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Dr. William Beecher Scoville (1906–1984) is a giant figure in the history of neurosurgery, well known by the public for his operation on Patient H.M. He developed dozens of neurosurgical instruments and techniques, with many tools named after him that are still widely used today. He founded numerous neurosurgical societies around the world. He led the movement in psychosurgery, developing the technique of selective orbital undercutting and performing hundreds of lobotomies throughout his career. However, his many contributions to the advancement of neurosurgery have not been well described in the medical literature. To bridge the knowledge gap, this article seeks to detail the life and career of William Beecher Scoville and bring to attention the enduring impact of his work.

BackgroundOne key contributor to lumbar stenosis is thickening of the ligamentum flavum (LF), a process still poorly understood. Wild-type transthyretin amyloid (ATTRwt) has been found in the LF of patients undergoing decompression surgery, suggesting that amyloid may play a role. However, it is unclear whether within patients harboring ATTRwt, the amount of amyloid is associated with LF thickness.MethodsFrom an initial cohort of 324 consecutive lumbar stenosis patients whose LF specimens from decompression surgery were sent for analysis (2018-2019), 33 patients met the following criteria: (1) Congo red-positive amyloid in the LF; (2) ATTRwt by mass spectrometry-based proteomics; and (3) an available preoperative MRI. Histological specimens were digitized, and amyloid load quantified through Trainable Weka Segmentation (TWS) machine learning. LF thicknesses were manually measured on axial T2-weighted preoperative MRI scans at each lumbar level, L1-S1. The sum of thicknesses at every lumbar LF level (L1-S1) equals “lumbar LF burden.”ResultsPatients had a mean age of 72.7 years (range 59-87), were mostly male (61%) and white (82%); and predominantly had surgery at L4-L5 levels (73%). Amyloid load was positively correlated with LF thickness (R=0.345, p=0.0492) at the levels of surgical decompression. Furthermore, amyloid load was positively correlated with lumbar LF burden (R=0.383, p=0.0279).ConclusionsAmyloid load is positively correlated with LF thickness and lumbar LF burden across all lumbar levels, in a dose-dependent manner. Further studies are needed to validate these findings, uncover the underlying pathophysiology, and pave the way towards using therapies that slow LF thickening.

En Wuhan a finales del 2019 se dio un brote de neumonía con etiología no totalmente esclarecida. El virus denominado posteriormente como SARS- CoV2 afecta a las vías respiratorias, presentando síntomas leves como: fiebre, tos seca y cansancio, hasta llegar a una neumonía que puede ser causante del fallecimiento del paciente. La Rehabilitación Oral es una de las áreas odontológicas, de trabajo con más riesgo, por la producción de una gran cantidad de aerosoles durante sus procedimientos. OBJETIVO: Establecer normas de bioseguridad que permitan al rehabilitador, así como al odontólogo general trabajar de forma más segura. MATERIALES Y MÉTODOS: Se realizó una búsqueda de artículos publicados en el primer semestre del año 2020, en razón de la reciente situación de salud y cualquier otra información complementaria se revisó que fuera dentro de los últimos cinco años, dentro de las bases científicas Scielo, Pubmed, Google Académico, Web of Science, Contemporary Clinical Dentristy, Journal section: Oral Surgery, y Ebsco, se incluyeron artículos en inglés, español y portugués. Se obtuvieron un total de 56 fuentes, de las cuales 30 fueron seleccionados de acuerdo a los criterios de selección: información en idiomas referidos, acordes al tema de investigación, y los criterios de exclusión, es decir, aquellos artículos y fuentes de más de 5 años de antigüedad y que no cumplieran con los idiomas mencionados. CONCLUSIÓN: El rehabilitador oral está expuesto en mayor grado a un contagio, puesto que el trabajo de esta especialidad genera más cantidad de aerosoles durante los procedimientos protésicos, por lo que es de vital importancia el mantener normas estrictas para la desinfección de los materiales de impresión y evitar infecciones cruzadas en trabajos con laboratorio dental; se hace indispensable el uso de una succión de alta potencia, barreras de bioseguridad como pantallas faciales y el uso de aislamiento absoluto siempre que sea posible. PALABRAS CLAVE: Covid 19, Rehabilitación oral, SARS-COV 2, Covid 19 y odontología, Protocolos odontológicos y Covid 19.

El estudio tuvo como finalidad determinar la relación entre sexismo y violencia cometida y sufrida en las relaciones de noviazgo en adolescentes entre 15 y 17 años de Lima Norte. La muestra se conformó por 93 adolescentes, para lo cual el tipo de investigación fue aplicada y el diseño no experimental de corte transversal. Los instrumentos empleados fueron; la Escala de Detección del Sexismo en Adolescentes (DSA) y el Inventario de violencia en las relaciones de noviazgo entre adolescentes (CADRI). Los resultados evidencian que el sexismo se correlaciona de manera directa y significativa con la violencia cometida, y de manera no significativa y directa con la violencia sufrida, en grado bajo para ambas.

Significance Political polarization impeded public support for policies to address the spread of COVID-19, much as polarization hinders responses to other societal challenges. The present cross-country study demonstrates how the cues from political elites and affective polarization are analogous across countries addressing COVID-19. Far from being an outlier, the United States faces polarization challenges similar to those of other countries. Importantly, the results demonstrate that policies to combat public health crises are more supported when proposed by nonpartisan experts and bipartisan coalitions of political leaders. These results provide clear guidance on depolarizing communication strategies to improve global responses to health crises., Political polarization impeded public support for policies to reduce the spread of COVID-19, much as polarization hinders responses to other contemporary challenges. Unlike previous theory and research that focused on the United States, the present research examined the effects of political elite cues and affective polarization on support for policies to manage the COVID-19 pandemic in seven countries (n = 12,955): Brazil, Israel, Italy, South Korea, Sweden, the United Kingdom, and the United States. Across countries, cues from political elites polarized public attitudes toward COVID-19 policies. Liberal and conservative respondents supported policies proposed by ingroup politicians and parties more than the same policies from outgroup politicians and parties. Respondents disliked, distrusted, and felt cold toward outgroup political elites, whereas they liked, trusted, and felt warm toward both ingroup political elites and nonpartisan experts. This affective polarization was correlated with policy support. These findings imply that policies from bipartisan coalitions and nonpartisan experts would be less polarizing, enjoying broader public support. Indeed, across countries, policies from bipartisan coalitions and experts were more widely supported. A follow-up experiment replicated these findings among US respondents considering international vaccine distribution policies. The polarizing effects of partisan elites and affective polarization emerged across nations that vary in cultures, ideologies, and political systems. Contrary to some propositions, the United States was not exceptionally polarized. Rather, these results suggest that polarizing processes emerged simply from categorizing people into political ingroups and outgroups. Political elites drive polarization globally, but nonpartisan experts can help resolve the conflicts that arise from it.

BackgroundWild-type transthyretin amyloidosis (ATTRwt) is an underdiagnosed and potentially fatal disease. Interestingly, ATTRwt deposits have been found to deposit in the ligamentum flavum (LF) of patients with lumbar spinal stenosis prior to the development of systemic and cardiac amyloidosis. In order to study this phenomenon and its possible relationship with LF thickening and systemic amyloidosis, a precise method of quantifying amyloid deposits in histological slides of LF is critical. However, such a method is currently unavailable. Here, we present a machine learning quantification method with Trainable Weka Segmentation (TWS) to assess amyloid deposition in histological slides of LF.MethodsImages of ligamentum flavum specimens stained with Congo red are obtained from spinal stenosis patients undergoing laminectomies and confirmed to be positive for ATTRwt. Amyloid deposits in these specimens are classified and quantified by TWS through training the algorithm via user-directed annotations on images of LF. TWS can also be automated through exposure to a set of training images with user-directed annotations, and then application to a set of new images without additional annotations. Additional methods of color thresholding and manual segmentation are also used on these images for comparison to TWS.ResultsWe develop the use of TWS in images of LF and demonstrate its potential for automated quantification. TWS is strongly correlated with manual segmentation in the training set of images with user-directed annotations (R = 0.98; p = 0.0033) as well as in the application set of images where TWS was automated (R = 0.94; p = 0.016). Color thresholding was weakly correlated with manual segmentation in the training set of images (R = 0.78; p = 0.12) and in the application set of images (R = 0.65; p = 0.23).ConclusionTWS machine learning closely correlates with the gold standard comparator of manual segmentation and outperforms the color thresholding method. This novel machine learning method to quantify amyloid deposition in histological slides of ligamentum flavum is a precise, objective, accessible, high throughput, and powerful tool that will hopefully pave the way towards future research and clinical applications.

Two experiments examined the polarization of public support for COVID-19 policies due to people’s (lack of) trust in political leaders and nonpartisan experts. In diverse samples in the United States (Experiment 1; N = 1,802) and the United Kingdom (Experiment 2; N = 1,825), participants evaluated COVID-19 policies that were framed as proposed by ingroup political leaders, outgroup political leaders, nonpartisan experts, or, in the United States, a bipartisan group of political leaders. At the time of the study in April 2020, COVID-19 was an unfamiliar and shared threat. Therefore, there were theoretical reasons suggesting that attitudes toward COVID-19 policy may not have been politically polarized. Yet, our results demonstrated that even relatively early in the pandemic people supported policies from ingroup political leaders more than the same policies from outgroup leaders, extending prior research on how people align their policy stances to political elites from their own parties. People also trusted experts and ingroup political leaders more than they did outgroup political leaders. Partly because of this polarized trust, policies from experts and bipartisan groups were more widely supported than policies from ingroup political leaders. These results illustrate the potentially detrimental role political leaders may play and the potential for effective leadership by bipartisan groups and nonpartisan experts in shaping public policy attitudes during crises.

Introducción:La aplicación de nemotecnias facilita al personal de salud, los criterios necesarios para una aproximación diagnóstica oportuna, evitando realizar procedimientos inadecuados y perjudiciales en pacientes con posible lesión de codo. Objetivo:Proporcionar al personal de salud una nemotecnia adecuada y fácil de recordar, para identificar las características de los núcleos de osificación del codo, en una imagen radiográfica simple. Métodos:Se realizó un estudio transversal y descriptivo, enfocado en crear una nemotécnica fácil de acordarse y además conocer los núcleos de osificación de codo a lo largo de la edad pediátrica, esto se realizó durante el periodo Enero 2016- Junio 2017. Resultados:En el estudio y análisis radiológico correspondiente a las 120 placas seleccionadas en el RIS-PACS (Radiology Information System - Picture Archiving and Communications System), para el almacenamiento, distribución, presentación y administración de las imágenes radiológicas del Hospital Axxis se destacó; que la identificación de los núcleos de osificación fue adecuada y con mayor facilidad, aplicando los criterios nemotécnicos propuestos en CCETOE (Capitellium, Cabeza de radio, Epicóndilo Interno, Tróclea, Olecranon, Epicóndilo Externo). Conclusiones:Las nemotecnias proporcionan una opción adecuada para memorizar conceptos en el área de salud, facilitando la aplicación del conocimiento y disminuyendo el uso de exámenes perjudiciales para los pacientes.

El artículo se centró en analizar un mecanismo de tutela, desde la norma jurídico penal sustantiva, con la que cuentan los titulares de bienes inmateriales, particularmente, los titulares de patentes de invención, modelos de utilidad y de diseños industriales, como medida coercitiva de mayor rigurosidad para perseguir y castigar a los infractores de sus derechos exclusivos con penas que incluye la privación de libertad, para ello se utilizó en la elaboración de este trabajo investigativo el método teórico-documental a través de instrumentos como la exploración y análisis documental de una serie de fuentes primarias y secundarias del conocimiento, mediante lo cual se evidenció por un lado que los delitos contra la Propiedad Industrial presentan características similares que son perfectamente deducibles del propio precepto normativo y por otro lado, se determinó la protección de la Propiedad Industrial desde la norma jurídico penal sustantiva, como una herramienta a conocer y aplicar por los titulares de Derechos de Propiedad Industrial en la resolución de sus controversias en esta materia.

The purposeof this investigation is to recommend marketing strategies fora high technology cinema theater,which is locatedin a low-and medium-low socioeconomic populationin the city of Guayaquil-Ecuador.Thehigh sales growth for this segment of the market is unusual,considering thatthis type of entertainment is not the most economical option for this market. In addition, given the restrictions on incomes for this segment, a favorable reaction was not expected immediately.Thesurveysand in-depth interviews conducted to the cinema clients, showed the consumer profile, their perception about the service, their recognition and acceptance of the brand and theircurrent motivators of purchase.The results of this research favor the developing of marketing strategies for this new brand of movie theaters in Guayaquil. La presente investigación tiene como objetivo proponer estrategias de marketing para un complejo de cines con alta tecnología, ubicado en una zona de población de nivel socioeconómico bajo y medio bajo en la ciudad de Guayaquil-Ecuador. Su alto crecimiento en ventas resulta interesante, considerando que este tipo de entretenimiento no es la opción más económica para este mercado y que, dadas las restricciones en ingresos de la población cercana, no se esperaba una reacción favorable de manera inmediata. Mediante encuestas a una muestra de la población de clientes del cine y entrevistas a profundidad, se obtuvo la información requerida sobre el perfil del consumidor, su percepción sobre el servicio, reconocimiento, aceptación de la marca y los motivadores actuales de compra. Los resultados de esta investigación favorecen a la definición de estrategias de marketing para esta nueva marca de cines en Guayaquil.

Background & Aims: Surgery in cirrhosis is associated with a high morbidity and mortality. Retrospectively reported prognostic factors include emergency procedures, liver function (MELD/Child-Pugh scores) and portal hypertension (assessed by indirect markers). This study assessed the prognostic role of hepatic venous pressure gradient (HVPG) and other variables in elective extrahepatic surgery in patients with cirrhosis. Methods: A total of 140 patients with cirrhosis (Child-Pugh A/B/C: 59/37/4%), who were due to have elective extrahepatic surgery (121 abdominal; 9 cardiovascular/thoracic; 10 orthopedic and others), were prospectively included in 4 centers (2002–2011). Hepatic and systemic hemodynamics (HVPG, indocyanine green clearance, pulmonary artery catheterization) were assessed prior to surgery, and clinical and laboratory data were collected. Patients were followed-up for 1 year and mortality, transplantation, morbidity and post-surgical decompensation were studied. Results: Ninety-day and 1-year mortality rates were 8% and 17%, respectively. Variables independently associated with 1-year mortality were ASA class (American Society of Anesthesiologists), high-risk surgery (defined as open abdominal and cardiovascular/thoracic) and HVPG. These variables closely predicted 90-, 180- and 365-day mortality (C-statistic >0.8). HVPG values >16 mmHg were independently associated with mortality and values ≥20 mmHg identified a subgroup at very high risk of death (44%). Twenty-four patients presented persistent or de novo decompensation at 3 months. Low body mass index, Child-Pugh class and high-risk surgery were associated with death or decompensation. No patient with HVPG 0.63 developed decompensation. Conclusions: ASA class, HVPG and high-risk surgery were prognostic factors of 1-year mortality in cirrhotic patients undergoing elective extrahepatic surgery. HVPG values >16 mmHg, especially ≥20 mmHg, were associated with a high risk of post-surgical mortality. Lay summary: The hepatic venous pressure gradient is associated with outcomes in patients with cirrhosis undergoing elective extrahepatic surgery. It enables a better stratification of risk in these patients and provides the foundations for potential interventions to improve post-surgical outcomes.

Relatório final do estágio profissionalizante do 6.º ano

Dissertação de Mestrado em Ciências da Educação, Especialização em Animação Sociocultural A Animação Sociocultural, Expressão Dramática e Inclusão Social é o tema da nossa dissertação, que acreditamos estar implícito no mesmo processo de estruturação, aplicação e vivência da medida PIEF (Programa Integrado de Educação e Formação). No nosso trabalho pretendemos descrever, refletir e pensar sobre as experiências dos jovens integrantes deste projeto, em nossa opinião tão particular e minucioso no empenho de integração dos mesmos. Partimos assim à procura de referenciais teóricos para a construção e sustentação do que observámos, sentimos e vivemos no decorrer de um ano letivo. Encontrámos respostas às nossas questões, às nossas dúvidas. No processo vivido foi constante a fusão entre a teoria e a prática. Desta forma, após a apresentação do problema falamos da metodologia adequada à nossa investigação; partimos do Estudo de Caso, recorrendo à observação participante e não participante, assim como à observação documental e entrevistas. Em benefício dos alunos e dos seus pares verificamos que projetos desta dimensão envolvem os intervenientes de uma forma sustentada, persistente e dedicada em benefício dos alunos e dos seus pares. Nesta medida os professores, técnicos e parcerias, investem sem receio naqueles que são o futuro. Assim, apresentamos a nossa própria experiência, que serviu de instrumento, de confrontação, com material recolhido na discussão de dados. Na abordagem teórica tentamos explicitar as raízes e as influências visíveis da Animação Sociocultural e a sua interação com a Expressão Dramática e a Inclusão Social. Na discussão de dados baseadas na realidade estudada, na teoria aplicada ao PIEF e às boas práticas de Inclusão assumimos as nossas convicções. Na conclusão refletimos sobre a importância da nossa investigação que sentimos como uma “brisa” no grande “sopro” que é a Educação. Sociocultural Animation, Drama and Social Inclusion is the theme of our work, which we believe it is implicit in the structuring process, application and experience of the measure PIEF (Integrated Program for Education and Training). We tried to describe, reflect and think about what follows the experiences of young members of this project, so particular in the task of integrating them. So we started in search of theoretical frameworks for the construction and support of what we see, feel and live. By experiencing the course of one academic year, we found answers to our questions and our doubts. In this process there was a constant mixture of theory and practice. Therefore, after the presentation of the problem, we talked about the appropriated methodology to our investigation, which was the case study, using participant and non-participant observation, documentary observation and interviews. We found that projects of this size, involving people at a sustained, persistent and dedicated way, benefit the students. Also their peers, teachers, technicians and partners invest without fear in those who are the future. So we presented our own experience, which served as means of settling the discussion of data with the collected material. In the theoretical approach we tried to leave the roots and fully visibility from the Sociocultural Animation and its relation with Drama and Social Inclusion. In the discussion of data, we took our beliefs based on the studied reality, on the theory applied to PIEF and best practices for Inclusion. In conclusion we reflected on the importance of our research that we compared to a "breeze" on the big "blow" which is Education.