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1.
PeerJ ; 12: e17343, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38948212

RESUMEN

Tolerance against acute warming is an essential trait that can determine how organisms cope during heat waves, yet the mechanisms underlying it remain elusive. Water salinity has previously been suggested to modulate warming tolerance in fish and may therefore provide clues towards these limiting mechanisms. Here, using the critical thermal maximum (CTmax) test, we investigated whether short (2 hours) and long (10 days) term exposure to different water salinities (2 hours: 0-5 ppt, 10 days: 0-3 ppt) affected acute warming tolerance in zebrafish (N = 263). We found that water salinity did not affect the warming tolerance of zebrafish at either time point, indicating that salinity does not affect the mechanism limiting acute warming tolerance in zebrafish at these salinity ranges, and that natural fluctuations in salinity levels might not have a large impact on acute warming tolerance in wild zebrafish.


Asunto(s)
Salinidad , Pez Cebra , Pez Cebra/fisiología , Animales , Calor/efectos adversos , Termotolerancia , Agua/metabolismo
2.
Proc Natl Acad Sci U S A ; 119(22): e2201919119, 2022 05 31.
Artículo en Inglés | MEDLINE | ID: mdl-35617428

RESUMEN

Plasticity can allow organisms to maintain consistent performance across a wide range of environmental conditions. However, it remains largely unknown how costly plasticity is and whether a trade-off exists between plasticity and performance under optimal conditions. Biological rates generally increase with temperature, and to counter that effect, fish use physiological plasticity to adjust their biochemical and physiological functions. Zebrafish in the wild encounter large daily and seasonal temperature fluctuations, suggesting they should display high physiological plasticity. Conversely, laboratory zebrafish have been at optimal temperatures with low thermal fluctuations for over 150 generations. We treated this domestication as an evolution experiment and asked whether this has reduced the physiological plasticity of laboratory fish compared to their wild counterparts. We measured a diverse range of phenotypic traits, from gene expression through physiology to behavior, in wild and laboratory zebrafish acclimated to 15 temperatures from 10 °C to 38 °C. We show that adaptation to the laboratory environment has had major effects on all levels of biology. Laboratory fish show reduced plasticity and are thus less able to counter the direct effects of temperature on key traits like metabolic rates and thermal tolerance, and this difference is detectable down to gene expression level. Rapid selection for faster growth in stable laboratory environments appears to have carried with it a trade-off against physiological plasticity in captive zebrafish compared with their wild counterparts.


Asunto(s)
Temperatura Corporal , Termotolerancia , Pez Cebra , Animales , Fenotipo , Temperatura , Termotolerancia/genética , Termotolerancia/fisiología , Pez Cebra/genética , Pez Cebra/fisiología
3.
J Exp Biol ; 225(Suppl_1)2022 03 08.
Artículo en Inglés | MEDLINE | ID: mdl-35258604

RESUMEN

In a recent editorial, the Editors-in-Chief of Journal of Experimental Biology argued that consensus building, data sharing, and better integration across disciplines are needed to address the urgent scientific challenges posed by climate change. We agree and expand on the importance of cross-disciplinary integration and transparency to improve consensus building and advance climate change research in experimental biology. We investigated reproducible research practices in experimental biology through a review of open data and analysis code associated with empirical studies on three debated paradigms and for unrelated studies published in leading journals in comparative physiology and behavioural ecology over the last 10 years. Nineteen per cent of studies on the three paradigms had open data, and 3.2% had open code. Similarly, 12.1% of studies in the journals we examined had open data, and 3.1% had open code. Previous research indicates that only 50% of shared datasets are complete and re-usable, suggesting that fewer than 10% of studies in experimental biology have usable open data. Encouragingly, our results indicate that reproducible research practices are increasing over time, with data sharing rates in some journals reaching 75% in recent years. Rigorous empirical research in experimental biology is key to understanding the mechanisms by which climate change affects organisms, and ultimately promotes evidence-based conservation policy and practice. We argue that a greater adoption of open science practices, with a particular focus on FAIR (Findable, Accessible, Interoperable, Re-usable) data and code, represents a much-needed paradigm shift towards improved transparency, cross-disciplinary integration, and consensus building to maximize the contributions of experimental biologists in addressing the impacts of environmental change on living organisms.


Asunto(s)
Ecología , Difusión de la Información , Cambio Climático , Consenso
4.
J Neurooncol ; 156(1): 153-161, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34820776

RESUMEN

BACKGROUND: Hematological adverse events (HAEs) are common during treatment for glioblastoma (GBM), usually associated with temozolomide (TMZ). Their clinical value is uncertain, as few investigations have focused on outcomes for HAEs during GBM treatment. METHODS: We combined data from two randomized clinical trials, RTOG 0525 and RTOG 0825, to analyze HAEs during treatment for GBM. We investigated differences between chemoradiation and adjuvant therapy, and by regimen received during adjuvant treatment. RESULTS: 1454 patients participated in these trials, of which 1154 (79.4%) developed HAEs. During chemoradiation, 44.4% of patients developed HAEs (54% involving more than one cell line), and were most commonly lymphopenia (50.6%), and thrombocytopenia (47.5%). During adjuvant treatment, 45% of patients presented HAEs (78.6% involving more than one cell line), and were more commonly leukopenia (62.7%), and thrombocytopenia (62.3%). Median overall survival (OS) and progression free survival (PFS) were longer in patients with HAEs (OS 19.4 months and PFS 9.9 months) compared to those with other or no adverse events (OS 14.1 months and PFS 5.9 months). There was no significant difference in survival between grade 1 and/or 2 versus grade 3 and/or 4 HAEs. History of HAEs during chemoradiation was a protective factor for presentation of HAEs during adjuvant therapy. CONCLUSION: HAEs are common during GBM treatment, and often involve more than one cell line (more likely during adjuvant therapy). HAEs may be associated with prolonged OS and PFS, particularly during adjuvant therapy. HAEs during chemoradiation was a protective factor for HAEs during adjuvant therapy.


Asunto(s)
Neoplasias Encefálicas , Glioblastoma , Antineoplásicos Alquilantes/efectos adversos , Neoplasias Encefálicas/tratamiento farmacológico , Glioblastoma/tratamiento farmacológico , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Temozolomida/efectos adversos , Trombocitopenia/inducido químicamente
5.
J Exp Zool A Ecol Integr Physiol ; 335(9-10): 820-830, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-33773086

RESUMEN

We investigated the extent to which the facultative air-breathing fish, the striped catfish (Pangasianodon hypophthalmus), uses air-breathing to cope with aquatic hypercarbia, and how air-breathing is influenced by the experimental exposure protocol and level of hypercarbia. We exposed individuals to severe aquatic hypercarbia (up to Pw CO2 = 81 mmHg) using step-wise and progressive exposure protocols while measuring gill ventilation rate, heart rate, mean arterial blood pressure, and air-breathing frequency, as well as arterial blood pH and PCO2 . We confirm that P. hypophthalmus is tolerant of hypercarbia. Under both protocols gill ventilation rate, heart rate, and mean arterial blood pressure were maintained near control levels even at very high CO2 levels. We observed a marked amount of individual variation in the PwCO2 at which air-breathing was elicited, with some individuals not responding at all. The experimental protocol also influenced the onset of air-breathing. Air-breathing began at lower Pw CO2 in the step-wise protocol (23 ± 4.1 mmHg) compared with the progressive protocol (46 ± 7.8 mmHg). Air-breathing was often followed by aquatic surface respiration, at higher PCO2 (71 ± 5.2 mmHg) levels. On average, the blood PCO2 was approximately 43% lower (46 ± 2.5 mmHg) than water Pw CO2 (~81 mmHg) at our highest tested CO2 level. While this suggests that aerial CO2 elimination is an effective, and perhaps critical, respiratory strategy used by P. hypophthalmus to cope with severe hypercarbia, this observation may also be explained by a long lag time required for equilibration.


Asunto(s)
Bagres , Animales , Branquias , Frecuencia Cardíaca , Respiración
6.
Proc Natl Acad Sci U S A ; 117(52): 33365-33372, 2020 12 29.
Artículo en Inglés | MEDLINE | ID: mdl-33318195

RESUMEN

Climate change is increasing global temperatures and intensifying the frequency and severity of extreme heat waves. How organisms will cope with these changes depends on their inherent thermal tolerance, acclimation capacity, and ability for evolutionary adaptation. Yet, the potential for adaptation of upper thermal tolerance in vertebrates is largely unknown. We artificially selected offspring from wild-caught zebrafish (Danio rerio) to increase (Up-selected) or decrease (Down-selected) upper thermal tolerance over six generations. Selection to increase upper thermal tolerance was also performed on warm-acclimated fish to test whether plasticity in the form of inducible warm tolerance also evolved. Upper thermal tolerance responded to selection in the predicted directions. However, compared to the control lines, the response was stronger in the Down-selected than in the Up-selected lines in which evolution toward higher upper thermal tolerance was slow (0.04 ± 0.008 °C per generation). Furthermore, the scope for plasticity resulting from warm acclimation decreased in the Up-selected lines. These results suggest the existence of a hard limit in upper thermal tolerance. Considering the rate at which global temperatures are increasing, the observed rates of adaptation and the possible hard limit in upper thermal tolerance suggest a low potential for evolutionary rescue in tropical fish living at the edge of their thermal limits.


Asunto(s)
Evolución Biológica , Cambio Climático , Clima Tropical , Pez Cebra/fisiología , Aclimatación/fisiología , Animales , Temperatura
7.
J Exp Biol ; 223(Pt 23)2020 12 11.
Artículo en Inglés | MEDLINE | ID: mdl-33071218

RESUMEN

Global warming is predicted to increase both acute and prolonged thermal challenges for aquatic ectotherms. Severe short- and medium-term thermal stress over hours to days may cause mortality, while longer sub-lethal thermal challenges may cause performance declines. The inter-relationship between the responses to short, medium and longer thermal challenges is unresolved. We asked if the same individuals are tolerant to both rapid and slow warming challenges, a question that has so far received little attention. Additionally, we investigated the possibility of a thermal syndrome where individuals in a population are distributed along a warm-type to cold-type axis. We tested whether different thermal traits correlate across individuals by acclimating 200 juvenile zebrafish (Danio rerio) to sub- or supra-optimal temperatures for growth (22 and 34°C) for 40 days and measuring growth and thermal tolerance at two different warming rates. We found that tolerance to rapid warming correlated with tolerance to slow warming in the 22°C treatment. However, individual tolerance to neither rapid nor slow warming correlated with growth at the supra-optimal temperature. We thus find some support for a syndrome-like organisation of thermal traits, but the lack of connection between tolerance and growth performance indicates a restricted generality of a thermal syndrome. The results suggest that tolerance to rapid warming may share underlying physiological mechanisms with tolerance to slower heating, and indicate that the relevance of acute critical thermal tolerance extends beyond the rapid ramping rates used to measure them.


Asunto(s)
Calor , Pez Cebra , Aclimatación , Animales , Frío , Calentamiento Global , Temperatura
8.
Zebrafish ; 16(6): 546-553, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31670616

RESUMEN

Zebrafish is one of the world's most widely used laboratory species, and it is utilized to answer important research questions in disparate fields such as biomedicine, genetics, developmental biology, pharmacology, toxicology, physiology, and evolution. Despite their popularity, very little is known about the biology of zebrafish in their natural habitat. This may, in part, be due to the difficulties associated with undertaking field trips to the remote areas of northern India, Nepal, and Bangladesh, which is the natural distribution range of zebrafish. Here, we present a field report describing a recent trip where we, together with local collaborators, visited several rivers in West Bengal, India, to observe wild zebrafish and their habitat. We present an overview of our observations on the biology of wild zebrafish, and the great variability of the different environments where they were found. We also include data collected on water chemistry parameters at 12 zebrafish sites, and weight data and photos of fish from these sites. We present extensive underwater videos of wild zebrafish and photographs of the sites, including video footage of courtship behavior. We show that the breeding period of wild zebrafish can be extended from the previous record of April-August to April-October. In addition, we provide practical advice for future zebrafish expeditions to this rural and inaccessible area. The goals of this article are to shed some light on the ecology of wild zebrafish, and to facilitate scientists in their future research trips. We hope that by observing zebrafish in the wild, we can increase our understanding of the natural ecology of this important model organism.


Asunto(s)
Conducta Animal , Ecosistema , Rasgos de la Historia de Vida , Pez Cebra/fisiología , Animales , India
9.
J Exp Biol ; 222(Pt 19)2019 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-31527178

RESUMEN

Physiological mechanisms determining thermal limits in fishes are debated but remain elusive. It has been hypothesised that motor function loss, observed as loss of equilibrium during acute warming, is due to direct thermal effects on brain neuronal function. To test this, we mounted cooling plates on the heads of Atlantic cod (Gadus morhua) and quantified whether local brain cooling increased whole-organism acute upper thermal tolerance. Brain cooling reduced brain temperature by 2-6°C below ambient water temperature and increased thermal tolerance by 0.5 and 0.6°C on average relative to instrumented and uninstrumented controls, respectively, suggesting that direct thermal effects on brain neurons may contribute to setting upper thermal limits in fish. However, the improvement in thermal tolerance with brain cooling was small relative to the difference in brain temperature, demonstrating that other mechanisms (e.g. failure of spinal and peripheral neurons, or muscle) may also contribute to controlling acute thermal tolerance.


Asunto(s)
Aclimatación/fisiología , Encéfalo/fisiología , Frío , Gadus morhua/fisiología , Animales , Reproducibilidad de los Resultados
10.
Conserv Physiol ; 7(1): coz036, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31249690

RESUMEN

Model organisms can be useful for studying climate change impacts, but it is unclear whether domestication to laboratory conditions has altered their thermal tolerance and therefore how representative of wild populations they are. Zebrafish in the wild live in fluctuating thermal environments that potentially reach harmful temperatures. In the laboratory, zebrafish have gone through four decades of domestication and adaptation to stable optimal temperatures with few thermal extremes. If maintaining thermal tolerance is costly or if genetic traits promoting laboratory fitness at optimal temperature differ from genetic traits for high thermal tolerance, the thermal tolerance of laboratory zebrafish could be hypothesized to be lower than that of wild zebrafish. Furthermore, very little is known about the thermal environment of wild zebrafish and how close to their thermal limits they live. Here, we compared the acute upper thermal tolerance (critical thermal maxima; CTmax) of wild zebrafish measured on-site in West Bengal, India, to zebrafish at three laboratory acclimation/domestication levels: wild-caught, F1 generation wild-caught and domesticated laboratory AB-WT line. We found that in the wild, CTmax increased with increasing site temperature. Yet at the warmest site, zebrafish lived very close to their thermal limit, suggesting that they may currently encounter lethal temperatures. In the laboratory, acclimation temperature appeared to have a stronger effect on CTmax than it did in the wild. The fish in the wild also had a 0.85-1.01°C lower CTmax compared to all laboratory populations. This difference between laboratory-held and wild populations shows that environmental conditions can affect zebrafish's thermal tolerance. However, there was no difference in CTmax between the laboratory-held populations regardless of the domestication duration. This suggests that thermal tolerance is maintained during domestication and highlights that experiments using domesticated laboratory-reared model species can be appropriate for addressing certain questions on thermal tolerance and global warming impacts.

11.
Med Oncol ; 35(10): 136, 2018 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-30155806

RESUMEN

There are limited treatment modalities after high-grade gliomas recurrence. MGMT depletion modulated by dose-dense temozolomide (ddTMZ) remains a debated therapy for initial TMZ responders. Patients were selected retrospectively from our practice with diagnosis of high-grade gliomas (WHO grade III or IV), and were followed since the start of ddTMZ until death or change of therapy. Twenty-one patients were reviewed, with a median age of 47 (25-61) years and a median of 5.8 (1.5-38.8) cycles of ddTMZ. The majority were males (71.4%). Sixty-six percent received 21 on/28 off ddTMZ schedule, 28.6% daily, and 1 patient received a 7 days on/7 days off schedule. IDH mutation status was available for 18 (85.7%) patients, with 7 (33.3%) IDH mutant and 11 (52.5%) IDH wild type. MGMT methylation was assessed in 6 (28.6%) of the patients, being MGMT methylated in 3 (14.3%) patients, and non-methylated in 3 (14.3%) patients. The majority of patients (57.1%) were receiving ddTMZ in addition to other forms of therapy, including either bevacizumab (38.1%) or tumor-treating fields (TTFields) (19.1%). Overall ddTMZ was well tolerated, with few adverse events reported. The estimated median overall survival after ddTMZ start was 11 months. Median progression-free survival (PFS) was 6 months. Outcomes did not vary between patients receiving ddTMZ alone or those using TTFields or bevacizumab as concomitant therapy, but there was a trend to longer survival with the use of concomitant TTFields. Our results demonstrate benefit of ddTMZ after previous treatment with standard TMZ dosing with no apparent increase in treatment-related toxicities. In summary, ddTMZ should be considered in TMZ responsive patients and warrants further investigation.


Asunto(s)
Antineoplásicos Alquilantes/administración & dosificación , Neoplasias Encefálicas/tratamiento farmacológico , Glioma/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Temozolomida/administración & dosificación , Adulto , Neoplasias Encefálicas/diagnóstico , Relación Dosis-Respuesta a Droga , Femenino , Glioma/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor/métodos , Clasificación del Tumor/tendencias , Recurrencia Local de Neoplasia/diagnóstico , Estudios Retrospectivos , Tasa de Supervivencia/tendencias
12.
Sci Rep ; 8(1): 7099, 2018 05 08.
Artículo en Inglés | MEDLINE | ID: mdl-29740113

RESUMEN

Critical thermal maximum (CTmax) is a commonly and increasingly used measure of an animal's upper thermal tolerance limit. However, it is unknown how consistent CTmax is within an individual, and how physiologically taxing such experiments are. We addressed this by estimating the repeatability of CTmax in zebrafish, and measured how growth and survival were affected by multiple trials. The repeatability of CTmax over four trials was 0.22 (0.07-0.43). However, CTmax increased from the first to the second trial, likely because of thermal acclimation triggered by the heat shock. After this initial acclimation response individuals became more consistent in their CTmax, reflected in a higher repeatability measure of 0.45 (0.28-0.65) for trials 2-4. We found a high innate thermal tolerance led to a lower acclimation response, whereas a high acclimation response was present in individuals that displayed a low initial CTmax. This could indicate that different strategies for thermal tolerance (i.e. plasticity vs. high innate tolerance) can co-exist in a population. Additionally, repeated CTmax trials had no effect on growth, and survival was high (99%). This validates the method and, combined with the relatively high repeatability, highlights the relevance of CTmax for continued use as a metric for acute thermal tolerance.


Asunto(s)
Aclimatación/genética , Respuesta al Choque Térmico/genética , Larva/crecimiento & desarrollo , Pez Cebra/crecimiento & desarrollo , Aclimatación/fisiología , Animales , Cambio Climático , Respuesta al Choque Térmico/fisiología , Calor , Larva/genética , Tomografía Computarizada por Rayos X , Pez Cebra/genética
13.
Cancer Chemother Pharmacol ; 81(5): 965-968, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29610932

RESUMEN

EML4-ALK alterations are more common in adenocarcinomas and are rarely found in squamous cell histology. In documented cases, the majority of EML4-ALK translocations are identified in squamous cell histology and occur in patients with no or light smoking history. We report an EML4-ALK4 translocation in a 50-year-old patient with squamous cell carcinoma and an 18 pack-year smoking history. The patient had a near complete response in the CNS to alectinib treatment. Our observation suggests that EML4-ALK genomic testing may be clinically useful in patients with heavy smoking history.


Asunto(s)
Carcinoma de Células Escamosas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Proteínas de Fusión Oncogénica/genética , Carbazoles/farmacología , Carbazoles/uso terapéutico , Carcinoma de Células Escamosas/etiología , Carcinoma de Células Escamosas/genética , Crizotinib/farmacología , Crizotinib/uso terapéutico , Pruebas Genéticas , Humanos , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/genética , Masculino , Persona de Mediana Edad , Proteínas de Fusión Oncogénica/antagonistas & inhibidores , Selección de Paciente , Piperidinas/farmacología , Piperidinas/uso terapéutico , Fumar/efectos adversos , Resultado del Tratamiento
16.
FEMS Microbiol Ecol ; 60(1): 85-97, 2007 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-17381526

RESUMEN

The identity of the numerically dominant N(2)-fixing bacteria in biological soil crusts of the Colorado Plateau region and two outlying areas was determined using multiple approaches, to link the environmental diversity of nifH gene sequences to cultured bacterial isolates from the regions. Of the nifH sequence-types detected in soil crusts of the Colorado Plateau, 89% (421/473) were most closely related to nifH signature sequences from cyanobacteria of the order Nostocales. N(2)-fixing cyanobacterial strains were cultured from crusts and their morphotypes, 16S rRNA gene and nifH gene sequences were characterized. The numerically dominant diazotrophs in the Colorado Plateau crusts fell within three clades of heterocystous cyanobacteria. Two clades are well-represented by phylogenetically and morphologically coherent strains, corresponding to the descriptions of Nostoc commune and Scytonema hyalinum, which are widely recognized as important N(2)-fixing components of soil crusts. A third, previously-overlooked clade was represented by a phylogenetically coherent but morphologically diverse group of strains that encompass the morphogenera Tolypothrix and Spirirestis. Many of the strains in each of these groups contained at least two nifH copies that represent different clusters in the nifH environmental survey.


Asunto(s)
Cianobacterias/clasificación , Cianobacterias/genética , Ecosistema , Fijación del Nitrógeno , Microbiología del Suelo , Colorado , Cianobacterias/metabolismo , ADN Bacteriano/análisis , ADN Bacteriano/aislamiento & purificación , Genes de ARNr , Datos de Secuencia Molecular , Nostoc/clasificación , Nostoc/genética , Nostoc/metabolismo , Oxidorreductasas/genética , Filogenia , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN
17.
J Pain Symptom Manage ; 32(3): 245-54, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16939849

RESUMEN

The aim of this study was to evaluate whether diagnostic criteria for cancer-related fatigue syndrome (CRFS) could be rigorously applied to cancer inpatients, and to explore the relationship between subjective fatigue and objective measures of physical activity, sleep, and circadian rhythm. Female cancer patients (n=25) and a comparison group of subjects without cancer (n=25) were studied. Study participants completed a structured interview for CRFS and questionnaires relating to fatigue, psychological symptoms, and quality of life (QoL). Wrist actigraphs worn for 72 hours were used as an objective measure of activity, sleep, and circadian rhythm. Compared to controls, cancer patients were more fatigued, had worse sleep quality, more disrupted circadian rhythms, lower daytime activity levels, and worse QoL. After exclusion of subjects with "probable" mood disorders, the prevalence of CRFS was 56%. Fatigue severity among the cancer patients was significantly correlated with low QoL, depression, constipation, and decreased self-reported physical functioning. It can be concluded that the diagnostic criteria for CRFS can be applied to cancer inpatients but strict application requires a rigorous assessment of psychiatric comorbidity. Despite cancer inpatients having greater impairments of sleep and circadian rhythm, it was found that fatigue severity did not appear to be related to these impairments.


Asunto(s)
Trastornos Cronobiológicos/complicaciones , Fatiga/complicaciones , Fatiga/diagnóstico , Neoplasias/diagnóstico , Trastornos del Sueño-Vigilia/complicaciones , Anciano , Anciano de 80 o más Años , Trastornos Cronobiológicos/diagnóstico , Trastornos Cronobiológicos/fisiopatología , Fatiga/fisiopatología , Femenino , Humanos , Pacientes Internos , Persona de Mediana Edad , Neoplasias/complicaciones , Neoplasias/fisiopatología , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/fisiopatología , Estadística como Asunto
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