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Objetivo: evaluar la relación del índice cardio – timo torácico (ICT/T) y el síndrome de dificultad respiratoria tipo I (SDR I), en hospitales regionales de Escuintla, de Zacapa y de La Antigua Guatemala, en 2020. Material y métodos: estudio transversal prospectivo en 228 RNP, con análisis multivariado y aval del Comité de Bioética en Salud de la Facultad de Ciencias Médicas. Resultados: El 49.56% (113) de RNP desarrollaron SDR I, con una media de ICT/T de 0.43, DE ±0.05, edad gestacional media de 32.75 semanas, DE ±2.00 semanas, partos por cesárea transperitoneal 68.85% (157), el sexo masculino representó el 50.43% (115) y el femenino, 49.56% (113), media del peso de RNP con SDR I fue de 1752.16 gramos, DE ±656.90 gramos, diferencia de medias del ICT/T en RNP con y sin SDRI t=0.12 (p= 0.001), razón de probabilidad OR= 65.05 (p

The Pacific Ocean hosts one of the most extensive areas of oxygen deficient waters at present with well-defined areas of oxygen minima existing both north and south of the equator along the eastern basin. This deficiency in oceanic O2 concentrations is mainly due to a combination of upwelling induced high primary productivity and poorly ventilated intermediate waters. Across the Miocene-Pliocene the Pacific Ocean is thought to have been distinctly different with an elevated water column temperature profile, reduced Walker circulation, active deep-water formation in the north Pacific, high primary productivity, and differences in its fundamental configuration with gateway changes occurring at the eastern and western margins. Collectively, and individually, these different factors will have had implications on Pacific Ocean O2 distribution. To better understand the past oxygenation of Pacific waters amidst this backdrop of climatic and geographical changes we reconstruct iodine/calcium ratios from planktic foraminifera across multiple Pacific Ocean sites. Our I/Ca records extending from the mid-late Miocene through to Pleistocene show the progressive reduction in oceanic O2 content across the Pacific. We place these records in the context of changes in the Central American Seaway and the resultant changes in oceanic circulation.

Clinical Practice Guidelines (CPGs) have been shown to improve healthcare services and clinical outcomes. However, they are useful resources only to the degree that they are developed according to the most rigorous standards. Multiple studies have demonstrated significant variability between CPGs with regard to specific indicators of quality. The Ordre des psychologues du Québec (OPQ), the College of psychologists of Quebec, has published several CPGs that are intended to provide empirically supported guidance for psychologists in the areas of assessment, diagnosis, general functioning, treatment and other decision-making support. The aim of this study was to evaluate the quality of these CPGs.The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to assess the quality of the CPGs.Our results show that although there have been some modest improvements in quality of the CPGs over time, there are important methodological inadequacies in all CPGs evaluated.The findings of this study demonstrate the need for more methodological rigour in CPGs development as such, recommendations to improve CPG quality are discussed.

Background: Imbalance in tryptophan (TRP) metabolism and its neuroactive metabolites, serotonin and kynurenine (KYN), is a known pathogenic mechanism underlying neurocognitive impairment. Gut microbiota plays an important role in TRP metabolism, and the production of these neuroactive molecules affects neurocognitive function. Although both HIV infection and normal aging independently induce gut dysbiosis and influence TRP metabolism, their interactive effects on compositional/functional changes in gut microbiota and consequent alterations in TRP metabolites remain largely undetermined. Methods: Older people living with HIV infection (PLWH, aged 50–70 years, n = 22) were enrolled in this cross-sectional pilot study. Metagenomic analysis of fecal microbiome using 16S Ribosomal ribonucleic acid gene sequencing and metabolomics analysis of plasma using mass spectrometry with a reverse-phase iquid chromatography tandem mass spectrometry were performed. Statistical analyses included the univariate linear regression and Spearman correlation analyses. Results: Age-associated changes in plasma levels of key neuroactive TRP metabolites, serotonin and KYN, were seen in PLWH. Specifically, we observed age-dependent decreases in serotonin and increases in KYN and KYN-to-TRP ratio, indicative of dysfunctional TRP metabolism. Furthermore, the gut dysbiosis seen in older PLWH is characterized by a reduction of Firmicutes/Bacteroidetes ratio and butyrate-producing microbial families Lachnospiraceae and Lactobacillaceae. Of importance, correspondent with gut dysbiosis, increasing age was significantly associated with decreased plasma butyrate levels, which in turn correlated positively with serotonin and negatively with KYN/TRP ratio. Conclusions: Age-dependent gut microbial dysbiosis distinguished by a decrease in butyrogenic potential is a key pathogenic feature associated with the shift in TRP metabolism from serotonin to KYN in older PLWH.

Introducción: el dengue es una infección vírica transmitida por la picadura del Aedes aegypti hembra, que afecta a toda la población sin distinción alguna. Objetivo: identificar la percepción de las familias de la comuna cuatro del municipio de Villavicencio, Meta, respecto al manejo del dengue en su entorno familiar. Materiales y métodos: estudio descriptivo, transversal con variables cualitativas y cuantitativas, con aplicación de una encuesta sociodemográfica y de conocimientos, actitudes y prácticas sobre el dengue a las familias de la comuna cuatro de Villavicencio. Resultados: se encuestaron 317 familias, el sexo femenino tuvo mayor participación, se encontró un porcentaje considerable de población que no tiene conocimientos suficientes sobre el dengue, aun así, las familias desarrollan prácticas en prevención. La participación de actividades comunitarias para la prevención es muy poca, se evidencia que entre mayor escolaridad más eficientes son las prácticas empleadas por las familias de la comuna. Conclusiones: se evidencia intervención de primer nivel mediante acciones de autocuidado familiar, lideradas por las mujeres; sin embargo, se encuentra un porcentaje significativo de riesgo y de no adherencia a la participación de actividades en conjunto con la comunidad. Esto indica la necesidad de implementar estrategias de prevención del dengue y promoción del autocuidado.

Introducción: El consumo de marihuana es una problemática de salud pública y cobra relevancia en la población escolar. Objetivo: Describir la accesibilidad de consumo de marihuana por características sociodemográficas, relaciones familiares y de consumo en escolarizados colombianos 2016. Material y métodos: Estudio descriptivo, transversal, secundario del Estudio Nacional de Consumo de Sustancias Psicoactivas en Población Escolar Colombia - 2016, con una muestra de 80.018 estudiantes, mediante análisis univariado y bivariado. Resultados: Se analizó una muestra de 80.018 escolares, el promedio de edad de consumo de marihuana es de 15,55 años; el 51.9% eran mujeres. La mayoría de escolares estudian en colegios mixtos (96.11%); un 37.3% considera que le sería fácil conseguir marihuana; aquellos que manifestaron ser consumidores actuales de marihuana, los que manifiestan que todos sus amigos son consumidores y aquellos que conviven con un consumidor mostraron ser los que percibían muy fácil acceder a la marihuana (88,0%, 80.1% y 71,6% respectivamente). Conclusiones: Existe una alta proporción de adolescentes que perciben un acceso muy fácil a la marihuana, los consumidores o aquellos que se relacionan con consumidores fueron quienes percibían en mayor proporción un fácil acceso a la marihuana. Se sugieren intervenciones que puedan contrarrestar este fenómeno.

Astrocytes and brain endothelial cells are components of the neurovascular unit that comprises the blood–brain barrier (BBB) and their dysfunction contributes to pathogenesis in Huntington’s disease (HD). Defining the contribution of these cells to disease can inform cell-type-specific effects and uncover new disease-modifying therapeutic targets. These cells express integrin (ITG) adhesion receptors that anchor the cells to the extracellular matrix (ECM) to maintain the integrity of the BBB. We used HD patient-derived induced pluripotent stem cell (iPSC) modeling to study the ECM–ITG interface in astrocytes and brain microvascular endothelial cells and found ECM–ITG dysregulation in human iPSC-derived cells that may contribute to the dysfunction of the BBB in HD. This disruption has functional consequences since reducing ITG expression in glia in an HD Drosophila model suppressed disease-associated CNS dysfunction. Since ITGs can be targeted therapeutically and manipulating ITG signaling prevents neurodegeneration in other diseases, defining the role of ITGs in HD may provide a novel strategy of intervention to slow CNS pathophysiology to treat HD.

La necesidad de habitar en un planeta cuyos recursos son limitados ha llevado a que se desarrollen estrategias desde todos los campos del conocimiento para cumplir con el objetivo de evitar la destrucción total de los recursos naturales. El concepto de economía circular comenzó a vislumbrarse en la década de los 70, sin embargo, actualmente sigue siendo un tema nuevo para muchos. Este artículo tiene como objetivo revisar e identificar los trabajos centrados en las estrategias de diseño de producto que han surgido para la economía circular, con el fin de servir como guía en las barreras, indicadores y herramientas que resultan útiles para personas interesadas en procesos de diseño con un enfoque en la sostenibilidad. Los criterios para delimitar la búsqueda, selección, codificación y síntesis de los 50 artículos científicos originales que formaron parte de la revisión fueron los siguientes: incluir estudios publicados desde 2013 hasta el 2019, publicados en el continente europeo, en lengua inglesa y española, por medio de palabras clave en bases de datos y en citas bibliográficas. La información obtenida mediante los artículos seleccionados demostró que, a cualquier disciplina relacionada con el desarrollo de bienes y servicios, le compete aplicar, o al menos conocer, modelos acordes con la economía circular, concepto que ha nacido para disociar el crecimiento económico con la explotación de recursos.

Citrus canker is a major disease caused by Xanthomonas citri pv. citri. Snakin-1 is an antimicrobial peptide, which was previously shown to be effective against different bacterial and fungal diseases in potato, wheat and lettuce when expressed in transgenic plants. We generated transgenic Citrange Troyer citrus rootstocks constitutively expressing this peptide and 5 different transgenic lines were challenged against virulent X. citri isolates. Challenge assays conducted in vitro using detached leaves and in planta by infiltration revealed a significant reduction of the number and size of canker lesions in some of the transgenic lines.

Education is important for fostering research integrity (RI). Although RI training is increasingly provided, there is little knowledge on how research stakeholders view institutional RI education and training policies. Following a constructivist approach, we present insights about research stakeholders’ views and experiences regarding how research institutions can develop and implement RI education and training policies. We conducted thirty focus groups, engaging 147 participants in eight European countries. Using a mixed deductive-inductive thematic analysis, we identified five themes: (1) RI education should be available to all; (2) education and training approaches and goals should be tailored; (3) motivating trainees is essential; (4) both formal and informal educational formats are necessary; and (5) institutions should take into account various individual, institutional, and system-of-science factors when implementing RI education. Our findings suggest that institutions should make RI education attractive for all and tailor training to disciplinary-specific contexts.

Objectives The aim of this study was to describe the treatment and outcome of acetabular and other pelvic fractures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods Data were collated on cats with PADS that were reported to have sustained pelvic fractures or had fractures or fissures of the pelvis identified on submitted radiographs. The details of the fractures were recorded, in addition to any treatment and outcome information. Results Of the 215 cases reported with PADS, 58 cats (27%) were found to have pelvic fractures, none of which were known to have resulted from significant trauma. There were 101 fractures in total and of these 15 were treated with surgery, including 10 acetabular fractures, two ilial, two pubic and one ischial fracture. Screw loosening and loss of fracture reduction was seen in four of the surgically treated fractures (two pubic fractures, one ilial and one acetabular fracture). Fourteen cats were euthanased as a direct result of a fracture occurring. While most pelvic fractures healed uneventfully, some cats remained intermittently lame, but it was not always possible to determine the cause of the lameness from the information available and because all cats had concurrent patellar fractures. Conclusions and relevance Many of the pelvic fractures healed with conservative management. Fractures involving articular surfaces such as acetabular fractures may benefit from surgical stabilisation as surgery may offer the benefits of articular fracture repair with improved joint congruency and a faster return to normal activity.

Objectives The aim of this study is to describe the treatment and outcome of humeral condylar fractures and humeral intracondylar fissures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods Data were collated on cats with PADS that were reported to have sustained humeral fractures or had fractures or fissures of the humerus identified on radiographs. The details of the fractures were recorded in addition to any treatment and outcome information. Results Of the 207 cases reported with PADS, 18 cats (8.7%) were found to have humeral condylar fractures, none of which was known to have resulted from significant trauma. Where treatment occurred, it involved the placement of transcondylar positional or lag screws. In some cases additional implants, including supracondylar bone plates and screws or Kirschner wires (K-wires), were used. Follow-up data revealed that only two cats were euthanased owing to the presence of the humeral fractures, with at least eight achieving some degree of recovery of function. Conclusions and relevance These humeral fractures all have the characteristics of stress insufficiency fractures, being simple isolated fractures that are short oblique, with increased radio-density at the fracture line and occurring following minimal or no trauma. Humeral intracondylar fissures were identified in two cats and it is possible that some of the other fractures may have occurred secondary to pre-existing fissures. To our knowledge, no prior reports exist of fissures in cats that do not meet the criteria for PADS. Surgical repair primarily consisted of the placement of transcondylar lag or positional screws with, in some cases, adjunct implants such as bone plates and screws or K-wires. Though there were insufficient data to determine the prognosis for these fractures in the long term, unlike patellar fractures, many of these fractures will heal if treated appropriately.

Objectives To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. Design This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. Setting The study took place in all nine acute care hospitals for adults in Louisville, KY. Participants Residents in the city of Louisville, KY, who were diagnosed with CAP between the inclusion dates were included and who were aged 65 years or older. Measurements Incidence of CAP and outcomes were measured. A total of nine risk factors were also assessed for any potential association with time to clinical stability, length of stay (LOS), and mortality. Results During the 2-year study, from a Louisville population of 102 264 adults aged 65 years or older, 4760 were hospitalized with CAP. The incidence of older adults hospitalized with CAP was 2093 per 100 000 population. This corresponds to 967 470 older adults in the United States hospitalized per year with CAP. The median time to clinical stability was 2 days, and the median LOS was 6 days. The 30-day all-cause mortality was 17%. The 1-year all-cause mortality was 38% (829 patients), which corresponds to 361 982 deaths in the United States with CAP in older adults. Conclusion The estimated burden of CAP in older adults is substantial in the United States. Nearly 1 million older adults are hospitalized for CAP, and over a third of those die within 1 year. J Am Geriatr Soc 68:1007-1014, 2020.

This study examines whether religious beliefs motivate nonviolent behavior and lower rates of recidivism among Chilean inmates. We collected data through in-depth interviews with 174 inmates using open and close-ended questions. The research used a proportional random sample to select participants, principal component analysis to identify similarities and differences between groups, and content analysis to examine answers to the open-ended interview questions. Its findings indicate that evangelical inmates in Chilean prisons are less violent, more likely to follow internal jail regulations, and more cooperative with professionals and officials. This study contributes to the literature because there was no previous evidence in Chile that religious association, religious conviction, or a desire to change criminal behavior is instrumental to achieving better security during inmates’ stays in prison. The results also demonstrate that the presence of a peer group, with its emotional support and provision of a daily routine, is fundamental if inmates are to successfully handle their anxiety and be less violent.

Planktic and benthic foraminiferal iodine (I) to calcium (Ca) molar ratios have been proposed as an exciting new proxy to assess subsurface and bottom water oxygenation in the past. Compared to trace metals, the analysis of iodine in foraminiferal calcite is more challenging, as iodine is volatile in acid solution. Here, we compare previous analyses that use tertiary amine with alternative analyses using tetramethylammonium hydroxide (TMAH) and ammonium hydroxide (NH4OH) to stabilize iodine in solution. In addition, we assess the effect of sample size and cleaning on planktic and benthic foraminiferal I/Ca. Our stabilization experiments with TMAH and NH4OH show similar trends as those using tertiary amine, giving relatively low I/Ca ratios for planktic and benthic foraminifera samples from poorly oxygenated waters, and high ratios for well-oxygenated waters. This suggests that both alternative methods are suitable to stabilize iodine initially dissolved in acid. Samples that contain 5–10 specimens show a wide spread in I/Ca. Samples containing 20 specimens or more show more centered I/Ca values, indicating that a larger sample size is more representative of the average planktic foraminifera community. The impact of cleaning on planktic and benthic foraminifera I/Ca ratios is very similar to Mg/Ca, with the largest effect occurring during the clay removal step. The largest iodine contaminations were recorded at locations characterized by moderate to high organic carbon contents. In those circumstances, we recommend doubling the oxidative cleaning steps (4 instead of 2 repetitions) to ensure that all organic material is removed.

The widespread problems with scientific fraud, questionable research practices, and the reliability of scientific results have led to an increased focus on research integrity (RI). International organisations and networks have been established, declarations have been issued, and codes of conducts have been formed. The abstract principles of these documents are now also being translated into concrete topic areas that Research Performing organisations (RPOs) and Research Funding organisations (RFOs) should focus on. However, so far, we know very little about disciplinary differences in the need for RI support from RPOs and RFOs. The paper attempts to fill this knowledge gap. It reports on a comprehensive focus group study with 30 focus group interviews carried out in eight different countries across Europe focusing on the following research question: “Which RI topics would researchers and stakeholders from the four main areas of research (humanities, social science, natural science incl. technical science, and medical science incl. biomedicine) prioritise for RPOs and RFOs?” The paper reports on the results of these focus group interviews and gives an overview of the priorities of the four main areas of research. The paper ends with six policy recommendations and a reflection on how the results of the study can be used in RPOs and RFOs.

Chronic obstructive pulmonary disease (COPD) is prevalent in patients infected with HIV. The purpose of this study was to test the hypothesis that systemic oxidation correlates with loss of lung function in subjects with COPD, and that HIV infection can contribute to creating such an environment. Subjects were recruited at the University of Louisville in the following groups: HIV-infected (n = 36), COPD (n = 32), HIV and COPD (n = 28), and uninfected controls with normal lung function (n = 34). HIV infection was assessed by viral load and CD4 cell counts. Pulmonary function was determined by spirometry, and plasma was collected for measurement of cysteine (Cys), cystine (CySS), glutathione (GSH) and GSH disulfide (GSSG) by HPLC followed by estimation of redox potentials (Eh) using the Nernst equation. Results showed that patients with COPD had more oxidized plasma Eh Cys/CySS than patients with normal lung function, but plasma Eh GSH/GSSG was unaltered. In addition, there was a correlation between the extent of plasma Eh Cys/CySS oxidation and loss of lung function, and this correlation remained even after correcting for age, sex, race and body mass index. HIV infection per se was not associated with increased oxidation of plasma Eh Cys/CySS, but plasma Eh Cys/CySS was more oxidized in patients with lower CD4-positve T cell counts. In patients with both HIV infection and COPD, there was a significant correlation between CD4 cell counts and lung function. Thus, systemic oxidation correlated with decreased lung function in subjects with COPD and decreased CD4 counts in subjects infected with HIV. Thus, factors contributing to plasma Eh Cys/CySS may represent novel mechanisms underlying the increased prevalence of COPD in people living with HIV.