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Abstract Background The evidence of prognostic factors and individualized surveillance strategies for upper tract urothelial carcinoma are still weak. Objectives To evaluate whether the history of previous malignancy (HPM) affects the oncological outcomes of upper tract urothelial carcinoma (UTUC). Methods The CROES-UTUC registry is an international, observational, multicenter cohort study on patients diagnosed with UTUC. Patient and disease characteristics from 2380 patients with UTUC were collected. The primary outcome of this study was recurrence-free survival. Kaplan-Meier and multivariate Cox regression analyses were performed by stratifying patients according to their HPM. Results A total of 996 patients were included in this study. With a median recurrence-free survival time of 7.2 months and a median follow-up time of 9.2 months, 19.5% of patients had disease recurrence. The recurrence-free survival rate in the HPM group was 75.7%, which was significantly lower than non-HPM group (82.7%, P = 0.012). Kaplan-Meier analyses also showed that HPM could increase the risk of upper tract recurrence (P = 0.048). Furthermore, patients with a history of non-urothelial cancers had a higher risk of intravesical recurrence (P = 0.003), and patients with a history of urothelial cancers had a higher risk of upper tract recurrence (P = 0.015). Upon multivariate Cox regression analysis, the history of non-urothelial cancer was a risk factor for intravesical recurrence (P = 0.004), and the history of urothelial cancer was a risk factor for upper tract recurrence (P = 0.006). Conclusion Both previous non-urothelial and urothelial malignancy could increase the risk of tumor recurrence. But different cancer types may increase different sites’ risk of tumor recurrence for patients with UTUC. According to present study, more personalized follow-up plans and active treatment strategies should be considered for UTUC patients.

Abstract Background Irritable bowel syndrome (IBS) and sexual dysfunction (SxD) lowers quality of life (QOL) separately, but the effect of their overlap in unselected populations has not been studied. Objective To evaluate the QOL of IBS women with and without SxD and compare it with controls. Methods In this cross-sectional assessment, we studied 51 IBS women (Rome IV criteria) and 54 controls. SxD was determined using the female sexual function index questionnaire. QOL was evaluated by the Short Form 36 (SF-36) and IBS-QOL questionnaires. Results SxD prevalence was similar between IBS women (39.22%) and controls (38.89%). Compared with other groups, IBS patients with SxD showed lower scores in all domains as well as in the physical, mental summaries of the SF-36 and almost all domains (except for body image, food avoidance, and social reaction compared with IBS patients without SxD) and the total score of IBS-QOL. Conclusions These findings show that SxD worsens both general and specific QOL of women with IBS. The consideration of SxD in patients with IBS will allow us to make a more effective diagnostic and therapeutic approach. Clinical trial registry in Mexico City General Hospital: DI/19/107/03/080. Clinical trials registration: NCT04716738.

Objectives To assess the status of the pelvic floor muscle (PFM) of premature ovarian insufficiency women (POI women) and the incidence of fecal incontinence (FI) and pelvic organ prolapse (POP). Methods A secondary analysis of a cross-sectional study with 150 women with POI was performed. Pelvic floor muscle assessment was performed with the PERFECT scale. The subscales POPDI-6 and CRADI-8 of the questionnaire Pelvic Floor Distress Inventory-20 (PFDI-20) were used for pelvic floor symptoms focused on FI and POP. Moreover, FI and POP were also assessed as dichotomous variables (yes/no). Results Women with FI and POP did not present differences in the PFM assessment across P (p = 0.61), E (p = 0.78), R (p = 0.22), and F (p = 0.79) variables when compared with women with POI; no differences were also seen between women with and without POP according the pelvic muscles: P (p = 0.91), E (p = 0.99), R (p = 0.62), and F (p = 0.10). Women with FI and POP presented higher scores in all PFDI-20 subscales and total score when compared with the control group (p

Identifying the contexts of episodes of (un)healthy food/drink intake could inform strategies for eating more healthily. This study assessed memories of recent episodes of healthy and unhealthy eating from adults in Mexico. For each (un)healthy eating episode participants recalled place, time of day, people present and food/drink intake. Categories were formed for the contextual features and foods/drinks that were reported, then the relative frequency of each category was tested between healthy and unhealthy eating episodes. Overall, there was a large set of categories of (un)healthy food/drink choices, and there were more healthy eating episodes with family at home and unhealthy eating episodes with friends out of home. However, as expected, a more specific context as well as food/drink intake was identified for each sort of recalled (un)healthy eating episode of the day. Additionally, eating out of home, later in the day and with people present were features related to higher estimated energy content across (un)healthy eating episodes. These findings support the assessment of self-reported memories of recent eating episodes to generate evidence that contribute to contexts that support healthy eating habits.

Se brinda una introducción a la ciencia abierta por medio de la revisión de sus aspectos básicos. En particular, se presenta la crisis de replicación en investigación y ejemplos de prácticas cuestionables que generan resultados falsos positivos. Se presentan también iniciativas de ciencia abierta para mejorar la reproducibilidad y confiabilidad del saber científico. Se discute además el impacto de la adopción de los principios de ciencia abierta en elevar los estándares para publicar reportes científicos, así como retos para transformar el sistema en el que se desarrolla la investigación. En general, se busca una reflexión para acercar la comunidad académica en Latinoamérica al movimiento de ciencia abierta y se comparten recursos para que el lector interesado pueda profundizar e involucrarse.

Purpose: To evaluate the patient-reported outcomes of primary direct visual internal urethrotomy (DVIU) and nontransecting bulbar urethroplasty techniques (NTBU) for the short segment (

The use of sensors to detect or measure ripening changes in fruit is a growing area of interest to the scientific community. Colorimeters are commonly employed for color and shade identification; however, their usage to measure the color parameters of fruit rinds based on image analysis can be expensive. This article presents a non-invasive and low-cost optoelectronic system for detecting color changes in oranges to predict the ripening stage. The system utilises a 1 W white LED as a light source, an RGB photodiode array, and two plastic optical fibres bundled in parallel to form the head of an extrinsic sensor. A microcontroller is employed for model integration and data acquisition. The evolution of the skin color of the fruit was monitored until over-ripeness was evident. The sensor was designed to detect the color changes; the CIE L*a*b* color difference between the optoelectronic device results and those obtained by colorimetry was 2.6–4.5. To predict the ideal conditions for fruit handling and determine the maturity level, a multilevel perceptron ANN was trained, achieving an accuracy of 96.4%. In addition, an overall precision of 96.6% was achieved when classifying fruit into three maturity categories (under-ripe, ripe, and over-ripe), and the error was 3.4%. The combination of the optoelectronic device and ANN improves considerably this fruit color classification accuracy, can facilitate the determination of the optimal time for consumption, and optimize the postharvest process efficiency.

Fundamento: las enfermedades cerebrovasculares constituyen un problema de salud a nivel mundial y una de las principales causas de mortalidad y discapacidad global. Objetivo: caracterizar clínicamente a los pacientes con enfermedad cerebrovascular isquémica ingresados en el Servicio de Medicina Interna del Hospital General Docente Guillermo Domínguez López en el período comprendido entre mayo de 2019 y mayo de 2021. Método: se realizó un estudio descriptivo de corte transversal en el Servicio de Medicina Interna del Hospital General Docente Guillermo Domínguez López en el municipio Puerto Padre en la provincia Las Tunas en el período comprendido entre mayo de 2019 y mayo de 2021. La población de estudio estuvo conformada por 184 pacientes con diagnóstico de enfermedad cerebrovascular isquémica. La muestra coincidió con el universo al estudiar el total de pacientes. Se caracterizaron las siguientes variables: edad, sexo, factores de riesgo, formas clínicas de presentación, complicaciones y supervivencia al egreso. Se utilizó estadística descriptiva. Los resultados se presentaron en cuadros de distribución de frecuencias para su mejor comprensión y análisis. Resultados: predominaron los pacientes de sexo masculino (53,80 %) y el grupo etáreo de 65 a 74 años con un 33,15 %. El principal factor de riesgo fue la hipertensión arterial (58,29 %) y predominó el infarto cerebral aterotrombótico con un 47,83 % como forma clínica de presentación. Las infecciones respiratorias (28 %) fueron las de mayor incidencia en cuanto a complicaciones. El 92,93 % de los pacientes egresaron vivos. Conclusiones: predominaron los hipertensos mayores de sesenta años, ingresados con infarto cerebral aterotrombótico.

El recurso humano y su relación con el medio ambiente, constituyen clave esencial para el exitoso desempeño y operatividad de cualquier organización. Su protección y seguridad integral en la actividad productiva es tarea obligatoria que debe ser brindada por la gerencia encargada de ello, sea cual fuese su naturaleza. A la vez, atender la protección del medio ambiente en su entorno en lo que depende de su objeto social y su misión, que conlleven a la prevención de enfermedades profesionales y accidentes laborales en un ambiente de trabajo seguro, responsabilidad que atiende la seguridad y salud en el trabajo. El presente artículo se desarrolla con el objetivo de contribuir a resolver insuficiencias presentes en organizaciones en estos temas. Entre sus resultados está, además de los fundamentos teóricos utilizados, las acciones que se proponen que responden a las insuficiencias más frecuentes de prevención y protección, y pueden ser útiles a las organizaciones empresariales, docentes, investigadores y estudiantes de universidades.

Resumen: La gestión de las listas de espera de los diferentes sistemas de salud autonómicos para procedimientos de cirugía cardiaca constituye una importante preocupación entre los profesionales, de la que nuestra Sociedad científica no es ajena. En el año 2000 fue publicada la primera iniciativa de ordenación temporal de los pacientes con patología cardiovascular incluidos en lista de espera quirúrgica. Con los cambios en el manejo y en la concepción de algunas patologías, un nuevo marco normativo vigente y la coyuntura asistencial actual, se hace necesaria una revisión de los mencionados criterios para ofrecer una actualización adecuada al contexto clínico-asistencial presente. Por ello, se ha elaborado un documento basado en la revisión de la literatura científica disponible y en el consenso de un grupo de trabajo dentro de la Sociedad Española de Cirugía Cardiovascular y Endovascular, para actualizar en nuestro país las recomendaciones de prioridad de estas patologías en las listas de espera. Abstract: Waiting list management of cardiac surgical procedures is a main concern for all the Spanish autonomic health systems and for our scientific Society. The first statement for optimal timing of patients waiting for cardiac surgery was published in 2000. Since then, after significant changes in the management of some pathologies, new normative frameworks and the current healthcare situation, a review of the timing criteria to offer an adequate and updated standard of care is needed. In this document we aim to review the available literature in the field and stablish a consensus within a working group of the Spanish Society of Cardiovascular and Endovascular Surgery to optimize the priority recommendations in cardiac surgical waiting lists in our country.

PurposePreclinical and early clinical data suggested that combining histone deacetylase (HDAC) and mTOR inhibitors can synergistically inhibit Hodgkin lymphoma.Patients and methodsDuring the dose-escalation study (ClinicalTrials.gov number: NCT01087554) with the HDAC inhibitor vorinostat and the mTOR inhibitor sirolimus (V+S), a patient with Hodgkin lymphoma refractory to nine prior therapies demonstrated a partial response (PR) lasting for 18.5 months, which promoted additional enrollment of patients with Hodgkin lymphoma as well as exploration of an alternative combination of vorinostat and mTOR inhibitor everolimus (V+E).ResultsA total of 40 patients with refractory Hodgkin lymphoma received V+S (n = 22) or V+E (n = 18). Patients received a median of five prior therapies, including brentuximab (n = 39), autologous stem cell transplantation (n = 26), and allogeneic stem cell transplantation (n = 12). The most frequent grade ≥3 treatment-related adverse event was thrombocytopenia in 55% and 67% of patients treated with V+S and V+E, respectively. Complete response was reported in 6 (27%) patients treated with V+S and 2 (11%) patients treated with V+E, and PR was reported in 6 patients (27%) treated with V+S and 4 (22%) patients treated with V+E (objective response rate of 55% and 33%, respectively). In summary, combined HDAC and mTOR inhibition had encouraging activity in heavily pretreated patients with relapsed/refractory Hodgkin lymphoma and warrants further investigation.ConclusionsCombined HDAC and mTOR inhibition has salutary activity in patients with relapsed refractory Hodgkin lymphoma and warrants further investigation.

The ideal radiology report reduces diagnostic uncertainty, while avoiding ambiguity whenever possible. The purpose of this study was to characterize the use of uncertainty terms in radiology reports at a single institution and compare the use of these terms across imaging modalities, anatomic sections, patient characteristics, and radiologist characteristics. We hypothesized that there would be variability among radiologists and between subspecialities within radiology regarding the use of uncertainty terms and that the length of the impression of a report would be a predictor of use of uncertainty terms. Finally, we hypothesized that use of uncertainty terms would often be interpreted by human readers as hedging. To test these hypotheses, we applied a natural language processing (NLP) algorithm to assess and count the number of uncertainty terms within radiology reports. An algorithm was created to detect usage of a published set of uncertainty terms. All 642,569 radiology report impressions from 171 reporting radiologists were collected from 2011 through 2015. For validation, two radiologists without knowledge of the software algorithm reviewed report impressions and were asked to determine whether the report was uncertain or hedging. The relationship between the presence of 1 or more uncertainty terms and the human readers assessment was compared. There were significant differences in the proportion of reports containing uncertainty terms across patient admission status and across anatomic imaging subsections. Reports with uncertainty were significantly longer than those without, although report length was not significantly different between subspecialities or modalities. There were no significant differences in rates of uncertainty when comparing the experience of the attending radiologist. When compared with reader 1 as a gold standard, accuracy was 0.91, sensitivity was 0.92, specificity was 0.9, and precision was 0.88, with an F1-score of 0.9. When compared with reader 2, accuracy was 0.84, sensitivity was 0.88, specificity was 0.82, and precision was 0.68, with an F1-score of 0.77. Substantial variability exists among radiologists and subspecialities regarding the use of uncertainty terms, and this variability cannot be explained by years of radiologist experience or differences in proportions of specific modalities. Furthermore, detection of uncertainty terms demonstrates good test characteristics for predicting human readers assessment of uncertainty.

The efficacy and safety of olaratumab plus nabpaclitaxel and gemcitabine in treatment-naïve participants with metastatic pancreatic ductal adenocarcinoma was evaluated. An initial phase 1b dose-escalation trial was conducted to determine the olaratumab dose for the phase 2 trial, a randomized, double-blind, placebo-controlled trial to compare overall survival (OS) in the olaratumab arm vs. placebo arms. In phase 1b, 22 participants received olaratumab at doses of 15 and 20 mg/kg with a fixed dose of nabpaclitaxel and gemcitabine. In phase 2, 159 participants were randomized to receive olaratumab 20 mg/kg in cycle 1 followed by 15 mg/kg in the subsequent cycles (n = 81) or the placebo (n = 78) on days 1, 8, and 15 of a 28-day cycle, plus nabpaclitaxel and gemcitabine. The primary objective of the trial was not met, with a median OS of 9.1 vs. 10.8 months (hazard ratio [HR] = 1.05; 95% confidence interval [CI]: 0.728, 1.527; p = 0.79) and the median progression-free survival (PFS) was 5.5 vs. 6.4 months (HR = 1.19; 95% CI: 0.806, 1.764; p = 0.38), in the olaratumab vs. placebo arms, respectively. The most common treatment-emergent adverse event of any grade across both arms was fatigue. Olaratumab plus chemotherapy failed to improve the OS or PFS in participants with metastatic PDAC. There were no new safety signals.

Background: Despite the increasing number of ICU admissions among patients with solid tumours, there is a lack of tools with which to identify patients who may benefit from critical support. We aim to characterize the clinical profile and outcomes of patients with solid malignancies admitted to the ICU. Methods: Retrospective observational study of patients with cancer non-electively admitted to the ICU of the Hospital Clinic of Barcelona (Spain) between January 2019 and December 2019. Data regarding patient and neoplasm characteristics, ICU admission features and outcomes were collected from medical records. Results: 97 ICU admissions of 84 patients were analysed. Lung cancer (22.6%) was the most frequent neoplasm. Most of the patients had metastatic disease (79.5%) and were receiving oncological treatment (75%). The main reason for ICU admission was respiratory failure (38%). Intra-ICU and in-hospital mortality rates were 9.4% and 24%, respectively. Mortality rates at 1, 3 and 6 months were 19.6%, 36.1% and 53.6%. Liver metastasis, gastrointestinal cancer, hypoalbuminemia, elevated basal C-reactive protein, ECOG-PS greater than 2 at ICU admission, admission from ward and an APACHE II score over 14 were related to higher mortality. Functional status was severely affected at discharge, and oncological treatment was definitively discontinued in 40% of the patients. Conclusion: Medium-term mortality and functional deterioration of patients with solid cancers non-electively admitted to the ICU are high. Surrogate markers of cachexia, liver metastasis and poor ECOG-PS at ICU admission are risk factors for mortality.

A fiber curvature sensor based on a Mach–Zehnder Interferometer (MZI) constructed using the waist-enlarged technique to splice a segment of non-zero dispersion-shifted fiber (NZ-DSF) between two segments of single mode fiber (SMF) is proposed and experimentally demonstrated. All fabricated sensors presented an improvement in their curvature sensitivity when they were coated with polydimethylsiloxane (PDMS) polymer. The sensor that exhibited the best performance was 6.5 cm long, with a curvature sensitivity of 8.27 nm/m−1 in a range of 0.69 m−1 (from 1.08 to 1.77 m−1). This sensitivity is 3.22 times higher than that of the sensor without polymer. Additionally, the sensor coated with polymer exhibited cross-sensitivity that is 2.23 times smaller than the sensor without polymer. The easy fabrication and notable performance of this device makes it alluring for structural health monitoring.

Developing prolonged antigen delivery systems that mimic long-term exposure to pathogens appears as a promising but still poorly explored approach to reach durable immunities. In this study, we have used a simple technology by which His-tagged proteins can be assembled, assisted by divalent cations, as supramolecular complexes with progressive complexity, namely protein-only nanoparticles and microparticles. Microparticles produced out of nanoparticles are biomimetics of secretory granules from the mammalian hormonal system. Upon subcutaneous administration, they slowly disintegrate, acting as an endocrine-like secretory system and rendering the building block nanoparticles progressively bioavailable. The performance of such materials, previously validated for drug delivery in oncology, has been tested here regarding the potential for time-prolonged antigen release. This has been completed by taking, as a building block, a nanostructured version of p30, a main structural immunogen from the African swine fever virus (ASFV). By challenging the system in both mice and pigs, we have observed unusually potent pro-inflammatory activity in porcine macrophages, and long-lasting humoral and cellular responses in vivo, which might overcome the need for an adjuvant. The robustness of both innate and adaptive responses tag, for the first time, these dynamic depot materials as a novel and valuable instrument with transversal applicability in immune stimulation and vaccinology.

Acute lymphoblastic leukemia (ALL) represents around 25% of adult acute leukemias. Despite the increasing improvement in the survival rate of ALL patients during the last decade, the heterogeneous clinical and molecular features of this malignancy still represent a major challenge for treatment and achieving better outcomes. To identify aberrantly expressed genes in bone marrow (BM) samples from adults with ALL, transcriptomic analysis was performed using Affymetrix Human Transcriptome Array 2.0 (HTA 2.0). Differentially expressed genes (DEGs) (±2-fold change, p-value < 0.05, and FDR < 0.05) were detected using the Transcriptome Analysis Console. Gene Ontology (GO), Database for Annotation, Visualization, and Integrated Discovery (DAVID), and Ingenuity Pathway Analysis (IPA) were employed to identify gene function and define the enriched pathways of DEGs. The protein–protein interactions (PPIs) of DEGs were constructed. A total of 871 genes were differentially expressed, and DNTT, MYB, EBF1, SOX4, and ERG were the top five up-regulated genes. Meanwhile, the top five down-regulated genes were PTGS2, PPBP, ADGRE3, LUCAT1, and VCAN. An association between ERG, CDK6, and SOX4 expression levels and the probability of relapse and death was observed. Regulation of the immune system, immune response, cellular response to stimulus, as well as apoptosis signaling, inflammation mediated by chemokines and cytokines, and T cell activation were among the most altered biological processes and pathways, respectively. Transcriptome analysis of ALL in adults reveals a group of genes consistently associated with hematological malignancies and underscores their relevance in the development of ALL in adults.

This paper underscores the critical need for open data practices in archaeo-historical research, particularly in the face of limited historical data availability, especially in underrepresented regions. Our study was conducted within the framework of the PERAIA project, which introduced an innovative approach by creating an open data database and web application to enhance data accessibility and reusability. This platform offers a comprehensive gazetteer that covers archaeological and heritage sites within the Eastern Mediterranean area (Crete and Marmarica) spanning Late Prehistory and Antiquity. To achieve this, we employed a digital research methodology that integrated legacy data with systematic aerial and satellite imagery analysis. This integration allowed us to identify previously known and unknown sites, enriched with associated (meta)data. Our commitment to open science is embodied in our open data practices. We also make the data accessible through Zenodo, ensuring that such data are available for potential reuse.

Introduction: Psoriasis is a chronic disease of the skin with a prevalence of 2% in the general population. The high prevalence of psoriasis has prompted the study of its comorbidities in recent decades. We designed a study to determine the prevalence of psoriasis in a large-scale, population-based cohort, to exhaustively describe its comorbidities, and to analyze which diseases are associated with psoriasis. Methods: Retrospective, observational study based on the clinical information contained in the electronic health records of the individuals in the EpiChron Cohort with a diagnosis of psoriasis (31,178 individuals) in 2019. We used logistic regression models and calculated the likelihood of the occurrence of each comorbidity based on the presence of psoriasis (p-value < 0.05). Results: The prevalence of psoriasis was 2.84%, and it was more prevalent in men (3.31% vs. 2.43%). The most frequent chronic comorbidities were disorders of lipid metabolism (35.87%), hypertension (35.50%), and other nutritional-endocrine-metabolic disorders (21.79%). The conditions most associated with psoriasis were (odds ratio; 95% confidence interval) tuberculosis (2.36; 1.24–4.49), cystic fibrosis (2.15; 1.25–3.69), amongst others. We did not find a significant association between psoriasis and hypertension or neoplasms (0.90; 0.86–0.95). Conclusions: This study revealed significant associations between psoriasis and cardiac, psychological, and musculoskeletal comorbidities.

The present work reports on an empirical mathematical expression for predicting the digital porosity (DP) of electrospun nanofiber veils, employing emulsions of poly(vinyl alcohol) (PVOH) and olive and orange oils. The electrospun nanofibers were analyzed by scanning electron microscopy (SEM), observing orientation and digital porosity (DP) in the electrospun veils. To determine the DP of the veils, the SEM micrographs were transformed into a binary system, and then the threshold was established, and the nanofiber solid surfaces were emphasized. The relationship between the experimental results and those obtained with the empirical mathematical expression displayed a correlation coefficient (R2) of 0.97 by employing threshold II. The mathematical expression took into account experimental variables such as the nanofiber humidity and emulsion conductivity prior to electrospinning, in addition to the corresponding operation conditions. The results produced with the proposed expression showed that the prediction of the DP of the electrospun veils was feasible with the considered thresholds.

Este escrito detalla algunos hallazgos identificados durante una investigación postdoctoral, en la cual se buscaba identificar cambios en las masculinidades, así como reconocer qué es lo que permite que se efectúen tales modificaciones. Esta indagación se realizó en bares donde varones bailan y se desnudan (estríperes) ante una audiencia compuesta por hombres de la diversidad sexual y afectiva (homosexuales y bisexuales). En ella se estudiaron y analizaron los desplazamientos identificados en la expresión y materialización del género de los estríperes y, al mismo tiempo, se identificaron espacios donde se transforma la masculinidad, las razones por las cuales es posible y las condiciones que los favorecen. Durante la pesquisa se reconocieron algunas modificaciones en la masculinidad de estos varones; éstas se realizan durante el tiempo que ellos se encuentran desarrollando sus labores, tanto por las necesidades del servicio como por las solicitudes expresas de los clientes.

This study analyzes changes in social life during the pandemic and the early stages of the post-pandemic period within a population characterized by high levels of informality in Lima, particularly the textile district of Gamarra, encompassing 89,123 people. A qualitative approach was adopted, based on 62 semi-structured interviews with garment manufacturers, in-store traders, and street vendors. Two distinct moments could be identified: a) experiences confronting the shock induced by the Covid-19 pandemic; and b) experiences of reconfiguring work and daily life, alongside strategies adopted by the population. In conclusion, the study suggests that some elements of daily life acquired during the Covid-19 pandemic may carry over into the future, inducing society to place greater emphasis on preventive measures against emerging risks, including behaviors related to hygiene and health, fostering closer family ties, increased utilization of digitalization and hybrid work models, and the cultivation of enhanced social capital.

The use of strength training is important for athletes in combat sports such as judo and jiu-jitsu. Specificity is key when prescribing strength training programs for athletes, considering maximal strength, muscular power and strength-endurance. Grappling combat sports require grip control, which is necessary to execute throwing techniques and groundwork. The aim of this study was to verify the bilateral strength deficit in general and in grappling combat sport-specific action in the control group and grapplers. A sample of 73 subjects, divided into 2 groups, was used: the Student Group (15 females and 16 males) and the Grappler Group (29 males and 13 females). The male and female participants attended four laboratory sessions over a 48-hour interval, the first two to familiarize themselves with the Electromechanical Functional Dynamometer (EMFD), and the last two to collect maximal isometric strength data, using a standard grip and a judo/jiujitsu specific grip. Significant differences in mean and peak forces (p

IntroductionEven though infant crying is a common phenomenon in humans’ early life, it is still a challenge for researchers to properly understand it as a reflection of complex neurophysiological functions. Our study aims to determine the association between neonatal cry acoustics with neurophysiological signals and behavioral features according to different cry distress levels of newborns.MethodsMultimodal data from 25 healthy term newborns were collected simultaneously recording infant cry vocalizations, electroencephalography (EEG), near-infrared spectroscopy (NIRS) and videos of facial expressions and body movements. Statistical analysis was conducted on this dataset to identify correlations among variables during three different infant conditions (i.e., resting, cry, and distress). A Deep Learning (DL) algorithm was used to objectively and automatically evaluate the level of cry distress in infants.ResultsWe found correlations between most of the features extracted from the signals depending on the infant’s arousal state, among them: fundamental frequency (F0), brain activity (delta, theta, and alpha frequency bands), cerebral and body oxygenation, heart rate, facial tension, and body rigidity. Additionally, these associations reinforce that what is occurring at an acoustic level can be characterized by behavioral and neurophysiological patterns. Finally, the DL audio model developed was able to classify the different levels of distress achieving 93% accuracy.ConclusionOur findings strengthen the potential of crying as a biomarker evidencing the physical, emotional and health status of the infant becoming a crucial tool for caregivers and clinicians.

Crossbite is a common anomaly in orthodontic patients. One therapeutic option is functional orthopedics. We present the case of a patient who went directly to the orthodontic service, with canine and molar relations of bilateral mesioclusion, negative overjet, full crown overshoot, left unilateral anterior and posterior crossbite. After preparing the study models and indicating the radiographic study, the orthodontic correction was carried out with the Klammt class III open elastic activator. He was checked every 21 days, after six months of treatment the molar and canine relationship was corrected, his facial aesthetics improved, but even without occlusion in the lateral sectors, the treatment with the activator was continued until the permanent dentition was completed. After two years of treatment, a correct occlusal relations was achieved in the three senses of space and adequate facial aesthetics. Treatment with the Klammt class III open elastic activator, in this patient, allowed the molar relationship to be corrected, a 1/3 crown overgrowth and a 3 mm overjet were prepared, and the unilateral left anterior and posterior crossbite was eliminated, with proper facial aesthetics.

Background and aimsDespite enteral nutrition (EN) is the preferred route of nutrition in patients with critical illness, EN is not always able to provide optimal nutrient provision and parenteral nutrition (PN) is needed. This is strongly associated with gastrointestinal (GI) complications, a feature of gastrointestinal dysfunction and disease severity. The aim of the present study was to investigate factors associated with the need of PN after start of EN, together with the use and complications associated with EN.MethodsAdult patients admitted to 38 Spanish intensive care units (ICUs) between April and July 2018, who needed EN therapy were included in a prospective observational study. The characteristics of EN-treated patients and those who required PN after start EN were analyzed (i.e., clinical, laboratory and scores).ResultsOf a total of 443 patients, 43 (9.7%) received PN. One-third (29.3%) of patients presented GI complications, which were more frequent among those needing PN (26% vs. 60%, p = 0.001). No differences regarding mean energy and protein delivery were found between patients treated only with EN (n = 400) and those needing supplementary or total PN (n = 43). Abnormalities in lipid profile, blood proteins, and inflammatory markers, such as C-Reactive Protein, were shown in those patients needing PN. Sequential Organ Failure Assessment (SOFA) on ICU admission (Hazard ratio [HR]:1.161, 95% confidence interval [CI]:1.053–1.281, p = 0.003) and modified Nutrition Risk in Critically Ill (mNUTRIC) score (HR:1.311, 95% CI:1.098–1.565, p = 0.003) were higher among those who needed PN. In the multivariate analysis, higher SOFA score (HR:1.221, 95% CI:1.057–1.410, p = 0.007) and higher triglyceride levels on ICU admission (HR:1.004, 95% CI:1.001–1.007, p = 0.003) were associated with an increased risk for the need of PN, whereas higher albumin levels on ICU admission (HR:0.424, 95% CI:0.210–0.687, p = 0.016) was associated with lower need of PN.ConclusionA higher SOFA and nutrition-related laboratory parameters on ICU admission may be associated with the need of PN after starting EN therapy. This may be related with a higher occurrence of GI complications, a feature of GI dysfunction.Clinical trial registrationClinicalTrials.gov: NCT03634943.

Abstract Objectives: to describe behavioral changes related to mental health in children and adolescents with Attention Deficit Hyperactivity Disorder during social isolation due to the COVID-19 pandemic. Methods: this is a systematic review conducted under the PRISMA protocol (2020) in the PubMed, SciELO and VHL databases, with a period of 2019-2022. Results: 3,735 studies were screened and ten were selected, according to the eligibility criteria. The sample had 4,688 participants. There was evidence of a worsening of signs and symptoms regarding the mental health of this population, expressed mainly through changes in mood, with increased anxiety, sadness or depressed symptoms, in addition to increased hyperactivity. Behavioral changes also included reduced sleep quality and physical activity, and increased use of digital technologies and screen time. Conclusions: it was described that children and youth groups, especially those with attention deficit hyperactivity disorder, had increased emotional symptoms and conduct problems when compared to before the pandemic, making it possible to recognize the negative repercussions of the changes imposed by it. These factors are important for planning more effective care strategies.

Background Pembrolizumab is FDA approved for tumors with tumor mutational burden (TMB) of ≥10 mutations/megabase (mut/Mb). However, the response to immune checkpoint inhibitors (ICI) varies significantly among cancer histologies. We describe the landscape of frameshift mutations (FSs) and evaluated their role as a predictive biomarker to ICI in a clinical cohort of patients.Methods Comprehensive genomic profiling was performed on a cohort of solid tumor samples examining at least 324 genes. The clinical cohort included patients with metastatic solid malignancies who received ICI monotherapy and had tumor sequencing. Progression-free survival (PFS), overall survival, and objective response rates (ORR) were compared between the groups.Results We analyzed 246,252 microsatellite stable (MSS) and 4561 samples with microsatellite instability across solid tumors. Histologies were divided into groups according to TMB and FS. MSS distribution: TMB-L (

Resumen: La reparación quirúrgica de la insuficiencia mitral por prolapso de uno o varios segmentos del velo anterior, tanto aislada como en combinación con patología comisural o de velo posterior, es compleja. Las técnicas resectivas presentan menos indicaciones y peores resultados que en el prolapso del velo posterior (PrVP). Las técnicas de preservación son la transposición o acortamiento de cuerdas o de músculos papilares, la reparación borde-con-borde o, más frecuentemente, la implantación de neocuerdas. En este trabajo se pretenden revisar las diferentes variantes técnicas para el abordaje del prolapso del velo anterior mitral, que en el caso de la implantación de neocuerdas son tremendamente variadas, junto a sus indicaciones y resultados. Abstract: Surgical mitral valve repair due to anterior leaflet prolapse is complex, both isolated or combined with commisural and/or posterior leaflet pathology. Resective techniques are less indicated and are associated with worse long-term results that those observed after posterior leaflet resection. Leaflet preservation techniques are pappilary muscle or chordae transposition or shortening, the edge-to-edge repair and, more frequently, artificial neochordae implantation. This paper aims to describe the most important techniques used for anterior leaflet prolapse repair, extremely numerous in the neochordae implantation subset, in addition to their indications and results.

La radioterapia corporal estereotáctica es una modalidad que con alta precisión administra dosis alta de radiación a un objetivo tumoral bien definido, en una o en pocas fracciones, y reduce significativamente la dosis que reciben los tejidos sanos circundantes. Está indicada en cáncer primario de pulmón de células no pequeñas en estadios tempranos (T1 y T2) no operable, metástasis pulmonares con un tumor primario controlado, tumores prostáticos y enfermedad oligometastásica. A pesar de la falta de estudios a largo plazo o fase III, los resultados de su eficacia en el control local es superior a 90 %, con toxicidad similar a la reportada con fraccionamientos convencionales de radioterapia. Este artículo describe la tecnología y la técnica de radioterapia corporal estereotáctica, con las aplicaciones clínicas, indicaciones y limitaciones de esta modalidad terapéutica.

Genomic selection (GS) is transforming plant and animal breeding, but its practical implementation for complex traits and multi-environmental trials remains challenging. To address this issue, this study investigates the integration of environmental information with genotypic information in GS. The study proposes the use of two feature selection methods (Pearson’s correlation and Boruta) for the integration of environmental information. Results indicate that the simple incorporation of environmental covariates may increase or decrease prediction accuracy depending on the case. However, optimal incorporation of environmental covariates using feature selection significantly improves prediction accuracy in four out of six datasets between 14.25% and 218.71% under a leave one environment out cross validation scenario in terms of Normalized Root Mean Squared Error, but not relevant gain was observed in terms of Pearson´s correlation. In two datasets where environmental covariates are unrelated to the response variable, feature selection is unable to enhance prediction accuracy. Therefore, the study provides empirical evidence supporting the use of feature selection to improve the prediction power of GS.

This research aimed to find out the relationship between informality and the internalization of the rules of behavior required for complexity in the economic system, as better knowledge is required for formalization policy to have a greater impact. We use the economic complexity index (ECI) for 2018 at the regional level in Colombia, which combines the country's productive structure with the amount of knowledge and know-how embodied in the goods it produces. The informality measure we use is the individual's affiliation to social security (in particular health insurance), and we use a proxy of civic rule's internalization as an inverse relation with traffic tickets. This research aimed to shed new light on public policy to improve formalization and its economic impact. First, we include a theory that includes both intrinsic and extrinsic motivation types. The self-determination theory or organismic integration theory proposes this theory. Second, we have argued that the motivation to formalize is intrinsic to greater cultural capacity. Individuals gradually internalize rules of behavior that have repercussions on social dynamics. Third, the composition and characteristics of the families in the study sample seem to show that some factors increase the propensity for informality. Our empirical analysis reveals that group of people with a lower educational level are the ones who are more likely to belong to the informal labor market. These results are consistent with the literature. Multivariate Probit regression was used to examine these factors.

ABSTRACT BACKGROUND: Abnormal uterine bleeding (AUB) is a common condition, and the Menstrual Bleeding Questionnaire (MBQ) is used for its assessment. OBJECTIVES: To translate, assess the cut-off point for diagnosis, and explore psychometric properties of the MBQ for use in Brazilian Portuguese. DESIGN AND SETTING: Prospective cohort study including 200 women (100 with and 100 without AUB) at a tertiary referral center. METHODS: MBQ translation involved a pilot-testing phase, instrument adjustment, data collection, and back-translation. Cut-off point was obtained using receiver operating curve analysis. Menstrual patterns, impact on quality of life due to AUB, internal consistency, test-retest, responsiveness, and discriminant validity were assessed. For construct validity, the Pictorial Blood Assessment Chart (PBAC) and World Health Organization Quality of Life – abbreviated version (WHOQOL-BREF) were applied. RESULTS: Women with AUB were older, had higher body mass indices, and had a worse quality of life during menstruation. Regarding the MBQ's psychometric variables, Cronbach's alpha coefficient was > 0.70 in all analyses, high intraclass correlation coefficient was found in both groups; no ceiling and floor effects were observed, and construct validity was demonstrated (correlation between MBQ score, PBAC score, and clinical menstrual cycle data). No difference between MBQ and PBAC scores were perceived after the test-retest. Significant differences were found between MBQ and PBAC scores before and after treatment. An MBQ score ≥ 24 was associated with a high probability of AUB; accuracy of 98%. CONCLUSION: The MBQ is a reliable questionnaire for Brazilian women. The cut-off ≥ 24 shows high accuracy to discriminate AUB.

Este artículo analiza el fotolibro Monsanto®: a Photographic Investigation del fotógrafo documental Mathieu Asselin. En primer lugar, se abordan los fotolibros desde una perspectiva semiótica, especialmente empleando las funciones de Roman Jakobson, y después, en este caso, se entiende parcialmente la diferencia entre fotolibros y fotoperiodismo como una cuestión de tiempo, ya que los fotolibros suelen informar sobre hechos que no están de actualidad. Después, se considera Monsanto® en relación con la tradición de los fotolibros bélicos, especialmente Agent Orange: «Collateral Damage» in Viet Nam, de Philip Jones Griffiths, y War against War!, de Ernst Friedrich. Asselin relaciona a las víctimas de la guerra con las víctimas de las corporaciones capitalistas, superando la diferencia colonial entre los soldados occidentales y las víctimas orientales, y profundizando en las causas del capitalismo bélico. Monsanto® también toma decisiones sobre los límites de la fotografía para presentar el mundo y, por ende, sobre la visibilidad. A diferencia de Friedrich, Asselin asume que la fotografía no tiene que representar visualmente todo lo que se cuenta en el libro, además, los pies de foto brindan información esencial y algunas fotografías solo pretenden mostrar lo que Asselin presenció. Finalmente, se utilizan las consideraciones de Nassim Nicholas Taleb sobre evidencias para comprender cómo la fotografía se destina a ser evidencia de hechos, lo que podría llevar a que las imágenes precedan y creen el evento relatado por ellas.