Search

Abstract Background Intraoperative pulmonary embolism (PE) with cardiac arrest (CA) represents a critical and potentially fatal condition. Available treatments include systemic thrombolysis, catheter-based thrombus fragmentation or aspiration, and surgical embolectomy. However, limited studies are focused on the optimal treatment choice for this critical condition. We present a case series and an updated review of the management of intraoperative CA secondary to PE. Methods A retrospective review of patients who developed high-risk intraoperative PE was performed between June 2012 and June 2022. For the updated review, a literature search on PubMed and Scopus was conducted which resulted in the inclusion of a total of 46 articles. Results A total of 196 174 major non-cardiac surgeries were performed between 2012 and 2022. Eight cases of intraoperative CA secondary to high-risk PE were identified. We found a mortality rate of 75%. Anticoagulation therapy was administered to one patient (12.5%), while two patients (25%) underwent thrombolysis, and one case (12.5%) underwent mechanical thrombectomy combined with thrombus aspiration. Based on the literature review and our 10-year experience, we propose an algorithm for the management of intraoperative CA caused by PE. Conclusion The essential components for adequate management of intraoperative PE with CA include hemodynamic support, cardiopulmonary resuscitation, and the implementation of a primary perfusion intervention. The prompt identification of the criteria for each specific treatment modality, guided by the individual patient’s characteristics, is necessary for an optimal approach.

Listeria monocytogenes is a saprophytic gram-positive bacterium, and an opportunistic foodborne pathogen that can produce listeriosis in humans and animals. It has evolved an exceptional ability to adapt to stress conditions encountered in different environments, resulting in a ubiquitous distribution. Because some food preservation methods and disinfection protocols in food-processing environments cannot efficiently prevent contaminations, L. monocytogenes constitutes a threat to human health and a challenge to food safety. In the host, Listeria colonizes the gastrointestinal tract, crosses the intestinal barrier, and disseminates through the blood to target organs. In immunocompromised individuals, the elderly, and pregnant women, the pathogen can cross the blood-brain and placental barriers, leading to neurolisteriosis and materno-fetal listeriosis. Molecular and cell biology studies of infection have proven L. monocytogenes to be a versatile pathogen that deploys unique strategies to invade different cell types, survive and move inside the eukaryotic host cell, and spread from cell to cell. Here, we present the multifaceted Listeria life cycle from a comprehensive perspective. We discuss genetic features of pathogenic Listeria species, analyze factors involved in food contamination, and review bacterial strategies to tolerate stresses encountered both during food processing and along the host’s gastrointestinal tract. Then we dissect host–pathogen interactions underlying listerial pathogenesis in mammals from a cell biology and systemic point of view. Finally, we summarize the epidemiology, pathophysiology, and clinical features of listeriosis in humans and animals. This work aims to gather information from different fields crucial for a comprehensive understanding of the pathogenesis of L. monocytogenes.

Motor imagery (MI)-based brain-computer interface (BCI) systems have shown promising advances for lower limb motor rehabilitation. The purpose of this study was to develop an MI-based BCI for the actions of standing and sitting. Thirty-two healthy subjects participated in the study using 17 active EEG electrodes. We used a combination of the filter bank common spatial pattern (FBCSP) method and the regularized linear discriminant analysis (RLDA) technique for decoding EEG rhythms offline and online during motor imagery for standing and sitting. The offline analysis indicated the classification of motor imagery and idle state provided a mean accuracy of 88.51 ± 1.43% and 85.29 ± 1.83% for the sit-to-stand and stand-to-sit transitions, respectively. The mean accuracies of the sit-to-stand and stand-to-sit online experiments were 94.69 ± 1.29% and 96.56 ± 0.83%, respectively. From these results, we believe that the MI-based BCI may be useful to future brain-controlled standing systems.

The use of machine learning (ML) for diagnosis support has advanced in the field of health. In the present paper, the results of studying ML techniques in a tuberculosis diagnosis loop in a scenario of limited resources are presented. Data are analyzed using a tuberculosis (TB) therapy program at a health institution in a main city of a developing country using five ML models. Logistic regression, classification trees, random forest, support vector machines, and artificial neural networks are trained under physician supervision following physicians' typical daily work. The models are trained on seven main variables collected when patients arrive at the facility. Additionally, the variables applied to train the models are analyzed, and the models' advantages and limitations are discussed in the context of the automated ML techniques. The results show that artificial neural networks obtain the best results in terms of accuracy, sensitivity, and area under the receiver operating curve. These results represent an improvement over smear microscopy, which is commonly used techniques to detect TB for special cases. Findings demonstrate that ML in the TB diagnosis loop can be reinforced with available data to serve as an alternative diagnosis tool based on data processing in places where the health infrastructure is limited.

Ectomesenchymal chondromyxoid tumor (ECMT) is a recently described benign tumor, with a striking predilection for the oral cavity. We present the case of a 26-year-old female complaining of a small polypoid lesion, in the right dorsal-anterior aspect of the tongue. The polypoid lesion was resected, and after histopathological analysis a diagnosis of ECMT was rendered. ECMT is a very rare tumor with only a few published cases, none of them in Colombia.

Background: Asynchronous telepsychiatry (ATP) consultations are a novel form of psychiatric consultation. Studies comparing patient and provider satisfaction for ATP with that for synchronous telepsychiatry (STP) do not exist. Methods: This mixed-methods study is a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial of ATP compared with STP. Patients and their PCPs completed satisfaction surveys, and provided unstructured feedback about their experiences with either ATP or STP. Differences in patient satisfaction were assessed using mixed-effects logistic regression models, and the qualitative data were analyzed using thematic analysis with an inductive coding framework. Results: Patient satisfaction overall was high with 84% and 97% of respondents at 6 months reported being somewhat or completely satisfied with ATP and STP, respectively. Patients in the STP group were more likely to report being completely satisfied, to recommend the program to a friend, and to report being comfortable with their care compared with ATP (all p < 0.05). However, there was no difference between the patients in ATP and STP in perceived change in clinical outcomes (p = 0.51). The PCP quantitative data were small, and thus only summarized descriptively. Conclusions: Patients expressed their overall satisfaction with both STP and ATP. Patients in ATP reported more concerns about the process, likely because feedback after ATP was slower than that after STP consultations. PCPs had no apparent preference for STP or ATP, and reported implementing the psychiatrists' recommendations for both groups when such recommendations were made, which supports our previous findings. Trial Registration: ClinicalTrials.gov NCT02084979; https://clinicaltrials.gov/ct2/show/NCT02084979.

We studied the correlation between oscillatory brain activity and performance in healthy subjects performing the error awareness task (EAT) every 2 h, for 24 h. In the EAT, subjects were shown on a screen the names of colors and were asked to press a key if the name of the color and the color it was shown in matched, and the screen was not a duplicate of the one before (“Go” trials). In the event of a duplicate screen (“Repeat No-Go” trial) or a color mismatch (“Stroop No-Go” trial), the subjects were asked to withhold from pressing the key. We assessed subjects’ (N = 10) response inhibition by measuring accuracy of the “Stroop No-Go” (SNGacc) and “Repeat No-Go” trials (RNGacc). We assessed their reactivity by measuring reaction time in the “Go” trials (GRT). Simultaneously, nine electroencephalographic (EEG) channels were recorded (Fp2, F7, F8, O1, Oz, Pz, O2, T7, and T8). The correlation between reactivity and response inhibition measures to brain activity was tested using quantitative measures of brain activity based on the relative power of gamma, beta, alpha, theta, and delta waves. In general, response inhibition and reactivity reached a steady level between 6 and 16 h of sleep deprivation, which was followed by sustained impairment after 18 h. Channels F7 and Fp2 had the highest correlation to the indices of performance. Measures of response inhibition (RNGacc and SNGacc) were correlated to the alpha and theta waves’ power for most of the channels, especially in the F7 channel (r = 0.82 and 0.84, respectively). The reactivity (GRT) exhibited the highest correlation to the power of gamma waves in channel Fp2 (0.76). We conclude that quantitative measures of EEG provide information that can help us to better understand changes in subjects’ performance and could be used as an indicator to prevent the adverse consequences of sleep deprivation.

Abstract The Hymenoptera collection of the Museu de Zoologia da Universidade de São Paulo, Brazil (MZSP) houses one of the most important collections for the Brazilian and Neotropical wasp faunas. The present catalogue lists the type specimens of Pompiloidea, Thynnoidea and Vespoidea (Insecta, Hymenoptera) deposited in the MZSP. The collection includes a total of 422 type specimens (66 holotypes, 28 lectotypes, 278 paratypes, 45 paralectotypes, and five syntypes), being 91 Pompiloidea (40 Mutillidae type specimens of 10 genera and 25 species, 51 Pompilidae type specimens of 4 genera and 27 species), 191 Vespoidea (15 genera and 86 species of Vespidae), and 18 Thynnoidea (eight genera and 12 species of Thynnidae). All information written in labels was compiled and is presented along with additional data from the original descriptions, MZSP records and other sources. We provide Specimage links to high-resolution photographs of holotypes and lectotypes at the Hymenoptera image database of the Ohio State University.

When divers are at depth in water, the high pressure and low temperature alone can cause severe stress, challenging the human physiological control systems. The addition of cognitive stress, for example during a military mission, exacerbates the challenge. In these conditions, humans are more susceptible to autonomic imbalance. Reliable tools for the assessment of the autonomic nervous system (ANS) could be used as indicators of the relative degree of stress a diver is experiencing, which could reveal heightened risk during a mission. Electrodermal activity (EDA), a measure of the changes in conductance at the skin surface due to sweat production, is considered a promising alternative for the non-invasive assessment of sympathetic control of the ANS. EDA is sensitive to stress of many kinds. Therefore, as a first step, we tested the sensitivity of EDA, in the time and frequency domains, specifically to cognitive stress during water immersion of the subject (albeit with their measurement finger dry for safety). The data from 14 volunteer subjects were used from the experiment. After a 4-min adjustment and baseline period after being immersed in water, subjects underwent the Stroop task, which is known to induce cognitive stress. The time-domain indices of EDA, skin conductance level (SCL) and non-specific skin conductance responses (NS.SCRs), did not change during cognitive stress, compared to baseline measurements. Frequency-domain indices of EDA, EDASymp (based on power spectral analysis) and TVSymp (based on time-frequency analysis), did significantly change during cognitive stress. This leads to the conclusion that EDA, assessed by spectral analysis, is sensitive to cognitive stress in water-immersed subjects, and can potentially be used to detect cognitive stress in divers.

Chemical modifications of clay to remove methylene blue (MB) from aqueous solutions at room temperature were compared. Natural bentonite (NC) was modified by cation exchange with hexadecyltrimethylammonium chloride (HC), bencyltriethylammonium chloride (BC), and tetramethylammonium chloride (TC) to reverse the surface polarity of the hydrophilic bentonite. The adsorption of MB was studied and fitted by the adsorption theories of Langmuir, Freundlich, Dubinin-Radushkevich, and Temkin. Equilibrium parameters were calculated, indicating that chemical modification did not improve the adsorption, due to the electrostatic adsorption mechanism. Specific surface area was determined, reporting the following trend: NC > TC > BC > HC. Isotherms show that TC is the best modified clay for the adsorption of MB with a capacity of 217 mg/g. Adsorbents were characterized by SEM and the determination of their point zero charge, indicating a charge reversal at pH 9.5 and a heterogeneous surface that is optimum for the adsorption of molecules and ions onto their surfaces.

Objective:To compare clinical recommendations given by psychiatrists and the adherence to these recommendations by primary care physicians (PCP) following consultations conducted by asynchronous telepsychiatry (ATP) and synchronous telepsychiatry (STP).Materials and Methods:ATP and STP consultations were compared using intermediate data from a randomized clinical trial with adult participant enrollment between April 2014 and December 2017. In both study arms, PCPs received written recommendations from the psychiatrist after each encounter. Independent clinicians reviewed PCP documentation to measure adherence to those recommendations in the 6 months following the baseline consultation.Results:Medical records were reviewed for 645 psychiatrists' consult recommendations; 344 from 61 ATP consultations and 301 from 62 STP consultations. Of those recommendations, 191 (56%) and 173 (58%) were rated fully adherent by two independent raters for ATP and STP, respectively. In a multilevel ordinal logistic regression model adjusted for recommendation type and recommended implementation timing, there was no statistically significant difference in adherence to recommendations for ATP compared with STP (adjusted odds ratio = 0.91, 95% confidence interval = 0.51-1.62). The profiles of recommendation type were comparable between ATP and STP.Conclusions:This is the first PCP adherence study comparing two forms of telemedicine. Although we did not find evidence of a difference between ATP and STP; this study supports the feasibility and acceptability of ATP and STP for the provision of collaborative psychiatric care. Clinical Trial Identifier NCT02084979.

Um grupo de 226 universitários do sexo masculino, cursando os 3 primeiros anos da escola, foram interrogados com relação às moléstias venéreas adquiridas durante êste período. A enfermidade mais freqüente foi a gonorréia, com uma incidência anual média de 119 por mil para os indivíduos que moravam com suas famílias, e de 153 por mil para aqueles que residiam em "repúblicas" de estudantes. Embora se tratasse de um estudo retrospectivo, os dados colhidos parecem suficientemente exatos para permitir a exclusão de uretrites de outras origens. No mesmo grupo foram observados 5 casos de sífilis, e respectivamente 9, 7 e 10 casos de condylomata acuminata, cancro mole e uretrite não específica. Comenta-se a terapêutica medicamentosa, totalmente ortodoxa, empregada bem como as medidas profiláticas, também inadequadas. A atitude dos universitários quanto ao problema preventivo revelou-se suficientemente madura, e medidas de controle das enfermidades venéreas parecem inteiramente viáveis nêste meio.

Secreted signaling peptides are central regulators of growth, development, and stress responses, but specific steps in the evolution of these peptides and their receptors are not well understood. Also, the molecular mechanisms of peptide-receptor binding are only known for a few examples, primarily owing to the limited availability of protein structural determination capabilities to few laboratories worldwide. Plants have evolved a multitude of secreted signaling peptides and corresponding transmembrane receptors. Stress-responsive SERINE RICH ENDOGENOUS PEPTIDES (SCOOPs) were recently identified. Bioactive SCOOPs are proteolytically processed by subtilases and are perceived by the leucine-rich repeat receptor kinase MALE DISCOVERER 1-INTERACTING RECEPTOR-LIKE KINASE 2 (MIK2) in the model plant Arabidopsis thaliana. How SCOOPs and MIK2 have (co)evolved, and how SCOOPs bind to MIK2 are unknown. Using in silico analysis of 350 plant genomes and subsequent functional testing, we revealed the conservation of MIK2 as SCOOP receptor within the plant order Brassicales. We then leveraged AI-based structural modeling and comparative genomics to identify two conserved putative SCOOP-MIK2 binding pockets across Brassicales MIK2 homologues predicted to interact with the "SxS" motif of otherwise sequence-divergent SCOOPs. Mutagenesis of both predicted binding pockets compromised SCOOP binding to MIK2, SCOOP-induced complex formation between MIK2 and its coreceptor BRASSINOSTEROID INSENSITIVE 1-ASSOCIATED KINASE 1, and SCOOP-induced reactive oxygen species production, thus, confirming our in silico predictions. Collectively, in addition to revealing the elusive SCOOP-MIK2 binding mechanism, our analytic pipeline combining phylogenomics, AI-based structural predictions, and experimental biochemical and physiological validation provides a blueprint for the elucidation of peptide ligand-receptor perception mechanisms. [ABSTRACT FROM AUTHOR]

Background:Asynchronous telepsychiatry (ATP) consultations are a novel form of psychiatric consultation. Studies comparing patient and provider satisfaction for ATP with that for synchronous telepsychiatry (STP) do not exist. Methods:This mixed-methods study is a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial of ATP compared with STP. Patients and their PCPs completed satisfaction surveys, and provided unstructured feedback about their experiences with either ATP or STP. Differences in patient satisfaction were assessed using mixed-effects logistic regression models, and the qualitative data were analyzed using thematic analysis with an inductive coding framework. Results:Patient satisfaction overall was high with 84% and 97% of respondents at 6 months reported being somewhat or completely satisfied with ATP and STP, respectively. Patients in the STP group were more likely to report being completely satisfied, to recommend the program to a friend, and to report being comfortable with their care compared with ATP (all p < 0.05). However, there was no difference between the patients in ATP and STP in perceived change in clinical outcomes (p = 0.51). The PCP quantitative data were small, and thus only summarized descriptively. Conclusions:Patients expressed their overall satisfaction with both STP and ATP. Patients in ATP reported more concerns about the process, likely because feedback after ATP was slower than that after STP consultations. PCPs had no apparent preference for STP or ATP, and reported implementing the psychiatrists' recommendations for both groups when such recommendations were made, which supports our previous findings. Trial Registration:ClinicalTrials.gov NCT02084979; https://clinicaltrials.gov/ct2/show/NCT02084979. [ABSTRACT FROM AUTHOR]