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AbstractThe plea of accused persons, whether guilty or not, forms a central part of the legal process. Such a decision must exclusively rest with the accused person and be devoid of judicial and extrajudicial influence. This study seeks to interrogate the contexts within which accused persons determine their plea in court. It is argued that all the forms of plea are employed by accused persons as a means of navigating the sentencing outcomes of their cases. The study used a mixed-methods approach to data gathering and analysis. The respondents explained their guilty plea within the context of leniency, the expedition of cases, and to avoid prison remand. Those who pleaded not guilty largely thought of it within the context of identifying a legal loophole and having the opportunity to appeal their sentence after conviction. The extent to which the police influenced the accused to plead guilty requires further investigation.

The longevity of current joint replacements is limited by aseptic loosening, which is the primary cause of non-infectious failure for hip, knee, and ankle arthroplasty. Aseptic loosening is typically caused either by osteolysis from particulate wear, or by high shear stresses at the bone-implant interface from over-constraint. Our objective was to demonstrate feasibility of a compliant intramedullary stem that eliminates over-constraint without generating particulate wear. The compliant stem is built around a compliant mechanism that permits rotation about a single axis. We first established several models to understand the relationship between mechanism geometry and implant performance under a given angular displacement and compressive load. We then used a neural network to identify a design space of geometries that would support an expected 100-year fatigue life inside the body. We additively manufactured one representative mechanism for each of three anatomic locations, and evaluated these prototypes on a KR-210 robot. The neural network predicts maximum stress and torsional stiffness with 2.69% and 4.08% error respectively, relative to finite element analysis data. We identified feasible design spaces for all three of the anatomic locations. Simulated peak stresses for the three stem prototypes were below the fatigue limit. Benchtop performance of all three prototypes was within design specifications. Our results demonstrate the feasibility of designing patient- and joint-specific compliant stems that address the root causes of aseptic loosening. Guided by these results, we expect the use of compliant intramedullary stems in joint reconstruction technology to increase implant lifetime.

Introducción: La neuropatía autonómica cardíaca es una entidad poco conocida y subdiagnosticada en los pacientes diabéticos, la cual se caracteriza por el daño de las fibras nerviosas autónomas; ocasiona síntomas como intolerancia al ejercicio e hipotensión postural. La prevalencia y los factores de riesgo en la población diabética colombiana son poco claros y poco estudiados. Objetivo: Determinar la prevalencia de la neuropatía autonómica cardíaca y de los factores asociados en pacientes diabéticos de una población colombiana. Materiales y método: Estudio transversal analítico, en una población de 107 pacientes con diagnóstico de diabetes mellitus tipos I y II, que consultaron a un hospital de segundo nivel de atención en Colombia, entre abril y septiembre de 2022. Se realizó diagnóstico utilizando el test de Ewing de reflejo autonómico cardiovascular. Los análisis estadísticos fueron del orden descriptivo y de asociación mediante regresión logística calculando razón de disparidad e intervalos de confianza del 95%. Resultados: La población estudiada tuvo una edad promedio de 62 años; el 56.1% fueron mujeres. El 94.4% (IC 95%: 89.9-98.6) de los participantes presentaron una evaluación positiva para neuropatía autonómica cardíaca; el estado incipiente fue del 6.5%, la afectación confirmada del 26.2% y el compromiso grave del 61.7%. La edad está asociada con la aparición de neuropatía autonómica cardíaca (ORa: 1.07; IC 95%: 1.03-1.11). Conclusiones: Este estudio encontró alta prevalencia de neuropatía autonómica cardíaca (94.4%) cuando se utilizó el estándar de oro de diagnóstico. La edad de los pacientes tiene asociación con la presencia y la gravedad de esta enfermedad.

Cardiovascular disease (CVD) poses a significant health burden, particularly among individuals of low socioeconomic status (SES) in low- and middle-income countries (LMICs). This study evaluates the clinical effectiveness of cardiac rehabilitation (CR) in addressing CVD outcomes among very low-SES patients in Colombia. Data from participants enrolled in a CR program in Colombia between 2022 and 2023 were analyzed retrospectively. Measures included heart-healthy behaviors, physical/psychological outcomes, and quality of life assessed at 18, 36, and 60 sessions. Significant improvements were observed in exercise capacity, psychological well-being, and quality of life metrics throughout the CR program. However, barriers to CR attendance and the critical need for expanded program availability remain evident, particularly in LMIC settings like Colombia. In conclusion, structured CR programs demonstrate substantial benefits for very low-SES individuals in a LMIC country, highlighting the urgent need for increased program accessibility and equitable healthcare provision to optimize cardiovascular health outcomes.

Abstract The p53 tumor suppressor regulates multiple context-dependent tumor suppressive programs. Although p53 is mutated in ~90% of small cell lung cancer (SCLC) tumors, how p53 mediates tumor suppression in this context is unknown. Here, using a mouse model of SCLC in which endogenous p53 expression can be conditionally and temporally regulated, we show that SCLC tumors maintain a requirement for p53 inactivation. However, we identify tumor subtype heterogeneity between SCLC tumors such that p53 reactivation induces senescence in a subset of tumors, while in others, p53 induces necrosis. We pinpoint cyclophilins as critical determinants of a p53-induced transcriptional program that is specific to SCLC tumors and cell lines poised to undergo p53-mediated necrosis. Importantly, inhibition of cyclophilin isomerase activity, or genetic ablation of specific cyclophilin genes, suppresses p53-mediated necrosis by limiting p53 transcriptional output without impacting p53 chromatin binding. Our study demonstrates that intertumoral heterogeneity in SCLC influences the biological response to p53 restoration, describes a cyclophilin-dependent mechanism of p53-regulated cell death, and uncovers putative mechanisms for the treatment of this most-recalcitrant tumor type.

Introduction The most common surgical options for geriatric proximal humerus fractures are open reduction and internal fixation (ORIF), hemiarthroplasty (HA), and reverse total shoulder arthroplasty. We used a longitudinal inpatient discharge database to determine the cumulative incidence of conversion to arthroplasty after ORIF of geriatric proximal humerus fractures. The rates of short-term complications and all-cause reoperation were also compared. Patients and Methods All patients 65 or older who sustained a proximal humerus fracture and underwent either ORIF, HA, or shoulder arthroplasty (SA) as an inpatient from 2000 through 2017 were identified. Survival analysis was performed with ORIF conversion to arthroplasty and all-cause reoperation as the endpoints of interest. Rates of 30-day readmission and short-term complications were compared. Trends in procedure choice and outcomes over the study period were analyzed. Results A total of 27 102 geriatric patients that underwent inpatient surgical management of proximal humerus fractures were identified. Among geriatric patients undergoing ORIF, the cumulative incidence of conversion to arthroplasty within 10 years was 8.2%. The 10-year cumulative incidence of all-cause reoperation was 12.1% for ORIF patients and less than 4% for both HA and SA patients. Female sex was associated with increased risk of ORIF conversion and younger age was associated with higher all-cause reoperation. ORIF was associated with higher 30-day readmission and short-term complication rates. Over the study period, the proportion of patients treated with ORIF or SA increased while the proportion of patients treated with HA decreased. Short-term complication rates were similar between arthroplasty and ORIF patients in the later cohort (2015-2017). Conclusion The 10-year cumulative incidence of conversion to arthroplasty for geriatric patients undergoing proximal humerus ORIF as an inpatient was found to be 8.2%. All-cause reoperations, short-term complications, and 30-day readmissions were all significantly lower among patients undergoing arthroplasty, but the difference in complication rate between arthroplasty and ORIF was attenuated in more recent years. Younger age was a risk factor for reoperation and female sex was associated with increased risk of requiring conversion to arthroplasty after ORIF.

Over the last decades, increased emission of greenhouse gases has led to hot weather extremes, heavy precipitation and worsening of agricultural and ecological droughts. Although Africa’s contribution to climate change is minimal, the continent is especially vulnerable to its effects. This report aims to describe the effect of climate change leading to drought in Kilifi County, Kenya, and the communities’ experiences of this effect on food availability. During their community rotation, residents from a university in Nairobi, Kenya, evaluated changes in weather patterns and nutrition indicators in Kilifi County and conducted focus group discussions (FGDs) with community members and health care stakeholders to explore challenges in access to adequate nutrition and possible local solutions. Kilifi County has one of the highest rates of undernutrition in Kenya, with one in five under-5 children being underweight. County data showed that rainfall in the last 4 years has become increasingly unpredictable, resulting in reduced household milk production, one of the indicators of nutrition security. Three major themes emerged from the FGDs: lack of food variety, collapse of drought mitigating projects and increasing poverty levels. Possible solutions to these problems include promoting alternatives to the current diet that are culturally sensitive and adaptable to recent climate changes, ensuring continuity of agricultural and financial support projects and improved local leadership and governance.

The paper introduces the Oil-Slick Hub (OSH), a computational platform to facilitate the data visualization of a large database of petroleum signatures observed on the surface of the ocean with synthetic aperture radar (SAR) measurements. This Internet platform offers an information search and retrieval system of a database resulting from >20 years of scientific projects that interpreted ~15 thousand offshore mineral oil “slicks”: natural oil “seeps” versus operational oil “spills”. Such a Digital Mega-Collection Database consists of satellite images and oil-slick polygons identified in the Gulf of Mexico (GMex) and the Brazilian Continental Margin (BCM). A series of attributes describing the interpreted slicks are also included, along with technical reports and scientific papers. Two experiments illustrate the use of the OSH to facilitate the selection of data subsets from the mega collection (GMex variables and BCM samples), in which artificial intelligence techniques—machine learning (ML)—classify slicks into seeps or spills. The GMex variable dataset was analyzed with simple linear discriminant analyses (LDAs), and a three-fold accuracy performance pattern was observed: (i) the least accurate subset (~65%) solely used acquisition aspects (e.g., acquisition beam mode, date, and time, satellite name, etc.); (ii) the best results (>90%) were achieved with the inclusion of location attributes (i.e., latitude, longitude, and bathymetry); and (iii) moderate performances (~70%) were reached using only morphological information (e.g., area, perimeter, perimeter to area ratio, etc.). The BCM sample dataset was analyzed with six traditional ML methods, namely naive Bayes (NB), K-nearest neighbors (KNN), decision trees (DT), random forests (RF), support vector machines (SVM), and artificial neural networks (ANN), and the most effective algorithms per sample subsets were: (i) RF (86.8%) for Campos, Santos, and Ceará Basins; (ii) NB (87.2%) for Campos with Santos Basins; (iii) SVM (86.9%) for Campos with Ceará Basins; and (iv) SVM (87.8%) for only Campos Basin. The OSH can assist in different concerns (general public, social, economic, political, ecological, and scientific) related to petroleum exploration and production activities, serving as an important aid in discovering new offshore exploratory frontiers, avoiding legal penalties on oil-seep events, supporting oceanic monitoring systems, and providing valuable information to environmental studies.

Background: There remains a lack of accurate and validated outcome-prediction models in total knee arthroplasty (TKA). While machine learning (ML) is a powerful predictive tool, determining the proper algorithm to apply across diverse data sets is challenging. AutoPrognosis (AP) is a novel method that uses automated ML framework to incorporate the best performing stages of prognostic modeling into a single well-calibrated algorithm. We aimed to compare various ML methods to AP in predictive performance of complications after TKA. Methods: Thirty-eight preoperative patient demographics and clinical features from all primary TKAs performed at California-licensed hospitals between 2015 and 2017 were evaluated as predictors of major complications after TKA. Traditional logistic regression (LR), various other ML methods (XGBoost, Gradient Boosting, AdaBoost, and Random Forest), and AP were used for model building to determine discriminative power (area under receiver operating curve), calibration (Brier score), and feature importance. Results: Between 2015 and 2017, there were a total of 156,750 TKAs with 1109 (0.7%) total major complications. AP had the highest discriminative performance with area under receiver operating curve 0.679 compared with LR, XGBoost, Gradient Boosting, AdaBoost, and Random Forest (0.617, 0.601, 0.662, 0.657, and 0.545, respectively). AP (Brier score 0.007) had similar calibration as the other ML methods (0.006, 0.006, 0.022, 0.007, and 0.008, respectively). The variables that are most important for AP differ from those that are most important for LR. Conclusion: Compared to conventional ML algorithms, AP has superior discriminative ability with similar calibration and suggests nonlinear relationships between variables in outcomes of TKA.

El término «patrón nodular» hace referencia a lesiones nodulares pequeñas y múltiples en el parénquima pulmonar. La localización de los nódulos en relación con las estructuras del lobulillo pulmonar secundario permite estrechar el diagnóstico diferencial y categoriza el patrón nodular en perilinfático, centrolobulillar y aleatorio. El patrón miliar de tipo aleatorio, aunque comúnmente vinculado a la tuberculosis, es una manifestación radiológica presente en varias afecciones, destacando las infecciones fúngicas y las metástasis. Clínicamente estas afecciones cursan con signos y síntomas similares e inespecíficos, siendo el estudio histopatológico el método de referencia para el diagnóstico. Los hallazgos radiográficos dependen principalmente del estado inmunitario del huésped y de la carga exposicional

En el presente trabajo se determinó la causa de la falla en el techo flotante de un tanque que almacena gasolina en una refinería de petróleo. Mediante la inspección visual se observó el elevado deterioro de las planchas de aluminio que conforman la membrana y se percibió un sólido esparcido sobre las mismas. El estudio estructural de la aleación se realizó mediante la Espectrometría de Emisión por Arco Eléctrico y Metalografía. Los productos de corrosión se caracterizaron por Difractometría de rayos-X. El material se correspondió con la aleación de aluminio 3003 y no se encontraron deficiencias estructurales que sensibilizaran el material a la corrosión. En la superficie expuesta a la humedad y al oxígeno se evidenció el ataque localizado. La causa de la falla fue la corrosión galvánica, debido a diferencias de concentración de oxígeno entre las zonas cubiertas del sólido y las zonas libres del mismo.

The objective of the study was to evaluate the deterioration by corrosion of the tubes of a condenser, in contact with naphtha and residual water. Visual inspection revealed that the outer surface of the tubes was irregular, with abundant deposits and shallow cavities, which were attributed to the incidence of the acid corrosive medium. By Digital Multichannel Emission Spectrometry it was determined that the material of the tubes corresponds to a brass with a high zinc content, susceptible to densification and cracking under stress. Light microscopy revealed a biphasic structure and preferential dissolution of the β' phase. Electron microscopy and X-ray spectrometry techniques revealed a predominance of chemical elements in the deposits that are related to the formation of non-protective metal oxides and sulfides. The initial dissolution of the β´ phase and subsequent loss of the α phase, led to general corrosion.

Background The demand and incidence of anatomic total shoulder arthroplasty (aTSA) procedures is projected to increase substantially over the next decade. There is a paucity of accurate risk prediction models which would be of great utility in minimizing morbidity and costs associated with major post-operative complications. Machine learning is a powerful predictive modeling tool and has become increasingly popular, especially in orthopedics. We aimed to build a ML model for prediction of major complications and readmission following primary aTSA. Methods A large California administrative database was retrospectively reviewed for all adults undergoing primary aTSA between 2015 to 2017. The primary outcome was any major complication or readmission following aTSA. A wide scope of standard ML benchmarks, including Logistic regression (LR), XGBoost, Gradient boosting, AdaBoost and Random Forest were employed to determine their power to predict outcomes. Additionally, important patient features to the prediction models were indentified. Results There were a total of 10,302 aTSAs with 598 (5.8%) having at least one major post-operative complication or readmission. XGBoost had the highest discriminative power (area under receiver operating curve AUROC of 0.689) of the 5 ML benchmarks with an area under precision recall curve AURPC of 0.207. History of implant complication, severe chronic kidney disease, teaching hospital status, coronary artery disease and male sex were the most important features for the performance of XGBoost. In addition, XGBoost identified teaching hospital status and male sex as markedly more important predictors of outcomes compared to LR models. Conclusion We report a well calibrated XGBoost ML algorithm for predicting major complications and 30-day readmission following aTSA. History of prior implant complication was the most important patient feature for XGBoost performance, a novel patient feature that surgeons should consider when counseling patients.

Pictures at an exhibtion (Cuadros de una exposición) es una Suite para piano de diez movimientos compuesta por Modest Mussorgsky. En 1874 el compositor visitó una exposición de su amigo, el artista Viktor Hartmann, quien había muerto un año antes. Para homenajear a su amigo y capturar la experiencia del recorrido, compuso una pieza en la que cada uno de los movimientos es una ilustración musical de cada obra de Hartmann. El colectivo Artes No Decorativas S.A hace un recorrido sonoro por la exhibición Objetos de duda y de certeza de Manuela Ribadeneira, (Centro de Arte Contemporáneo de Quito 2019-2020). Al igual que en la obra de Mussorgski, cada sonido es una ilustración musical/sonora de cada obra y en su conjunto, es un recorrido de la muestra. Como toda exhibición, se puede escuchar en el orden sugerido por Rodolfo Kronfle, curador de la muestra, y caminar de la sala uno a la cuatro. Sin embargo, como en casi toda exhibición, el visitante puede escoger su orden y crear su propio recorrido. Este proyecto responde a una invitación de la revista Index para hacer un ensayo visual, que resultó en uno sonoro. El hecho de que la exhibición esté montada, inaugurada pero cerrada al público por la pandemia, nos llevó a recorrerla de otra manera. Notas: La portada, diseñada por Adrián Balseca, se basa en la primera versión de la partitura impresa de la obra de Mussorgsky.

Category: Ankle Arthritis; Ankle Introduction/Purpose: Ankle arthrodesis and total ankle replacement are the most commonly performed procedures for surgical management of ankle arthritis. Arthrodesis provides effective pain relief but the rate of complications after arthrodesis is higher as it is more commonly performed in patients with comorbidities that preclude ankle replacement. Accurately risk- stratifying patients who undergo ankle arthrodesis would be of great utility, given the significant cost and morbidity associated with developing major perioperative complications. There is a paucity of accurate prediction models that can be used to pre- operatively risk-stratify patients for ankle arthrodesis. We aim to develop a machine learning (ML) algorithm for prediction of major perioperative complication after ankle arthrodesis as well as compare its performance against traditional predictive models based on logistic regression. Methods: This is a retrospective cohort study of adult patients who underwent ankle arthrodesis at any non-federal California hospital between 2015 and 2017. The primary outcome was readmission within 30 days or major perioperative complication - venous thromboembolism within 30 days, myocardial infarction within 7 days, pneumonia within 7 days, systemic infection within 7 days, surgical site bleeding within 90 days, and wound complications within 90 days. We build ML and logistic regression models that span different classes of modeling approaches: XGBoost, AdaBoost, Gradient Boosting, and Random Forest. Discrimination and calibration were assessed using area under the receiver operating characteristic curve (AUROC) and Brier score, respectively. We utilize a partial dependence function to measure the importance of an individual feature by assessing the average effect in predicted risks when its value is altered. We rank the contribution of the included variables to the prediction of adverse outcomes. Results: A total of 1,084 patients met inclusion criteria for this study. There were 131 major complications or readmission (12.1%). The optimized XGBoost algorithm demonstrates higher discrimination (AUROC: 0.707 + 0.052) compared to LR (0.691 + 0.055). The receiver operating characteristic curves for the XGBoost and logistic regression models are visualized in Figure 1. XGBoost also outperforms the three other ML models. This model was well calibrated (Brier score: 0.103 + 0.001). The variables most important for the XGBoost model include diabetes, chronic kidney disease, implant complication, and major fracture. Five of the ten most important features for XGBoost were markedly less important for the traditional logistic regression model: male sex, prior hip fracture, cardiorespiratory failure, acute renal failure, and dialysis status. Conclusion: We report a ML algorithm for prediction of major perioperative complications after ankle arthrodesis. The optimized XGBoost model is well-calibrated and demonstrates superior risk prediction to logistic regression. This tool may identify and address potentially modifiable risk factors, helping to accurately risk-stratify patients and decrease likelihood of major complications. Notably, the predictors most important for XGBoost are different from those for logistic regression. This suggests that the superior discriminative capability of ML methods stems from their ability to capture complex non-linear relationships between variables that logistic regression is unable to detect.

Background Reverse total shoulder arthroplasty (rTSA) offers tremendous promise for the treatment of complex pathologies beyond the scope of anatomic total shoulder arthroplasty but is associated with a higher rate of major postoperative complications. We aimed to design and validate a machine learning (ML) model to predict major postoperative complications or readmission following rTSA. Methods We retrospectively reviewed California's Office of Statewide Health Planning and Development database for patients who underwent rTSA between 2015 and 2017. We implemented logistic regression (LR), extreme gradient boosting (XGBoost), gradient boosting machines, adaptive boosting, and random forest classifiers in Python and trained these models using 64 binary, continuous, and discrete variables to predict the occurrence of at least one major postoperative complication or readmission following primary rTSA. Models were validated using the standard metrics of area under the receiver operating characteristic (AUROC) curve, area under the precision–recall curve (AUPRC), and Brier scores. The key factors for the top-performing model were determined. Results Of 2799 rTSAs performed during the study period, 152 patients (5%) had at least 1 major postoperative complication or 30-day readmission. XGBoost had the highest AUROC and AUPRC of 0.681 and 0.129, respectively. The key predictive features in this model were patients with a history of implant complications, protein-calorie malnutrition, and a higher number of comorbidities. Conclusion Our study reports an ML model for the prediction of major complications or 30-day readmission following rTSA. XGBoost outperformed traditional LR models and also identified key predictive features of complications and readmission.

Abstract Bismuth triiodide (BiI3) has been studied in recent years with the aim of developing lead-free semiconductors for photovoltaics. It has also appeared in X-ray detectors due to the high density of the Bismuth element. This material is attractive as an active layer in solar cells, or may be feasible for conversion into perovskite-like material (MA3Bi2I9), being also suitable for photovoltaic applications. In this study, we report on the thermomechanical properties (stress, hardness, coefficient of thermal expansion, and biaxial and reduced Young’s moduli) of BiI3 thin films deposited by thermal evaporation. The stress was determined as a function of temperature, adopting the thermally induced bending technique, which allowed us to extract the coefficient of thermal expansion (31 × 10−6 °C−1) and Young’s biaxial modulus (19.6 GPa) for the films. Nanohardness (~0.76 GPa) and a reduced Young’s modulus of 27.1 GPa were determined through nanoindentation measurements.

Sea-surface petroleum pollution is observed as “oil slicks” (i.e., “oil spills” or “oil seeps”) and can be confused with “look-alike slicks” (i.e., environmental phenomena, such as low-wind speed, upwelling conditions, chlorophyll, etc.) in synthetic aperture radar (SAR) measurements, the most proficient satellite sensor to detect mineral oil on the sea surface. Even though machine learning (ML) has become widely used to classify remotely-sensed petroleum signatures, few papers have been published comparing various ML methods to distinguish spills from look-alikes. Our research fills this gap by comparing and evaluating six traditional techniques: simple (naive Bayes (NB), K-nearest neighbor (KNN), decision trees (DT)) and advanced (random forest (RF), support vector machine (SVM), artificial neural network (ANN)) applied to different combinations of satellite-retrieved attributes. 36 ML algorithms were used to discriminate “ocean-slick signatures” (spills versus look-alikes) with ten-times repeated random subsampling cross validation (70-30 train-test partition). Our results found that the best algorithm (ANN: 90%) was >20% more effective than the least accurate one (DT: ~68%). Our empirical ML observations contribute to both scientific ocean remote-sensing research and to oil and gas industry activities, in that: (i) most techniques were superior when morphological information and Meteorological and Oceanographic (MetOc) parameters were included together, and less accurate when these variables were used separately; (ii) the algorithms with the better performance used more variables (without feature selection), while lower accuracy algorithms were those that used fewer variables (with feature selection); (iii) we created algorithms more effective than those of benchmark-past studies that used linear discriminant analysis (LDA: ~85%) on the same dataset; and (iv) accurate algorithms can assist in finding new offshore fossil fuel discoveries (i.e., misclassification reduction).

Soil ecosystem service (SES) approaches evidence the importance of soil for human well-being, contribute to improving dialogue between science and decision-making and encourage the translation of scientific results into public policies. Herein, through systematic review, we assess the state of the art of SES approaches in tropical regions. Through this review, 41 publications were identified; while most of these studies considered SES, a lack of a consistent framework to define SES was apparent. Most studies measured soil natural capital and processes, while only three studies undertook monetary valuation. Although the number of publications increased (from 1 to 41), between 2001 and 2019, the total number of publications for tropical regions is still small. Countries with the largest number of publications were Brazil (n = 8), Colombia (n = 6) and Mexico (n = 4). This observation emphasizes an important knowledge gap pertaining to SES approaches and their link to tropical regions. With global momentum behind SES approaches, there is an opportunity to integrate SES approaches into policy and practice in tropical regions. The use of SES evaluation tools in tropical regions could transform how land use decisions are informed, mitigating soil degradation and protecting the ecosystems that soil underpins.

Introduction A growing number of Liaison Committee on Medical Education–accredited allopathic medical schools offer formal bilingual (English and Spanish) medical education, and numerous other schools offer medical Spanish through elective workshops as part of their curricula. One significant health disparity in the Hispanic community is the incidence of HIV among Spanish-speaking men who have sex with men (MSM). Pre-exposure prophylaxis (PrEP) has emerged as an effective strategy to reduce the risk of HIV transmission. Methods We developed an education module to train clinicians to discuss PrEP with Spanish-speaking MSM. Our module is adapted from an English module on PrEP education. It includes a Spanish-language PowerPoint slide deck with information about PrEP as well as a Spanish-language videotaped scripted clinical encounter. Results The module was implemented on three occasions with 18 participants, and learners reported increased comfort in discussing and confidence in prescribing PrEP with Spanish-speaking patients. Discussion This workshop can be incorporated within medical Spanish curriculums offered at health professional schools and community-based organizations dedicated to reducing the HIV burden in the Spanish-speaking Hispanic community.

ABSTRACT This study aimed to describe the growth parameters of Anchoa tricolor in a subtropical estuary. From August 2010 to July 2011, 10.009 specimens of the anchovy Anchoa tricolor, mean total length 4.2 cm (±1.45), were captured in the intertidal region of the Estuarine Complex of Paranaguá (25º 15’ - 25° 35’ S and 48° 20’ - 48° 45’ W). Species´s weight/length relationship for grouped genders was described as follow: W = 0.0000591.Lt3.282 (length in centimeters; weight in grams) showing a positive allometric growth pattern (b>3; P=0.000). Significant differences concerning weight/length relationship for males, females and unsexed individuals were identified. Parameters of the length to age growth curve were estimated by adjusting a von Bertalanffy growth equation from aged individuals from a length-frequency distribution: L∞ = 10.06 (1-e-17715(t + 0.205)) (length in centimeters, age in years). The age to attain 95% of the asymptotic length ( A95 ; longevity sensu Taylor) was estimated at 1.7 years. Size frequency distributions indicate that A. tricolor uses the estuarine area as reproductive and growing grounds, especially during the first year of the life cycle, where the species represent a key element for ecosystem functioning due to relatively high abundance and energy transference from plankton to top predators.

Resumen: Los beneficios de la actividad física y el ejercicio en la salud de la mujer son indiscutibles, hecho que está respaldado con fuerte evidencia científica en más de veinticinco condiciones médicas, incluidas la enfermedad cardiovascular y la mortalidad prematura.La actividad física provee beneficios de forma multifactorial con efectos en el sistema inmune, hemostático, autonómico, metabólico y hormonal entre otros, que pueden ser aplicables en las diferentes etapas de la historia fisiológica de la mujer. Por ende se requiere un abordaje específico de cada una de esas etapas para dar provecho a todas las ganancias que trae consigo la práctica del ejercicio físico.Los beneficios de la actividad física y la prescripción de ejercicio individualizada siempre superan considerablemente los posibles riesgos a los que se exponen por su práctica. A la hora de la prescripción del ejercicio es importante tener en cuenta características propias de la mujer, como composición corporal y rasgos endocrinológicos ya que representan diferencias en la respuesta fisiológica al ejercicio agudo y a entrenamientos prolongados. Adicionalmente, dentro de la evaluación médica es importante hacer una búsqueda activa de los riesgos cardiovascular, osteoarticular y metabólico.A pesar de los beneficios demostrados, los indicadores de inactividad física y sus consecuencias siguen siendo alarmantes en las mujeres. Estrategias que promuevan la actividad física en las mujeres y que permitan eliminar las barreras de acceso, además de nuevos métodos para cuantificar de manera indicada los niveles de actividad física, se convierten en un desafío para los profesionales de la salud y los planificadores de políticas de salud pública. Abstract: The benefits of physical activity and exercise on health are indisputable for women. There is scientific evidence of the benefits in more than 25 medical conditions, including cardiovascular disease and premature mortality.Physical activity provides multifactorial benefits with effects on the hemostatic, autonomic, metabolic, endocrine and immune systems, among others, that may be applicable at different stages of a woman's physiological history. A specific approach is therefore required at each of these stages to gain all the benefits that physical exercise can bring. Differences in physiological responses to acute exercise and periods of training are related to body size, body composition, and the endocrinological properties of women.The benefits of physical activity and the individualized prescription of exercise always outweigh their possible risks. Nevertheless, it is necessary to bear in mind that if there is a cardiovascular, osteoarticular or metabolic risk, there must be a proper assessment by medical professionals specialized in the management of physical activity and sports. Despite the known benefits, women's physical inactivity indicators are alarming, as well as their potential effects and consequences. Strategies that promote physical activity in women, new methods to adequately quantify its levels, and strategies for eliminating barriers to access have become a challenge for health professionals and public health policy planners. Palabras clave: Actividad física, Ejercicio, Mujer, Hormonas, Embarazo, Keywords: Physical activity, Exercise, Women, Hormones, Pregnancy

Linear discriminant analysis (LDA) is a mathematically robust multivariate data analysis approach that is sometimes used for surface oil slick signature classification. Our goal is to rank the effectiveness of LDAs to differentiate oil spills from look-alike slicks. We explored multiple combinations of (i) variables (size information, Meteorological-Oceanographic (metoc), geo-location parameters) and (ii) data transformations (non-transformed, cube root, log10). Active and passive satellite-based measurements of RADARSAT, QuikSCAT, AVHRR, SeaWiFS, and MODIS were used. Results from two experiments are reported and discussed: (i) an investigation of 60 combinations of several attributes subjected to the same data transformation and (ii) a survey of 54 other data combinations of three selected variables subjected to different data transformations. In Experiment 1, the best discrimination was reached using ten cube-transformed attributes: ~85% overall accuracy using six pieces of size information, three metoc variables, and one geo-location parameter. In Experiment 2, two combinations of three variables tied as the most effective: ~81% of overall accuracy using area (log transformed), length-to-width ratio (log- or cube-transformed), and number of feature parts (non-transformed). After verifying the classification accuracy of 114 algorithms by comparing with expert interpretations, we concluded that applying different data transformations and accounting for metoc and geo-location attributes optimizes the accuracies of binary classifiers (oil spill vs. look-alike slicks) using the simple LDA technique.

Resumen: Introducción: en rehabilitación cardiaca, el test de caminata de 6 minutos es una herramienta eficaz y segura en la evaluación del estado funcional, la eficacia terapéutica, la orientación de modalidades de entrenamiento y el establecimiento del pronóstico de morbilidad y mortalidad. Objetivo: caracterizar la respuesta ï¬siológica en la caminata de 6 minutos de pacientes en rehabilitación cardiovascular ubicados en altitud moderada, 2.550 metros sobre el nivel del mar, y determinar la importancia clínica. Métodos: estudio descriptivo de 487 caminatas de 6 minutos en pacientes con edades entre los 18 a 80 años, adscritos a un programa de rehabilitación cardiaca ubicado en altitud moderada. Resultados: los pacientes cardiovasculares colombianos presentan menores distancias recorridas que las demostradas en otras poblaciones y patologías. Durante el test la frecuencia cardiaca se incrementa en 40 latidos por minuto y alcanza el 65% de la frecuencia cardiaca máxima, en tanto que la presión arterial sistólica aumenta 20 mm Hg, la percepción del esfuerzo central y periférico aumentan hasta 4 puntos en escala de Borg y disminuye la saturación de oxígeno de 3 puntos porcentuales. Conclusión: el test caminata de 6 minutos es seguro y bien tolerado en pacientes cardiovasculares ubicados en altitud moderada. Durante la caminata se evidencia cambios signiï¬cativos en cuanto a respuesta cronotrópica, presora, percepción del esfuerzo y saturación arterial de oxígeno que difieren de resultados encontrados a nivel del mar, fenómeno que aporta valores de referencia para las pruebas realizadas en pacientes cardiovasculares de altitud moderada y para el abordaje clínico de la evaluación de la capacidad funcional, independencia física, riesgo de caídas, ajustes en medicación y valoración integral de comorbilidades. Abstract: Introduction: The 6-minute walk test in cardiac rehabilitation is and effective and safe tool for the evaluation of functional status, as well of the effectiveness of the therapy, the adjustment of training methods, and to establish the morbidity and mortality prognosis. Objective: To investigate the aspects that affect the physiological response in the 6-minute walk test in cardiovascular rehabilitation patients at moderate altitudes (2,550 metres above sea level), and determine the clinical importance. Material and methods: A descriptive study was conducted on 487 six-minute walks by patients with ages between 18 and 80 years, enrolled in cardiac rehabilitation programme and who lived at a moderate altitude. Results: The Colombian cardiovascular patients covered shorter distances than those demonstrated in other populations and other diseases. The heart rate during the test increased by 40 beats per minute and reached 65% of the maximum heart rate, as such that the systolic blood pressure increased by 20 mmHg. The perception of central and peripheral effort also increased up to 4 points on the Borg scale, as well as a mean decrease of 3% in oxygen saturation. Conclusion: The 6-minute test is safe and well-tolerated in cardiovascular patients living at moderate altitudes. Significant changes were seen during the walk as regards chronotropic response, pressure, perception of effort, oxygen saturation levels, which were different from the results found at sea level. This phenomenon provides reference values for tests performed on cardiovascular patients at moderate altitudes, as well as for the clinical approach to the evaluation of the functional capacity, physical independence, falls risk, adjustments to medication, and an integral assessment of comorbidities. Palabras clave: Enfermedad cardiovascular, Rehabilitación, Test, Ejercicio, Hipoxia, Keywords: Cardiovascular disease, Rehabilitation, Test, Exercise, Hypoxia

Omega-3 long-chain polyunsaturated fatty acids (n-3 LC PUFAs) and vitamin D3 are essential components of human nutrition. A regular human diet is highly deficient in n-3 LC PUFAs. Fish like salmon are highly recommended in the human diet as they are a major source of high-value n-3 LC PUFAs and vitamin D3. The levels of these nutrients have been decreasing over the last few years in farmed salmon, whose production urgently needs sustainable sources of these nutrients. The microalga Nannochloropsis gaditana (NG) is known for its naturally high potential for the production of eicosapentaenoic (EPA, 20:5 n-3) fatty acid. A commercial diet for Atlantic salmon was supplemented with 1% and 10% of spray-dried NG grown under controlled conditions for a high EPA content. Salmon were harvested on day 49, following which, boneless and skinless salmon meat was recovered from fish and analyzed for the fatty acid profile, total fat, and vitamin D3. Vitamin D3, EPA, and docosapentaenoic fatty acid (DPA, 22:5 n-3) levels were significantly increased (p < 0.05) by supplementing the basal diet with 10% NG, thus, NG represents a novel, functional, natural ingredient and a sustainable source of n-3 LC-PUFAs that can raise the levels of healthy fats and vitamin D3 in farmed salmon meat.

We classify low-backscatter regions observed in Synthetic Aperture Radar (SAR) measurements of the surface of the ocean as either oil slicks or look-alike slicks (radar false targets). Our proposed classification algorithm is based on Linear Discriminant Analyses (LDAs) of RADARSAT-1 measurements (402 scenes off the southeast coast of Brazil from July 2001 to June 2003) and Meteorological-Oceanographic (MetOc) data from other earth observation sensors: Advanced Very High Resolution Radiometer (AVHRR), Sea-Viewing Wide Field-of-View Sensor (SeaWiFS), Moderate Resolution Imaging Spectroradiometer (MODIS), and Quick Scatterometer (QuikSCAT). Oil slicks are sea-surface expressions of exploration and production oil, ship- and orphan-spills. False targets are associated with environmental phenomena, such as biogenic films, algal blooms, upwelling, low wind, or rain cells. Both categories have been interpreted by domain-experts: mineral oil (n = 350; 45.5%) and petroleum free (n = 419; 54.5%). We explore nine size variables (area, perimeter, etc.) and three types of MetOc information (sea surface temperature, chlorophyll-a, and wind speed) that describe the 769 samples analyzed. Seven attribute–domain combinations are tested with three non-linear transformations (none, cube root, log10), with and without MetOc, adding to 39 attribute subdivisions. Classification accuracies are independent of data transformation and improve when selected size attributes are combined with MetOc, leading to overall accuracies of ~80% and sound levels of sensitivity (~90%), specificity (~80%), positive (~80%) and negative (~90%) predictive values. The effectiveness of this data-driven attempt supports further commercial or academic implementation of our LDA algorithm.

Vector-borne diseases account for more than 17% of all infectious diseases, causing more than one million deaths annually. Malaria remains one of the most important public health problems worldwide. These vectors are bloodsucking insects, which can transmit disease-producing microorganisms during a blood meal. The contact of culicids with human populations living in malaria-endemic areas suggests that the identification of Plasmodium genetic material in the blood present in the gut of these mosquitoes may be possible. The process of assessing the blood meal for the presence of pathogens is termed 'xenosurveillance'. In view of this, the present work investigated the relationship between the frequency with which Plasmodium DNA is found in culicids and the frequency with which individuals are found to be carrying malaria parasites. A cross-sectional study was performed in a peri-urban area of Manaus, in the Western Brazilian Amazon, by simultaneously collecting human blood samples and trapping culicids from households. A total of 875 individuals were included in the study and a total of 13,374mosquito specimens were captured. Malaria prevalence in the study area was 7.7%. The frequency of households with at least one culicid specimen carrying Plasmodium DNA was 6.4%. Plasmodium infection incidence was significantly related to whether any Plasmodium positive blood-fed culicid was found in the same household [IRR 3.49 (CI95% 1.38-8.84); p = 0.008] and for indoor-collected culicids [IRR 4.07 (CI95%1.25-13.24); p = 0.020]. Furthermore, the number of infected people in the house at the time of mosquito collection was related to whether there were any positive blood-fed culicid mosquitoes in that household for collection methods combined [IRR 4.48 (CI95%2.22-9.05); p

Mussels (Mytilus spp.) are one of the most cultivated and commercialized bivalves in southern Chile; culture is currently supplied almost entirely from wild-caught seed obtained from relatively few collection centers. The genetic diversity and differentiation of the blue mussel in southern Chile was investigated by sampling six locations: one natural bank and five seed collection centers. Nine polymorphic microsatellite (SSR) loci were genotyped (Mgu1, Mgu3, MT203, MT282, Mg15, Mg56, Med737, MIT02 and MGE005). We found 75 different alleles, six of which were private alleles. Of the analyzed loci, 45 of 54 tests performed deviated from Hardy-Weinberg equilibrium after sequential Bonferroni correction (P < 0.05), revealing significant heterozygote deficiencies. The polymorphic information content (PIC) ranged from 0.322 (MGE005) to 0.893 (Mgu1). Despite the long distance between some sampling sites (up to 1360 km), genetic differentiation among the sites was low (F ST = 0.043, P < 0.0001). The Bayesian cluster analysis (STRUCTURE) indicated two probable clusters, while the non-parametric cluster analysis (AWclust) identified two to four clusters. Both analyses showed a high level of admixture within clusters. Our results indicate that blue mussels in southern Chile show lower genetic diversity than in other countries, low inbreeding levels, and limited genetic differentiation among locations.

OBJECTIVE: To investigate trends in breastfeeding indicators in the city of Feira de Santana, Brazil, and to identify population characteristics that might have influenced this trend. METHODS: Three methodologically comparable cross-sectional surveys performed in 1996, 2001, and 2009 were analyzed. These involved 2,159, 2,319, and 1,471 children younger than 1 year of age who were vaccinated in national multivaccination campaigns in the respective years. A standardized questionnaire was used, containing closed questions on consumption of breast milk and other foods on the day before the survey, along with questions regarding the characteristics of the population. RESULTS: The annual growth of the breastfeeding indicators was 2.1% for breastfeeding in the first hour of life (from 52.2% to 68.9%); 1.1% for breastfeeding among children aged 9 to 12 months (from 45% to 59.6%); and 0.8% for exclusive breastfeeding among infants younger than 6 months (from 36.9% to 47.4%). The median duration of exclusive breastfeeding increased from 52.3 to 84.3 days, and overall breastfeeding from 278 to 376 days. Some changes in the characteristics of the population were observed, which may have positively influenced the evolution of the breastfeeding indicators (better schooling level among the mothers, less use of dummies/pacifiers, and lower proportions of adolescent mothers), or negatively (greater proportions of primiparous mothers and cesarean deliveries, and lower frequency of births in Baby-Friendly Hospitals). CONCLUSION: There were significant advances in breastfeeding indicators, although they are still far from ideal. Changes observed in population characteristics may have positively or negatively influenced this evolution.

Prediabetes is associated with cardiovascular diseases. We hypothesized that white tea (WTEA) consumption by prediabetic rats improved cardiac glycolytic and oxidative profile. Prenatal male Wistar rats were divided in control group and prediabetes (PrDM) group which received a streptozotocin injection. After one month, PrDM rats were divided: half consumed water and half WTEA during two months. WTEA phytochemical profile was determined. Rats were then subjected to glucose tolerance and insulin resistance tests. Cardiac glycolytic and oxidative profiles were determined. Prediabetes decreased glucose transporters (GLUT1 and GLUT3) mRNA expression, lactate and acetate content and lactate dehydrogenase activity in cardiac tissue. Prediabetes also decreased heart antioxidant capacity, increasing lipid peroxidation and protein oxidation. WTEA consumption improved glucose tolerance and insulin sensitivity in prediabetic rats and increased cardiac acetate and alanine contents and protein oxidation levels. WTEA consumption ameliorated overall metabolic status of prediabetic rats and prevented most of heart-related deleterious effects evaluated.

The rainbow trout Oncorhynchus mykiss, was first introduced in Chile between 1905 and 1920 and is currently widely distributed in Chile from Antofagasta (23°S) to Patagonia (55°S). The broad range of the geographic and climatic distributions of this species in Chile offers a unique opportunity to study the effect of naturalization of an introduced species on its genetic variability. It is of particular importance to observe the genetic variability of populations in the northern range of this species distribution, in a transition zone where a Mediterranean-type climate changes to an arid climate. The present study analyzed allozymic variability and distribution within and between populations of O. mykiss from the river basins of Elqui and Limari rivers, and six culture strains, using starch-gel protein electrophoresis. Populations were found to be in Hardy-Weinberg equilibrium and the average values of He (0.045), polymorphism (13.9%) and allele per locus (1.19) are similar to rainbow trout in its native distributional range. About 77.8% of the genetic variability was within population, similar to the variability reported for wild populations in the northern hemisphere. However, a marked genetic differentiation between wild populations was also found. This is likely to be the consequence of initial founder effects followed by subsequent introgression of resident populations caused by reseeding with trout of different origins in both basins.

BACKGROUND: Helicobacter pylori plays a significant role in gastritis and ulcers. It is a carcinogen as defined by the WHO, and infection can result in adenocarcinomas and mucosa-associated lymphoid tissue lymphomas. In Canada, rates of antimicrobial resistance are relatively unknown, with very few studies conducted in the past 15 years.

EVAR has become the predominant repair technique for abdominal aortic aneurysm. Long-term clinical success relies greatly upon a long-lasting proximal seal. EVAR has achieved good outcomes on the short-term in patients with hostile neck features such as large proximal necks. However, the long-term outcomes in these patients is greatly unknown. In this article, the authors perform a literature review in order to assess the clinical impact of wide proximal neck on mid to long-term outcomes following EVAR.

The potent adjuvant activity of the novel adjuvant, poly[di(sodiumcarboxylatoethylphenoxy)phosphazene] (PCEP), with various antigens has been reported previously. However, very little is known about its mechanisms of action. We have recently reported that intramuscular injection of PCEP induces NLRP3, an inflammasome receptor gene, and inflammatory cytokines, including IL-1β and IL-18, in mouse muscle tissue. Caspase-1 is required for the processing of pro-forms of IL-1β and IL-18 into mature forms and is a critical constituent of the NLRP3 inflammasome. Hence, in the present study, we investigated the role of caspase-1 in the secretion of IL-1β and IL-18 in PCEP-stimulated splenic dendritic cells (DCs). Caspase inhibitor YVAD-fmk-treated splenic DCs showed significantly reduced IL-1β and IL-18 secretion in response to PCEP stimulation. Further, PCEP had no effect on the expression of MHC class II or co-stimulatory molecules, CD86 and CD40, suggesting that PCEP does not induce DC maturation. However, PCEP directly activated B-cells to induce significant production of IgM. In addition, PCEP+ovalbumin (OVA) immunized mice showed significantly increased production of antigen-specific IFN-γ by CD4+ and CD8+ T-cells. We conclude that PCEP activates innate immunity, leading to increased antigen-specific T-cell responses.

Tobacco smoking is recognized as a global pandemic resulting in 6 million deaths per year. Despite a variety of anti-smoking products available to aid with tobacco cessation, the majority of people who attempt to quit smoking relapse within 6 months due to the addictive nature of nicotine. An immunotherapy approach could offer a promising treatment option by inducing a potent selective antibody response against nicotine in order to block its distribution to the brain and its addictive effects in the central nervous system. Our nicotine vaccine candidate was administered intranasally using the Neisseria meningitidis serogroup B Adjuvant Finlay Proteoliposome 1 (AFPL1) as a part of the delivery system. This system was designed to generate a robust immune response by stimulating IL-1β production through Toll-like receptor 4 (TLR4), a potent mechanism for mucosal immunity. The vaccine induced high antibody titers in mice sera in addition to inducing mucosal antibodies. The efficacy of our vaccine was demonstrated using in vivo challenge experiments with radioactive [3H]-nicotine, followed by an analysis of nicotine distribution in the lung, liver, blood and brain. Our results were encouraging as the nicotine concentration in the brain tissue of mice vaccinated with our candidate vaccine was four times lower than in non-vaccinated controls; suggesting that the anti-nicotine antibodies were able to block nicotine from crossing the blood brain barrier. In summary, we have developed a novel nicotine vaccine for the treatment of tobacco addiction by intranasal administration and also demonstrated that the AFPL1 can be used as a potential adjuvant for this vaccine design.

ABSTRACT A weight-length relationship was established for Corydoras paleatus (Jenyns, 1842) (Siluriformes, Callichthyidae) (n=596) from samples taken in November-December 2009 and March-April 2010, in Pinguela Lagoon (29°46'57"S; 50°11'16"W), Rio Grande do Sul, Brazil. The species showed a polyphasic allometric growth pattern, each stanza described by an independent power equation controlled by a switch function: W = a1Lb1 ∙ (1 + eRsc ∙ (L-SCP))-1 + a2Lb2 ∙ [1 - (1 + eRsc ∙ (L-SCP))-1] ; where W is the expected weight for a specific length L, a1 and a2 are the proportionality coefficients for stanzas 1 and 2, b1 and b2 are the allometric coefficients for stanzas 1 and 2, Rsc is the stanza changing rate for the switch function and SCP is the stanza changing point for the switch function. The stanza changing point was estimated as 5.28 cm, corresponding with the length at first maturity for this species Lmat (5.29 cm). Our data suggest that a complex growth pattern can be in nature, and perhaps not often identified because trends are obscured by natural variability.

Mussels are one of the most cultivated and commercialized bivalves worldwide and in southern Chile its culture represent an important economic activity. The species identification within the Mytilus genera, by morphological features, is unreliable, so we used a polymorphism RFLP in the gene encoding the polyphenolic adhesive protein as a species-specific genetic marker to describe Mytilus species diversity in southern Chile, and evaluate possible applications in traceability, food quality and safety. Using Me 15-16 marker most mussels were M. chilensis, finding no other pure individuals; however, putative hybrids of M. chilensis x M. trossulus and M. chilensis x M. galloprovincialis were detected. There was no evidence of M. edulis. The presence of the M. trossulus allele, faraway from its distribution area, demands further analysis with different genetic markers to allow a better understanding of its origin. In addition, the correspondence between markers that distinguishes northern from southern hemisphere M. galloprovincialis, with those who discriminates between M. chilensis and M. galloprovincialis would contribute to the taxonomic status of Chilean blue mussels. In Chile, the genetic composition of Mytilus indicates that geographical origin of mussels and its traceability cannot be established merely from the identification of the species. The use of other markers would be required.Los mejillones son una de las especies de bivalvos más cultivadas y comercializadas, en el sur de Chile donde su cultivo representa una actividad económica importante. La identificación de la especie dentro del género Mytilus, basada en las características morfológicas no es confiable por lo que se utilizó un polimorfismo RFLP en el gen que codifica la proteína adhesiva polifenólica como marcador genético específico de la especie para describir la diversidad de especies Mytilus en el sur de Chile, y evaluar posibles aplicaciones en trazabilidad, calidad e inocuidad de los alimentos. Usando el marcador Me 15-16, la mayoría de los mejillones fueron M. chilensis, no se encontraron individuos puros de otras especies. Sin embargo, se detectaron híbridos putativos M. chilensis x M. trossulus y M. chilensis x M. galloprovincialis. No se encontró evidencia de M. edulis. La presencia del alelo de M. trossulus, lejos de su área de distribución, requiere de análisis posteriores con diferentes marcadores genéticos para entender su origen. Además, conocer la correspondencia entre marcadores que distinguen M. galloprovincialis del hemisferio norte y sur con aquellos que discriminan entre M. chilensis y M. galloprovincialis contribuirá al estatus taxonómico del mítilido chileno. La composición genética de Mytilus en Chile no permite establecer su origen geográfico ni la trazabilidad, basándose solo en la identificación de la especie y se requiere el uso de otros marcadores.

ResumenIntroducción y objetivos: El infarto agudo de miocardio continúa siendo un grave problema de salud. Su diagnóstico certero puede mejorar el pronóstico. El objetivo de la investigación fue identificar la concordancia en el diagnóstico clínico−patológico en fallecidos por esta enfermedad. Método: Se realizó un estudio descriptivo, transversal, en fallecidos por infarto agudo de miocardio en el Hospital General "Camilo Cienfuegos" de Sancti Spíritus, desde enero 2009 hasta diciembre 2010 para determinar la eficacia diagnóstica. Se estudiaron todos los fallecidos con el mencionado diagnóstico y que se les había realizado la necropsia. Se emplearon los índices de eficacia diagnóstica sensibilidad, especificidad e índice Kappa. Resultados: Se constató una mayor concordancia clínico−patológica en el sexo masculino (sensibilidad de 78 % en el 2009 y de 81 % en el 2010), así como en los mayores de 65 años (sensibilidad de 82 % y 85 %), y cuando la estadía hospitalaria fue mayor de 24 horas (sensibilidad en 80 % y 83 %). Las salas con mejor concordancia clínico−patológica fueron las de Cardiología y la Unidad de Terapia Intensiva en los dos períodos estudiados. El índice Kappa mostró una eficacia en el diagnóstico clínico−patológico del infarto agudo de miocardio y mejoraron sus indicadores de un año al siguiente (0,85 en el 2009 y 0,87 en el 2010). Conclusiones: Existió una mayor concordancia clínico−patológica en los fallecidos del sexo masculino, en los menores de 65 años de edad y en los que tuvieron una estadía hospitalaria mayor de 24 horas. Los servicios con mejor concordancia fueron los de Cardiología y de Terapia Intensiva. Se puede afirmar que existe muy buena eficacia diagnóstica para el infarto agudo de miocardio en el Hospital "Camilo Cienfuegos" de Sancti Spíritus. / AbstractIntroduction and Objectives: Acute myocardial infarction remains a serious health problem. Its accurate diagnosis may improve prognosis. The objective of this research was to identify the consistency in clinical and pathological diagnosis in deaths from this disease. Method: A descriptive and cross−sectional study was performed in deaths from acute myocardial infarction at Camilo Cienfuegos General Hospital in Sancti Spiritus, from January 2009 to December 2010 to determine the diagnostic efficacy. All deaths with the above−mentioned diagnosis, which had undergone autopsy, were studied. Indexes of diagnostic efficacy such as sensitivity, specificity and Kappa index were used. Results: A higher clinical and pathological consistency was found in males (sensitivity of 78% in 2009 and 81% in 2010) and in those over 65 years (sensitivity of 82% and 85%) and when hospital stay was longer than 24 hours (sensitivity in 80% and 83%). The units with the best clinical and pathological consistency in the two periods studied were cardiology and the intensive care. Kappa index showed that there was efficacy in the clinical and pathological diagnosis of acute myocardial infarction and their indicators improved from one year to the next (0.85 in 2009 and 0.87 in 2010). Conclusions: There was an increased clinical and pathological consistency in male deaths, in those under 65 years of age and in those who had a hospital stay longer than 24 hours. The units with better consistency were Cardiology and Intensive Care. It can be said there is very good diagnostic accuracy for acute myocardial infarction at Camilo Cienfuegos Hospital in Sancti Spiritus.

Spawning time in salmonids is a sex-limited quantitative trait that can be modified by selection. In rainbow trout (Oncorhynchus mykiss), various quantitative trait loci (QTL) that affect the expression of this trait have been discovered. In this study, we describe four microsatellite loci associated with two possible spawning time QTL regions in coho salmon (Oncorhynchus kisutch). The four loci were identified in females from two populations (early and late spawners) produced by divergent selection from the same base population. Three of the loci (OmyFGT34TUF, One2ASC and One19ASC) that were strongly associated with spawning time in coho salmon (p < 0.0002) were previously associated with QTL for the same trait in rainbow trout; a fourth loci (Oki10) with a suggestive association (p = 0.00035) mapped 10 cM from locus OmyFGT34TUF in rainbow trout. The changes in allelic frequency observed after three generations of selection were greater than expected because of genetic drift. This work shows that comparing information from closely-related species is a valid strategy for identifying QTLs for marker-assisted selection in species whose genomes are poorly characterized or lack a saturated genetic map.

Metamysidopsis atlantica elongata (Bascescu, 1968) is a common mysid in the surf zone of sandy beaches from the state of Rio Grande do Sul, Brazil, where it is frequently recorded forming dense aggregations. Trough laboratory trials, behavioral responses to salinity (10, 20, 25, 28, 30, 40 e 45), temperature (10, 15, 20, 30±1ºC) and light (yes/no) were tested using adult males, adult females and juveniles. Although there was no response to temperature, the species showed clear response to salinity and light. In the presence of light, organisms remained in the bottom of the aquaria, but moved to surface when bottom salinities were increased. In the absence of light, adults moved to the surface. However, juveniles moved down to or remained on the bottom, maybe as a response to avoid adult predation.

Structural equation modeling (SEM) is an important statistical tool for evaluating complex relations in several research areas. In epidemiology, the use and discussion of SEM have been limited thus far. This article presents basic principles and concepts in SEM, including an application using epidemiological data analysis from a study on the determinants of cognitive development in young children, considering constructs related to organization of the child's home environment, parenting style, and the child's health status. The relations between the constructs and cognitive development were measured. The results showed a positive association between psychosocial stimulus at home and cognitive development in young children. The article presents the contributions by SEM to epidemiology, highlighting the need for an a priori theoretical model for improving the study of epidemiological questions from a new perspective.A modelagem de equações estruturais (MEE) é uma ferramenta estatística importante para avaliar relações complexas em várias áreas do conhecimento. Em Epidemiologia sua divulgação e uso são limitados. Este artigo apresenta princípios e conceitos básicos da MEE, com exemplo de aplicação na análise de dados epidemiológicos. A análise de dados é realizada em estudo que investiga determinantes do desenvolvimento cognitivo infantil, sendo definidos construtos relacionados à organização do ambiente da criança, ao seu status de saúde, e às práticas e estilo de vida dos pais. O impacto positivo da qualidade de estimulação psicossocial do ambiente doméstico sobre o índice de desempenho cognitivo (IDC) esclarece que parte do efeito da estimulação sobre o IDC deve-se ao estilo parental de interação com a criança e às características físico-ambientais do contexto familiar. As potencialidades do uso da MEE em Epidemiologia são apresentadas, enfatizando-se a definição do modelo teórico e seu uso para aprofundamento de questões epidemiológicas sob nova perspectiva.

OBJETIVO: Averiguar os fatores associados à interrupção do aleitamento materno exclusivo no primeiro mês de lactação na cidade de Feira de Santana, BA. MÉTODOS: Estudo de coorte com 1.309 duplas mães-bebês selecionadas em todas as maternidades do município. Os dados foram coletados no hospital e domicílio ao final do primeiro mês. A associação entre desfecho e variáveis de interesse foi avaliada por meio de regressão logística. RESULTADOS: Falta de experiência prévia com amamentação (razão de prevalência 1,24; IC95% 1,75-1,43), presença de fissura mamilar (razão de prevalência 1,25; IC95% 1,09-1,43), horários pré-determinados para amamentar (razão de prevalência 1,42; IC95% 1,09-1,84) e uso de chupeta (razão de prevalência 1,53; IC95% 1,34-1,76) foram identificados como fatores preditivos da interrupção do aleitamento exclusivo. CONCLUSÕES: Medidas de prevenção da interrupção do aleitamento exclusivo devem priorizar mulheres sem experiência com amamentação e contemplar prevenção de traumas mamilares, incentivo à prática do aleitamento em livre demanda e desestímulo ao uso de chupeta.OBJECTIVE: To investigate factors associated with discontinuation of exclusive breastfeeding in the first month of lactation, in the city of Feira de Santana, Brazil. METHODS: Cohort study with follow-up of 1,309 mother-child pairs selected from all maternities in the municipality. Data were collected in hospital and in home visits during the first month of life. Logistic regression analysis was used to examine the relationship between outcome and variables of interest. RESULTS: Lack of prior breastfeeding experience (PR 1.24; 95%CI 1.75-1.43), cracked nipples (PR 1.25; 95%CI 1.09-1.43), use of fixed breastfeeding schedules (PR 1.42; 95%CI 1.09-1.84) and pacifier use (PR 1.53; 95%CI 1.34-1.76) were identified as factors predicting discontinuation of exclusive breastfeeding. CONCLUSIONS: Measures to prevent early discontinuation of exclusive breastfeeding must focus on women without breastfeeding experience and include prevention of nipple trauma, encourage breastfeeding on demand, and discourage the use of pacifiers.