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The development of new fields of study in genetics, as the -omic sciences (transcriptomics, proteomics, metabolomics), has allowed the study of the regulation and expression of genomes. Therefore, nowadays it is possible to study global alterations--in the whole genome--and their effect at the protein and metabolic levels. Importantly, this new way of studying genetics has opened new areas of knowledge, and new cellular mechanisms that regulate the functioning of biological systems have been elucidated. In the clinical field, in the last years new molecular tools have been implemented. These tools are favorable to a better classification, diagnosis and prognosis of several human diseases. Additionally, in some cases best treatments, which improve the quality of life of patients, have been established. Due to the previous assertion, it is important to review and divulge changes in the study of genetics as a result of the development of the -omic sciences, which is the aim of this review.

The development of the Internet is continuous and appears to be never-ending, although with the arrival of Web 3.0 it could be said that the Internet is what its creators intended it to be from the first moment, an extraordinary and immense organised, understandable, and easy to access data base, characteristics still not achieved. The innovations and services included in Web 3.0 will result, in the first place, in better, faster and safer access to quality information. In the second place it should provide better personalisation of the health services that Internet users access, avoiding irrelevant information that may contain wrong, false and dangerous recommendations. However, these changes will have to be accompanied by the legal requirements common to the information society, by the ethical aspects associated with medical care, guaranteeing and contributing, in all cases, to improving the doctor-patient relationship., (Copyright 2009 Elsevier España, S.L. All rights reserved.)

Abstract Predictive value of metabolic syndrome for prostate cancer risk is not clear. We aimed to assess the association between metabolic syndrome and its components with prostate cancer incidence. The primary outcome was prostate cancer incidence, i.e., incidence rate ratios and adjusted cumulative incidence curves derived from flexible parametric survival models. Adjusted cumulative incidence curves were derived using a flexible survival parametrical modeling framework. We analysed UK Biobank data including 242,349 adult males, recruited during 2006–2010 and followed up until 2021, during which 6,467 (2.7%) participants were diagnosed with prostate cancer. Our findings indicate that metabolic syndrome, as a whole, was not associated with prostate cancer risk (incidence rate ratios, 1.07; 95% confidence interval, 0.94–1.22). However, specific components such as hypertension and obesity increased the risk (incidence rate ratios, 1.22; 95% confidence interval, 1.03–1.44 and incidence rate ratios, 1.24; 95% confidence interval, 1.05–1.46, respectively). Other components, such as prediabetes/diabetes and low cholesterol, were associated with a reduced risk (incidence rate ratios, 0.80; 95% confidence interval, 0.67–0.94 and incidence rate ratios, 0.82; 95% confidence interval, 0.69–0.97, respectively), while hyperlipidaemia showed no significant effect (incidence rate ratios, 1.07; 95% confidence interval, 0.93–1.24). Further research is needed to understand the underlying mechanisms behind these relationships. Prostate cancer prevention strategies might benefit from targeting modifiable risk factors, particularly hypertension and obesity.

Abstract Knowing mechanisms that facilitate the emergence of post-glacial ecosystems is urgently required given rapid recent glacial retreat in high latitude and high elevation regions. We examined the effect of nutrient hotspots created via communal dung deposition by wild, native Andean camelids on soil abiotic and biotic properties and plant cover in the rapidly deglaciating Cordillera Vilcanota, southeastern Peru. Animal-modified proglacial soils were significantly enriched in all measured edaphic properties compared to reference glacial-till soils of the same age adjacent to animal-modified soil patches. Organic matter composition, soil moisture, available inorganic nitrogen, and plant cover were nearly zero in glacial-moraine reference soils, but were at least one order of magnitude greater in animal-modified soils. Likewise, DNA concentrations were almost two orders of magnitude higher in modified soils (23 ± 9 µg DNA g soil−1) compared to reference soils (0.6 ± 0.3 µg DNA g soil−1). Animal-modified soil microbial community composition differed significantly from reference soils for both prokaryotes and eukaryotes, and eukaryote ASV richness was significantly higher in camelid latrines than in controls. Nutrient transfer into glacier forefields by native camelids shortcuts a 100+ year lag between glacier retreat and primary succession. Our results suggest that nutrient transfer into glacier forefields by wild, native animals may be an important, natural mechanism by which tropical Andean species can expand upslope at a pace relevant to climate change.

Abstract Background Progressive hearing loss is a common problem in the human population with no effective therapeutics currently available. However, it has a strong genetic contribution, and investigating the genes and regulatory interactions underlying hearing loss offers the possibility of identifying therapeutic candidates. Mutations in regulatory genes are particularly useful for this, and an example is the microRNA miR-96, a post-transcriptional regulator which controls hair cell maturation. Mice and humans carrying mutations in miR-96 all exhibit hearing impairment, in homozygosis if not in heterozygosis, but different mutations result in different physiological, structural and transcriptional phenotypes. Methods Here we present our characterisation of two lines of mice carrying different human mutations knocked-in to Mir96. We have carried out auditory brainstem response tests to examine their hearing with age and after noise exposure and have used confocal and scanning electron microscopy to examine the ultrastructure of the organ of Corti and hair cell synapses. Bulk RNA-seq was carried out on the organs of Corti of postnatal mice, followed by bioinformatic analyses to identify candidate targets. Results While mice homozygous for either mutation are profoundly deaf from 2 weeks old, the heterozygous phenotypes differ markedly, with only one mutation resulting in hearing impairment in heterozygosis. Investigations of the structural phenotype showed that one mutation appears to lead to synaptic defects, while the other has a much more severe effect on the hair cell stereociliary bundles. Transcriptome analyses revealed a wide range of misregulated genes in both mutants which were notably dissimilar. We used the transcriptome analyses to investigate candidate therapeutics, and tested one, finding that it delayed the progression of hearing loss in heterozygous mice. Conclusions Our work adds further support for the importance of the gain of novel targets in microRNA mutants and offers a proof of concept for the identification of pharmacological interventions to maintain hearing.

RESUMEN Objetivo: Valorar si en nuestra población los factores de riesgo cardiovascular (FRCV) se correlacionan con la severidad de la COVID-19 en pacientes hospitalizados. Material y Métodos: Estudio de cohortes retrospectivo de pacientes con COVID-19 ingresados entre los meses de abril y diciembre del 2020 en un centro terciario en el sur de España. Se valoró la asociación entre los FRCV y la severidad del SARS-COV2. Se consideró como COVID severo aquel que ingresó en la Unidad de Cuidados Intensivos (UCI) o que falleció. Resultados: Se analizaron 608 pacientes ingresados con diagnóstico de neumonía por COVID-19, la mediana de edad fue de 73 años (RIC: 64-81) años. Los pacientes fueron predominantemente varones (55,8%). La hipertensión arterial fue el FRCV más común (83,7%), seguido de la dislipemia (50,2%), diabetes (43,1%), obesidad (32,9%) y tabaquismo (15,6%). Durante la estancia un total del 25,8% de los pacientes tuvieron un pronóstico desfavorable: un 7,9% precisó ingreso en UCI y un 22,9% fallecieron. En el análisis multivariante resultaron variables independientes para padecer un COVID severo el género masculino (OR: 1,697; IC 95%: 1,138-2,532), la edad avanzada (OR: 1,697; IC 95%: 1,138-2,532), y la obesidad (OR: 1,634; IC95%: 1,370-1,947). Conclusión. Existe una gran prevalencia de FRCV en los pacientes ingresados por COVID 19 de nuestra población. La obesidad, junto con la edad avanzada y el género masculino se asocian con una mayor gravedad y mortalidad hospitalaria en los pacientes ingresados con SARS-CoV 2. ABSTRACT Objective: To assess whether cardiovascular risk factors (CVRF) are correlated with the severity of COVID-19 in hospitalized patients in our population. Material and Methods: Retrospective cohort study of patients with COVID-19 admitted between the months of April and December 2020 in a tertiary center in southern Spain. The association between CVRF and the severity of SARS-COV2 was assessed. Severe COVID was considered to be one who was admitted to the Intensive Care Unit (ICU) or who died. Results: 608 patients admitted with a diagnosis of COVID-19 pneumonia were analyzed, the median age was 73 years (IQR: 64-81) years. The patients were predominantly male (55.8%). Hypertension was the most common CVRF (83.7%), followed by dyslipidemia (50.2%), diabetes mellitus (43.1%), obesity (32.9%), and smoking (15.6%). During the stay, a total of 25.8% of the patients had an unfavorable prognosis: 22.9% died and 7.9% required admission in the ICU. In the multivariate analysis, significant independent variables were found for suffering from severe COVID: male sex (OR: 1,697; IC 95%: 1,138-2,532), age (OR: 1.697; CI 95%: 1,138-2,532), and obesity (OR: 1,634; 95% CI: 1,370-1,947). Conclusions: There is a high prevalence of CVRF in patients hospitalized for COVID 19 in our population. Obesity, along with older age and male gender, are associated with greater severity and hospital mortality in patients admitted with SARS-CoV-2

BackgroundPsoriasis is an inflammatory disease primarily treated through molecular-targeted therapies. However, emerging evidence suggests that dietary interventions may also play a role in managing inflammation associated with this condition. The Mediterranean diet (MedDiet), prevalent in southern European countries, has been widely recognized for its ability to reduce cardiovascular mortality, largely due to its anti-inflammatory properties. This anti-inflammatory potential has prompted interest in exploring the MedDiet’s role in immune-mediated diseases, including psoriasis. Observational studies have indicated potential benefits, such as reductions in the Psoriasis Area and Severity Index. However, there is a need for well-designed clinical trials to address the methodological limitations of these studies and to establish specific dietary recommendations for psoriasis. ObjectiveThis study aims to evaluate the impact of an intensive dietary intervention based on the MedDiet in patients with psoriasis. The study will assess the effects of this intervention on skin involvement, metabolic parameters, and inflammatory cytokines. In addition, the emotional well-being and quality of life of participants will be evaluated using validated questionnaires. A methodological analysis will also be conducted to enhance the design of future large-scale clinical trials. MethodsAn open-label, single-blinded (evaluator) randomized controlled trial was designed to assess the impact of a high-intensity MedDiet intervention in patients with mild-to-moderate psoriasis. A total of 38 patients will be randomly assigned into 2 groups—an intervention group receiving the MedDiet intervention and a control group receiving standard care. The intervention group will participate in dietary education sessions aimed at adopting the MedDiet over 4 months, with monthly monitoring by experienced nutritionists. Participants will receive 500 mL of extra virgin olive oil per week, along with informative materials, recipes, and weekly menus. In contrast, the control group will receive standard low-fat diet recommendations without nutritionist monitoring. All participants will undergo a baseline visit, a 2-month follow-up visit, and a final visit at 4 months. Blood tests will be conducted at the beginning and end of the study. This study protocol was approved by the Institutional Review Board of the Hospital Ramón y Cajal (Madrid) in July 2023. ResultsEnrollment concluded in October 2024, with data collection set to finish by February 2025. The findings will be presented at national and international conferences and published in peer-reviewed journals. ConclusionsThis protocol outlines the design of a clinical trial that implements the MedDiet in patients with psoriasis to evaluate its benefits on skin involvement, systemic inflammation, and quality of life. Trial RegistrationClinicalTrials.gov NCT06257641; https://clinicaltrials.gov/study/NCT06257641 International Registered Report Identifier (IRRID)DERR1-10.2196/64277

Accurate and efficient diagnosis of schizophrenia remains a critical challenge in clinical neuroscience. This study presents a novel approach leveraging complex network analysis and Discrete Fourier Transform (DFT) applied to electroencephalogram (EEG) data for the diagnosis of schizophrenia. EEG, due to its high versatility and low cost, offers significant potential for widespread clinical application. Utilizing a rigorously validated dataset comprising 28 subjects—14 diagnosed with paranoid schizophrenia and 14 healthy controls—we achieved a classification accuracy of 93%. The methodology emphasizes computational efficiency, scalability, and flexibility, making it a promising tool for clinical applications. The findings demonstrate the potential of integrating advanced signal processing techniques with machine learning algorithms to advance psychiatric diagnostics.

ABSTRACT This case report explores the management of a 56‐year‐old female oncology patient presenting with acute ST‐elevation myocardial infarction (STEMI) and an incidental atrial septal defect (ASD). The patient, with a history of rectal cancer and hypothyroidism, experienced acute chest pain and dyspnea. She was diagnosed with an inferior STEMI and underwent percutaneous coronary intervention (PCI) with the placement of three medicated stents in the right coronary artery. During hospitalization, an echocardiogram revealed a significant ostium secundum ASD. Angiography indicated thrombi, suggesting a potential paradoxical embolism. Percutaneous ASD closure was performed during the same hospital stay, leading to a favorable clinical course without immediate complications. This case highlights the importance of a multidisciplinary approach and comprehensive evaluation in managing complex cardiovascular conditions, particularly in patients with increased thrombotic risk due to malignancy.

Introduction The current gold standard treatment for patients with orofacial clefts is surgical repair of the palatal defect (uranostaphylorrhaphy), which is associated with growth defects and hypoplasia of the maxillofacial structures. This trial aims to evaluate the potential of a bioengineered artificial palate mucosa, created through tissue engineering with autologous stromal and epithelial cells and nanostructured fibrin–agarose biomaterials, to enhance treatment outcomes for patients with unilateral cleft lip and palate.Methods and analysis This phase I-IIa clinical trial aims to evaluate the feasibility and biosafety of a procedure involving grafting bioartificial palate mucosa onto the areas of denudated bone in patients undergoing uranostaphylorrhaphy. The control patients will undergo standard surgical treatment. Five patients will be included in the first biosafety phase. In the second phase, 10 patients will be randomly assigned to the intervention or control group (1:1). The intervention group will undergo standard surgical treatment followed by the application of autologous bioartificial palate mucosa. Feasibility will be analysed at the time of surgery. Nine postimplant visits will be scheduled over a 2-year follow-up period, in which local and systemic biosafety will be investigated by determining graft evolution, including signs of necrosis, rejection, inflammation and patient factors. Preliminary signs of efficiency will be explored by sequentially evaluating craniomaxillofacial development, hearing impairment, speech capability and quality of life of the family. The research will be published in journals and posted in the relevant repositories when available.Ethics and dissemination This study has been approved by the Committee of Ethics in Research with Medicinal Products (CEIm) and authorised by the Spanish Medicines Agency (AEMPS). The results of this study will be published in peer-reviewed journals.Trial registration number NCT06408337; ClinicalTrials.gov: EuclinicalTrials. eu: 2023-506913-23-00.

Abstract Obstructive sleep apnea (OSA) and hypertension are two important modifiable risk factors for cardiovascular disease and mortality. Numerous studies have highlighted the interplay between these two conditions. We provide a critical review of the current literature on the role of the OSA as a risk factor for hypertension and its effect on blood pressure (BP). We discuss several key topics: the effect of OSA on nocturnal BP, BP response to continuous positive airway pressure (CPAP) treatment, CPAP effect on BP in refractory hypertension, the role of OSA in BP variability (BPV), and maladaptive cardiac remodeling mediated by OSA’s effect on BP. Finally, we discuss the unique aspects of ethnicity and social determinants of health on OSA with a focus on Asian populations and the disparity in BP control and cardiovascular outcomes.

Abstract The data on the use of a one- or two-screw technique (1S, 2S) for ventral osteosynthesis of type II dens fractures are contradictory. The aim was to design an apparatus to mimic the physiological conditions and test stability with 1S, 2S, and a headless compression screw (HCS) for osteosynthesis of artificially created type II odontoid fractures. The apparatus was mounted on a Zwick materials testing machine. A total of 18 C1–2 specimens were stratified into three groups (1S, 2S, HCS). Odontoid fractures were artificially created, and osteosynthesis was performed. Each specimen was tested at loads increasing from 1 to 40 N. Screw loosening was observed visually, by fatigue data, and by a camera tracking system. Analysis of the Zwick data and the camera data revealed a significant higher stability after 2S compared to 1S and HCS treatment (Zwick data: p = 0.021, camera data: p

Abstract The essence of quantum machine learning is to optimize problem-solving by executing machine learning algorithms on quantum computers and exploiting potent laws such as superposition and entanglement. Support vector machine (SVM) is widely recognized as one of the most effective classification machine learning techniques currently available. Since, in conventional systems, the SVM kernel technique tends to sluggish down and even fail as datasets become increasingly complex or jumbled. To compare the execution time and accuracy of conventional SVM classification to that of quantum SVM classification, the appropriate quantum features for mapping need to be selected. As the dataset grows complex, the importance of selecting an appropriate feature map that outperforms or performs as well as the classification grows. This paper utilizes conventional SVM to select an optimal feature map and benchmark dataset for predicting air quality. Experimental evidence demonstrates that the precision of quantum SVM surpasses that of classical SVM for air quality assessment. Using quantum labs from IBM’s quantum computer cloud, conventional and quantum computing have been compared. When applied to the same dataset, the conventional SVM achieved an accuracy of 91% and 87% respectively, whereas the quantum SVM demonstrated an accuracy of 97% and 94% respectively for air quality prediction. The study introduces the use of quantum Support Vector Machines (SVM) for predicting air quality. It emphasizes the novel method of choosing the best quantum feature maps. Through the utilization of quantum-enhanced feature mapping, our objective is to exceed the constraints of classical SVM and achieve unparalleled levels of precision and effectiveness. We conduct precise experiments utilizing IBM’s state-of-the-art quantum computer cloud to compare the performance of conventional and quantum SVM algorithms on a shared dataset.

Background: Rooms illuminated by “black light” (

Abstract Background KRAS-mutant non-small cell lung cancer (NSCLC) shows a relatively low response rate to chemotherapy, immunotherapy and KRAS-G12C selective inhibitors, leading to short median progression-free survival, and overall survival. The MET receptor tyrosine kinase (c-MET), the cognate receptor of hepatocyte growth factor (HGF), was reported to be overexpressed in KRAS-mutant lung cancer cells leading to tumor-growth in anchorage-independent conditions. Methods Cell viability assay and synergy analysis were carried out in native, sotorasib and trametinib-resistant KRAS-mutant NSCLC cell lines. Colony formation assays and Western blot analysis were also performed. RNA isolation from tumors of KRAS-mutant NSCLC patients was performed and KRAS and MET mRNA expression was determined by real-time RT-qPCR. In vivo studies were conducted in NSCLC (NCI-H358) cell-derived tumor xenograft model. Results Our research has shown promising activity of omeprazole, a V-ATPase-driven proton pump inhibitor with potential anti-cancer properties, in combination with the MET inhibitor tepotinib in KRAS-mutant G12C and non-G12C NSCLC cell lines, as well as in G12C inhibitor (AMG510, sotorasib) and MEK inhibitor (trametinib)-resistant cell lines. Moreover, in a xenograft mouse model, combination of omeprazole plus tepotinib caused tumor growth regression. We observed that the combination of these two drugs downregulates phosphorylation of the glycolytic enzyme enolase 1 (ENO1) and the low-density lipoprotein receptor-related protein (LRP) 5/6 in the H358 KRAS G12C cell line, but not in the H358 sotorasib resistant, indicating that the effect of the combination could be independent of ENO1. In addition, we examined the probability of recurrence-free survival and overall survival in 40 early lung adenocarcinoma patients with KRAS G12C mutation stratified by KRAS and MET mRNA levels. Significant differences were observed in recurrence-free survival according to high levels of KRAS mRNA expression. Hazard ratio (HR) of recurrence-free survival was 7.291 (p = 0.014) for high levels of KRAS mRNA expression and 3.742 (p = 0.052) for high MET mRNA expression. Conclusions We posit that the combination of the V-ATPase inhibitor omeprazole plus tepotinib warrants further assessment in KRAS-mutant G12C and non G12C cell lines, including those resistant to the covalent KRAS G12C inhibitors.

Abstract Objetive this study was to determine the relationship between acute febrile illness and bacterial pathogens with zoonotic potential that cause emerging and re-emerging diseases in a central-eastern region of Peru. Results Out of the 279 samples analyzed, 23 (8.2%) tested positive for infection by Rickettsia spp., while a total of 15 (5.4%) tested positive for Leptospira spp. Women had a higher frequency of infection by Rickettsia spp., with 13 cases (53.3%), while men had a higher frequency of infection by Leptospira spp., with 10 cases (66.7%). The most frequently reported general symptom was headache, with 100.0% (n = 23) of patients with Rickettsia (+) and 86.7% (n = 13) of patients with Leptospira (+) experiencing it. Arthralgia was the second most frequent symptom, reported by 95.6% (n = 22) and 60% (n = 9) of patients with Rickettsia (+) and Leptospira (+), respectively. Myalgia was reported by 91.3% (n = 21) and 66.7% (n = 10) of patients with Rickettsia (+) and Leptospira (+), respectively. Retroocular pain, low back pain, and skin rash were also present, but less frequently. Among the positives, no manifestation of bleeding was recorded, although only one positive case for Leptospira spp. presented a decrease in the number of platelets.

Background The zoonotic infection caused by tapeworms Echinococcus is a neglected tropical disease in poor regions with limited access to suitable sanitary conditions. Hydatid cysts produced by Echinococcus granulosus use fatty-acid-binding proteins (FABP) to obtain the fatty acids and cholesterol necessary for their survival from the host. In this work, we analyzed the behaviour of saturated, monounsaturated, and polyunsaturated fatty acids against EgFABP1. Methods We used computational biology and chemistry techniques and binding free energy estimations by molecular mechanics generalized Born surface area (MM/GBSA). Results This research has enabled us to clarify the EgFABP1 isoforms identified in the database, suggesting their potential involvement in diverse cellular activities of Echinococcus granulosus. Conversely, examining the global and local chemical reactivity of 14 fatty acids revealed that liposolubility is contingent upon the degree of unsaturation in the FAs. Additionally, FAs exhibited acceptable levels of oral absorption and bioavailability. The binding of EgFABP1 with FAs analyzed by molecular dynamics simulation showed us that these are highly stable, where the best affinity was with docosahexaenoic acid. Conclusions Our results suggest that the action of fatty acids could play an interesting role in detecting early Echinococcus granulosus.

Background Although the COVID-19 pandemic has diminished in intensity, the virus continues to circulate globally. The SARS-CoV-2 main protease (Mpro) is a key enzyme in the life cycle of the virus, making it important for the development of treatments against future variants of the virus. In this work, Peruvian natural compounds were evaluated against different mutations of the SARS-CoV-2 Mpro. Methods In silico techniques such as virtual screening, all-atom molecular dynamics simulations, and energy estimation analysis were applied. Results Of the tested compounds by virtual screening, rutin was identified as the best binding agent against the different proposed Mpro mutations. In addition, computational simulations and energy estimation analysis demonstrated the high structural and energetic stability between the Mpro-rutin systems. Conclusions Overall, our study identified rutin as the most promising compound with a strong affinity for various Mpro mutations, potentially playing a key role in the development of new treatments for emerging viral variants.

The metaverse is based on immersive technologies such as virtual and augmented reality, body tracking, tactile sensation, etc. A growing number of studies are demonstrating the potential of the metaverse as an attractive resource for learning medicine. However, in practice, medical teachers and students often encounter significant challenges when utilizing the underlying technologies, potentially leading to frustrating learning experiences. A significant part of the teaching time is often devoted to troubleshooting technical issues with the metaverse, and the medical content itself taking a backseat until students become proficient in navigating the metaverse environment. Therefore, it is essential to fit the metaverse's underlying technologies specifically for medical education, minimizing technical hurdles for both teachers and students. In this paper, we deal with this challenge and we present a collection of practical tips that serves as a guide for medical educators making decisions in this emerging field, where they may lack prior experience. Drawing on our observation with a cohort of 776 medical students, we conclude how to effectively identify, design, or implement educational applications tailored for efficient medical learning through the metaverse. Our work may support teachers considering metaverse learning platforms for their classrooms and it is a beneficial reference for the medical education community during the initial stages of implementing the metaverse for teaching.

The metaverse is based on immersive technologies such as virtual and augmented reality, body tracking, tactile sensation, etc. A growing number of studies are demonstrating the potential of the metaverse as an attractive resource for learning medicine. However, in practice, medical teachers and students often encounter significant challenges when utilizing the underlying technologies, potentially leading to frustrating learning experiences. A significant part of the teaching time is often devoted to troubleshooting technical issues with the metaverse, and the medical content itself taking a backseat until students become proficient in navigating the metaverse environment. Therefore, it is essential to fit the metaverse's underlying technologies specifically for medical education, minimizing technical hurdles for both teachers and students. In this paper, we deal with this challenge and we present a collection of practical tips that serves as a guide for medical educators making decisions in this emerging field, where they may lack prior experience. Drawing on our observation with a cohort of 776 medical students, we conclude how to effectively identify, design, or implement educational applications tailored for efficient medical learning through the metaverse. Our work may support teachers considering metaverse learning platforms for their classrooms and it is a beneficial reference for the medical education community during the initial stages of implementing the metaverse for teaching.

Objetivo. Este estudo teve como objetivo estimar a prevalência da doença de Chagas (DC) crônica (DCC) na população brasileira, em mulheres e em mulheres em idade fértil. Métodos. Foi realizada uma metanálise da literatura para extrair dados de prevalência de DCC na população brasileira, em mulheres e em mulheres em idade fértil, em municípios do Brasil, no período 2010–2022. Indicadores relacionados com a DCC disponíveis nos sistemas de informação em saúde foram selecionados em escala municipal. A modelagem estatística dos dados extraídos da metanálise em função daqueles obtidos dos sistemas de informação foi aplicada a modelos lineares, lineares generalizados e aditivos. Resultados. Foram selecionados os cinco modelos mais adequados de um total de 549 modelos testados para obtenção de um modelo de consenso (R2 ajustado = 54%). O preditor mais importante foi o cadastro autorreferido de DCC do sistema de informação da Atenção Primária à Saúde. Dos 5 570 munícipios brasileiros, a prevalência foi estimada como zero em 1 792 (32%); nos 3 778 municípios restantes, a prevalência média da doença foi estimada em 3,25% (± 2,9%). O número de portadores de DCC foi estimado na população brasileira (~3,7 milhões), mulheres (~2,1 milhões) e mulheres em idade fértil (~590 mil). A taxa de reprodução da doença foi calculada em 1,0336. Todas as estimativas se referem ao intervalo 2015–2016. Conclusões. As prevalências estimadas de DCC, especialmente entre mulheres em idade fértil, evidenciam o desafio da transmissão vertical em municípios brasileiros. Estas estimativas são comparadas aos padrões de projeções matemáticas, sugerindo sua incorporação ao Pacto Nacional para a Eliminação da Transmissão Vertical da DC.

Abstract Here, we conducted a comprehensive analysis of 356 Klebsiella pneumoniae species complex (KpSC) isolates that were classified as classical (cl), presumptive hypervirulent (p-hv) and hypermucoviscous-like (hmv-like). Overall, K. pneumoniae (82.3%), K. variicola (2.5%) and K. quasipneumoniae (2.5%) were identified. These isolates comprised 321 cl-KpSC, 7 p-hv-KpSC and 18 hmv-like-KpSC. A large proportion of cl-KpSC isolates were extended-spectrum-β-lactamases (ESBLs)-producers (64.4%) and 3.4% of isolates were colistin-resistant carrying carbapenemase and ESBL genes. All p-hv-KpSC showed an antibiotic susceptible phenotype and hmv-like isolates were found to be ESBL-producers (8/18). Assays for capsule production and capsule-dependent virulence phenotypes and whole-genome sequencing (WGS) were performed in a subset of isolates. Capsule amount differed in all p-hv strains and hmv-like produced higher capsule amounts than cl strains; these variations had important implications in phagocytosis and virulence. Murine sepsis model showed that most cl strains were nonlethal and the hmv-like caused 100% mortality with 3 × 108 CFUs. Unexpectedly, 3/7 (42.9%) of p-hv strains required 108 CFUs to cause 100% mortality (atypical hypervirulent), and 4/7 (57.1%) strains were considered truly hypervirulent (hv). Genomic analyses confirmed the diverse population, including isolates belonging to hv clonal groups (CG) CG23, CG86, CG380 and CG25 (this corresponded to the ST3999 a novel hv clone) and MDR clones such as CG258 and CG147 (ST392) among others. We noted that the hmv-like and hv-ST3999 isolates showed a close phylogenetic relationship with cl-MDR K. pneumoniae. The information collected here is important to understand the evolution of clinically important phenotypes such as hypervirulent and ESBL-producing-hypermucoviscous-like amongst the KpSC in Mexican healthcare settings. Likewise, this study shows that mgrB inactivation is the main mechanism of colistin resistance in K. pneumoniae isolates from Mexico.

El propósito central de este estudio se enfoca en desarrollar un modelo explicativo de la felicidad subjetiva en adultos de Tacna, integrando la inteligencia emocional y la satisfacción con la vida como variables centrales. La muestra abarcó a 191 adultos de Tacna, con una distribución de género que comprendió el 54% de mujeres y el 46% de hombres. Se aplicaron tres modelos de ecuaciones estructurales para examinar la felicidad subjetiva en esta población. En el Modelo 1, se registró un cociente Chi-cuadrado sobre grados de libertad (X2/GL) de 1.644, con un Índice de Ajuste Comparativo (CFI) de 0.933, un Índice de Tucker-Lewis (TLI) de 0.919 y un Índice de Ajuste Normado por Parsimonia (PNFI) de 0.702. En el Modelo 2, luego de la eliminación de un predictor, se observó un X2/GL de 1.527, CFI de 0.951, TLI de 0.939 y PNFI de 0.709. Al incorporar una covarianza en el Modelo 3, se evidenciaron mejoras, con un X2/GL de 1.438, CFI de 0.959, TLI de 0.949 y PNFI de 0.706. La correlación más significativa se observó entre la felicidad subjetiva y la inteligencia emocional, con un valor p de 0.004. No se encontraron diferencias significativas en la felicidad, inteligencia y satisfacción entre mujeres y hombres al realizar comparaciones por género. Estos resultados señalan que el Modelo 3 presenta el ajuste más sólido y una correlación significativa entre la felicidad y la inteligencia emocional

Introduction. The factors that best predict academic performance are motivation, learning strategies, and classroom climate. In this context, gamification has advantages for promoting these variables. Objective. The objective of this research was to evaluate the effect of a gamified strategy on motivation and academic performance in the anatomy and physiology of systems course. Method. The MSQL-SF questionnaire was administered to 81 nursing students to assess their perception regarding motivation and learning strategies. Motivation, in turn, considered the dimensions of task value and test anxiety. Learning strategies assessed metacognitive strategies, resource management, and intrinsic orientation. The effect of strategy on performance was analyzed using students' grades. Results. The main results suggest that 70% of students feel anxious about evaluations, and 50% express difficulties in adapting a study schedule. Both findings are related to motivation. Regarding academic performance, there were no significant differences between the control and experimental groups. Conclusion. The use of gamification in learning anatomy constitutes a supplement that has shown to have rapid adherence and affinity with health students in activities that are playful, entertaining, and based on collaborative learning. However, its evidence regarding performance is limited.

Objective Billions of vascular access devices (VADs) are inserted annually for intravenous therapy worldwide. However, their use is not without challenges. Facilitating the process and enhancing results, hospital authorities have created vascular access specialist teams (VASTs) with advanced competencies in the evaluation, insertion, care and management of VADs. The objective is to compare the effectiveness of VASTs versus standard practice regarding cannulation success and vascular access maintenance in hospitalised adults.Design Systematic review, using the Mixed Methods Appraisal Tool.Data sources We conducted a structured data search on Cochrane Library, MEDLINE, Web of Science, Scopus and EBSCOhost up to 31 May 2023. We did not impose a time limit regarding the date of publication.Eligibility criteria Studies were eligible for inclusion in the review if they were randomised and non-randomised trials and observational studies.Data extraction and synthesis We included studies that described or evaluated the activity of VASTs compared with clinical practitioners. The outcomes analysed were the success of the cannulation and the incidence of associated adverse effects.Results The search strategy produced 3053 papers published between 1984 and 2020, from which 12 were selected for analysis. VASTs are heterogeneously described among these studies, which mainly focus on insertions, frequently for patients with difficult intravenous access. Some patients presented with specific needs or requirement for specific insertion technique or catheter type. Compared with usual practice, these studies indicate that the involvement of a VAST is associated with a higher effectiveness in terms of first attempt insertions and insertion success rates, and a reduction in catheter-associated adverse events. However, meta-analyses confirming this trend are not currently possible.Conclusions It seems apparent that VASTS contribute to improving the health of patients during the administration of intravenous. VASTs seem to increase the effectiveness of VAD insertion and care and reduce complications.PROSPERO registration number CRD42021231259.

A pesar de la mala fama y reputación de las arañas, la realidad es que su mordedura ocurre de manera accidental y es peligrosa únicamente en un número muy limitado de casos. Sin embargo, durante los últimos años se está observando un aumento significativo de los casos de mordeduras en España, principalmente atribuidas a la especie Loxosceles rufescens (Dufour,1820), vulgarmente conocida como la araña reclusa mediterránea, cuyo veneno citotóxico, proteolítico y hemolítico, puede producir lesiones en la piel y causar un cuadro clínico conocido como loxoscelismo. En este estudio presentamos cuatro casos humanos de mordedura presuntivamente por L. rufescens en Mallorca, Gerona y Bizkaia, con diferente tipo de clínica y evolución tras la mordedura. Además, se aporta una sucinta revisión sobre otros casos de mordeduras ocurridos en España, orientaciones en la identificación de L. rufescens, así como de su biología, vigilancia, control integrado y tratamiento médico. El principal objetivo del presente artículo es arrojar información objetiva sobre estos artrópodos cuya aparición resulta cada vez más evidente, así como sensibilizar a la sociedad y concienciar a las autoridades de la necesidad de incluir a esta especie en los programas de vigilancia y control de plagas urbanas, ya que se trata de un problema de repercusión en la salud pública del ámbito privado y público.

Abstract The COVID-19 pandemic had a profound global impact, characterized by a high fatality rate and the emergence of enduring consequences known as Long COVID. Our study sought to determine the prevalence of Long COVID syndrome within a population of Northeastern Mexico, correlating it with patients' comorbidities, number of COVID-19 reinfection, and vaccination status. Employing an observational cross-sectional approach, we administered a comprehensive questionnaire covering medical history, demographics, vaccination status, COVID-related symptoms, and treatment. Our participant cohort included 807 patients, with an average age of 41.5 (SD 13.6) years, and women accounting 59.3% of the cohort. The follow-up was 488 (IQR 456) days. One hundred sixty-eight subjects (20.9%) met Long COVID criteria. Long COVID-19 was more prevalent when subjects had reinfections (p = 0.02) and less frequent when they had a complete vaccination scheme (p = 0.05). Through logistic regression, we found that male gender (OR 0.5, p ≤ 0.001), blood types of AB− (OR 0.48, p = 0.003) and O− (OR 0.27, p ≤ 0.001) in comparison with A+ and two doses of vaccines (OR 0.5, p = 006) to be protective factors against Long COVID; while higher BMI (OR 1.04, p = 0.005) was a risk factor. We saw that the prevalence of Long COVID was different within vaccinated patients and specific blood types, while being female and a higher BMI were associated with an increased risk of having long-COVID.

Abstract Background The immune system has a central role in preventing carcinogenesis. Alteration of systemic immune cell levels may increase cancer risk. However, the extent to which common genetic variation influences blood traits and cancer risk remains largely undetermined. Here, we identify pleiotropic variants and predict their underlying molecular and cellular alterations. Methods Multivariate Cox regression was used to evaluate associations between blood traits and cancer diagnosis in cases in the UK Biobank. Shared genetic variants were identified from the summary statistics of the genome-wide association studies of 27 blood traits and 27 cancer types and subtypes, applying the conditional/conjunctional false-discovery rate approach. Analysis of genomic positions, expression quantitative trait loci, enhancers, regulatory marks, functionally defined gene sets, and bulk- and single-cell expression profiles predicted the biological impact of pleiotropic variants. Plasma small RNAs were sequenced to assess association with cancer diagnosis. Results The study identified 4093 common genetic variants, involving 1248 gene loci, that contributed to blood–cancer pleiotropism. Genomic hotspots of pleiotropism include chromosomal regions 5p15-TERT and 6p21-HLA. Genes whose products are involved in regulating telomere length are found to be enriched in pleiotropic variants. Pleiotropic gene candidates are frequently linked to transcriptional programs that regulate hematopoiesis and define progenitor cell states of immune system development. Perturbation of the myeloid lineage is indicated by pleiotropic associations with defined master regulators and cell alterations. Eosinophil count is inversely associated with cancer risk. A high frequency of pleiotropic associations is also centered on the regulation of small noncoding Y-RNAs. Predicted pleiotropic Y-RNAs show specific regulatory marks and are overabundant in the normal tissue and blood of cancer patients. Analysis of plasma small RNAs in women who developed breast cancer indicates there is an overabundance of Y-RNA preceding neoplasm diagnosis. Conclusions This study reveals extensive pleiotropism between blood traits and cancer risk. Pleiotropism is linked to factors and processes involved in hematopoietic development and immune system function, including components of the major histocompatibility complexes, and regulators of telomere length and myeloid lineage. Deregulation of Y-RNAs is also associated with pleiotropism. Overexpression of these elements might indicate increased cancer risk.

Abstract A supercritical CO2 method was optimized to recover naringenin-rich extract from Mexican oregano (Lippia graveolens), a flavanone with high antioxidant and anti-inflammatory activity. The effect of the extraction parameters like pressure, temperature, and co-solvent on naringenin concentration was evaluated. We used response surface methodology to optimize the naringenin extraction from oregano; the chemical composition by UPLC-MS of the optimized extract and the effect of simulated gastrointestinal digestion on its antioxidant capacity and total phenolic content were also evaluated. The optimum conditions were 58.4 °C and 12.46% co-solvent (ethanol), with a pressure of 166 bar, obtaining a naringenin content of 46.59 mg/g extract. Also, supercritical optimized extracts yielded high quantities of cirsimaritin, quercetin, phloridzin, apigenin, and luteolin. The results indicated that the naringenin-rich extract obtained at optimized conditions had higher total phenolic content, antioxidant capacity by TEAC and ORAC, and flavonoid content, compared with the methanolic extract, and the simulated gastrointestinal digestion reduced all these values.

Introducción: La hipocalcemia transitoria postiroidectomia es la complicación más frecuente de la cirugía cervical, la misma puede ser leve y asintomática, o grave. El objetivo fue identificar la prevalencia de hipocalcemia transitoria en paciente operados de tiroidectomía total, en el servicio de cirugía general del Hospital Nacional de Itauguá, durante el periodo entre enero de 2016 a diciembre de 2022. Métodos: Se realizó un estudio descriptivo, observacional, retrospectivo de corte transversal, con un muestreo no probabilístico de casos consecutivos de todos los pacientes sometidos a tiroidectomía total por patología benigna, desde enero 2016 hasta diciembre 2022. Resultados: Del total de 141 fichas de pacientes post operados, en la distribución por sexo se encontró una prevalencia del 92% del sexo femenino con una edad promedio de 55 años ± 5. La prevalencia de hipocalcemia laboratorial fue de 32,6% (46), considerando el valor de calcio total inferior a 8 mg/dL, sin embargo, solo el 19,1% (27) de los pacientes presentó hipocalcemia clínica. Conclusión: La hipocalcemia sigue representando una complicación frecuente en la tiroidectomía: desde un 19,1% con manifestaciones clínicas hasta casi un tercio de los pacientes en los análisis laboratoriales.

Background: Chagas disease (CD), a Neglected Tropical Disease caused by Trypanosoma cruzi, affects millions of people in Latin America and the southern US and spreads worldwide. CD results from close interactions between humans, animals, and vectors, influenced by sociodemographic factors and housing materials. Methods: This study aimed to evaluate how these factors, along with seasonal changes, affect the distribution of CD vectors in an endemic community near Puebla, Mexico, using a cross-sectional survey. A total of 383 people from this area, known for the presence of major vectors such as Triatoma barberi and Triatoma pallidipennis, were surveyed. Results: As a result of the survey, it was found that only 27.4% of respondents knew about CD, and 83.3% owned potential reservoir pets; additionally, the quality of the wall, roof, and floor significantly influenced vector sightings, while the seasonal pattern showed less of an association. Chi-square tests confirmed these associations between vector sightings and housing materials (p < 0.001); vector sightings versus seasonal patterns showed less of an association (p = 0.04), and land use changes did not show an association (p = 0.27). Conclusions: Construction materials play an important role in the sighting of triatomines in homes, so important actions should be taken to improve homes. However, further experimental or longitudinal studies are needed to establish causality.

Abstract Objective Wild-type transthyretin (ATTRwt) amyloidosis is caused by the misfolding and deposition of the transthyretin protein (TTR) in the absence of mutations in the TTR gene. Studies regarding the variant form of ATTR amyloidosis (ATTRv) suggest that the presence of single-nucleotide polymorphisms (SNP) in genes other than the TTR, may influence the development of the disease. However, other genetic factors involved in the aetiopathogenesis of ATTRwt are currently unknown. This work investigates the presence of sequence variants in genes selected for their possible impact on ATTRwt amyloidosis. To do so, targeted sequencing of 84 protein-coding genes was performed in a cohort of 27 patients diagnosed with ATTRwt. Results After applying quality and frequency filtering criteria, 72 rare or novel genetic variants were found. Subsequent classification according to the ACMG-AMP criteria resulted in 17 variants classified as of uncertain significance in 14 different genes. To our knowledge, this is the first report associating novel gene variants with ATTRwt amyloidosis. In conclusion, this study provides potential insights into the aetiopathogenesis of ATTRwt amyloidosis by linking novel coding-gene variants with the occurrence of the disease.

Dye-decolorizing peroxidases (DyPs) (E.C. 1.11.1.19) are heme peroxidases that catalyze oxygen transfer reactions similarly to oxygenases. DyPs utilize hydrogen peroxide (H2O2) both as an electron acceptor co-substrate and as an electron donor when oxidized to their respective radicals. The production of both DyPs and lignin-modifying enzymes (LMEs) is regulated by the carbon source, although less readily metabolizable carbon sources do improve LME production. The present study analyzed the effect of glycerol on Pleurotus ostreatus growth, total DyP activity, and the expression of three Pleos-dyp genes (Pleos-dyp1, Pleos-dyp2 and Pleos-dyp4), via real-time RT-qPCR, monitoring the time course of P. ostreatus cultures supplemented with either glycerol or glucose and Acetyl Yellow G (AYG) dye. The results obtained indicate that glycerol negatively affects P. ostreatus growth, giving a biomass production of 5.31 and 5.62 g/L with respective growth rates (micra; m) of 0.027 and 0.023 h−1 for fermentations in the absence and presence of AYG dye. In contrast, respective biomass production levels of 7.09 and 7.20 g/L and growth rates (μ) of 0.033 and 0.047 h−1 were observed in equivalent control fermentations conducted with glucose in the absence and presence of AYG dye. Higher DyP activity levels, 4,043 and 4,902 IU/L, were obtained for fermentations conducted on glycerol, equivalent to 2.6-fold and 3.16-fold higher than the activity observed when glucose is used as the carbon source. The differential regulation of the DyP-encoding genes in P. ostreatus were explored, evaluating the carbon source, the growth phase, and the influence of the dye. The global analysis of the expression patterns throughout the fermentation showed the up- and down- regulation of the three Pleos-dyp genes evaluated. The highest induction observed for the control media was that found for the Pleos-dyp1 gene, which is equivalent to an 11.1-fold increase in relative expression (log2) during the stationary phase of the culture (360 h), and for the glucose/AYG media was Pleos-dyp-4 with 8.28-fold increase after 168 h. In addition, glycerol preferentially induced the Pleos-dyp1 and Pleos-dyp2 genes, leading to respective 11.61 and 4.28-fold increases after 144 h. After 360 and 504 h of culture, 12.86 and 4.02-fold increases were observed in the induction levels presented by Pleos-dyp1 and Pleos-dyp2, respectively, in the presence of AYG. When transcription levels were referred to those found in the control media, adding AYG led to up-regulation of the three dyp genes throughout the fermentation. Contrary to the fermentation with glycerol, where up- and down-regulation was observed. The present study is the first report describing the effect of a less-metabolizable carbon source, such as glycerol, on the differential expression of DyP-encoding genes and their corresponding activity.

Introduction: Cervical thymic cysts are a rare, benign and mostly asymptomatic lesions that are usually related to developmental malformations. In adults are extremely unusual and since first described by Lane in 1960, only about 36 cases have been published. Objective: To present a case of latero-cervical thymic cyst diagnosed in adulthood. Clinical case: A healthy 38-year-old female patient with an asymptomatic swelling neck mass of 2 years evolution. On physical examination she presented a right, mobile, not painful and extremely soft cervico-lateral mass of approximately 8 cm. The ultrasonographic characteristics showed an echo-lucent image measuring 14 x 8 cm. A surgical excision was performed and pathology reported a unilocular cervical thymic cyst. Conclusions: This case is a rare one not only because the latero-cervical thymic cyst is an uncommon neck cyst, but also because it is not usually diagnosed in adult women.

An analysis of the effects of microgravity and space radiation on astronauts’ RNA expression has been developed, utilizing data from NASA’s “Cell-Free RNA Analysis of Plasma Samples Collected from Six Astronauts in JAXA Cell-Free Epigenome (CFE) Study.” The project aims to deepen our understanding of how the space environment affects gene expression, particularly in key genes such as ACTB and ACTG1, by employing quantum simulations and unconventional logic, including quantum and fuzzy logic. The results suggest that specific genes like ACTB and ACTG1 undergo significant changes in their expression under these unique conditions. This in-terdisciplinary approach allows for a detailed analysis of gene expression data and explores the potential of emerging technologies in space research and bioinformatics.

A 73-year-old woman arrived at the ER claiming to be experiencing low back pain. To investigate the source of her pain, she was admitted to the Internal Medicine department. After a heterogeneous abdominal mass in the right upper quadrant was discovered by abdominal point-of-care ultrasonography (POCUS), it was confirmed by an abdominal CT scan, which also identified a metastatic lytic bone lesion in the L4. This finding is consistent with a malignant tumor of the right adrenal gland. POCUS was repeated right after the occurrence of dyspnea, and a 40x6 mm floating thrombus in the inferior vena cava was detected. A conservative approach with anticoagulants was chosen, with improvement of the clinical conditions. The diagnosis of adrenal carcinoma was ultimately made possible by the mass biopsy. POCUS is a safe, low-cost method that provides prompt results at the patient's bedside. We support the implementation of POCUS in all clinical departments, as it provides significant contributions to the assessment of prognosis and diagnosis.

Introducción: La calidad de atención y satisfacción del usuario en un servicio de emergencia se ha convertido en una preocupación prioritaria para los pacientes. En especial porque el sistema de salud no abastece lo suficiente a los establecimientos públicos para brindar una atención de calidad y obtener una satisfacción del usuario. Objetivo: Establecer la relación entre la calidad de atención y satisfacción del usuario en un Servicio de Emergencia de un Hospital del Seguro Social. Metodología: Se realizó un estudio analítico de corte transversal con una muestra de 400 pacientes en un Servicio de Emergencia del Seguro Social de la region sur del Perú; se utilizaron como instrumentos el cuestionario SERVPERF y el elaborado por Feletti G, Firman D y Sansón-Fisher R para medir las variables. Los datos fueron presentados mediante tablas y gráficos. Resultados: Las dimensiones de la calidad de atención como fiabilidad, capacidad de respuesta, seguridad, empatía y aspectos tangibles, se encontró que el 49.25%, 67%, 72.25%, 54.25% y 55.75% estuvo de acuerdo con la atención brindada, respectivamente. En la variable satisfacción del usuario el 50.25% de usuarios estuvieron de acuerdo. Por otro lado, la relación entre las variables mediante Rho de Spearman fue 0.8590 con un p

Abstract Background The screening of high-risk populations using dried blood spots (DBS) has allowed the rapid identification of patients with Pompe disease, mostly in Neurology departments. The aim of the study was to determine the prevalence of late-onset Pompe disease (LOPD) among patients not previously diagnosed or tested for this entity despite presenting possible signs or symptoms of the disease in Internal Medicine departments in Spain. Methods This epidemiological, observational, cross-sectional, multicenter study included a single cohort of individuals with clinical suspicion of LOPD seen at Internal Medicine departments in Spain. The diagnosis of LOPD was initially established on the basis of the result of DBS. If decreased enzyme acid-alpha-1,4-glucosidase (GAA) activity was detected in DBS, additional confirmatory diagnostic measurements were conducted, including GAA activity in lymphocytes, fibroblasts, or muscle and/or genetic testing. Results The diagnosis of LOPD was confirmed in 2 out of 322 patients (0.6%). Reasons for suspecting LOPD diagnosis were polymyositis or any type of myopathy of unknown etiology (in one patient), and asymptomatic or pauci-symptomatic hyperCKemia (in the other). The time between symptom onset and LOPD diagnosis was 2.0 and 0.0 years. Both patients were asymptomatic, with no muscle weakness. Additionally, 19.7% of the non-LOPD cases received an alternative diagnosis. Conclusions Our study highlights the existence of a hidden population of LOPD patients in Internal Medicine departments who might benefit from early diagnosis and early initiation of potential treatments.

BackgroundCOVID-19-related acute hypoxic respiratory failure patients often use high-flow nasal cannula (HFNO) oxygen therapy. COVID-19 HFNO intubation and mortality risk factors are understudied in the Mexican population, so the aim was to study them.MethodsThis retrospective study searched electronic medical records from March 2020 to June 2022 for patients with COVID-19 who required hospitalization and HFNO. Descriptive statistics, a survival curve analysis, and Cox proportional hazard models were used to determine predictor factors for intubation and mortality in patients with HFNO and COVID-19, respectively.ResultsA total of 134 patients received HFNO treatment. Ninety-one (67.9%) were men with a mean (SD) age of 54.5 (17.9) years. Common medical history included obesity (n = 89, 66.4%) with a Body Mass Index (BMI) mean (SD) of 31.8 (5.9), hypertension (n = 67, 50.0%), type 2 diabetes (n = 55, 41.0%), and dyslipidemias (n = 43, 32.1%). The variables associated with a greater risk of requiring intubation after high-flow therapy were age (HR = 1.018, 95% CI 1.003-1.034, p = 0.022) and BMI (HR = 1.071, 95% CI 1.024-1.120, p = 0.003). No variables were associated with lower risk. Increased mortality was associated with increasing age (HR = 1.151, 95% CI 1.102-1.201, p = ConclusionsA higher age and BMI were associated with an increased risk of intubation in patients with HFNO and COVID-19. Hypertension and dyslipidemias were associated with a higher risk of mortality.

Introduction: psychological stress in university students studying Bachelor of Tourism can cause negative manifestations in the psychological, physical and social order. Objective: to present the validity of a therapeutic massage procedure that contributes to reducing psychological stress in Bachelor of Tourism students at the University of Holguín. Methods: a quantitative research was carried out, theoretical and empirical methods were used. Mathematical statistics were used to process the data. 17 experts were selected to evaluate the procedure used, with an average experience of 17 years. The research was from September 2019 to July 2022. A sample of 82 students was selected, to whom a pre-test was applied before treatment, with therapeutic massage, and a post-test at the end. Results: by observing the students in the different contexts of action and reviewing the sources of information, results indicative of psychological stress were evident. In a survey administered to teachers, little theoretical and methodological knowledge was demonstrated for the application of therapeutic massage for university students with psychological stress. Conclusions: the procedure developed to reduce stress was applied and demonstrate its effectiveness on the health and well-being of the selected sample.

For decades, fossil fuels have accounted for 70% to 80% of global primary energy demand. Far from ending this trend, O&G companies continue to be the main fore-runners in providing secure, versatile and widespread energy to the entire world. The relevance of this sector in the economic-financial landscape and the concern for its stability, makes that the high interest of the scientific community to explore the factors that explain the O&G cross-sectional expected returns remains intact. Through a new approach from the Random Matrix Theory, the aim is to know how many are the factors that explain the market performance of the O&G subsectors (upstream, midstream & downstream), and also if the Brent price can be considered an explanatory factor. We will show that for certain periods, Brent becomes the only factor explaining the movements in the upstream and midstream subsectors, while for most of the time the only factor is the market. Other interesting finding is that no significant factors are found for the downstream subsector, except in certain periods. With a purely statistical approach, we show the factors that explain the cross-sectional expected return of the O&G companies, providing information of special relevance for the decision making of investors, executives and politicians.

Purpose: Despite the rapid advancements in genomics and the enactment of a new cancer law in Chile, the implementation of cancer genetic counseling continues to face significant challenges because of limited resources and infrastructure. Methods: We conducted a survey targeting health care providers who offer genetic counseling to patients with cancer and possess training in genetics and counseling. Additionally, we distributed a separate survey to high-risk patients associated with an advocacy group to gather insights on their perceptions of and experiences with cancer genetic counseling. Results: Among the surveyed providers, 21% were nonmedical professionals who developed their skills through postgraduate continuing education programs. Germline testing was not performed in 47% of cases. Among the participants, 37% considered genetic counseling important for understanding the cause of their cancer, 25% valued knowing their risk of developing future tumors, and 33% believed it would benefit their current cancer treatment. Just over half of the patients (54%) had access to genetic counseling. Among those that received genetic counseling, 85% found it beneficial. Conclusion: In Chile, barriers to genetic counseling persist, particularly in rural areas and because of a shortage of trained professionals. Public policies recognizing genetic counseling’s importance are crucial, along with expanding training and infrastructure. Understanding patient perceptions and increasing the number of trained genetic counseling into cancer care, educating clinicians, and advocating for increased access are key steps for enhancing cancer treatment effectiveness in Chile.

BackgroundThe cornea plays a role in the refractive power of the eye, and when its natural curvature and thickness are compromised by diseases such as keratoconus or high myopia, this results in loss of visual acuity. Intracorneal rings (ICRs) were developed as a treatment option to restore the natural corneal curvature by implanting rings into tunnels cut within the corneal stroma. However, selecting and placing the appropriate ring can be difficult, and predicting refractive outcomes is challenging.ObjectiveThe purpose of this study was to better understand the design parameters of the rings that determine postoperative refractive and mechanical outcomes.MethodsWe developed an automated finite element simulation pipeline for ICR implantation and tested 300 variations of 20 ICRs.ResultsThe outcome of ICR was dominated by the vertical size of the ring; 84% of the change in corneal curvature can be attributed to the vertical size of the ring, while only 13% were attributed to the detailed cross-sectional shape of the ring. However, the cross-sectional shape of the ring is limited to the change in axial length and contact pressure between the ring and the cornea. The horizontal dimension of the ring plays only a minor role in the postoperative outcome.ConclusionThese results support Keraring's approach to ring scaling, in which only the vertical dimension of the ring is changed, while the horizontal dimension remains constant. Numerical models help to understand ICR outcomes, design implants, and personalize empirical nomograms to achieve more successful postoperative outcomes.

Introducción: los trastornos musculoesqueléticos en el contexto laboral metalúrgico repercuten negativamente desde la perspectiva personal, económica y social de los trabajadores. Objetivo: identificar las manifestaciones de trastornos musculoesqueléticos en los moldeadores manuales metalúrgicos del área de fundición de la empresa Holmeca de la provincia Holguín, Cuba, en el período comprendido enero-marzo de 2021. Método: se realizó un estudio observacional, no experimental de corte transversal en 19 moldeadores manuales metalúrgicos, en el que se incluyeron variables sociodemográficas, ubicación de zonas dolorosas, intensidad del dolor, tiempo de aparición y duración del trastorno. Se emplearon métodos teóricos, empíricos. Fue utilizado el Cuestionario Nórdico estandarizado de Kuorinka y la Escala Visual Analógica. El procesamiento de la información se llevó a cabo mediante la estadística descriptiva. Resultados: se identificaron las zonas dolorosas y la prevalencia más alta de dolor musculoesqueléticos en: muñeca/mano (94,74 %), hombro (89,47 %), dorsal/lumbar (89,47 %) y codo/antebrazo (84,21 %). La intensidad del dolor fue determinada como intenso en el 36,84 % y moderado en el 42,11 % de los trabajadores; mientras que en el 21,05 % fue leve. El tiempo de padecimiento de los trastornos fue de 3-38 años, que aparecieron luego de 5 a 7 años de haber comenzado las labores en el área de estudio. Conclusiones: la prevalencia de manifestaciones de trastornos musculoesqueléticos en los moldeadores manuales metalúrgicos del área de fundición de la empresa Holmeca de Holguín es elevada. Se identifican en mano/muñeca, hombro, lumbar y codo/antebrazo, como las zonas anatómicas más afectadas en este grupo poblacional.

Objetivo: Determinar los valores de referencia de espirometría y formular una ecuación de predicción de valores espirométricos en población económicamente activa (PEA) de regiones con altitud 0-100 m.s.n.m. Métodos: Se seleccionaron a los participantes del estudio considerando los criterios de selección del estudio. Se recogió la información sobre las variables consideradas en el estudio: Capacidad Vital Forzada (CVF) y Volumen Espiratorio Forzado en el primer Segundo (VEF1), datos sociodemográficos y medidas antropométricas. Se dividió a la muestra en dos grupos para poder formular la ecuación de referencia y para evaluar su confiabilidad en un subgrupo de validación mediante las pruebas de correlación intraclase, T de Student para muestras pareadas y los gráficos de Bland-Altman. Resultados: Se seleccionaron 1052 participantes varones. Los rangos normales de CVF y VEF1 calculados fueron de CVF de 3.48 – 5.47 y VEF1 de 2.83 – 4.41. Mediante una regresión lineal múltiple, se obtuvieron las siguientes fórmulas: CVF = 2.206 – 0.131 (Altitud Geográfica) – 0.014 (Edad) + 0.045 (Talla) y VEF1 = 1.589 – 0.08 (Altitud Geográfica) – 0.015 (Edad) + 0.033 (Talla). En los análisis de confiabilidad, se encontró una diferencia estadísticamente significativa en las medias entre los valores predichos por la ecuación y los valores reales, aunque en los gráficos de Bland-Altman no se evidenció un sesgo significativo y los coeficientes de correlación intraclase (CVF-ICC: 0.69; VEF1-ICC: 0.70) se encontraban dentro de un rango adecuado. Conclusiones: Las ecuaciones de CVF y VEF1 desarrolladas permiten predecir adecuadamente los valores espirométricos en PEA masculina de las regiones incluidas en el estudio.

The transmission of DNA through extracellular vesicles (EVs) represents a novel genetic material transfer mechanism that may impact genome evolution and tumorigenesis. We aimed to investigate the potential for vertical DNA transmission within maternal endometrial EVs to the pre-implantation embryo and describe any effect on embryo bioenergetics. We discovered that the human endometrium secretes all three general subtypes of EV - apoptotic bodies (ABs), microvesicles (MVs), and exosomes (EXOs) - into the human endometrial fluid (EF) within the uterine cavity. EVs become uniformly secreted into the EF during the menstrual cycle, with the proportion of different EV populations remaining constant; however, MVs contain significantly higher levels of mitochondrial (mt)DNA than ABs or EXOs. During the window of implantation, MVs contain an eleven-fold higher level of mtDNA when compared to cells-of-origin within the receptive endometrium, which possesses a lower mtDNA content and displays the upregulated expression of mitophagy-related genes. Furthermore, we demonstrate the internalization of EV-derived nuclear-encoded (n)DNA/mtDNA by trophoblast cells of murine embryos, which associates with a reduction in mitochondrial respiration and ATP production. These findings suggest that the maternal endometrium suffers a reduction in mtDNA content during the preconceptional period, that nDNA/mtDNA become packaged into secreted EVs that the embryo uptakes, and that the transfer of DNA to the embryo within EVs occurs alongside the modulation of bioenergetics during implantation.

Objectives This study aimed to evaluate the effectiveness, safety and costs of FreeStyle Libre (FSL) glucose monitoring system for children and adolescents with type 1 diabetes mellitus (T1DM) in Spain.Design Prospective, multicentre pre-post study.Setting Thirteen Spanish public hospitals recruited patients from January 2019 to March 2020, with a 12-month follow-up.Participants 156 patients were included.Primary and secondary outcome measures Primary: glycated haemoglobin (HbA1c) change. Secondary: severe hypoglycaemic events (self-reported and clinical records), quality of life, diabetes treatment knowledge, treatment satisfaction, adverse events, adherence, sensor usage time and scans. Healthcare resource utilisation was assessed for cost analysis from the National Health System perspective, incorporating direct healthcare costs. Data analysis used mixed regression models with repeated measures. The intervention’s total cost was estimated by multiplying health resource usage with unit costs.Results In the whole sample, HbA1c increased significantly (0.32%; 95% CI 0.10% to 0.55%). In the subgroup with baseline HbA1c≥7.5% (n=88), there was a significant reduction at 3 months (−0.46%; 95% CI −0.69% to −0.23%), 6 months (−0.49%; 95% CI −0.73% to −0.25%) and 12 months (−0.43%; 95% CI −0.68% to –0.19%). Well-controlled patients had a significant 12-month worsening (0.32%; 95% CI 0.18% to 0.47%). Self-reported severe hypoglycaemia significantly decreased compared with the previous year for the whole sample (−0.37; 95% CI −0.62 to –0.11). Quality of life and diabetes treatment knowledge showed no significant differences, but satisfaction increased. Adolescents had lower sensor usage time and scans than children. Reduction in HbA1c was significantly associated with device adherence. No serious adverse effects were observed. Data suggest that use of FSL could reduce healthcare resource use (strips and lancets) and costs related to productivity loss.Conclusions The use of FSL in young patients with T1DM was associated with a significant reduction in severe hypoglycaemia, and improved HbA1c levels were seen in patients with poor baseline control. Findings suggest cost savings and productivity gains for caregivers. Causal evidence is limited due to the study design. Further research is needed to confirm results and assess risks, especially for patients with lower baseline HbA1c.

Objetivo: Conocer el consumo de tabaco, mariguana y cocaína en adolescentes mexicanos en tiempos de la COVID-19. Materiales y métodos: Estudio cuantitativo, descriptivo y transversal realizado con 265 adolescentes mexicanos entre 12 y 19 años de edad, elegidos mediante un muestreo no probabilístico. La recolección de la información se llevó a cabo mediante la plataforma digital SurveyMonkey, los datos fueron procesados en el programa estadístico SPSS 23.0. Se utilizó estadística descriptiva para obtener frecuencias, proporciones, medidas de tendencia central y de variabilidad. Resultados: El promedio de edad fue de 17.8 años, el inicio de consumo de alcohol fue a los 16.7 años, tabaco a los 16.8 años, marihuana a los 17 años y cocaína a los 17.3 años. El promedio de bebidas alcohólicas consumidas en un día típico fue de 3.3, la media de cigarrillos consumidos en un día típico fue de 2.2, la media del consumo marihuana fue de 1.2 y la de cocaína de 2.5. El 66.8 % de los participantes han consumido alcohol alguna vez en la vida, 49.9% ha consumido alcohol en el último año. El 18.5% han consumido cigarrillos al menos una vez en la vida y solo el 13.6% lo consumió en el último año. El 7.2% del adolescente han consumido marihuana alguna vez en la vida y solo el 3.8% consumió en el último año. El 3.4% ha consumido cocaína alguna vez en la vida y 1.9% en el último año. Conclusiones: Las prevalencias del consumo de drogas lícitas e ilícitas denotan un incremento significativo, lo cual es preocupante, debido que durante la adolescencia cualquier cantidad consumida es riesgosa y dañina para la salud física y mental. Palabras clave: Adolescente; Drogas; Drogas ilícitas, COVID-19