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Benjamin Skov Kaas-Hansen,1– 3 Cristina Leal Rodríguez,2 Davide Placido,2 Hans-Christian Thorsen-Meyer,2,4 Anna Pors Nielsen,2 Nicolas Dérian,5 Søren Brunak,2 Stig Ejdrup Andersen1 1Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Denmark; 2NNF Center for Protein Research, University of Copenhagen, Copenhagen, Denmark; 3Section for Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; 4Department of Intensive Care Medicine, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; 5Data and Development Support, Region Zealand, Sorø, DenmarkCorrespondence: Benjamin Skov Kaas-Hansen, Clinical Pharmacology Unit, Zealand University Hospital, Munkesoevej 18, Roskilde, 4000, Denmark, Tel +45 60 19 68 02, Email epiben@hey.comPurpose: Dosing of renally cleared drugs in patients with kidney failure often deviates from clinical guidelines, so we sought to elicit predictors of receiving inappropriate doses of renal risk drugs.Patients and methods: We combined data from the Danish National Patient Register and in-hospital data on drug administrations and estimated glomerular filtration rates for admissions between 1 October 2009 and 1 June 2016, from a pool of about 2.6 million persons. We trained artificial neural network and linear logistic ridge regression models to predict the risk of five outcomes (> 0, ≥ 1, ≥ 2, ≥ 3 and ≥ 5 inappropriate doses daily) with index set 24 hours after admission. We used time-series validation for evaluating discrimination, calibration, clinical utility and explanations.Results: Of 52,451 admissions included, 42,250 (81%) were used for model development. The median age was 77 years; 50% of admissions were of women. ≥ 5 drugs were used between admission start and index in 23,124 admissions (44%); the most common drug classes were analgesics, systemic antibacterials, diuretics, antithrombotics, and antacids. The neural network models had better discriminative power (all AUROCs between 0.77 and 0.81) and were better calibrated than their linear counterparts. The main prediction drivers were use of anti-inflammatory, antidiabetic and anti-Parkinson’s drugs as well as having a diagnosis of chronic kidney failure. Sex and age affected predictions but slightly.Conclusion: Our models can flag patients at high risk of receiving at least one inappropriate dose daily in a controlled in-silico setting. A prospective clinical study may confirm that this holds in real-life settings and translates into benefits in hard endpoints.Keywords: predictive modelling, kidney failure, machine learning, risk markers, inappropriate drug dosing, renal risk drugs

Se presentan diversos aspectos de la biología y ecología de las especies del género Morpho Fabricius, 1807 que habitan en la localidad de Otanche del Departamento de Boyacá y los resultados de la búsqueda y ciclo de vida de Morpho cypris cypris De Vries, como, características de huevos, orugas y planta hospedante entre otros.Some aspects of the biology and ecology of the species of the genus Morpho Fabricius, 1807 as eggs, caterpillar and host plant of the Morpho cypris cypris De Vries, of the locality Otanche in the Department of Boyaca have been added.

Se presenta una clave dicotómica para determinar las diferentes especies de mariposas del género Morpho que habitan en Colombia, con ilustraciones sobre las genitalias de los principales subgéneros y fotografías (dorsal y ventral) de los adultos más representativos de ambos sexos. Para la determinación taxonómica de las especies, se siguieron los parámetros propuestos por Clarke (1941) con algunas modificaciones que simplifican la utilización de esta técnica. También, se tuvieron en cuenta aspectos morfométricos alares, patrones de coloración alar y características de las genitalias de los machos; enalgunos casos, se recurrió a la consulta de la literatura de referencia (Le Moult y Real, 1962; Blandin, 1984).A dichotomous key is provided for determining the different species of butterflies of the genus Morpho from Colombia, withilustrations of the male genitalia and dorsal and ventral pictures of representative males and females of the main subgenera. For the study of the taxonomic characteristics of the species, the parameters given by Clarke (1941) were followed with some modifications that simplified the use of this technique. Wingmorphometrics and coloration patterns and mal e genitalia features were also included, in some cases, references of the literature were given (Le Moult & Real, 1962; Blandin, 1984).

This work puts together the results of six studies carried out in Colombia on the genus Morpho, with a revised description of. the species found in Colombia based on color patterns and mal egenitalia. Biological and ecological data are included, such as geographic and altitudinal distribution, habitat, habits and behavior, and annotated comments on each of the 24 species.The work features drawings of genitalia for each species, some of which had not been published before. This first issue covers the distribution of species found in Colombia.En este trabajo, se presentan los resultados de los estudios sobre el género Morphoen Colombia recopilados (6), con una redescripción de las especies del género que habitan en Colombia, con base en las características de patrones decoloración y genitalias. Simultáneamente, se incluyen datos biológicos y ecológicos, como: distribución geográfica y altitudinal, hábitos, hábitat y comportamiento, además de otras anotaciones y comentarios de cada una de las 24 especies; se adicionan gráficos simplificados de las genitalias de cada una de las especies, muchas de las cuales no habían sido ilustradas anteriormente y, finalmente, se incluyen los registros de diferentes colecciones. En esta primera entrega, se señala la distribución geográfica y altitudinal de las especies que habitan en Colombia.

While students were involved in English classes throughout last year (1998), it was noticed that all of them recognised isolated vocabulary, but were not able to apply it in oral or written sentences. Some action research was carried out on how the Literature Approach and the continuous repetition of stories could increase oral production. It became clear that the students enjoyed and comprehended stories and answered questions in complete sentences.

Several informatic systems (HIDROGEOQUIM, SAMA, GEOQUIM, BATOMET, SACAN, SIMUCIN, MODELAGUA), which has been designed and implemented from 1980 to the present year by the collective of this paper are discussed and with application examples about underground water characterization and quality control. These computer programs are based on thermodynamic and kinetics principles as well as statistics, pattern recognition, mass balance and mixing water models. The last programs were developed in DELPHI language version 3 for WINDOWS. [ABSTRACT FROM AUTHOR]

Patients experiencing adverse drug events (ADE) from polypharmaceutical regimens present a huge challenge to modern healthcare. While computational efforts may reduce the incidence of these ADEs, current strategies are typically non-generalizable for standard healthcare systems. To address this, we carried out a retrospective study aimed at developing a statistical approach to detect and quantify potential ADEs. The data foundation comprised of almost 2 million patients from two health regions in Denmark and their drug and laboratory data during the years 2011 to 2016. We developed a series of multistate Cox models to compute hazard ratios for changes in laboratory test results before and after drug exposure. By linking the results to data from a drug-drug interaction database, we found that the models showed potential for applications for medical safety agencies and improved efficiency for drug approval pipelines.

Biocontrol Agents (BCAs) can be an eco-friendly alternative to fungicides to reduce the contamination with mycotoxigenic fungi on coffee. In the present study, different strains of bacteria and yeasts were isolated from Ivorian Robusta coffee. Their ability to reduce fungal growth and Ochratoxin A (OTA) production during their confrontation against Aspergillus carbonarius was screened on solid media. Some strains were able to reduce growth and OTA production by 85 % and 90 % and were molecularly identified as two yeasts, Rhodosporidiobolus ruineniae and Meyerozyma caribbica. Subsequent tests on liquid media with A. carbonarius or solely with OTA revealed adhesion of R. ruineniae to the mycelium of A. carbonarius through Scanning Electron Microscopy, and an OTA adsorption efficiency of 50 %. For M. caribbica potential degradation of OTA after 24 h incubation was observed. Both yeasts could be potential BCAs good candidates for Ivorian Robusta coffee protection against A. carbonarius and OTA contamination., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The wheat crop that fulfills 35% of human food demand is facing several problems due to a lack of transparency, security, reliability, and traceability in the existing agriculture supply chain. Many systems have been developed for the agriculture supply chain to overcome such issues, however, monopolistic centralized control is the biggest hurdle to realizing the use of such systems. It has eventually gained consumers' trust in branded products and rejected other products due to the lack of traceable supply chain information. This study proposes a blockchain-based framework for supply chain traceability which provides trustable, transparent, secure, and reliable services for the wheat crop. A crypto token called wheat coin (WC) has been introduced to keep track of transactions among the stakeholders of the wheat supply chain. Moreover, an initial coin offering (ICO) of WC, crypto wallets, and an economic model are proposed. Furthermore, a smart contract-based transaction system has been devised for the transparency of wheat crop transactions and conversion of WC to fiat and vice versa. We have developed the interplanetary file system (IPFS) to improve data availability, security, and transparency which stores encrypted private data of farmers, businesses, and merchants. Lastly, the results of the experiments show that the proposed framework shows better performance as compared to previous crop supply chain solutions in terms of latency to add-blocks, per-minute transactions, average gas charge for the transaction, and transaction verification time. Performance analysis with Bitcoin and Ethereum shows the superior performance of the proposed system., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Farooq et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

White blood cell (WBC) type classification is a task of significant importance for diagnosis using microscopic images of WBC, which develop immunity to fight against infections and foreign substances. WBCs consist of different types, and abnormalities in a type of WBC may potentially represent a disease such as leukemia. Existing studies are limited by low accuracy and overrated performance, often caused by model overfit due to an imbalanced dataset. Additionally, many studies consider a lower number of WBC types, and the accuracy is exaggerated. This study presents a hybrid feature set of selective features and synthetic minority oversampling technique-based resampling to mitigate the influence of the above-mentioned problems. Furthermore, machine learning models are adopted for being less computationally complex, requiring less data for training, and providing robust results. Experiments are performed using both machine- and deep learning models for performance comparison using the original dataset, augmented dataset, and oversampled dataset to analyze the performances of the models. The results suggest that a hybrid feature set of both texture and RGB features from microscopic images, selected using Chi2, produces a high accuracy of 0.97 with random forest. Performance appraisal using k-fold cross-validation and comparison with existing state-of-the-art studies shows that the proposed approach outperforms existing studies regarding the obtained accuracy and computational complexity.

Herbal medicine and nutritional supplements are suggested to treat premenstrual somatic and psycho-behavioural symptoms in clinical guidelines; nonetheless, this is at present based on poor-quality trial evidence. Hence, we aimed to design a systematic review and meta-analysis for their effectiveness in alleviating premenstrual symptoms. The published randomized controlled trials (RCTs) were extracted from Google scholar, PubMed, Scopus and PROSPERO databases. The risk of bias in randomized trials was assessed by Cochrane risk-of-bias tool . The main outcome parameters were analysed separately based on the Premenstrual Symptom Screening Tool and PMTS and DRSP scores. Secondary parameters of somatic, psychological, and behavioural subscale symptoms of PSST were also analysed. Data synthesis was performed assuming a random-effects model, and standardized mean difference (SMDs) was analysed using SPSS version 28.0.0 (IBM, Armonk, NY, USA). A total of 754 articles were screened, and 15 RCTs were included ( n = 1211 patients). Primary results for participants randomized to an intervention reported reduced PSST ( n = 9), PMTS ( n = 2), and DSR ( n = 4) scores with (SMD = -1.44; 95% CI: -1.72 to -1.17), (SMD = -1.69; 95% CI: -3.80 to 0.42) and (SMD = 2.86; 95% CI: 1.02 to 4.69) verses comparator with substantial heterogeneity. Physical (SMD = -1.61; 95% CI = -2.56 to -0.66), behavioural (SMD = -0.60; 95% CI = -1.55 to0.35) and mood (SMD = 0.57; 95% CI = -0.96 to 2.11) subscale symptom groupings of PSST displayed similar findings. Fifty-three studies ( n = 8) were considered at low risk of bias with high quality. Mild adverse events were reported by four RCTs. Based on the existing evidence, herbal medicine and nutritional supplements may be effective and safe for PMS., Competing Interests: The authors declare that there are no conflict of interest regarding the publication of this study.

Asthma is a deadly disease that affects the lungs and air supply of the human body. Coronavirus and its variants also affect the airways of the lungs. Asthma patients approach hospitals mostly in a critical condition and require emergency treatment, which creates a burden on health institutions during pandemics. The similar symptoms of asthma and coronavirus create confusion for health workers during patient handling and treatment of disease. The unavailability of patient history to physicians causes complications in proper diagnostics and treatments. Many asthma patient deaths have been reported especially during pandemics, which necessitates an efficient framework for asthma patients. In this article, we have proposed a blockchain consortium healthcare framework for asthma patients. The proposed framework helps in managing asthma healthcare units, coronavirus patient records and vaccination centers, insurance companies, and government agencies, which are connected through the secure blockchain network. The proposed framework increases data security and scalability as it stores encrypted patient data on the Interplanetary File System (IPFS) and keeps data hash values on the blockchain. The patient data are traceable and accessible to physicians and stakeholders, which helps in accurate diagnostics, timely treatment, and the management of patients. The smart contract ensures the execution of all business rules. The patient profile generation mechanism is also discussed. The experiment results revealed that the proposed framework has better transaction throughput, query delay, and security than existing solutions.

Building energy consumption prediction has become an important research problem within the context of sustainable homes and smart cities. Data-driven approaches have been regarded as the most suitable for integration into smart houses. With the wide deployment of IoT sensors, the data generated from these sensors can be used for modeling and forecasting energy consumption patterns. Existing studies lag in prediction accuracy and various attributes of buildings are not very well studied. This study follows a data-driven approach in this regard. The novelty of the paper lies in the fact that an ensemble model is proposed, which provides higher performance regarding cooling and heating load prediction. Moreover, the influence of different features on heating and cooling load is investigated. Experiments are performed by considering different features such as glazing area, orientation, height, relative compactness, roof area, surface area, and wall area. Results indicate that relative compactness, surface area, and wall area play a significant role in selecting the appropriate cooling and heating load for a building. The proposed model achieves 0.999 R2 for heating load prediction and 0.997 R2 for cooling load prediction, which is superior to existing state-of-the-art models. The precise prediction of heating and cooling load, can help engineers design energy-efficient buildings, especially in the context of future smart homes.

We sought to craft a drug safety signalling pipeline associating latent information in clinical free text with exposures to single drugs and drug pairs. Data arose from 12 secondary and tertiary public hospitals in two Danish regions, comprising approximately half the Danish population. Notes were operationalised with a fastText embedding, based on which we trained 10 270 neural-network models (one for each distinct single-drug/drug-pair exposure) predicting the risk of exposure given an embedding vector. We included 2 905 251 admissions between May 2008 and June 2016, with 13 740 564 distinct drug prescriptions; the median number of prescriptions was 5 (IQR: 3-9) and in 1 184 340 (41%) admissions patients used ≥5 drugs concomitantly. A total of 10 788 259 clinical notes were included, with 179 441 739 tokens retained after pruning. Of 345 single-drug signals reviewed, 28 (8.1%) represented possibly undescribed relationships; 186 (54%) signals were clinically meaningful. Sixteen (14%) of the 115 drug-pair signals were possible interactions, and two (1.7%) were known. In conclusion, we built a language-agnostic pipeline for mining associations between free-text information and medication exposure without manual curation, predicting not the likely outcome of a range of exposures but also the likely exposures for outcomes of interest. Our approach may help overcome limitations of text mining methods relying on curated data in English and can help leverage non-English free text for pharmacovigilance., (© 2022 The Authors. Basic & Clinical Pharmacology & Toxicology published by John Wiley & Sons Ltd on behalf of Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).)

Introduction: The chin is one of the most visible facial structures. Chin surgery, was initially described, for, the treatment of facial abnormalities, advancing the mandibular symphysis; achieved anterior displacement of the base of the tongue showing some value in the treatment of snoring and obstructive sleep apnea, and achieved adequate lip competence. We designed the Basal Extended Mentoplasty (BEM) based on the needs of patients orthodontically compensated, but dissatisfied with the appearance of his face as well as upper airway problems looking for a solution to this, design and planning the advances of the chin., Materials and Methods: Patients operated in the service of Maxillofacial Surgery, Specialist Hospital, "Dr. Bernardo Sepulveda "XXI Century National Medical Center, during the period of 2015-2019, orthodontically compensated patients, with labial incompetence and Class II skeletal. Sixty-five patients were operated during this period, and eight cases are presented., Results: Lip competition, osseointegration of the segments is observed, with a proper projection of the lower third, no nerve or vascular damage in the area., Conclusions: The design of the osteotomy is for orthodontically compensated patients with labial incompetence and Class II skeletal, giving a result mandibular lengthening. The BEM achieved adequate lip competence demonstrated by an interlabial gap of 0 mm, achieved adequate osseous consolidation of the fracture site with a more harmonious facial balance and profile, without nerve or vascular damage with spectacular results., Competing Interests: Conflict of interestThere are no conflict of interest from authors., (© The Association of Oral and Maxillofacial Surgeons of India 2020.)

Thyroid disease prediction has emerged as an important task recently. Despite existing approaches for its diagnosis, often the target is binary classification, the used datasets are small-sized and results are not validated either. Predominantly, existing approaches focus on model optimization and the feature engineering part is less investigated. To overcome these limitations, this study presents an approach that investigates feature engineering for machine learning and deep learning models. Forward feature selection, backward feature elimination, bidirectional feature elimination, and machine learning-based feature selection using extra tree classifiers are adopted. The proposed approach can predict Hashimoto's thyroiditis (primary hypothyroid), binding protein (increased binding protein), autoimmune thyroiditis (compensated hypothyroid), and non-thyroidal syndrome (NTIS) (concurrent non-thyroidal illness). Extensive experiments show that the extra tree classifier-based selected feature yields the best results with 0.99 accuracy and an F1 score when used with the random forest classifier. Results suggest that the machine learning models are a better choice for thyroid disease detection regarding the provided accuracy and the computational complexity. K-fold cross-validation and performance comparison with existing studies corroborate the superior performance of the proposed approach.

Background: Facial paralysis is one of the conditions that affect functionally, emotionally and aesthetically to patients greatly. Multiple techniques have been described for its treatment, and we consider that Labbé's technique is the one that most surprises with its results., Materials and Methods: In the Specialty Hospital "Dr. Bernardo Sepúlveda" National Medical Center Century XXI (CMN SXXI), Mexican Institute of Social Security (IMSS), three cases are presented: patients with facial paralysis due to trauma, surgical damage on the VII cranial nerve and conditions due to otological and idiopathic infections. Four modifications to the original Labbé technique are proposed to execute it more easily: trans-zygomatic oblique osteotomy, to reach directly the coronoid process; osteotomy of the descending coronoid; radiated suture fixation at 180° for temporary muscle replacement with positional replacement of the sutures trans-operatively; and the next day of the intervention with the patient awake, fixation of the orbicularis muscle of the lips, to the temporal tendon previously referenced. The modifications and results obtained are shown., Results: The modifications offer a better surgical technique and very favorable results., Conclusions: The modification to Labbé technique gives excellent results in the treatment of permanent facial paralysis, improving facial symmetry, salivary incontinence, facial tone, improving speech, giving the patient movement on the affected side and the ability to smile again., Competing Interests: Conflict of interestThere are no conflicts of interest from authors, (© The Association of Oral and Maxillofacial Surgeons of India 2020.)

Community-acquired pneumonia (CAP) represents a major health issue and ≈20% of the patients require in-hospital attention. The main objective of the study was to determine clinical-imaging features of CAP episodes requiring hospitalization. The secondary objectives were to determine the diagnostic yield of microbiological analyses and the medical complications. A retrospective analytical study was conducted on adults admitted due to CAP in a third-level hospital in the period 2017-2019. Pregnant women were excluded. A total of 340 CAP episodes were identified in 321 patients; the median age was 75 years old (interquartile range 57-85). The most frequent risk factors were immunocompromise 102 (30%), neurological disease 75 (22%), and chronic kidney disease 58 (17%). According to three prognostic scores, CURB65, qSOFA and PSI/PORT, 216 (63.5%), 290 (83.5%) and 130 (38%) patients were identified as low risk, respectively. A total of 49 (14.4%) episodes required admission at the critical care unit and 39 (11.5%) required mechanical ventilation; 30 patients (8.8%) died during hospitalization. The radiologic patterns most frequently found were consolidation in 134 (39.4%), interstitial-alveolar pattern in 98 (28.8%), and the combination of both patterns in 67 (19.7%) episodes. Identification of the causal agent was achieved in 79 (23.2%) episodes. The most frequently isolated microorganisms were influenza virus in 37 (10.9%) episodes and Streptococcus pneumoniae in 11 (3.2%). Most of the hospitalized CAP patients were elderly with consolidative radiological patterns. The causal agent could be identified in less than a quarter of the patients, with the influenza test being the method with the highest diagnostic yield.

Objective: Hodgkin and non-Hodgkin lymphoma patients are at high risk of experiencing anxiety because the clinical processes and therapies they undergo produce strong adverse effects. In this review we discuss the prevalence of anxiety among these patients and examine the methods used for data collection, intervention frequency, types of instruments used to recognize anxiety, and data collection purposes, both in Hodgkin and non-Hodgkin lymphoma survivors and patients being treated or diagnosed with these diseases., Methods: This systematic review and meta-analysis of the literature was carried out using the following sources: PubMed, Scopus, LILACS, and PsycINFO., Results: The meta-analysis sample was n = 2,138 and the overall prevalence of anxiety was 19% (95% CI [12%, 25%]). According to the Egger test, there were no publication biases and no studies were eliminated after the sensitivity analysis. The I2 for the heterogeneity analysis was 92.6%., Conclusions: Hodgkin and non-Hodgkin lymphoma patients are vulnerable to suffering anxiety. It is important to focus on the psychological effect of anxiety during remission or current cancer treatments because they can affect patient outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Diabetes is a diverse and complex disease, with considerable variation in phenotypic manifestation and severity. This variation hampers the study of etiological differences and reduces the statistical power of analyses of associations to genetics, treatment outcomes, and complications. We address these issues through deep, fine-grained phenotypic stratification of a diabetes cohort. Text mining the electronic health records of 14,017 patients, we matched two controlled vocabularies (ICD-10 and a custom vocabulary developed at the clinical center Steno Diabetes Center Copenhagen) to clinical narratives spanning a 19 year period. The two matched vocabularies comprise over 20,000 medical terms describing symptoms, other diagnoses, and lifestyle factors. The cohort is genetically homogeneous (Caucasian diabetes patients from Denmark) so the resulting stratification is not driven by ethnic differences, but rather by inherently dissimilar progression patterns and lifestyle related risk factors. Using unsupervised Markov clustering, we defined 71 clusters of at least 50 individuals within the diabetes spectrum. The clusters display both distinct and shared longitudinal glycemic dysregulation patterns, temporal co-occurrences of comorbidities, and associations to single nucleotide polymorphisms in or near genes relevant for diabetes comorbidities., Competing Interests: IK, CS, KB, PH, AH, PJ, LJ, CR, MP, RE, HA, TA, JB, NG, KB, OP, FP, TH, RB, PR, SB No competing interests declared, (© 2019, Kirk et al.)

Among tephritid fruit flies, hybridization has been found to produce local adaptation and speciation, and in the case of pest species, induce behavioral and ecological alterations that can adversely impact efficient pest management. The fraterculus species group within Anastrepha (Diptera: Tephritidae), is a rapidly radiating aggregate, which includes cryptic species complexes, numerous sister species, and several pest species. Molecular studies have highlighted the possibility of introgression between A. fraterculus and A. obliqua. Reproductive isolation has been studied among morphotypes of the A. fraterculus species complex as a tool for species delimitation. Here we examined the existence and strength of prezygotic and postzygotic isolation between sympatric populations of two closely related species within the highly derived fraterculus group (A. fraterculus and A. obliqua), coexisting in nature. Although adults of both species showed a strong tendency for assortative mating, a small proportion of hybrid pairings in both directions were observed. We also observed asymmetric postzygotic isolation, with one hybrid cross displaying a strong reduction in fecundity and F1 egg fertility. Survival was greater for the progeny of homotypic and hybrid crosses in the maternal host. There was a marked female biased sex ratio distortion for both F1 hybrid adults. Hybridization between A. fraterculus and A. obliqua in nature may be difficult but possible; these two species display stronger reproductive isolation than all pairs of species previously examined in the A. fraterculus species complex. Asymmetric postzygotic isolation is suggestive of Wolbachia mediated cytoplasmic incompatibilities that may be exploited in area-wide pest management., (© 2017 Institute of Zoology, Chinese Academy of Sciences.)

Summary: Based on the new concepts of the modified Le Fort III osteotomy (MLFIIIO), Three variations of this technique are implemented: (A) the modified osteotomy Le Fort III Champy (1980) technique to be described with the use of surgical guides, and subciliary approach or an transconjunctival approach. Excellent technique for horizontal advancement no further to 6 mm, without requiring any type of graft.. (B) The modified Le Fort III osteotomy in "Z": to solve horizontal (posterior anterior) problems of more than 6 mm without bone grafting. It is itself a modification of the technique described by Champy. (C) The modified Le Fort III osteotomy ascending: modified the original technique described by Bell and Epker with interpositional grafts, was modified by the called ascendant, making it higher in cases where the patient has an acceptable nasal bridge, but exorbitism the lateral wall of the orbit. Le Fort III osteotomy combined with a Le Fort I osteotomy and a front implant., Method: As pointed out in Part I for the modified oblique Le Fort III osteotomy, methods for the design of the osteotomy Le Fort III property will depend on the requirements of individual patients, and this has led us to design specific techniques for the deformity., Results: Patients have a right projection of the middle third, and protection of the eyeball., Conclusions: The techniques presented for the advancement of the middle third have excellent results with the ability to be tailored to each patient deformity., Competing Interests: Compliance with Ethical StandardsThere are no conflict of interest from authors.

Introduction: Each year around the world, various surgical procedures are carried out with the goal of correcting laterognathia; both the intraoral vertical ramus osteotomy (IVRO) and bilateral sagittal split ramus osteotomy (OSB) have been the most used techniques in mandibular surgery. These techniques have advantages and disadvantages; for example the advantages of the OSB include: increased coefficient of friction between bony segments, for both the forward and the retroposition, as well as decrease in the time of intermaxillary fixation (IMF). Disadvantages include injury to the inferior alveolar nerve (IAN), hemorrhage, bad split, among others. The advantages of IVRO include decrease of possibility of injury to the IAN, ease of implementation of the technique, a lower incidence of hemorrhage and the short duration of the surgical procedure. Their disadvantages include: lower coefficient of friction between bony segments, requires a relatively long period of IMF. The combination between the techniques of mandibular osteotomy for the correction of minor 10 mm laterognathia is the ideal treatment, since it avoids potential recurrence., Materials and Methods: We describe two cases of patients with laterognathia greater than 6 mm associated with maxilla deformity, which were treated with combined osteotomies. At Maxillofacial Surgery Service, Specialty Hospital, National Medical Center XXI Century, we describe the advantages and disadvantages, pre and postoperative nosocomial, by comparing them with the reports of the literature., Conclusion: The combination of techniques in the correction of laterognathias greater than 4 mm (smaller than 10 mm) is the ideal treatment, eliminating problems of articular compression, recurrence and damage to the alveolar nerve.

Introduction: The purpose of this study is to demonstrate the surgical technique for the correction of midfacial deformities; vertical excess and posteroanterior hypoplasia. This situation obligates the need to move the whole osseous structure in an oblique posteroanterior movement that should correct both midfacial deformities. This should also correct the lip incompetence while improving the malar projection on a profile view of the patient. We also present a mathematical formula that gives the angulation needed for moving the midface complex in a simultaneous vertical and posteroanterior direction. Once given the correct angulation for the desired oblique movement, the surgeon can reproduce this angulation with custom made surgical guides over the stereolithographic model, that can then be used during surgery to achieve the desired movement accurately. This technique exemplified on this paper will give maxillofacial surgeons a new and affordable tool for the correction of midfacial deformities in an accurate and easily reproducible manner and amplifying the surgical repertoire., Materials and Methods: Patients seen in the specialty hospital "Dr. Bernardo Sepulveda" National Medical Center XXI Century, IMSS, during the period from February 2013 to November 2014 with Modified Oblique Le Fort III osteotomies, with the application of two trigonometric formulas for the accuracy of the technique., Conclusions: The application of the formulas give accurate results as well as the enlargement of the upper airway and esthetic results.

Background: In 2009, Mexico reformed its health law to partially decriminalize drug possession considered for personal use and to increase mandatory referrals to certified drug rehabilitation centers in lieu of incarceration. Concurrently, news media reported violent attacks perpetrated by drug cartels against Mexican drug rehabilitation centers and instances of human rights violations by staff against people who inject drugs (PWID) in treatment. In many cases, these violent situations took place at "Peer Support" (Ayuda Mutua) drug rehabilitation centers that house a large number of drug-dependent PWID. In an effort to understand barriers to treatment uptake, we examined prevalence and correlates of perceived risk of violence at drug rehabilitation centers among PWID in Tijuana, Mexico., Methods: Secondary analysis of baseline data collected between March 2011 and May 2013 of PWID recruited into a prospective cohort study in Tijuana. Interviewer-administered surveys measured perceived risk of violence at drug rehabilitation centers by asking participants to indicate their level of agreement with the statement "going to rehabilitation puts me at risk of violence". Logistic regression was used to examine factors associated with perceived risk of violence., Results: Of 733 PWID, 34.5 % perceived risk of violence at drug rehabilitation centers. In multivariate analysis, reporting ever having used crystal methamphetamine and cocaine (separately), having a great or urgent need to get help for drug use, and ever receiving professional help for drug/alcohol use were negatively associated with perceived risk of violence at drug rehabilitation centers, while having been told by law enforcement that drug rehabilitation attendance is mandatory was positively associated with perceived risk of violence. All associations were significant at a 0.05 alpha level., Conclusion: The perception of violence at drug rehabilitation centers among PWID does not represent the lived experience of those PWID who attended professionalized services, reported a great or urgent need to get help for their drug use and had a history of using crystal and cocaine. Professionalizing service delivery and engaging law enforcement in their new role of decriminalization and service referral for PWID could address the perceptions of violence at drug rehabilitation centers. Similarly, health authorities should expand periodic inspections at drug rehabilitation centers to guarantee quality service provision and minimize PWIDs' concerns about violence.

Introduction: The temporomandibular joint (TMJ) is anatomically complex; with its close proximity to neurovascular structures, including the facial nerve that gives a high degree of difficulty during surgical exposure. When the first description on TMJ surgery by Orlow in 1913 was published it gave an account describing the basic retroauricular, preauricular, endoaural and submandibular approaches, on treatment of articular pathologies as used today. The proposed study of the 'Bat Wing' approach, first described in 1993 by Garcia y Sanchez J.M. as a surgical alternative, offers great advantages is that it avoids the section of the ear canal and provides a wide surgical field. The management of the proposed technique has wide application with multiple joints addressed, achieving major objectives such as avoiding facial nerve damage, as well as avoiding the section of the external auditory canal with an optimum visibility of the operative field., Material and Methods: The Department of Maxillofacial Surgery National Medical Center XXI Century records over a period of approximately 18 months have completed twenty TMJ surgeries using the 'Bat Wing', approach., Conclusions: The bat wing approach is a surgical alternative that offers broad exposure of the surgical field in TMJ, it is effective and meets the goal of exposing the area to intervene safely, good visibility and access to the site to intervene. It perfectly fulfills the above described.

Introduction: The present work consists of the specific design of a surgical guide for modified oblique Le fort III osteotomy (MOLFIIIO), developed previously in the Stereolithography model of the patient. The guides are designed to perform an osteotomy for the orbital floor, zygoma and pterygomaxillary fossa. The fundamental objective of the malar guides will be: symmetrical orbitozygomatic osteotomies bilaterally. Regarding the guide of the orbital floor, it is of primary importance to begin the osteotomy 5 mm ahead of the inferior orbital fissure (IOF) in orbital antero posterior direction, crossing the orbital floor. The pterygomaxillary fossa guide, will cover the internal face of the malar bone exactly in the posterior portion of the butres (hidden portion) toward the IOF. This guide will be useful, revolutionize and make it easier and secure to access the osteotomy of the area for a lot of surgeons who fear manipulating the pterigomaxillary fossa in its upper third, due to the fear of damaging the internal maxillary artery, that will be reduced to a minimum with the guides., Materials and Methods: Initially requires a CT scan, for designed the model patient stereolithography. The guides are prepared from self-curing acrylic and monomer., Conclusion: Surgical guides are very useful for MOLFIIIO, as being custom, manage to make a stable symmetrical bilateral cut, decreasing the possibility of injury to vascular structures and shorten the surgical time.

Objective: To estimate the prevalence of delayed- initiation (DI) of antiretroviral therapy (ART) for people with HIV attended at the Ministry of Health (SS, for its initials in Spanish) in Mexico, and to describe its behavior over time (2008-2013) and differences by gender and age., Materials and Methods: Descriptive and sectional study of people entering ART in the period 2008-2013 in the SS. The prevalence of DI ART (CD4+ <200 cells/ml) was estimated and differences according to sex and age were analyzed., Results: The DI ART prevalence was 49%, having decreased 10% in the period. In men was 4.8% and 24.5% in women (p<0.01). The 15 to 29 years group also showed a decrease., Conclusions: Despite the decrease in ART DI prevalence, it still remains high. It is necessary to generate comprehensive screening strategies with multisectoral participation.

The synthesis and properties of gemini surfactants of the type (R(1)(CO)-Lys(H)-NH)2(CH2)n are reported. For a spacer length of n = 6, the hydrophobic acyl tail was varied in length (R(1) = C8, C10, C12, C14, C16, and C18) and, for R(1) = C18, the degree of unsaturation. For R(1)(CO) = oleoyl (C18:1 Z) the spacer length (n = 2-8) and the stereochemistry of the lysine building block were varied; a 'half-gemini' derivative with a single oleoyl tail and head group was also prepared. The potential of the gemini surfactants to transfer polynucleotides across a cell membrane was investigated by transfection of HeLa cells with beta-galactosidase, both in the presence and absence of the helper lipid DOPE. Oleoyl was found to be by far the best hydrophobic tail for this biological activity, whereas the effect of the lysine stereochemistry was less pronounced. The effect of an optimum spacer length (n = 6) was observed only in the absence of helper lipid. The most active surfactant, i.e. the one with oleoyl chains and n = 6, formed liposomes with sizes in the range of 60-350 nm, and its lipoplex underwent a transition from a lamellar to a hexagonal morphology upon lowering the pH from 7 to 3.

The extrusion process allows the production of nixtamalized corn flour rich in arabinoxylans, which help to prevent cardiovascular and intestinal diseases. During extrusion, physiochemical properties of nixtamalized corn flour are negatively modified. The use of enzymes such as xylanase in order to obtain nixtamalized corn flour using extrusion has been studied as an alternative to reduce these changes in corn flour tortilla. The aim of this research was to evaluate changes in protein solubility of extruded nixtamalized corn flour with and without different concentrations of xylanase enzyme (0.05, 0.075, and 0.1%, w/w). Soluble proteins of each corn flour were extracted and analyzed by SE-HPLC, while insoluble proteins were determined by the combustion method. In addition, each corn flour was analyzed by scanning electron microscopy (SEM). Results showed that the extruded nixtamalized corn flour, with and without xylanase, increased the protein solubility, and this effect was lower in extruded nixtamalized corn flour with xylanase. Insoluble protein diminished in corn flours either with or without xylanase enzyme. The addition of xylanase reduces the effect that the extrusion process has on the solubility proteins of extruded nixtamalized corn flour.

All therian mammals (eutherians and marsupials) have an XX female/XY male sex chromosome system or some variant of it. The X and Y evolved from a homologous pair of autosomes over the 166 million years since therian mammals diverged from monotremes. Comparing the sex chromosomes of eutherians and marsupials defined an ancient X conserved region that is shared between species of these mammalian clades. However, the eutherian X (and the Y) was augmented by a recent addition (XAR) that is autosomal in marsupials. XAR is part of the X in primates, rodents, and artiodactyls (which belong to the eutherian clade Boreoeutheria), but it is uncertain whether XAR is part of the X chromosome in more distantly related eutherian mammals. Here we report on the gene content and order on the X of the elephant (Loxodonta africana)-a representative of Afrotheria, a basal endemic clade of African mammals-and compare these findings to those of other documented eutherian species. A total of 17 genes were mapped to the elephant X chromosome. Our results support the hypothesis that the eutherian X and Y chromosomes were augmented by the addition of autosomal material prior to eutherian radiation. Not only does the elephant X bear the same suite of genes as other eutherian X chromosomes, but gene order appears to have been maintained across 105 million years of evolution, perhaps reflecting strong constraints posed by the eutherian X inactivation system.

The superior surfactant properties of cationic gemini surfactants are applied to the complex problem of introducing genes into cells. Of almost 250 new compounds tested, of some 20 different structural types, a majority showed very good transfection activity in vitro. The surfactant is shown to bind and compact DNA efficiently, and structural studies and calculations provide a working picture of the "lipoplex" formed. The lipoplex can penetrate the outer membranes of many cell types, to appear in the cytoplasm encapsulated within endosomes. Escape from the endosome--a key step for transfection--may be controlled by changes in the aggregation behavior of the lipoplex as the pH falls. The evidence suggests that DNA may be released from the lipoplex before entry into the nucleus, where the new gene can be expressed with high efficiency.

The action of somatostatin (SS) on acid secretion and histamine release was studied in isolated gastric mucosa of toads mounted in Ussing chambers. SS inhibited H+ secretion and histamine release stimulated by cholinergic and gastrinergic secretagogues. Exogenous histamine stimulation of H+ secretion was blocked noncompetitively by SS in a dose-dependent manner. In mucosae maximally stimulated by histamine or forskolin and cimetidine, acetylcholine (ACh) and tetragastrin (TG) induced a direct stimulation of the oxyntopeptic cell not inhibited by SS. Indomethacin, an inhibitor of prostaglandin synthesis, did not prevent SS inhibition of histamine stimulation. Pretreatment with SS abolished forskolin stimulation of H+ secretion. SS induced a small inhibition of the stimulatory effect of N6, 2'-O-dibutyryladenosine 3',5'-cyclic monophosphate. These results suggest that SS inhibits acid secretion stimulated by secretagogues through different mechanisms: 1) inhibition of histamine release by ACh and TG, 2) inhibition of endogenous and exogenous histamine stimulation through a blockade of adenylate cyclase, and 3) an inhibitory effect subsequent to the synthesis of adenosine 3',5'-cyclic monophosphate. The direct activation of the oxyntopeptic cell by ACh and TG does not seem to be affected by somatostatin.