Search

Background: The treatment of psoriasis in patients with a personal history of cancer is a matter of debate and limited evidence is available to guide clinicians. Objectives: To report a multicenter real-life experience of a group of patients with psoriasis undergoing treatment with guselkumab and a history of cancer. Methods: We conducted a multicenter retrospective Spanish study enrolling patients with moderate-to-severe plaque psoriasis and neoplasia being treated with guselkumab for their psoriasis. Results: Twenty patients with moderate-to-severe psoriasis and at least 12 weeks of ongoing treatment were included. For the analysis, a 52 week follow-up period was evaluated in terms of efficacy and safety. Most of the malignancies in these patients were solid tumors. The percentage of patients achieving psoriasis area and severity index ≤3 at week 12 and week 52 was 80% and 87.5%, respectively, whereas 68.8% of patients achieved psoriasis area and severity index ≤1. A 52-week survival rate of 100% in the study population was observed (n = 20), including those patients with concomitant active cancers (n = 14). No adverse effects or dropouts related to guselkumab safety profile were detected. Limitations: Modest sample size and the retrospective nature of the study. Conclusion: Guselkumab not only demonstrates high effectiveness in treating psoriasis but also exhibits a favorable safety profile in patients with neoplasms.

Sodium hypochlorite has significant potential as a sanitation solution in hard-to-reach areas. Few studies have investigated the optimal electrolysis parameters for its production with volumes greater than 10 L. This study evaluated sodium hypochlorite production through electrolysis in a 22-L prototype and identified the optimal operating parameters. Tests were performed using graphite electrodes with areas of 68.4 cm2 at the laboratory scale and 1 865.0 cm2 at the prototype scale. A design for experiments with different operating times, chloride concentrations, and electric current intensities was developed. The optimal operating time, sodium chloride concentration, and current intensity at the laboratory scale were 120 min, 150 g of chloride per liter, and 3 A, respectively, leading to the production of 5.02 g/L of the disinfectant with an energy efficiency of 12.21 mg of Cl2 per kilojoule. At the prototype scale, the maximum sodium hypochlorite concentration of 3.99 g of chloride per liter was achieved with an operating time of 120 min, a sodium chloride concentration of 100 g of chloride per liter, and a current intensity of 70 A, reaching an energy efficiency of 42.56 mg of Cl2 per kilojoule. In addition, this study evaluated the influences of the chloride concentration, current intensity, and operating time on the production of sodium hypochlorite at the two scales, and formulated the equations showing the trends of sodium hypochlorite production and energy efficiency in the electrochemical systems. The 22-L prototype model for production of this oxidizing substance is promising for disinfection of large volumes of water in areas that are difficult to access.

The rapid progress of TICs has generated different ways to modify and transfer information, which implies the generation of new forms of knowledge. The objective of this study is to establish the relationship between digital competencies and university teaching performance in public higher education in Huancayo. The study is of a basic type with a quantitative approach and correlational level, developed with the partition as a sample of 272 teachers and 387 students who develop teaching-learning activities at the UNCP. The data were analyzed and modeled through structural equations based on PLS. The research arrived at the following results: a value of 0.890 in Spearman's Rho correlation coefficient and a significance level of .000, which shows that there is a high positive relationship between the study variables; likewise, the hypothesis is accepted. general which considers that there is a significant relationship between digital competencies and teaching performance in the classroom.

Pandemic moments have generated mental and emotional problems in students at all levels. These have been affected by the format of virtual classes, the mandatory confinement and the little physical relationship due to the existing restrictions, generating academic burnout and anxiety in university students. In this context, the objective was to know the existing relationship between burnout and anxiety in students of the FIS-UNCP, the 15-question Maslach Burnout Inventory Student Questionnaire (MBI-SS) was used with the dimensions: Emotional Exhaustion, Cynicism and Loss of Academic Efficacy and 5 questions to know the level of technological anxiety or technostress, with a population of 328 university students of 10 semesters, through the questionnaire in Office Forms. The research design was non-experimental, transectional, with a qualitative-quantitative approach and descriptive-explanatory levels. The descriptive data analysis was made based on the scale, allowing the identification of students with burnout and the structural equation modeling facilitated the establishment of the relationship between the variables. The study showed that 26 students (7.93%) suffer from academic burnout. At the same time, it has been demonstrated that there is a positive and significant relationship between emotional exhaustion and lack of academic efficacy, with technological anxiety with path values of 0.701 and 0.345 respectively, the p-values allowed demonstrating hypotheses 1 and 3 formulated. At the level of the structural model, it allows anticipating future results, since the coefficient of determination (R2) calculated was 0.838.

This study investigates the goal/habit imbalance theory of compulsion in obsessive-compulsive disorder (OCD), which postulates enhanced habit formation, increased automaticity, and impaired goal/habit arbitration. It directly tests these hypotheses using newly developed behavioral tasks. First, OCD patients and healthy participants were trained daily for a month using a smartphone app to perform chunked action sequences. Despite similar procedural learning and attainment of habitual performance (measured by an objective automaticity criterion) by both groups, OCD patients self-reported higher subjective habitual tendencies via a recently developed questionnaire. Subsequently, in a re-evaluation task assessing choices between established automatic and novel goal-directed actions, both groups were sensitive to re-evaluation based on monetary feedback. However, OCD patients, especially those with higher compulsive symptoms and habitual tendencies, showed a clear preference for trained/habitual sequences when choices were based on physical effort, possibly due to their higher attributed intrinsic value. These patients also used the habit-training app more extensively and reported symptom relief post-study. The tendency to attribute higher intrinsic value to familiar actions may be a potential mechanism leading to compulsions and an important addition to the goal/habit imbalance hypothesis in OCD. We also highlight the potential of smartphone app training as a habit reversal therapeutic tool.

The purpose of the current study was to assess the prevalence of cyst formation at the brain-tumor interface in olfactory neuroblastoma. We used the UCLA patient-based Pathology and Radiology Head and Neck Database (UPP&R HAND) to identify the largest patient cohort reported to date with imaging and pathology data. Eighteen of thirty-one patients (58.1%) had evidence of intracranial extension on MRI, while four (22.0%) demonstrated cyst formation at the brain-tumor interface. The extent of intracranial extension was by far the strongest predictor for intracranial cyst formation, regardless of Hyams tumor grade, using a binary logistics regression model (p = 0.002) and ROC curve analysis (AUC 94.6%). Cyst formation at the brain-tumor interface was an uncommon imaging finding, and tends to occur with a larger component of intracranial tumor extension.

En el campo de los estudios sociales del arte, numerosas investigaciones indagan la sexualidad y el erotismo de distintas danzas en Argentina (por ejemplo, tango, música electrónica, cuarteto, etc.). Sin embargo, identificamos un área de vacancia respecto de la danza contemporánea. De este modo, en el siguiente trabajo reponemos los sentidos nativos de los erotismos en el mundo de la danza contemporánea independiente en el Valle de Paravachasca (Córdoba, Argentina), a partir de una investigación etnográfica colaborativa. Realizamos un trabajo de participación observante entre 2018 y 2022 desde un enfoque corpóreo. Asimismo, para el presente estudio entrevistamos a ocho bailarinas que performan diferentes identidades de género (cis, bisexual y trans). Empleamos un proceso de construcción de datos reflexivo y colaborativo de co-interpretación y co-teorización, con el aporte de la teoría fundamentada. Identificamos un erotismo ampliado que se caracteriza por la pluralidad, el placer y la no reducción a lo sexual. Distinguimos analiticamente tres tipos de erotismos (sexuales, sensuales y estéticos) que toman cuerpo de forma singular y dinámica en cada bailarina. Los erotismos se organizan bajo un régimen de ocultamiento y de discreción, en función del ethos y la micropolítica de este mundo del arte, que configura una cultura afectiva, donde una de las líneas de composición es una ética del cuidado relacionada a una ética feminista. Este análisis aporta al estudio del erotismo en la danza contemporánea, específicamente desde el interior provinciano.

Citrus polyploidy is associated with a wide range of morphological, genetic, and physiological changes that are often advantageous for breeding. Citrus triploid hybrids are very interesting as new seedless varieties. However, tetraploid rootstocks promote adaptation to different abiotic stresses and promote resilience. Triploid and tetraploid hybrids can be obtained through sexual hybridizations using tetraploid parents (2x × 4x, 4x × 2x, or 4x × 4x), but more knowledge is needed about the inheritance pattern of tetraploid parents to optimize the efficiency of triploid varieties and tetraploid rootstock breeding strategies. In this work, we have analyzed the inheritance pattern of three tetraploid genotypes: ‘Chandler’ pummelo (Citrus maxima) and ‘Cleopatra’ mandarin (Citrus reticulata), which represent two clear examples of autotetraploid plants constituted by the genome of a single species, and the ‘Sevillano’ sour orange, which is an allotetraploid interspecific hybrid between C. maxima and C. reticulata. Polymorphic simple sequence repeat (SSR) and single-nucleotide polymorphism (SNP) markers were used to estimate parental heterozygosity restitution, and allele frequencies for centromeric loci were used to calculate the preferential pairing rate related to the proportion of disomic and tetrasomic segregation. The tetraploid pummelo and mandarin displayed tetrasomic segregation. Sour orange evidenced a clear intermediate inheritance for five of the nine chromosomes (1, 2, 5, 7, and 8), a slight tendency toward tetrasomic inheritance on chromosome 3, and intermediate inheritance with a tendency toward disomy for chromosomes 4, 6, and 9. These results indicate that the interspecific versus intraspecific phylogenomic origin affects preferential pairing and, therefore, the inheritance patterns. Despite its high level of heterozygosity, the important preferential chromosome pairing observed in sour orange results in a limited diversity of the genotypic variability of its diploid gametes, and consequently, a large part of the genetic value of the original diploid sour orange is transferred to the tetraploid progenies.

Abstract The objective of this work was to evaluate biomass accumulation and photosynthesis in mangabeira, in response to water deficit and to successive soil drying and wetting cycles. Seedlings were grown in pots and subjected to the three following water regimes: soil at 35, 70, and 100% of field capacity (FC), followed by a drying-down period until photosynthesis (measured weekly) was close to zero. Then, the seedlings were rewatered until completing four drying-wetting cycles. The control treatment was a permanently well-irrigated soil. There was a decline in biomass accumulation under water deficit conditions. Photosynthesis responded to soil rewatering only at 70 and 100% FC and was null at 35% FC. The elapsed time for photosynthesis to reach a null value after rewatering increases with successive drying-wetting cycles. In soil at 100% FC, for photosynthesis to approach zero, it takes five weeks in the first and eight weeks in the last rewatering cycle. Photosynthesis improves with progressive drying-wetting cycles, particularly in soil at 100% FC. The pre-acclimation of mangabeira to drying-wetting cycles should be considered before transplanting the seedlings in the field, and pre-acclimation should be carried out initially with soil at its FC.

Context: Masonry bricks are one of the most widely used building materials in the world, which leads to the overexploitation of its raw materials. Its production consumes a large amount of energy and has a large environmental footprint. The clay brick industry can add residues to its raw materials; among those reported are tea processing waste, brick waste, paper industry residues, waste from coffee mills, and coal ashes. Method: Bottom coal ashes were characterized by X-ray fluorescence, X-ray diffraction, thermogravimetric analysis, electronic microscopy, and particle size analysis. In addition, their density and loss on ignition were determined. The incorporation of ashes in the elaboration of clay bricks was evaluated, with sand replacement percentages of 0, 3, 5, and 7%. Finally, the physical and mechanical properties of the bricks were evaluated. Results: The water absorption and apparent porosity increased, while the compressive strength and bulk density decreased with the incorporation of ash in the brick samples, except for those with a 3% replacement, which showed a better performance in the evaluated properties. Conclusions: Coal bottom ashes have great potential in the manufacturing of clay bricks. The findings of this study indicate that, by incorporating up to 3% ashes, bricks can be obtained which comply with the Colombian regulations.

Background: Monitoring and evaluation of the techniques used in weightlifting are based on the subjective observation of the coach, which can ignore important aspects of short duration. This study aimed to implement an embedded system to register the angular variation of the hip, knee, and ankle joints, and plantar pressure during training. Methods: Four professional and four amateur athletes performed five snatch lifts. To evaluate the angular measurement, the tests were simultaneously videotaped and the results were contrasted. Results: The angular data presented a correlation coefficient of 0.92 and a delay of 495 ± 200 ms. The characterization of the sensors was implemented in a microcontroller with a mean absolute percentage error of 18.8% in the measurements. When comparing the average results between the elite and amateur groups, the amateur group performed a delayed descent in the first three phases of the lift and an accelerated descent in the fourth phase. A not uniform plantar pressure was registered in the same group, causing a reduction in the final speed of recovery with the barbell. Conclusions: The proposed system has been developed for biaxial angular registration of hip, knee, ankle, and plantar pressure during weightlifting snatch. The option to contrast between signals presented by the system met the requirements requested by the coaching staff and is seen as a promising quantitative analysis tool to support the coach and the athlete.

Digital transformation has become fundamental to improving the competitiveness of microenterprises worldwide, and Huancayo, Peru is no exception. By adopting digital technologies, microenterprises can improve their operational efficiency, expand their market reach and enhance their abilities to make informed decisions. They have therefore found innovative ways to adapt to changing market conditions, such as incorporating information technologies, online sales, use of social networks and home delivery. Despite this, many microenterprises struggle to survive due to lack of access to financing and adequate government support. This study aimed to analyze how individual, group and organizational factors influence the digital transformation of microenterprises and its impact on their competitiveness. The research was carried out in a sample of 80 multi-sector microenterprises, using a non-probabilistic and cross-sectional research design of a quali-quantitative and explanatory nature, using SEM-PLS. The results of the study indicate a positive relationship between individual, group and organizational factors and digital transformation, as well as with the competitiveness of microenterprises. The coefficients of determination (R2) obtained were 0.8897 and 0.7931 for digital transformation and competitiveness, respectively, indicating a predictive ability in both cases. These findings are of great use to policy makers, business owners and researchers interested in fostering the growth and development of microenterprises in emerging economies.

Digital governance, institutional development and public higher education in Huancayo-Perú in the new situation where remote activities are prioritized, the use of information technologies has increased in the different activities of organizations, allowing them to provide adequate services in an efficient way. The research seeks to establish the relationship between digital governance and institutional development in public higher education in Huancayo - Perú. Basic research with a quantitative approach and correlational level with a sample of 828 people made up of teaching staff, administrative staff and students who interact with the administrative activities of the UNCP. The data analysis and modeling was performed through structural equations based on PLS. As a result of the research, a value of 0.815 was obtained in Spearman's Rho and a significance level of .000, which indicates a high positive relationship, also the general hypothesis that establishes that there is a significant relationship between digital governance and institutional development is accepted.

This systematic review aimed to identify and critically evaluate the available evidence of the appropriate moment to perform tooth whitening in conventional orthodontic patients. A systematic review in MEDLINE and SciELO databases from inception to February 2021 was carried out by two independent reviewers. Randomized clinical trials, non-randomized clinical trials, case-control, cohort, cross-sectional, case-series and reviews that focused on the application of tooth whitening during or after orthodontic treatment were considered for inclusion. The primary outcome was defined as tooth whitening during/after orthodontic treatment. The secondary outcome included the time in days after bracket debonding in which tooth whitening was performed. Risk of bias analysis was performed for each study and the findings were synthesized in a narrative summary. A total of 4 randomized clinical trials, 1 non-randomized clinical trial and 3 reviews were included in the qualitative synthesis. One study performed tooth whitening during, and three studies after orthodontic treatment. One study compared tooth whitening during and after orthodontic treatment. The time after which tooth whitening was applied following bracket debonding ranged from 7 to 90 days with a mean value of 40.2 days. All studies reported satisfactory improvements in tooth color shade during or after orthodontic treatment independent of the protocol. Low quality evidence suggests that the appropriate moment to perform tooth whitening in conventional orthodontic patients is after brackets removal with a waiting period of at least 30 days. There is not adequate evidence to support tooth whitening during conventional orthodontic treatment.

Educational activities have changed due to the pandemic and it was necessary to respond by giving continuity to the formative processes with virtual platforms as it happened at the Universidad Nacional del Centro del Perú - School of Social Work. The objective was to know the level of satisfaction of students in the use of the virtual platform chosen, using the Questionnaire for the evaluation of learning environments in distance education (Sp-DELES) of 42 questions with dimensions: teacher support, student interaction and collaboration, personal relevance, real learning, active learning, autonomy and satisfaction. A total of 213 students were consulted, the instrument was distributed digitally and anonymously. For the descriptive analysis, the results were ranked in three response categories: agree, indifferent and disagree; the Autonomy dimension was valued with 69.01% agreement and 9.39% disagreement. The dimension with the lowest appreciation was Satisfaction with 25.35% agreement and 28.64% disagreement. Structural equation modeling was performed with SmartPLS, obtaining that Faculty support (FS) and Active learning (AL) have a direct relationship with Satisfaction (S) in the use of the virtual platform with beta values (β) of 0.279 and 0.872 respectively. Contrarily, Real learning (RL) and Autonomy (A) have an inverse relationship with Satisfaction (S) with beta values (β) of -0.025 and -0.122 respectively. The study reflects that there is no relationship between Interaction and Communication among Students (ICS), Personal Relevance (PR) and Satisfaction (S) as the p-values were greater than 0.05. The value of the coefficient of determination (R2) was 0.778 being the representative model. The study is non-experimental, descriptive, explicative and cross-sectional.

Angiotensin II type 1 receptor (AT1R) antibody has been linked to poor allograft outcomes in adult kidney transplantation. However, its clinical consequences in children are unknown. To study this, we examined the relationship of AT1R antibody with clinical outcomes, biopsy findings, inflammatory cytokines, and HLA donor-specific antibodies (DSA) in a cohort of pediatric renal transplant recipients. Sixty-five patients were longitudinally monitored for AT1R antibody, HLA DSA, IL-8, TNF-α, IL-1β, IFN-γ, IL-17, and IL-6, renal dysfunction, hypertension, rejection, and allograft loss during the first two years post transplantation. AT1R antibody was positive in 38 of the 65 of children but was not associated with HLA DSA. AT1R antibody was associated with renal allograft loss (odds ratio of 13.1 [95% confidence interval 1.48-1728]), the presence of glomerulitis or arteritis, and significantly higher TNF-α, IL-1β, and IL-8 levels, but not rejection or hypertension. AT1R antibody was associated with significantly greater declines in eGFR in patients both with and without rejection. Furthermore, in patients without rejection, AT1R antibody was a significant risk factor for worsening eGFR over the two-year follow-up period. Thus, AT1R antibody is associated with vascular inflammation in the allograft, progressive decline in eGFR, and allograft loss. AT1R antibody and inflammatory cytokines may identify those at risk for renal vascular inflammation and lead to early biopsy and intervention in pediatric kidney transplantation.

Mechanisms have allowed for the automation of complex, repetitive, demanding, or dangerous tasks for humans. Among the different mechanisms, those with a closed kinematic chain are more precise and robust compared to open chain ones, which makes them suitable for many applications. One of the most widely used closed-chain alternatives is the four-bar Grashof-type mechanism, as it can generate highly nonlinear closed trajectories with a single degree of freedom. However, the dimensional synthesis of these mechanisms to generate specific trajectories is a complex task. Fortunately, computational methods known as metaheuristics can solve such problems effectively. Differential Evolution (DE) is a metaheuristic commonly used to tackle the dimensional synthesis problem. This paper presents a comparative study of the most commonly used variants of DE in solving the dimensional synthesis problem of four-bar Grashof-type mechanisms. The purpose of the study is to provide guidelines to choose the best DE alternative for solving problems of this type, as well as to support the development of DE-based algorithms that can solve more specific cases effectively. After analysis, the rand/1/exp variant was found to be the most effective in solving the dimensional synthesis problem, which was followed by best/1/bin. Based on these results, a Simple and Improved DE (SIDE) variant based on these two was proposed. The competitive performance of the SIDE with respect to the studied DE variants and in contrast to the results of algorithms used in the recent specialized literature for mechanism synthesis illustrates the usefulness of the study.

Resumen: Objetivo: Revisar y discutir la evidencia actual del uso de la metformina como herramienta terapéutica en enfermedades cutáneas. Diseño: Artículo original. Investigación cualitativa. Revisión narrativa. Emplazamiento: Aragón y Murcia, España. Participantes: Médicos Internos Residentes de Dermatología Médico-Quirúrgica y Venereología y de Atención Primaria y Comunitaria. Métodos: Se ha realizado una revisión narrativa utilizando la base de datos bibliográfica PubMed con fecha de búsqueda el 27 de enero de 2022. Resultados: La metformina ha demostrado ser efectiva en el tratamiento de dermatosis inflamatorias tales como el acné, hidrosadenitis supurativa, psoriasis y dermatitis de contacto alérgica. También ha demostrado propiedades antitumorales frente al carcinoma basocelular, carcinoma espinocelular y melanoma. De forma adicional, se ha descrito efectos beneficiosos del tratamiento adyuvante con metformina en pacientes con carcinoma basocelular que reciben terapia fotodinámica. En pacientes con dermatosis relacionadas con endocrinopatías tales como el hirsutismo, la acantosis nigricans y los xantomas eruptivos, el tratamiento con metformina ha demostrado efectividad terapéutica. El tratamiento tópico con metformina ha demostrado ser eficaz en el tratamiento del melasma. Finalmente se ha propuesto como un fármaco con propiedades antienvejecimiento cutáneo y favorecedoras de la cicatrización. Para ninguna de las indicaciones previamente descritas se han objetivado efectos adversos graves. Conclusiones: La metformina es un tratamiento efectivo y seguro en el esquema terapéutico de dermatosis inflamatorias, neoplasias cutáneas, dermatosis relacionadas con endocrinopatías, melasma, envejecimiento cutáneo y cicatrización. Abstract: Objetive: To review and discuss the current evidence of the use of metformin as a therapeutic tool in frequent skin diseases. Design: Original article. Qualitative research. Narrative review. Location: Aragon and Murcia, Spain. Participants: Resident Physicians. Dermatology and Primary Health Care. Method: A narrative review has been carried out using the PubMed bibliographic database, being the search date the 27th of January of 2022. Results: Metformin has proven to be effective in the treatment of inflammatory skin diseases such as acne, hidradenitis suppurativa, psoriasis and allergic contact dermatitis. It has also shown antitumor properties regarding basal cell carcinoma, squamous cell carcinoma and melanoma. Additionally, beneficial effects of adjuvant treatment with metformin have been described in patients with basal cell carcinoma receiving photodynamic therapy. In patients with endocrinology-related dermatosis such as hirsutism, acanthosis nigricans and eruptive xanthomas, treatment with metformin has demonstrated therapeutic effectiveness. Topical treatment with metformin has also been useful in the treatment of melasma. Finally, it has been proposed as a drug with anti-aging and wound-healing promoting properties. Severe adverse effects have not been observed for any of the previously described indications, being this a well-tolerated treatment. Conclusions: Metformin is an effective and safe adjuvant in the therapeutic scheme of various inflammatory dermatoses, skin neoplasms, endocrinology-related dermatosis, melasma, skin aging and wound healing processes.

Abstract Granuloma annulare may be caused by multiple triggers. Among these are vaccinations, which have been described as an infrequent cause of granuloma annulare. The authors report the first case of generalized granuloma annulare associated with pneumococcal vaccination in a 57-year-old woman, who presented cutaneous lesions 12 days after vaccination.

Expression of the long noncoding RNA (lncRNA) metastasis–associated lung adenocarcinoma transcript 1 (MALAT1) correlates with tumor progression and metastasis in many tumor types. However, the impact and mechanism of action by which MALAT1 promotes metastatic disease remain elusive. Here, we used CRISPR activation (CRISPRa) to overexpress MALAT1/Malat1 in patient-derived lung adenocarcinoma (LUAD) cell lines and in the autochthonous K-ras/p53 LUAD mouse model. Malat1 overexpression was sufficient to promote the progression of LUAD to metastatic disease in mice. Overexpression of MALAT1/Malat1 enhanced cell mobility and promoted the recruitment of protumorigenic macrophages to the tumor microenvironment through paracrine secretion of CCL2/Ccl2. Ccl2 up-regulation was the result of increased global chromatin accessibility upon Malat1 overexpression. Macrophage depletion and Ccl2 blockade counteracted the effects of Malat1 overexpression. These data demonstrate that a single lncRNA can drive LUAD metastasis through reprogramming of the tumor microenvironment. Editor's summary: The long noncoding RNA (lncRNA) MALAT1 is overexpressed in many tumor types, and expression is associated with metastasis. Martinez-Terroba et al. used CRISPR activation to investigate how MALAT1/Malat1 promotes metastasis in human and murine lung adenocarcinoma (LUAD). Overexpression of Malat1 resulted in altered global chromatin accessibility and increased transcription of Ccl2 in murine tumor cells. Ccl2 secretion promoted recruitment of protumorigenic macrophages and metastasis, which could be rescued by blockade of Ccl2 or by macrophage depletion. These findings indicate that MALAT1/Malat1 overexpression induces reprogramming of the tumor microenvironment in LUAD to drive metastasis. —Hannah Isles [ABSTRACT FROM AUTHOR]

Resumen: La toxoplasmosis cerebral es una una infección producida por un organismo oportunista, que en el caso de las personas inmunocompetentes puede ser asintomático o producir leves síntomas; sin embargo, en la población inmunodeprimida puede generar graves síntomas e incluso la muerte como desenlace final. Es preciso tener una sospecha diagnóstica y dar manejo adecuado para evitar las complicaciones, secuelas y/o la muerte. En este reporte de caso se busca promover la importancia de la sospecha clínica, el diagnóstico y el tratamiento oportunos. Abstract: Cerebral toxoplasmosis is an infection produced by an opportunistic organism, which in the case of immunocompetent people can be asymptomatic or produce mild symptoms, however in the immunocompromised population can generate severe symptoms and even death as a final outcome, it is necessary to have a diagnostic suspicion and provide appropriate management to avoid complications, sequelae and/or death. This case report seeks to promote the importance of clinical suspicion, diagnosis and timely treatment.

This paper presents a numerical model of an integrated 3D casing-cement-formation system, to evaluate the mechanical tensile and shear failure of the cement at the casing-cement interface as the pressure and temperature conditions of the formation and borehole vary during production. The model which includes the formation pressure, unlike others proposed, was developed by stages under finite element discretization and compared to analytical models. Results show that increasing the formation temperature increases the probability of tensile and shear failure in the cement, while increasing the wellbore temperature decreases these probabilities. On the other hand, the decrease in the well pressure reduces the probability of shear failure and increases the tensile failure. In the case of formation pressure, the opposite occurs.

BackgroundCurrent therapeutic strategies to effectively treat antibody-mediated rejection (AMR) are insufficient. Thus, we aimed to determine the benefit of a therapeutic protocol using bortezomib for refractory C4d + AMR in pediatric kidney transplant patients.MethodsWe examined seven patients with treatment-refractory C4d + AMR. Immunosuppression included antithymocyte globulin or anti-CD25 monoclonal antibody for induction therapy with maintenance corticosteroids, calcineurin inhibitor, and anti-metabolite. Estimated glomerular filtration rate (eGFR) calculated by the Schwartz equation, biopsy findings assessed by 2013 Banff criteria, and human leukocyte antigen (HLA) donor-specific antibodies (DSA) performed using the Luminex single antigen bead assay were monitored pre- and post- bortezomib therapy.ResultsSeven patients (86 % male, 86 % with ≥6/8 HLA mismatch, and 14 % with pre-formed DSA) age 5 to 19 (median 15) years developed refractory C4d + AMR between 1 and 145 (median 65) months post-transplantation. All patients tolerated bortezomib. One patient had allograft loss. Of the six patients with surviving grafts (86 %), mean pre-bortezomib eGFR was 42 ml/min/1.73 m(2) and the mean 1 year post-bortezomib eGFR was 53 ml/min/1.73 m(2). Five of seven (71 %) had improvement of histological findings of AMR, C4d staining, and/or acute cellular rejection. Reduction in HLA DSAs was more effective for class I than class II.ConclusionsBortezomib appears safe and may correlate with stabilization of eGFR in pediatric kidney transplant patients with refractory C4d + AMR.