the condition. Instagram demonstrated to be a low-cost support tool for caregivers. Also, it allows healthcare practitioners to disseminate medical information through online campaigns. By allowing users to share their individual perspectives and experiences through pictures, images, and videos, Instagram has become popular for users promptly seeking for information and social support.

Can we automate the energy exchange of a power trader? To address this challenge, we present the Meta Agent Learner (MAL). The MAL is a tiered and multi-policy energy trader. It comprises data analytics (DA), a deep sequence-to-sequence recurrent neural network (DS2S) and reinforcement learning (RL). The DA phase draws knowledge out of the sheer flow of data. The DS2S phase creates wisdom and provides the intelligence for decision making. The RL phase senses and learns from the market to act strategically. We demonstrate the MAL in a scenario of a price-taker wind farm with a hydro plant. The testbed is real data from the NordPool and East Denmark (DK2). More specifically, electricity consumption, wholesale and balancing prices, cross border energy exchange, and weather conditions. The MAL optimizes the combined production of the wind farm and hydro pumped storage. Runs the hydro plant such that spillage of wind power is avoided or stores cheap market electricity. The performance is benchmarked with three traders.

The problem of water insufficiency within the agriculture sector creates the need to create new strategies to optimize the use of this resource to the maximum. The purpose of this study was to evaluate if the use of membrane technology and the application of electrochemical techniques can be a viable strategy to create a system to achieve the continuous reuse of irrigation water in closed agricultural production systems. From an extensive review carried out, it was determined that the conventional treatment methods used in closed agricultural systems have considerable limitations since they cannot produce high purity water, which is a mandatory requirement for such systems. Because of this, membrane technology was selected as the basis for our proposal in this study, since it is widely used to generate potable water and to treat wastewater. Membrane fouling by natural organic matter (NOM) was identified as the main limitation of this technology. On this basis, the most effective technologies to solve this problem were sought and evaluated. The application of electrochemical techniques like electrooxidation, electrocoagulation, and the use of electroconductive membranes modified by nanomaterials, were found to be the most feasible means. From the analysis of the mechanisms of action of these technologies, we deduce that the application of electrocoagulation techniques adapted to electroconductive membranes which can carry out electrooxidation processes, could achieve a significant decrease in NOM. This would reduce the fouling problem considerably, optimizing irrigation water treatment systems to allow the reuse of water.

Purpose The purpose of this paper is to analyze a data set from a brokerage firm to find possible spoofing cases in ten stocks from the Ibovespa index. The studies proposed concerned the parameters used in the search for the practice, the frequency of occurrences during the negotiation period, the impact on the price caused by the size of the spoofing order and the correlation between the stock's liquidity and the number of occurrences. Design/methodology/approach By using intraday orders flows, the authors are able to reassemble the order book and perform an analysis of potential market manipulation. Findings The authors found six possible cases, all of them happened in the beginning or end of the negotiation period, confirming that there is a window of opportunity for the practice when there is greater uncertainty related to the stock's price. Moreover, they found that in the less liquid stocks, it was necessary to place greater spoofing orders aiming to narrow the wider spread. Practical implications A methodology for spoofing detection that can be replicated by brokerage firms and other researchers was developed. Social implications The study contributes to the literature of capital market regulation by suggesting best practices for regulators and self-regulatory entities to avoid a predatory market practice. Originality/value The authors present an algorithm and parameters for detecting spoofing; other papers are not practical orientated.

Introducción: La enfermedad de Parkinson (EP) es un trastorno neurodegenerativo, progresivo, caracterizado por diversos síntomas motores. El hallazgo patológico principal es la pérdida de neuronas productoras de dopamina en la sustancia nigra pars compacta. Los trastornos del sueño, apatía, ansiedad, deterioro cognitivo, demencia y depresión, son síntomas neuropsiquiátricos que también presentan los pacientes con EP. Debido a que las hormonas sexuales son factores importantes para la diferenciación estructural y funcional en el cerebro, existen diferencias entre géneros en los pacientes con EP. Objetivo: Analizar las diferencias en depresión y ansiedad entre géneros en pacientes con EP. Métodos: Se revisó la literatura en la base de datos de PubMed de enero 2000 a julio del 2019. Resultados: El 50% de los pacientes con EP cumplen con los criterios para depresión según la DSM-V y el 40% tiene síntomas consistentes con los trastornos de ansiedad. Las mujeres con EP tienen síntomas no motores más graves que los hombres. Conclusión: La EP y sus síntomas neuropsiquiátricos son de origen multifactorial pero parecen ser influenciados por el género, con una alta prevalencia en las mujeres.