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Introducción: El trasplante cardíaco tiene como objetivo principal mejorar la calidad de vida y la sobrevida de los pacientes con falla cardiaca avanzada. Pocos países en Latinoamérica tienen un sistema nacional de registro de trasplante de órganos sólidos, incluido corazón. En el caso de Colombia, cada institución maneja sus propias estadísticas. Objetivo: Describir la evolución de los trasplantes cardíacos realizados en Colombia desde sus inicios, como parte de la estrategia de implementación de un registro nacional de trasplante cardíaco. Materiales y método: Estudio descriptivo acerca de los trasplantes cardíacos realizados en las instituciones de Colombia que han hecho trasplante cardíaco en cualquier momento, desde el 01 de enero del 1985 hasta el 31 de diciembre del 2021. La información fue recolectada en un formato electrónico a través del capítulo de Falla Cardiaca, Trasplante Cardíaco e Hipertensión Pulmonar de la Asociación Sociedad Colombiana de Cardiología y Cirugía Cardiovascular. Resultados: se identificaron 10 instituciones que han realizado al menos un procedimiento de trasplante cardíaco en un período de 36 años (1985 a 2021), para un total de 1.451 trasplantes cardíacos. De estos procedimientos, 1.327 (91%) se realizaron en población adulta, 124 (9%) en población pediátrica y 80% en población masculina. Por otro lado, se han hecho 26 trasplantes cardíacos combinados (23 corazón/riñón y 3 corazón/pulmón) y 16 retrasplantes cardíacos. Conclusión: El número de trasplantes cardíacos que se realizan en Colombia es cada vez mayor. A pesar de las dificultades económicas, geográficas, logísticas, de disponibilidad de donantes, entre muchas otras, las instituciones trasplantadoras de Colombia, junto con el Instituto Nacional de Salud, continúan trabajando para lograr una mejor y mayor cobertura en salud de la población con falla cardíaca avanzada que requiere trasplante cardíaco y de los pacientes que son llevados a trasplante cardíaco. Este artículo pretende ser el inicio de un registro nacional de trasplante cardíaco.

Historically, reproductive health in wildlife species has been evaluated primarily via immunoassay detection of fecal and urinary steroid hormone metabolites. This combination of sample type, biomarker category, and assay has been preferred for decades due to the ease of assessing reproductive health through the evaluation of stable compounds in easily collected biological samples using a cost-effective method. Increasingly, beginning with high performance liquid chromatography (HPLC) and more recently with convergence chromatography and ultra HPLC coupled with mass spectrometry (MS), wildlife studies are incorporating more sensitive and specific high-throughput technologies for the assessment of not only steroid hormone metabolites but proteins as well. Of note, a comprehensive health evaluation requires the measurement of biological readouts that modulate reproduction such as: glucocorticoids, leptin, insulin, thyroid hormones, melatonin, the microbiome, and markers of inflammation. Emerging modulatory biomarkers of reproductive health include acute phase proteins, microRNAs, and reactive oxygen species. Several of these biomarkers require application of newer technologies such as LC-MS/MS and sequencing, which demonstrates the need for the field of wildlife reproductive biology to diversify from its reliance on immunoassays. Importantly, endocrine disrupting chemicals adversely affect many aspects of reproductive function and evaluation of these compounds requires high throughput technology such as LC-MS/MS. The application of sequencing, particularly Next Generation Sequencing of bulk RNA (RNA-Seq) and single cell RNA-Seq, is uncommon in studies of wildlife reproductive health. However, as the cost of these methods decreases and consortiums of wildlife researchers band together to raise funds in support of studies using these technologies, their use will become more routine. Future research should focus on integration of known biomarkers of related systems into comprehensive reproductive assessments and the development of new biomarkers which are sensitive, precise, and employ non-invasive methodologies for the assessment of reproductive health of wildlife species.

Introducción: La obstrucción intestinal por ingesta accidental de cuerpos extraños se presenta muy rara vez en la edad pediátrica debido a que del 80 al 90% de los objetos pueden pasar libremente por el tracto gastrointestinal. Caso clínico: Se aborda el caso de una paciente de sexo femenino de 1 año 2 meses quien presentó obstrucción intestinal debido a la ingesta de esferas de hidrogel (poliacrilato de sodio). Dichas esferas, que son utilizadas como juguetes didácticos o sensoriales, aumentan de 200 a 400 veces su tamaño inicial mediante la absorción de agua. Se realizó radiografía abdominal en proyección decúbito supino, donde llamó la atención el hallazgo de defecto de llenado redondeado en asa de flanco derecho, ya que las esferas de hidrogel son radiolúcidas. El diagnóstico se estableció mediante ultrasonido abdominal, donde se reportó líquido libre peritoneal con datos de suboclusión por cuerpos extraños a nivel intestinal. Se indicó tratamiento conservador, encontrando persistencia de aumento de perímetro abdominal. Se realizó enterotomía y se encontraron las esferas impactadas a 30 centímetros de la válvula ileocecal. Conclusiones: Las esferas de hidrogel son peligrosas para la población pediátrica. La evolución de la paciente fue favorable debido al conocimiento del objeto extraño ingerido. Sobresale la conducta expectante que se tuvo que desempeñar debido a que se desconocía el crecimiento de las esferas y en qué momento no podrían continuar su paso por el tracto gastrointestinal.

Choice impulsivity is characterized by the choice of immediate, smaller reward options over future, larger reward options, and is often thought to be associated with negative life outcomes. However, some environments make future rewards more uncertain, and in these environments impulsive choices can be beneficial. Here we examined the conditions under which impulsive vs. non-impulsive decision strategies would be advantageous. We used Markov Decision Processes (MDPs) to model three common decision-making tasks: Temporal Discounting, Information Sampling, and an Explore-Exploit task. We manipulated environmental variables to create circumstances where future outcomes were relatively uncertain. We then manipulated the discount factor of an MDP agent, which affects the value of immediate versus future rewards, to model impulsive and non-impulsive behavior. This allowed us to examine the performance of impulsive and non-impulsive agents in more or less predictable environments. In Temporal Discounting, we manipulated the transition probability to delayed rewards and found that the agent with the lower discount factor (i.e. the impulsive agent) collected more average reward than the agent with a higher discount factor (the non-impulsive agent) by selecting immediate reward options when the probability of receiving the future reward was low. In the Information Sampling task, we manipulated the amount of information obtained with each sample. When sampling led to small information gains, the impulsive MDP agent collected more average reward than the non-impulsive agent. Third, in the Explore-Exploit task, we manipulated the substitution rate for novel options. When the substitution rate was high, the impulsive agent again performed better than the non-impulsive agent, as it explored the novel options less and instead exploited options with known reward values. The results of these analyses show that impulsivity can be advantageous in environments that are unexpectedly uncertain.

Objetivo: Establecer la prevalencia de hipertensión arterial (HTA) en los pacientes pediátricos hospitalizados en un centro hospitalario de tercer nivel de Medellín, Colombia, durante seis años. Métodos: Se hizo un estudio descriptivo de corte transversal que revisó información retrospectiva obtenida de los registros de las historias clínicas de pacientes menores de 18 años hospitalizados en el Hospital Pablo Tobón Uribe de Medellín, Colombia. Resultados: De un total de 382 pacientes pediátricos hospitalizados en el periodo estudiado se obtuvo una prevalencia de HTA del 30.6%, la de hipertensión sistólica fue 23.6% y la de diastólica 20.7%. Los niños menores de cinco años, el uso de vancomicina y la estancia en cuidado crítico aumentan significativamente el riesgo de presentar hipertensión durante la hospitalización. Conclusiones: En pediatría la frecuencia de HTA en pacientes hospitalizados es elevada, mayor a la prevalencia reportada en pacientes ambulatorios. Se debe reconocer el grupo de mayor riesgo y los factores potencialmente modificables, así como definir el inicio de tratamiento de forma oportuna. Las complicaciones son bajas, excepto la hipertrofia ventricular izquierda, por lo que es necesario un seguimiento a largo plazo.

This paper presents the results of qualitative research in terms of supervision in social work organizations during the COVID-19 pandemic. Thedata were collected by applying an interview guide, to which 22 socialworkers responded. The results of the research refer to how the measurestaken during the pandemic affected social workers. It is also presented to what extent the supervision done within the organizations responded to theneeds of social workers in this period of crisis. This research confirms the factthat supervision is an indispensable activity in social work organizations,especially in Romania, where, as a professional activity, it is still in thebeginning.

Background While radiation and chemotherapy are primarily purposed for their cytotoxic effects, a growing body of preclinical and clinical evidence demonstrates an immunogenic potential for these standard therapies. Accordingly, we sought to characterize the immunogenic potential of radiation and cisplatin in human tumor models of HPV-associated malignancies. These studies may inform rational combination immuno-oncology (IO) strategies to be employed in the clinic on the backbone of standard of care, and in so doing exploit the immunogenic potential of standard of care to improve durable responses in HPV-associated malignancies.Methods Retroviral transduction with HPV16 E7 established a novel HPV-associated sinonasal squamous cell carcinoma (SNSCC) cell line. Three established HPV16-positive cell lines were also studied (cervical carcinoma and head and neck squamous cell carcinoma). Following determination of sensitivities to standard therapies using MTT assays, flow cytometry was used to characterize induction of immunogenic cell stress following sublethal exposure to radiation or cisplatin, and the functional consequence of this induction was determined using impedance-based real time cell analysis cytotoxicity assays employing HPV16 E7-specific cytotoxic lymphocytes (CTLs) with or without N803 (IL-15/IL-15-Rα superagonist) or exogenous death receptor ligands. In vitro observations were translated using an in vivo xenograft NSG mouse model of human cervical carcinoma evaluating cisplatin in combination with CTL adoptive cell transfer.Results We showed that subpopulations surviving clinically relevant doses of radiation or cisplatin therapy were more susceptible to CTL-mediated lysis in four of four tumor models of HPV-associated malignancies, serving as a model for HPV therapeutic vaccine or T-cell receptor adoptive cell transfer. This increased killing was further amplified by IL-15 agonism employing N803. We further characterized that radiation or cisplatin induced immunogenic cell stress in three of three cell lines, and consequently demonstrated that upregulated surface expression of Fas and TRAIL-R2 death receptors at least in part mediated enhanced CTL-mediated lysis. In vivo, cisplatin-induced immunogenic cell stress synergistically potentiated CTL-mediated tumor control in a human model of HPV-associated malignancy.Conclusion Standard of care radiation or cisplatin therapy induced immunogenic cell stress in preclinical models of HPV-associated malignancies, presenting an opportunity poised for exploitation by employing IO strategies in combination with standard of care.

In natural environments, bear behavior follows seasonal patterns but the zoo environment differs from the natural environment in several ways, including the presence of zoo visitors. Although typically difficult to disentangle, we were able to tease apart the effects of seasonal changes and visitor density on the visibility and behavior of 10 bears representing five species housed at Cleveland Metroparks Zoo due to the disruption caused by COVID-19. We conducted a longitudinal bear behavior monitoring project from June, 2017-November, 2020. Bears were more visible in the spring and in the presence of visitors, locomoted more and were less inactive when large crowds were present, foraged and locomoted more when it was earlier in the day, and locomoted more at higher temperatures. There were limited differences in bear visibility to observers between 2020 (when the zoo was temporarily closed to visitors) and the previous three years. There were no differences in rates of stereotypy or social behavior across seasons, crowds, or daily attendance categories. Based on these limited differences, neither season nor visitor density seemed to have an apparent effect on bear behavior or welfare.

Abstract Background Patients with ovarian cancer often present at advanced stage and, following initial treatment success, develop recurrent drug-resistant disease. PARP inhibitors (PARPi) are yielding unprecedented survival benefits for women with BRCA-deficient disease. However, options remain limited for disease that is platinum-resistant and/or has inherent or acquired PARPi-resistance. PARG, the PAR glycohydrolase that counterbalances PARP activity, is an emerging target with potential to selectively kill tumour cells harbouring oncogene-induced DNA replication and metabolic vulnerabilities. Clinical development of PARG inhibitors (PARGi) will however require predictive biomarkers, in turn requiring an understanding of their mode of action. Furthermore, differential sensitivity to PARPi is key for expanding treatment options available for patients. Methods A panel of 10 ovarian cancer cell lines and a living biobank of patient-derived ovarian cancer models (OCMs) were screened for PARGi-sensitivity using short- and long-term growth assays. PARGi-sensitivity was characterized using established markers for DNA replication stress, namely replication fibre asymmetry, RPA foci, KAP1 and Chk1 phosphorylation, and pan-nuclear γH2AX, indicating DNA replication catastrophe. Finally, gene expression in sensitive and resistant cells was also examined using NanoString or RNAseq. Results PARGi sensitivity was identified in both ovarian cancer cell lines and patient-derived OCMs, with sensitivity accompanied by markers of persistent replication stress, and a pre-mitotic cell cycle block. Moreover, DNA replication genes are down-regulated in PARGi-sensitive cell lines consistent with an inherent DNA replication vulnerability. However, DNA replication gene expression did not predict PARGi-sensitivity in OCMs. The subset of patient-derived OCMs that are sensitive to single-agent PARG inhibition, includes models that are PARPi- and/or platinum-resistant, indicating that PARG inhibitors may represent an alternative treatment strategy for women with otherwise limited therapeutic options. Conclusions We discover that a subset of ovarian cancers are intrinsically sensitive to pharmacological PARG blockade, including drug-resistant disease, underpinned by a common mechanism of replication catastrophe. We explore the use of a transcript-based biomarker, and provide insight into the design of future clinical trials of PARGi in patients with ovarian cancer. However, our results highlight the complexity of developing a predictive biomarker for PARGi sensitivity.

The detection of SARS-CoV in wastewater has been proposed as a tool for monitoring COVID-19 at the community level. Although many reports have been published about detecting viral RNA in wastewater and its presence has been linked to infected people, appropriate analytical methodologies to use this approach have not yet been established. In this study, we compared ultrafiltration, polyethylene glycol precipitation, flocculation using AlCl3, and flocculation with skim milk for the recovery of SARS-CoV-2, using RNA from patients with positive diagnoses for COVID-19 and Pseudomonas phage φ6 as the control. We also evaluated the primers for detecting the E, RdRp, and N genes of the virus, as well as different storage times. Differences in the recovery efficiencies were evident with the different concentration methods, the best being ultrafiltration and precipitation with aluminum, which had recovery rates of 42.0% and 30.0%, respectively, when virus was present at high levels. Significant differences were found between the recoveries using wastewater and deionized water and between different storage times, with better recoveries for 6 and 12 h samplings. The E gene was the only one detected in all the samples analyzed. The results show that although this approach can provide important data for studying the pandemic, clear protocols are necessary for investigations to be comparable. HIGHTLIGHTS RNA of SARS-CoV-2 was used to evaluate the recovery of different methods in wastewater.; The utility of phage φ6 of Pseudomonas as a control for evaluation of recovery methods of SARS-CoV-2 from wastewater was demonstrated.; Differences due to the target selected for the detection of SARS were demonstrated.; The results show that it is possible to detect SARS RNA in wastewater, however its epidemiological usefulness will depend on the correct validation of the technique used for detection.;

The efficient treatment of domestic wastewater is associated with good operational practices in wastewater treatment plants (WWTP) and the proper design of each treatment unit, which ensures the correct hydraulic performance of each WWTP. For this reason, the objective of this article was to study the design of the multiple influent distribution systems of a high-rate primary sedimentary, a UASB (Upflow Anaerobic Sludge Blanket) reactor, and an up-flow anaerobic filter (FAFA) in the WWTPs of the municipalities of San Carlos and San Roque, and in the township of Santiago, respectively, located in Antioquia-Colombia. For this purpose, the methodology proposed by Hudson in 1981 was used to evaluate the performance of the current design and, subsequently, a pre-dimensioning was carried out to distribute the flow uniformly, to have velocities within the ranges recommended by the literature, and to obtain the total head loss generated by the distribution manifold in each treatment unit evaluated. It was found that the existing design is not efficient and that the new pre-dimensioning ensures homogeneous flow distribution and provides velocities that contribute positively to the treatment process. The study concludes that the smaller the number of orifices and the larger the pipe diameter, the more uniform the flow distribution, and that the total head loss depends on both the velocity head and the head loss coefficient. The diameter of the orifice was the predominant parameter to control the inlet velocity of the treatment units.

Unvaccinated patients with comorbidities that impair the immune function, such as type 2 diabetes mellitus, are more likely to develop severe COVID-19. The COVID-19-associated acute respiratory distress syndrome has raised new concerns in intensive care units globally owing to the presence of secondary fungal infections. We report the case of a 71-year-old man from Ecuador with a history of type 2 diabetes mellitus, severe COVID-19 pneumonia, and lung cavitation associated with triple infections with Trichosporon asahii , Klebsiella pneumoniae , and Pseudomonas aeruginosa . The patient with a history of high blood pressure and type 2 diabetes was admitted to our hospital from a private care center with a diagnosis of COVID-19-associated acute respiratory distress syndrome. On arrival, the patient presented with signs of hypoxemic respiratory failure. During his stay at another hospital, he had received tocilizumab and corticosteroid therapy. Therefore, intubation was performed and mechanical ventilation was initiated. The patient developed a septic shock and renal failure with a glomerular filtration rate of 27.5 mL/min/1.73 m 2 ; therefore, two hemodiafiltration sessions were started. The bronchoalveolar lavage revealed erythematous lesions in the bronchial tree and abundant purulent secretions and erosions in the bronchial mucosa, with a cavitary lesion in the right bronchial tree. The bronchoalveolar lavage samples were used to isolate Trichosporon asahii , Klebsiella pneumoniae , and Pseudomonas aeruginosa carbapenemase class A . Matrix-assisted laser desorption/ionization–time of flight (MALDI-TOF) Biotyper mass spectrometry and polymerase chain reaction (PCR) molecular identification were performed. This case report suggested that patients with severe COVID-19 pneumonia, with or without comorbidities, are more susceptible to opportunistic infections.

Collaboration mechanisms in humanitarian supply chains increase efficiency levels in post-disaster relief operations. The scientific literature on the topic is mostly based on qualitative approaches to identify the barriers and benefits of collaborative relationships between stakeholders. Thus, this paper proposes the use of system dynamics simulation to evaluate the impact on the average response time of aid delivery resulting from implementing different collaborative strategies. In this sense, collaborative strategies are designed for humanitarian operations in the immediate response phase considering elements such as information exchange, shared resources, and infrastructure. To design and assess the impact of these collaborative strategies in a disaster scenario, we analyze the case of the city of Bogotá-Colombia and the surrounding cities, we have used public information for building and tuning the parameters of the simulation model. The simulation model results allow us to identify the main factors that reduce the average response times to serve the affected population. It can be concluded that the strategy which includes sharing resources and infrastructure, exchanging information, and the creation of joint knowledge has a greater improvement in response times becoming the best policy for disaster management given the results obtained in a collaborative planning environment.

The aim of this paper is to conduct a revenue management study, generating a theoretical model that establishes the relationship between the factors of a Short-Term Rental apartment offered on the Airbnb marketplace or similar and its optimal rental price set when the property is first put on the market, considering not only the characteristics defined in the platform listing but also the sociodemographic characteristics of the area in which the apartment is located. The research process was structured in six phases as case study for the technology transfer model. First, research planning was conducted to estimate the time, cost, and suitability of the research topic. Second, the study design was determined to establish a technology transfer model focusing on the theory of mixed revenue management. Third, data collection about the city of Madrid was extracted from two technological databases, namely SeeTransparent based mainly on Airbnb (28 internal characteristics of the apartment) and Deskmind Research (9 sociodemographic variables of the area in which the apartment is located). Fourth, the data were prepared to create a new descriptive variable of the apartments based on geolocation. Fifth, the analysis of this study was applied to explore the correlation between the price charged per night, the 28 internal characteristics of the apartments, and the 9 sociodemographic variables of their surrounding areas. Sixth, with this integrated database, the information was transformed into multivariate inferential statistics through Exploratory Factor Analysis and Multiple Linear Regression, creating a technology transfer model (big data algorithm) that allows revenue managers to set the price of an apartment based on known information, prior to having a history of market reactions. This research process and model consider some of the factors affecting the psychological behavior of tourism consumers. Practical implications of the findings indicate that the size/capacity of the apartments used for Short-Term rentals largely determines the initial rental price set (72%). The equipment offered by the apartments has a moderate impact (18%), and the sociodemographic characteristics of the surrounding area have a minor influence (11%).

BackgroundChordoma is a rare, invasive, and devastating bone malignancy of residual notochord tissue that arises at the skull base, sacrum, or spine. In order to maximize immunotherapeutic approaches as a potential treatment strategy in chordoma it is important to fully characterize the tumor immune microenvironment (TIME). Multispectral immunofluorescence (MIF) allows for comprehensive evaluation of tumor compartments, molecular co-expression, and immune cell spatial relationships. Here we implement MIF to define the myeloid, T cell, and natural killer (NK) cell compartments in an effort to guide rational design of immunotherapeutic strategies for chordoma.MethodsChordoma tumor tissue from 57 patients was evaluated using MIF. Three panels were validated to assess myeloid cell, T cell, and NK cell populations. Slides were stained using an automated system and HALO software objective analysis was utilized for quantitative immune cell density and spatial comparisons between tumor and stroma compartments.ResultsChordoma TIME analysis revealed macrophage infiltration of the tumor parenchyma at a significantly higher density than stroma. In contrast, helper T cells, cytotoxic T cells, and T regulatory cells were significantly more abundant in stroma versus tumor. T cell compartment infiltration more commonly demonstrated a tumor parenchymal exclusion pattern, most markedly among cytotoxic T cells. NK cells were sparsely found within the chordoma TIME and few were in an activated state. No immune composition differences were seen in chordomas originating from diverse anatomic sites or between those resected at primary versus advanced disease stage.ConclusionThis is the first comprehensive evaluation of the chordoma TIME including myeloid, T cell, and NK cell appraisal using MIF. Our findings demonstrate that myeloid cells significantly infiltrate chordoma tumor parenchyma while T cells tend to be tumor parenchymal excluded with high stromal infiltration. On average, myeloid cells are found nearer to target tumor cells than T cells, potentially resulting in restriction of T effector cell function. This study suggests that future immunotherapy combinations for chordoma should be aimed at decreasing myeloid cell suppressive function while enhancing cytotoxic T cell and NK cell killing.

Background: Student-run health initiatives in the community setting have been utilized to provide practical experience for undergraduate students to develop professional competencies, gain exposure to diverse populations, and to engage in activities of social accountability. There is much literature on student-run health initiatives; however, there is no consensus on a definition of this concept or a comprehensive synthesis of the literature that describes student-run health initiatives offered by students in pre-licensure healthcare education programs. Purpose: To provide a concept analysis of, and propose a definition for, student-run health initiatives that provide community-based services for students during pre-licensure health discipline education. Methods: A systematic literature search and review process was used to identify and synthesize peer-reviewed articles from 7 academic databases covering a range of pre-licensure health disciplines and education. Walker and Avant’s framework for concept analysis was used to guide exploration of attributes, antecedents and consequences of student-run initiatives, and to inform development of a definition for this concept. Results: The review yielded 222 articles for data extraction and represented 17 distinct pre-licensure health disciplines, 18 health-related disciplines, and a range of other baccalaureate and graduate programs. Our analysis revealed 16 definitions, 5 attributes, 6 antecedents, and consequences identified for student-run health initiatives. Attributes were Provision of Service, Service is Free, Target Clientele, Volunteerism, and Student Governance. Antecedents included Purpose/Rationale, Affiliation with Academic Unit, Location and Partnerships, Funding and Resources, Professional Oversight, and Preparation for Student Role. Consequences were improved access to services and outcomes for clients; competency development, personal gains and interprofessional learning for students; and positive outcomes for broader systems, such as decrease of service utilization and cost/benefit. Conclusions: There was no clear conceptual definition for student-run health initiatives, but many defining characteristics and well-described exemplars in the literature. Given the variations in purpose and scope of these initiatives, particularly to distinguish degree of students’ roles in operations and the involvement of academic institutions, we propose 3 distinct conceptual definitions: student-run, student-led, and student-infused health initiatives.

There is increasing evidence that the diet and nutritional status of women during pregnancy and lactation can modulate the microbiota of their milk and, therefore, the microbiota of the infant. An observational, descriptive, and cross-sectional study was carried out in a group of lactating women. Dietary intake during gestation and the first trimester of lactation was evaluated, and the microbiota was analyzed by 16S ribosomal RNA (rRNA) sequencing using the Illumina platform. Globally, Streptococcus spp. (32%), Staphylococcus spp. (17.3%), Corynebacterium spp. (5.1%) and Veillonella spp. (3.1%) were the predominant bacterial genera. The consumption of simple carbohydrates in gestation (rho = 0.55, p ≤ 0.01) and lactation (rho = 0.50, p ≤ 0.01) were positively correlated with Enterobacter spp. In lactation, a negative correlation was observed between the intake of simple carbohydrates and the genus Bifidobacterium spp. (rho = −0.51 p ≤ 0.01); furthermore, a positive correlation was identified between the intake of folic acid and Akkermansia spp. (rho = 0.47, p ≤ 0.01). Amplicon sequence variants (ASVs) associated with the delivery mode, employment relationship, the baby’s gender, birth weight, the Body Mass Index (BMI) of the breastfeeding woman, and gestational weight gain were recovered as covariates in a linear mixed model. The results of this research showed that the maternal nutritional status and diet of women during gestation and lactation could modulate the microbiota of breast milk.

In Colombia, most of the energy is produced by using water resources. However, the morphological impact of damming has not been thoroughly studied yet. Therefore, upstream and downstream changes in the channel width and sinuosity along the river due to the Betania, Prado, Salvajina, and Urrá I Dams, four of the oldest hydroelectric projects, were estimated. These changes were reported by using aerial photographs and satellite images to compare the river before and after dam construction. The analysis was complemented by including hydrological trends and geological characteristics of the areas to evaluate their relevance on the impacts on channel morphology. It was shown that factors such as valley confinement and the bank’s composition are key to determining the magnitude of the impact downstream of the dam. Upstream of the dam, contrastingly, the influence of the reservoir geometry controls the magnitude of the morphological changes, marking the boundaries of affected areas. The impacts of dam construction on river morphology vary notably, but including the geological characteristics of the river reach can be useful to improve predictions of the channel morphology response. The proposed methodology can be used to identify biotic compensation measures for new projects, a task that is not well defined in several countries.

Abstract Background TNF-α-stimulated gene 6 (TSG-6) protein, a TNF-α-responsive hyaladherin, possesses enzymatic activity that can catalyze covalent crosslinks of the polysaccharide hyaluronic acid (HA) to another protein to form heavy chain-hyaluronic acid (HC-HA) complexes in pathological conditions such as osteoarthritis (OA). Here, we examined HA synthase and inflammatory gene expression; synovial fluid HA, TNF-α, and viscosity; and TSG-6-mediated HC-HA complex formation in an equine OA model. The objectives of this study were to (1) evaluate the TNF-α-TSG-6-HC-HA signaling pathway across multiple joint tissues, including synovial membrane, cartilage, and synovial fluid, and (2) determine the impact of OA on synovial fluid composition and biophysical properties. Methods HA and inflammatory cytokine concentrations (TNF-α, IL-1β, CCL2, 3, 5, and 11) were analyzed in synovial fluid from 63 OA and 25 control joints, and HA synthase (HAS1-3), TSG-6, and hyaluronan-degrading enzyme (HYAL2, HEXA) gene expression was measured in synovial membrane and cartilage. HA molecular weight (MW) distributions were determined using agarose gel electrophoresis and solid-state nanopore measurements, and HC-HA complex formation was detected via immunoblotting and immunofluorescence. SEC-MALS was used to evaluate TSG-6-mediated HA crosslinking, and synovial fluid and HA solution viscosities were analyzed using multiple particle-tracking microrheology and microfluidic measurements, respectively. Results TNF-α concentrations were greater in OA synovial fluid, and TSG6 expression was upregulated in OA synovial membrane and cartilage. TSG-6-mediated HC-HA complex formation was greater in OA synovial fluid and tissues than controls, and HC-HA was localized to both synovial membrane and superficial zone chondrocytes in OA joints. SEC-MALS demonstrated macromolecular aggregation of low MW HA in the presence of TSG-6 and inter-α-inhibitor with concurrent increases in viscosity. Conclusions Synovial fluid TNF-α concentrations, synovial membrane and cartilage TSG6 gene expression, and HC-HA complex formation were increased in equine OA. Despite the ability of TSG-6 to induce macromolecular aggregation of low MW HA with resultant increases in the viscosity of low MW HA solutions in vitro, HA concentration was the primary determinant of synovial fluid viscosity rather than HA MW or HC-HA crosslinking. The TNF-α-TSG-6-HC-HA pathway may represent a potential therapeutic target in OA.

Abstract Background Single cell Strand-seq is a unique tool for the discovery and phasing of genomic inversions. Conventional methods to discover inversions with Strand-seq data are blind to known inversion locations, limiting their statistical power for the detection of inversions smaller than 10 Kb. Moreover, the methods rely on manual inspection to separate false and true positives. Results Here we describe “InvertypeR”, a method based on a Bayesian binomial model that genotypes inversions using fixed genomic coordinates. We validated InvertypeR by re-genotyping inversions reported for three trios by the Human Genome Structural Variation Consortium. Although 6.3% of the family inversion genotypes in the original study showed Mendelian discordance, this was reduced to 0.5% using InvertypeR. By applying InvertypeR to published inversion coordinates and predicted inversion hotspots (n = 3701), as well as coordinates from conventional inversion discovery, we furthermore genotyped 66 inversions not previously reported for the three trios. Conclusions InvertypeR discovers, genotypes, and phases inversions without relying on manual inspection. For greater accessibility, results are presented as phased chromosome ideograms with inversions linked to Strand-seq data in the genome browser. InvertypeR increases the power of Strand-seq for studies on the role of inversions in phenotypic variation, genome instability, and human disease.

El crecimiento sostenido del mercado de franquicias en países desarrollados, impulsa su afianzamiento en mercados emergentes. En Colombia se han establecido más de 500 marcas de este formato empresarial y, sin embargo, la documentación estadística o académica que describa la adaptación de este tipo de empresas en el país y sus procesos de internacionalización son escasos. Como una contribución al acervo académico y a la comprensión de este fenómeno, el presente artículo es un estudio de tres casos exploratorios que tiene como objetivo identificar los riesgos de adaptación de franquicias dedicadas a la prestación servicios de formación extracurricular para niños en Colombia. Las entrevistas fueron realizadas a los líderes responsables del proceso de expansión de la franquicia en Colombia. Los riesgos de adaptación identificados se agruparon en desarrollo comercial y animación de la red, los cuales evidencian, perfiles inadecuados en la selección de franquiciados, afectación de la marca, poco estudio de la competencia y problemas de comunicación y seguimiento.

BackgroundPrior research on health information behaviors of people with dementia has primarily focused on examining the types of information exchanged by people with dementia using various web-based platforms. A previous study investigated the information behaviors of people with dementia within a month of their diagnosis. There is an empirical gap in the literature regarding the evolution of health information needs and behaviors of people with dementia as their condition progresses. ObjectiveOur work primarily investigated the information behaviors of people with dementia who have been living with the condition for several (4 to 26) years. We also aimed to identify their motivations for changing their information behaviors over time. Our primary research questions were as follows: how do people with dementia get informed about their condition, and why do people with dementia seek information about their condition? MethodsWe adopted an action research approach by including 2 people with dementia as members of our research team. Collaboratively, we conducted 16 remote 1-hour contextual inquiry sessions with people living with mild to moderate dementia. During the study sessions, the first 40 minutes included semistructured interviews with participants concerning their information behaviors, followed by a 20-minute demonstration of their information-seeking strategies. Data from these interviews were analyzed using a constructivist grounded theory approach. ResultsParticipants described their information needs in terms of managing the disrupted physiological, emotional, and social aspects of their lives following a diagnosis of dementia. They used various information behaviors, including active search, ongoing search, monitoring, proxy search, information avoidance, and selective exposure. These information behaviors were not stagnant; however, they were adapted to accommodate the changing circumstances of their dementia and their lives as they worked to re-establish equilibrium to continue to engage in life while living with a degenerative neurological condition. ConclusionsOur research revealed the motivations, changing abilities, and chosen strategies of people with dementia in their search for information as their condition evolves. This knowledge can be used to develop and improve person-centered information and support services for people with dementia so that they can more easily re-establish equilibrium and continue to engage in life.

Foxa2, a member of the Forkhead box (Fox) family of transcription factors, plays an important role in the regulation of lung function and lung tissue homeostasis. FOXA2 expression is reduced in the lung and airways epithelium of asthmatic patients and in mice absence of Foxa2 from the lung epithelium contributes to airway inflammation and goblet cell hyperplasia. Here we demonstrate a novel role for Foxa2 in the regulation of T helper differentiation and investigate its impact on lung inflammation. Conditional deletion of Foxa2 from T-cells led to increased Th2 cytokine secretion and differentiation, but decreased Th1 differentiation and IFN-γ expression in vitro. Induction of mouse allergic airway inflammation resulted in more severe disease in the conditional Foxa2 knockout than in control mice, with increased cellular infiltration to the lung, characterized by the recruitment of eosinophils and basophils, increased mucus production and increased production of Th2 cytokines and serum IgE. Thus, these experiments suggest that Foxa2 expression in T-cells is required to protect against the Th2 inflammatory response in allergic airway inflammation and that Foxa2 is important in T-cells to maintain the balance of effector cell differentiation and function in the lung.

Membership in voluntary organizations is associated with individual and social benefits. Due to the negative consequences of the global pandemic on older people, and the governmental challenges posed by population aging, voluntary membership is of great importance to society. To effectively promote volunteering among older people, it is necessary to understand the determinants of voluntary membership. This study analyses the influence of individual values—secular/traditional and survival/self-expression–on voluntary membership among European adults (N = 31,985). Specifically, it examines which values orient two age groups (middle age: 50–64 and old age: 65–79), as well as men and women toward a certain type of association (Social Awareness; Professional and Political; Education and Leisure; Religion). The sample of 31,985 comprises 60% of adults aged 50–64 and 40% aged 65–79; of which 56% are women and 44% men. The empirical estimation considers different levels of data aggregation: individual, national and welfare system, therefore multilevel analysis is used as an analytical strategy. Individual-level variables from the Integrated Values Survey (2005/09, 2010/14, and 2017/20) and national-level variables (Gini Index and Gross Domestic Product Per Capita) from the World Bank and Eurostat are used. The results indicate that traditional and self-expression values promote membership in voluntary organizations in general more than secular and survival values. However, there are differences according to the type of organization. Furthermore, values are found to moderate the effect of age and gender on voluntary membership.

BackgroundThe impact of the COVID-19 pandemic and the associated restrictions on mental health is being studied.ObjectiveTo analyze the psychosocial response to the COVID-19 pandemic in adults residing in Panama.MethodsA community sample of 480 adult residents of Panama completed a survey that included sociodemographic questions, COVID-19 related questions (e.g., health concerns regarding the virus, knowledge and behaviors in biosafety) and scales of stress, anxiety, depression, prosocial behavior, resilience, perceived social support, and insomnia.ResultsMost of the participants (>60%) reported being negatively affected by the pandemic. Women experienced greater depression, anxiety, and stress symptoms than men, and age was negatively associated with depression, anxiety, and stress symptoms. Self-perceived health status and self-perceived social support were negatively associated with depression, anxiety, and stress symptoms. Self-perceived social isolation was positively associated with depression, anxiety, and stress symptoms. Psychiatric illness and insomnia were positively associated with depression, anxiety, and stress symptoms, whereas psychological resilience was negatively associated with depression, anxiety, and stress symptoms.DiscussionThese results corroborate other studies regarding COVID-19 and mental health. This study highlights the need for specific prevention and intervention mechanisms related to the COVID-19 pandemic in different population groups. This is the first report of the psychological impact of COVID-19 in the general Panamanian population and one of the only studies in the Latin American region and, therefore, contributes to research in the Latino population and lower-middle income countries.

Las enfermedades del sistema circulatorio constituyen la primera causa de muerte en el mundo. En Colombia, la enfermedad cardíaca isquémica se ubica como la principal causa de muerte, tanto en hombres como en mujeres. En la población femenina es la causa de más de la mitad de las muertes, cercana al 53%. La enfermedad isquémica en jóvenes, definidos como aquellos menores de 45 años, se ha descrito en cohortes en hasta un 11,6%, con una menor tasa de mortalidad. La dificultad para el abordaje de estos pacientes es mayor, dado que, al consultar al servicio de urgencias, pocas veces se sospecha enfermedad cardíaca isquémica.

Introduction: The presence of a fragility fracture increases the risk of new fractures. The timely and prompt initiation of treatment for osteoporosis can reduce the incidence of new fractures, for which adherence to management is a determining factor. The main objective of the study was to characterize the secondary prevention program for fragility hip fractures in patients older than 65 years, determine adherence to treatment and its effect on the appearance of new fractures in the established follow-up period. Materials and Methods: A descriptive retrospective cohort study was carried out. Patients older than 65 years with a fragility hip fracture treated by an Orthogeriatric Clinical Care Center between May 2014 and April 2020 who completed a one-year follow-up were included. Results: A final sample of 290 patients was obtained (226 women and 64 men) with an average age of 82.27 years. It was found that 84.5% of patients received indications to start osteoporotic management prior to hospital discharge and only 35.2% started the treatment in the first 6 postoperative months. 16.6% (n = 48) of patients presented a new fracture, with no significant difference between those who started their osteoporosis treatment in a timely manner. Out of the 48 patients, 5 patients (10.4%) met therapeutic failure criteria. Discussion: Most patients (84.5%) received indications for starting osteoporotic treatment before hospital discharge, nevertheless 35.2% started it during the first 6 postoperative months. 16.6% of patients presented a new fracture during follow up, of which only five met therapeutic failure criteria. Conclusions: No significant differences were found between the presence of new fractures and early initiation of osteoporotic management. However, literature shows that prompt and timely osteoporotic treatment reduces the incidence of new fractures, thus measures must be implemented to strengthen the adherence and surveillance of patients to the indicated treatment.

Background: Air pollution has been linked to obesity while higher ambient temperatures typically reduce metabolic demand in a compensatory manner. Both relationships may impact glucose metabolism, thus we examined the association between intermediate- and long-term exposure to fine particulate matter (PM2.5) and ambient temperature and glycated hemoglobin (HbA1c), a longer-term marker of glucose control. Methods: We assessed 3-month, 6-month, and 12-month average air pollution and ambient temperature at 1-km2 spatial resolution via satellite remote sensing models (2013–2019), and assessed HbA1c at four, six, and eight years postpartum in women enrolled in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort based in Mexico City. PM2.5 and ambient temperature were matched to participants’ addresses and confirmed by GPS tracker. Using linear mixed-effects models, we examined the association between 3-month, 6-month, and 12-month average PM2.5 and ambient temperature with repeated log-transformed HbA1c values. All models included a random intercept for each woman and were adjusted for calendar year, season, and individual-level confounders (age, marital status, smoking, alcohol consumption level, and education level). Results: We analyzed 1,265 HbA1c measurements of 484 women. Per 1 µg/m3 increase in 3-month and 6-month PM2.5, HbA1c levels increased by 0.28% (95% confidence interval (95 %CI): 0.14, 0.42%) and 0.28% (95 %CI: 0.04, 0.52%) respectively. No association was seen for 12-month average PM2.5. Per 1 °C increase in ambient temperature, HbA1c levels decreased by 0.63% (95 %CI: −1.06, −0.21%) and 0.61% (95 %CI: −1.08, −0.13%), while the 12-month average again is not associated with HbA1c. Conclusions: Intermediate-term exposure to PM2.5 and ambient temperature are associated with opposing changes in HbA1c levels, in this region of high PM2.5 and moderate temperature fluctuation. These effects, measurable in mid-adult life, may portend future risk of type 2 diabetes and possible heart disease.

Taking stanza two of Andrew Marvell’s “Mourning” as its focus, this essay argues that, within the poem’s multiple and intermingled readings of the mourner’s weeping, her tears fall in and out of figuration. Their state changes between charged image and mere water exploited by countervailing hydrologies of grace and carnality. Against the speaker’s conclusion that the meaning of women’s tears can be supposed but is finally unknowable, the poem proposes a masturbatory heresy of self-sufficiency and multiplicity.@font-face{font-family:Arial;panose-1:2 11 6 4 2 2 2 2 2 4;mso-font-charset:0;mso-generic-font-family:auto;mso-font-pitch:variable;mso-font-signature:-536859905 -1073711037 9 0 511 0;}@font-face{font-family:"ＭＳ 明朝";mso-font-charset:78;mso-generic-font-family:auto;mso-font-pitch:variable;mso-font-signature:1 134676480 16 0 131072 0;}@font-face{font-family:"ＭＳ 明朝";mso-font-charset:78;mso-generic-font-family:auto;mso-font-pitch:variable;mso-font-signature:1 134676480 16 0 131072 0;}p.MsoNormal, li.MsoNormal, div.MsoNormal{mso-style-unhide:no;mso-style-qformat:yes;mso-style-parent:"";margin:0in;margin-bottom:.0001pt;mso-pagination:widow-orphan;font-size:12.0pt;font-family:"Times New Roman";mso-fareast-font-family:"ＭＳ 明朝";mso-fareast-theme-font:minor-fareast;mso-bidi-font-family:"Times New Roman";mso-bidi-theme-font:minor-bidi;}.MsoChpDefault{mso-style-type:export-only;mso-default-props:yes;mso-fareast-font-family:"ＭＳ 明朝";mso-fareast-theme-font:minor-fareast;mso-bidi-font-family:"Times New Roman";mso-bidi-theme-font:minor-bidi;}div.WordSection1{page:WordSection1;}

Growing concern about climate change has been driving the search for solutions to mitigate greenhouse gas emissions. In this context, carbon capture and utilization (CCU) technologies have been proposed and developed as a way of giving CO2 a sustainable and economically viable destination. An interesting approach is the conversion of CO2 into valuable chemicals, such as methanol (MeOH) and dimethyl ether (DME), by means of catalytic hydrogenation on Cu-, Zn-, and Al-based catalysts. In this work, three catalysts were tested for the synthesis of MeOH and DME from CO2 using a single fixed-bed reactor. The first one was a commercial CuO/γ-Al2O3; the second one was CuO-ZnO/γ-Al2O3, obtained via incipient wetness impregnation of the first catalyst with an aqueous solution of zinc acetate; and the third one was a CZA catalyst obtained by the coprecipitation method. The samples were characterized by XRD, XRF, and N2 adsorption isotherms. The hydrogenation of CO2 was performed at 25 bar, 230°C, with a H2:CO2 ratio of 3 and space velocity of 1,200 ml (g cat · h)−1 in order to assess the potential of these catalysts in the conversion of CO2 to methanol and dimethyl ether. The catalyst activity was correlated to the adsorption isotherms of each reactant. The main results show that the highest CO2 conversion and the best yield of methanol are obtained with the CZACP catalyst, very likely due to its higher adsorption capacity of H2. In addition, although the presence of zinc oxide reduces the textural properties of the porous catalyst, CZAWI showed higher CO2 conversion than commercial catalyst CuO/γ-Al2O3.

Most countries in the world depend on energy, and it is suggested that it be generated from renewable sources that do not have a negative impact on the environment. The avocado pit is a residue that originates from the consumption of avocado pulp and can be used as biomass due to its potential calorific value. Thus, this research developed ecological briquettes from avocado pit waste as biofuel. The briquettes were made from a mixture of avocado pit, sawdust and cassava binder in different proportions. The briquettes were cylindrical in shape, 7 cm long and 5 cm in diameter, and their calorific value, combustion time, humidity, ash content and amount of CO2 emissions were evaluated. The results indicated that the best proportion for obtaining the ecological briquette was 70 g of avocado pit, 20 g of sawdust and 30 g of binder diluted in 120 ml of water. In addition, the briquettes showed reductions in CO2 emissions and high calorific value. Finally, it is concluded that the ecological briquettes are a great alternative as biofuel and could be used as a source of energy for different domestic cooking activities in rural areas and recreational and leisure centers, benefiting the environment.

Computational techniques for analyzing biological images offer a great potential to enhance our knowledge of the biological processes underlying disorders of the nervous system. Friedreich’s Ataxia (FRDA) is a rare progressive neurodegenerative inherited disorder caused by the low expression of frataxin, which is a small mitochondrial protein. In FRDA cells, the lack of frataxin promotes primarily mitochondrial dysfunction, an alteration of calcium (Ca2+) homeostasis and the destabilization of the actin cytoskeleton in the neurites and growth cones of sensory neurons. In this paper, a computational multilinear algebra approach was used to analyze the dynamics of the growth cone and its function in control and FRDA neurons. Computational approach, which includes principal component analysis and a multilinear algebra method, is used to quantify the dynamics of the growth cone (GC) morphology of sensory neurons from the dorsal root ganglia (DRG) of the YG8sR humanized murine model for FRDA. It was confirmed that the dynamics and patterns of turning were aberrant in the FRDA growth cones. In addition, our data suggest that other cellular processes dependent on functional GCs such as axonal regeneration might also be affected. Semiautomated computational approaches are presented to quantify differences in GC behaviors in neurodegenerative disease. In summary, the deficiency of frataxin has an adverse effect on the formation and, most importantly, the growth cones’ function in adult DRG neurons. As a result, frataxin deficient DRG neurons might lose the intrinsic capability to grow and regenerate axons properly due to the dysfunctional GCs they build.

In the genome, repetitive guanine-rich sequences have the potential to spontaneously fold into non-canonical DNA secondary structures known as G-quadruplex (G4). Using novel single-molecule imaging approaches, the authors reveal that G4 formation within active replication forks locally perturb replisome dynamics and damage response signaling, which require RPA and FANCJ for regulation.

The acquisition and especially the maintenance of a plasmid usually brings a fitness cost that reduces the reproductive rate of the bacterial host; for strains like Lysinibacillus sphaericus III(3)7, which possesses important environmental properties, this alteration along with morphological changes and reduced sporulation rates may exert a negative effect on metabolic studies using plasmids as cloning platforms. The aim of this study is to approach the metabolic behavior of pMK4-bearing cells of L. sphaericus III(3)7 through the use of bioinformatic and in vitro analyses. An incompatibility model between the pMK4 vector and a predicted megaplasmid, pBsph, inside III(3)7 cells was constructed based on an incA region. Additionally, in vitro long-term plasmid stability was not found in plasmid-bearing cells. Alignments between replicons, mobile genetic elements and RNA-RNA interactions were assessed, pairwise alignment visualization, graphic models and morphological changes were evaluated by SEM. Metabolite analysis was done through HPLC coupled to a Q-TOF 6545, and electrospray ionization was used, finally, Aedes aegypti and Culex quinquefasciatus larvae were used for larvicidal activity assessment. Results found, a decreased growth rate, spore formation reduction and morphological changes, which supported the idea of metabolic cost exerted by pMK4. An incompatibility between pMK4 and pBsph appears to take place inside L. sphaericus III(3)7 cells, however, further in vitro studies are needed to confirm it.

In Colombia, pneumococcal conjugate vaccines (PCVs) were implemented into the infant universal mass vaccination program in a stepwise manner; PCV-7 between 2009 and 2011 in different geographic regions/cities, with nationwide introduction of a 10-valent vaccine (PHiD-CV) in 2012. We aimed to describe trends in all-cause pneumonia mortality and overall mortality, and in the incidence of all-cause pneumonia and otitis media (OM) in Colombian children

Abstract Background Long-term use of urethral catheters is associated with high risk of urinary tract infection (UTI) and blockage. Microbial biofilms are a common cause of catheter blockage, reducing their lifetime and significantly increasing morbidity of UTIs. A 0.02% polyhexanide irrigation solution developed for routine mechanical rinsing shows potential for bacterial decolonization of urethral catheters and has the potential to reduce or prevent biofilm formation. Methods Using an in vitro assay with standard market-leading types of catheters artificially contaminated with clinically relevant bacteria, assays were carried out to evaluate the biofilm reduction and prevention potential of a 0.02% polyhexanide solution versus no intervention (standard approach) and irrigation with saline solution (NaCl 0.9%). The efficiency of decolonization was measured through microbial plate count and membrane filtration. Results Irrigation using a 0.02% polyhexanide solution is suitable for the decolonization of a variety of transurethral catheters. The effect observed is significant compared to irrigation with 0.9% saline solution (p = 0.002) or no treatment (p = 0.011). No significant difference was found between irrigation with 0.9% saline solution and no treatment (p = 0.74). Conclusions A 0.02% polyhexanide solution is able to reduce bacterial biofilm from catheters artificially contaminated with clinically relevant bacteria in vitro. The data shows a reduction of the viability of thick bacterial biofilms in a variety of commercially available urinary catheters made from silicone, latex-free silicone, hydrogel-coated silicone and PVC. Further research is required to evaluate the long-term tolerability and efficacy of polyhexanide in clinical practice.

Abstract Background Pregnant women are particularly vulnerable to malaria infections, increasing the risk of maternal–fetal complications, mainly in high-endemicity areas. However, few studies of malaria in pregnancy (MiP) have been carried out in Latin America, a region with low endemicity and transmission of both, Plasmodium falciparum and Plasmodium vivax. Despite the high malaria burden in Venezuela in the last years, no recent studies of MiP have been conducted. Hence, epidemiological and clinical characteristics of pregnant women with malaria in southern Venezuela are described herein. Methods A retrospective study in pregnant women attending at the “Ruíz y Páez” University Hospital Complex, Bolivar state, Venezuela, was carried out between February and October, 2019. Epidemiological, clinical, and laboratory information was analysed. Results Thirty-seven out of 52 pregnant women analysed were infected with P. vivax. Age ranged between 15 and 39 years, and adolescent pregnancies were common. Malaria infection was diagnosed mainly during the third trimester of pregnancy (63.4%). The distribution of symptoms and signs as well as clinical laboratory values was similar among Plasmodium spp. Although uncomplicated malaria was most frequent, 30% (13/52) had severe anaemia. A high proportion of studied women (44%) presented at least one complication during the pregnancy or delivery. Spontaneous abortion was recorded in four women, and three fetal deaths were observed. Six women had preterm delivery without any further complication. Conclusions A high prevalence of maternal–fetal complications was found in the studied population, highlighting the requirement for a careful medical follow up during the prenatal check-ups, which should include routinary malaria tests. Preventive measures as distribution of insecticide-treated mosquito net for pregnant women at risk should also be implemented. Those measures can help to reduce the negative impact of malaria on the newborn and mother.

Resumen: Objetivo: Determinar si la lactancia materna ≥ 6 meses se asocia con menor sobrepeso y obesidad en niños/as de 2 a 5 años de edad. Método: Análisis transversal de datos de encuestas nacionales de demografía y salud de Bolivia, Colombia y Perú. Se definieron sobrepeso y obesidad según los criterios de la Organización Mundial de la Salud. Se calculó la odds ratio (OR) utilizando regresión logística multinomial. Resultados: La prevalencia de obesidad en niños/as de 2 a 5 años fue del 10,4% (intervalo de confianza del 95% [IC95%]: 8,2-12,6) en Bolivia, del 4,9% (IC95%: 4,0-5,8) en Colombia y del 6,4% (IC95%: 5,2-8,0) en Perú. La lactancia materna ≥ 6 meses en la población estudiada fue del 89,9% (IC95%: 87,8-91,9) en Bolivia, del 73,9% (IC95%: 72,2-75,6) en Colombia y del 92,8% (IC95%: 91,2-94,4) en Perú. Se encontró evidencia de asociación entre lactancia materna ≥ 6 meses y menor posibilidad de obesidad en comparación con no lactancia o lactancia < 6 meses para Bolivia (OR = 0,30; IC95%: 0,16-0,57), y una asociación marginal para Colombia (OR = 0,71; IC95%: 0,47-1,06) y Perú (OR = 0,49; IC95%: 0,23-1,04). No hubo evidencia de asociación entre lactancia materna y sobrepeso. Conclusión: La lactancia materna ≥ 6 meses está asociada con una menor posibilidad de tener obesidad en niños/as de 2 a 5 años en Bolivia. Este patrón fue similar, pero marginal, para Colombia y Perú. Abstract: Objective: To determine if breastfeeding for at least the first six months of life is associated with overweight and obesity in children 2 to 5 years old. Method: Cross sectional analysis of data from national demographic and health surveys conducted in Bolivia, Colombia and Peru. Overweight and obesity were defined using World Health Organization standard definitions. Odds ratios (OR) were calculated using multinomial logistic regression. Results: The prevalence of obesity in children 2 to 5 years old was 10.4% (95% confidence interval [95%CI]: 8.2-12.6) in Bolivia, 4.9% in Colombia (95%CI: 4.0-5.8), and 6.4% (95%CI: 5.2-8.0) in Peru. Prevalence of exclusive breastfeeding for at least the first 6 months in the study population was 89.9% (95%CI: 87.8-91.9) in Bolivia, 73.9% (95%CI: 72.2-75.6) in Colombia, and 92.8% (95%CI: 91.2-92.4) in Peru. Exclusive breastfeeding was associated with a decreased risk of obesity in children as compared to no breastfeeding or breastfeeding for less than 6 months in Bolivia (OR = .30; 95%CI: .16-.57) and a marginal association in Colombia (OR = .71; 95%CI: .47-1.06) and Peru (OR = .49; 95%CI: 0.23-1.04). No association between breastfeeding and overweight was found. Conclusion: Exclusive breastfeeding for at least the first six months of life decreases the risk of obesity in children 2 to 5 years old in Bolivia. A similar but weaker pattern was observed for children in Colombia and Peru.

Abstract Background The growing societal and economic impact of Alzheimer’s disease (AD) is further compounded by the present lack of disease-modifying interventions. Non-pharmacological intervention approaches, such as exercise, have the potential to be powerful approaches to improve or mitigate the symptoms of AD without added side effects or financial burden associated with drug therapies. Various forms and regiments of exercise (i.e., strength, aerobic, multicomponent) have been reported in the literature; however, conflicting evidence obscures clear interpretation of the value and impact of exercise as an intervention for older adults with AD. The primary objective of this review will be to evaluate the effects of exercise interventions for older adults with AD. In addition, this review will evaluate the evidence quality and synthesize the exercise training prescriptions for proper clinical practice guidelines and recommendations. Methods This systematic review and meta-analysis will be carried out by an interdisciplinary collective representing clinical and research stakeholders with diverse expertise related to neurodegenerative diseases and rehabilitation medicine. Literature sources will include the following: Embase, PsychINFO, OVID Medline, and Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily. Inclusion criteria are participants with late onset AD and structured exercise interventions with prescribed duration, frequency, and intensity. The primary outcome of this study will center on improved or sustained cognitive functioning. Secondary outcomes will include institutionalization-related outcomes, ability in activities of daily living, mood and emotional well-being, quality of life, morbidity, and mortality. Analysis procedures to include measurement of bias, data synthesis, sensitivity analysis, and assessment of heterogeneity are described in this protocol. Discussion This review is anticipated to yield clinically meaningful insight on the specific value of exercise for older adults with AD. Improved understanding of diverse exercise intervention approaches and their specific impact on various health- and function-related outcomes is expected to guide clinicians to more frequently and accurately prescribe meaningful interventions for those affected by AD. Systematic review registration PROSPERO CRD42020175016 .

Abstract A new device architecture using giant magnetoresistive sensors demonstrates the capability to detect very low magnetic fields on the pT range. A combination of vertically packed spin-valve sensors with two-dimensional in-plane arrays, connected in series and in parallel, delivers a final detection level of 360 pT/ $$\sqrt{Hz}$$ Hz at 10 Hz at room temperature. The device design is supported by an analytical model developed for a vertically packed spin-valve system, which takes into account all magnetic couplings present. Optimization concerning the spacer thickness and sensor physical dimensions depending on the number of pilled up spin-valves is necessary. To push the limits of detection, arrays of a large number of sensing elements (up to 440,000) are patterned with a geometry that improves sensitivity and in a configuration that reduces the resistance, leading to a lower noise level. The final device performance with pT detectivity is demonstrated in an un-shielded environment suitable for detection of bio-signals.

Introducción. La neumonía es la principal causa de muerte por infección en el mundo y afecta principalmente a la población de adultos mayores. Objetivo. Determinar los factores de riesgo asociados con la letalidad a 30 días en pacientes con neumonía en una unidad de atención del paciente geriátrico agudo. Materiales y métodos. Se hizo un estudio observacional y analítico de cohorte retrospectiva. Se incluyeron 114 pacientes de 60 años o más hospitalizados en una unidad de atención del paciente geriátrico agudo con diagnóstico de neumonía. El resultado primario fue la letalidad a 30 días. Se hicieron análisis de regresión log-binomial bivariado y multivariable para explorar la relación entre las variables independientes y el resultado primario. Resultados. La letalidad a 30 días fue de 26,3 % y la edad media de 84,45 ± 7,37 años. El 54,4 % de los participantes era de sexo masculino. En el análisis multivariable se encontró que una edad de 90 años o más (riesgo relativo, RR=1,62; IC95%: 1,05-2,68; p=0,04), el compromiso multilobar (RR=1,92; IC95%: 1,12-3,32; p=0,02), el nitrógeno ureico elevado (mediana≥22,5; RR=3,93; IC95%: 1,67-9,25; p

DNA 5-hydroxymethylcytosine (5hmC) modification is associated with gene transcription and used as a mark of mammalian development. Here the authors report a comprehensive 5hmC tissue map and analysis of 5hmC genomic distributions in 19 human tissues derived from 10 organ systems, thus providing insights into the role of 5hmC in tissue-specific development.

Humans observe actions performed by others in many different visual and social settings. What features do we extract and attend when we view such complex scenes, and how are they processed in the brain? To answer these questions, we curated two large-scale sets of naturalistic videos of everyday actions and estimated their perceived similarity in two behavioral experiments. We normed and quantified a large range of visual, action-related, and social-affective features across the stimulus sets. Using a cross-validated variance partitioning analysis, we found that social-affective features predicted similarity judgments better than, and independently of, visual and action features in both behavioral experiments. Next, we conducted an electroencephalography experiment, which revealed a sustained correlation between neural responses to videos and their behavioral similarity. Visual, action, and social-affective features predicted neural patterns at early, intermediate, and late stages, respectively, during this behaviorally relevant time window. Together, these findings show that social-affective features are important for perceiving naturalistic actions and are extracted at the final stage of a temporal gradient in the brain.

Sympathetic denervation of the heart following ischemia/reperfusion induced myocardial infarction (MI) is sustained by chondroitin sulfate proteoglycans (CSPGs) in the cardiac scar. Denervation predicts risk of sudden cardiac death in humans. Blocking CSPG signaling restores sympathetic axon outgrowth into the cardiac scar, decreasing arrhythmia susceptibility. Axon growth inhibition by CSPGs can depend on the sulfation status of the glycosaminoglycan (CS-GAG) side chains. Tandem sulfation of CS-GAGs at the 4th (4S) and 6th (6S) positions of n-acetyl-galactosamine inhibits outgrowth in several types of central neurons, but we don’t know if sulfation is similarly critical during peripheral nerve regeneration. We asked if CSPG sulfation prevented sympathetic axon outgrowth after MI. Reducing 4S with the 4-sulfatase enzyme Arylsulfatase-B (ARSB) enhanced outgrowth of dissociated rat sympathetic neurons over CSPGs. Likewise, reducing 4S with ARSB restored axon outgrowth from mouse sympathetic ganglia co-cultured with cardiac scar tissue. We quantified enzymes responsible for adding and removing sulfation, and found that CHST15 (4S dependent 6-sulfotransferase) was upregulated, and ARSB was downregulated after MI. This suggests a mechanism for production and maintenance of sulfated CSPGs in the cardiac scar. We decreased 4S,6S CS-GAGs in vivo by transient siRNA knockdown of Chst15 after MI, and found that reducing 4S,6S restored tyrosine hydroxylase (TH) positive sympathetic nerve fibers in the cardiac scar. Reinnervation reduced isoproterenol induced arrhythmias. Our results suggest that modulating CSPG-sulfation after MI may be a therapeutic target to promote sympathetic nerve regeneration in the cardiac scar and reduce post-MI cardiac arrhythmias.

Background/objectives: Pregnant women are exposed to multiple phthalates and their replacements, which are endocrine disrupting chemicals associated with adverse maternal and child health outcomes. Identifying maternal characteristics associated with phthalate/replacement exposure during pregnancy is important. Methods: We evaluated 13 maternal sociodemographic and lifestyle factors, enrollment year, and conception season as determinants of exposure biomarkers of phthalates and their replacements in 482 pregnant women from the Illinois Kids Development Study (I-KIDS, enrolled 2013–2018). We quantified 19 phthalate/replacement metabolites in pools of five first-morning urines collected across pregnancy. K-means clustering identified women with distinct patterns of biomarker concentrations and principal component analysis (PCA) identified principal component (PC) profiles of biomarkers that exist together. We used multivariable regression models to evaluate associations of predictors with identified k-means clusters and PCs. Results: K-means clustering identified two clusters of women: 1) low phthalate/di(2-ethylhexyl) terephthalate (∑DEHTP) and 2) high phthalate/∑DEHTP biomarker concentrations. PCA identified four PCs with loadings heaviest for biomarkers of plasticizer phthalates [di-isononyl, di-isodecyl, di-n-octyl phthalates] (PC1), of other phthalates [dibenzyl, di-n-butyl, di-iso-butyl phthalates] (PC2), of phthalate replacements [∑DEHTP, di(isononyl) cyclohexane-1,2-dicarboxylate (∑DiNCH)] (PC3), and of monoethyl phthalate [MEP] (PC4). Overall, age, marital status, income, parity, pre-pregnancy BMI, caffeine intake, enrollment year, and conception season were independently associated with k-means cluster membership and at least one PC. Additionally, race/ethnicity, education, employment, pregnancy intention, smoking status, alcohol intake, and diet were associated with at least one PC. For instance, women who conceived in the spring, summer, and/or fall months had lower odds of high phthalate/∑DEHTP cluster membership and had lower plasticizer phthalate, phthalate replacement, and MEP PC scores. Conclusions: Conception season, enrollment year, and several sociodemographic/lifestyle factors were predictive of phthalate/replacement biomarker profiles. Future studies should corroborate these findings, with a special focus on replacements to which pregnant women are becoming increasingly exposed.

The CW domain binds to histone tail modifications found in different protein families involved in epigenetic regulation and chromatin remodeling. CW domains recognize the methylation state of the fourth lysine on histone 3 and could, therefore, be viewed as a reader of epigenetic information. The specificity toward different methylation states such as me1, me2, or me3 depends on the particular CW subtype. For example, the CW domain of ASHH2 methyltransferase binds preferentially to H3K4me1, and MORC3 binds to both H3K4me2 and me3 modifications, while ZCWPW1 is more specific to H3K4me3. The structural basis for these preferential bindings is not well understood, and recent research suggests that a more complete picture will emerge if dynamical and energetic assessments are included in the analysis of interactions. This study uses fold assessment by NMR in combination with mutagenesis, ITC affinity measurements, and thermal denaturation studies to investigate possible couplings between ASHH2 CW selectivity toward H3K4me1 and the stabilization of the domain and loops implicated in binding. The key elements of the binding site—the two tryptophans and the α1-helix form and maintain the binding pocket— were perturbed by mutagenesis and investigated. Results show that the α1-helix maintains the overall stability of the fold via the I915 and L919 residues and that the correct binding consolidates the loops designated as η1 and η3, as well as the C-terminal. This consolidation is incomplete for H3K4me3 binding to CW, which experiences a decrease in overall thermal stability on binding. Loop mutations not directly involved in the binding site, nonetheless, affect the equilibrium positions of the key residues.

Objetivo: Realizar un metaanálisis de la frecuencia de hiperreactividad plaquetaria (HPR) para aspirina y clopidogrel con diferentes agregómetros, en pacientes con diabetes mellitus (DM) e hipertensión (HTA) sometidos a intervención coronaria percutánea (ICP). Método: Revisión sistemática con metaanálisis a partir de 40 búsquedas en tres bases de datos multidisciplinarias (PubMed, ScienceDirect y SciELO), siguiendo las fases de la guía PRISMA entre los años 2005 y 2021. Se garantizaron la reproducibilidad y la calidad metodológica por parte de dos investigadores que usaron la guía STROBE. Los análisis se basaron en frecuencias y metaanálisis de razón de disparidad, para lo cual se empleó el software Epidat con un intervalo de confianza del 95%. Resultados: Se incluyeron 22 estudios. La frecuencia de hiperreactividad plaquetaria para la aspirina fue desde el 18.8% hasta el 81.8% y para el clopidogrel desde el 18.2% hasta el 71.3%, lo que denota una importante heterogeneidad. Se observó que la frecuencia de hiperreactividad plaquetaria en pacientes diabéticos varió del 21% al 78.7%, mientras que en los pacientes hipertensos fue del 17.6% al 76.8%, y finalmente, la hiperreactividad plaquetaria fue 1,38 veces mayor en los pacientes diabéticos que en aquellos que no lo eran y 1,23 veces mayor en los pacientes hipertensos que en aquellos que no lo eran. Conclusiones: La diabetes mellitus y la hipertensión arterial, como enfermedades de base en pacientes sometidos a intervención coronaria percutánea, están asociadas a hiperreactividad plaquetaria, y esta, a su vez, como demostraron estudios previos, al desarrollo de eventos vasculares a largo plazo. De ahí que una valoración posterior al procedimiento con pruebas de agregometría plaquetaria resultaría potencialmente útil en el marco de la terapia personalizada.