Humoral immune transcriptome signature in myelomeningocele patients.

INTRODUCTION: Myelomeningocele (MMC) results from incomplete closure of the neural tube, and has a complex multifactorial etiology, including an inflammatory microenvironment. OBJECTIVE: We evaluated the contribution of humoral immune response for development of inflammatory milieu. METHODS: Using public repository Gene Expression Omnibus (GEO), we retrieve dataset transcriptome from the amniotic fluid of ten fetuses with myelomeningocele and ten healthy control fetuses to found differential gene expression associated with disturbances and inflammatory signatures in MMC. The identified DEGs were submitted to enrichment, network, and matrix correlation analyses. RESULTS: Our initial analysis revealed 90 DEGs in MMC, mainly associated with signaling pathways of inflammation, including the immune modules, humoral immune response and IFN-type I signatures. Protein-protein analysis (PPI) revealed an association with three protein networks; positive regulation of B cell proliferation constituted the largest network. Matrix correlation analyses showed that MMC alters the co-expression of genes related to inflammatory processes that promote microenvironment inflammation. CONCLUSION: These results revealed an altered humoral immune response in MMC patients, contributing to an inflammatory profile and providing opportunities for identifying potential biomarkers in myelomeningocele disease.

Precisión diagnóstica de una versión abreviada de las pruebas de patrones de frecuencia y patrones de duración para la evaluación del ordenamiento auditivo temporal / Diagnostic accuracy of an abbreviated version of the frequency pattern and duration pattern tests for the evaluation of auditory temporal ordering

Introducción: Las pruebas de patrones de frecuencia y patrones de duración son consideradas los gold standard de evaluación del ordenamiento auditivo temporal. A pesar de su amplia difusión, la extensión y duración de estas pruebas dificultan su utilización dentro de baterías de evaluación del procesamiento auditivo. Sin embargo, dadas sus características estructurales, pareciera ser posible reducirlas sin perder su precisión diagnóstica. Objetivo: Determinar las propiedades diagnósticas de versiones abreviadas de las pruebas de patrones de frecuencia y patrones de duración. Material y Método: Se realizó un estudio transversal de diseño observacional analítico. Se evaluaron 166 oídos de 88 sujetos con edades entre 18 y 33 años, los cuales fueron clasificados con normalidad o alteración del ordenamiento auditivo temporal. Se utilizaron las pruebas originales de Auditec de 30 ítems por oído como referencia y los primeros 10 ítems de cada oído como versión abreviada. Resultados: La versión abreviada de la prueba de patrones de frecuencia obtuvo una sensibilidad de un 94,33%, una especificidad del 94,29% y un área bajo la curva ROC de 0,980. La versión abreviada de la prueba de patrones de duración obtuvo una sensibilidad de un 89,58%, especificidad del 71,88% y un área bajo la curva ROC de 0,916. Ambas versiones tuvieron un índice de concordancia adecuado. Conclusiones: Las versiones abreviadas de la prueba de patrones de frecuencia y patrones de duración cuentan con excelentes propiedades diagnósticas para la evaluación del ordenamiento auditivo temporal y pueden ser utilizadas de manera intercambiable con las versiones originales.

Introduction: The frequency and duration pattern tests are considered the gold standard for assessing auditory temporal ordering. Despite their wide dissemination, the length and duration of these tests make it difficult to use them within auditory processing assessment batteries. However, given their structural characteristics, reducing them without losing their diagnostic accuracy seems possible. Aim: Determine the diagnostic properties of abbreviated versions of the Frequency Patterns and Duration Patterns tests. Material and Method: A cross-sectional study with an analytical observational design was carried out. 166 ears of 88 subjects aged between 18 and 33 years were evaluated, classified as normal or altered in temporal auditory order. The original Auditec tests of 30 items per ear were used as a reference, and the first 10 items of each ear as an abbreviated version. Results: The abbreviated version of the frequency patterns test obtained a sensitivity of 94.33%, a specificity of 94.29%, and an area under the ROC curve of 0.980. The abbreviated version of the duration pattern test obtained a sensitivity of 89.58%, a specificity of 71.88%, and an area under the ROC curve of 0.916. Both versions had an adequate concordance index. Conclusion: The abbreviated versions of the frequency patterns and duration patterns test have excellent diagnostic properties for assessing auditory temporal ordering and can be used interchangeably with the original versions.

Valores normativos de pruebas conductuales de procesamiento auditivo para niños chilenos entre 7 y 12 años: una propuesta inicial / Normative values of auditory processing behavioral tests for chilean children between 7 and 12 years old: an initial proposal

Resumen Introducción: El trastorno del procesamiento auditivo en niños está relacionado con trastornos de lenguaje, bajo rendimiento académico, trastornos de aprendizaje y dificultades psicosociales. Existe consenso internacional sobre la utilidad de las pruebas conductuales para su evaluación y diagnóstico. Objetivo: Establecer valores normativos para pruebas conductuales de procesamiento auditivo en población pediátrica chilena con neurodesarrollo y audición normal. Material y Método: Se realizó un estudio observacional de corte transversal. Participaron 153 sujetos entre 7 y 12 años de la Región Metropolitana. Se estudiaron las pruebas de patrones de frecuencia, habla filtrada y dígitos dicóticos. Se construyeron modelos de regresión fraccional para estimar los valores normativos y además se calcularon los puntajes de corte en los percentiles 2.5, 5 y 10. Resultados: No se evidenciaron diferencias significativas entre oídos para las pruebas estudiadas a excepción de la prueba de dígitos dicóticos. Se construyeron modelos únicos para las pruebas patrones de frecuencia y habla filtrada, y modelos independientes para cada oído para la prueba dígitos dicóticos. Todas las estimaciones resultaron significativas y tuvieron niveles aceptables de precisión. Conclusión: Se obtuvieron los valores normativos y puntajes de corte para las tres pruebas estudiadas. Los valores obtenidos fueron similares a los reportados en otras poblaciones considerando los efectos de oído, de edad, sexo y escolaridad.

Abstract Introduction: Auditory processing disorder in children is related to language disorders, poor academic performance, learning disorders, and psychosocial difficulties. There is international consensus on the usefulness of behavioral tests for their evaluation and diagnosis. Aim: To establish normative values for auditory processing behavioral tests in Chilean pediatric population with normal neurodevelopment and hearing thresholds. Material and Method: An observational cross-sectional study was carried out. One hundred fifty-three subjects between 7 and 12 years old from the Metropolitan Region participated. Frequency pattern tests, filtered speech, and dichotic digits were studied. Fractional regression models were built to estimate the normative values, and cut-off scores were also calculated at the 2.5, 5, and 10 percentiles. Results: There were no significant differences between ears for the tests studied except for the dichotic digits test. Single models were built for the frequency and filtered speech patterns tests and independent models for each ear for the dichotic digit test. All estimates were significant and had acceptable levels of precision. Conclusion: The normative values and cut-off scores were obtained for the three tests studied. The values obtained were similar to those reported in other populations considering the effects of ear, age, sex, and education.

Retiro de elementos de osteosíntesis en trauma maxilofacial / Osteosynthesis elements removal in maxillofacial trauma

Resumen Objetivo: Analizar la prevalencia y los factores en la remoción de elementos de osteosíntesis (OTS) de pacientes tratados quirúrgicamente debido a fracturas maxilofaciales. Materiales y Método: Estudio retrospectivo descriptivo, donde fueron incluidos todos los pacientes con diagnóstico de fractura maxilofacial y tratados mediante reducción abierta y fijación interna rígida en un intervalo de 10 años, en el Servicio de Cirugía Oral y Maxilofacial en el Hospital Clínico Mutual de Seguridad (HCMS). Resultados: En un total de 807 pacientes intervenidos, con un rango etario entre 22-66 años, fueron utilizados 2.421 OTS. Entre ellos, 58 pacientes (7,2%) fueron sometidos a un segundo procedimiento quirúrgico, retirándose un total de 129 OTS (5,3%). La principal causa de retiro fue infección (41,1%), comúnmente de carácter tardío. El tercio inferior facial fue el más afectado, específicamente, la zona parasinfisiaria. El 39% fue retirado antes de los 12 meses de posicionados. Conclusiones: El retiro de OTS, posterior a trauma maxilofacial tiene una baja prevalencia. El sitio más afectado es el hueso mandibular y la mayoría se retira dentro de los primeros 12-24 meses. La etiología es variable, sin embargo, la infección se mantiene como una de las principales. Los hallazgos sugieren que no sería recomendable realizar este procedimiento de forma universal para todos los pacientes.

Aim: To analyse the prevalence and factors regarding to osteosynthesis elements (OTS) removal from patients surgically treated due to maxillofacial fractures. Materials and Method: Retrospective study in which all patients with diagnosis of maxillofacial fractures and treated with open reduction and internal rigid fixation were included, in an interval of 10 years, in the Maxillofacial Surgery Service of HCMS. Results: In 807 surgically treated patients, with an age between 22-66 years, 2.421 OTS were used. Among them, 58 patients (7.2%) underwent a second surgical procedure, with a total of 129 OTS removed (5.3%). The main cause of removal was infection (41.1%), commonly of a chronic nature. The lower third of the face was the most affected, specifically, the parasymphysis region. 39% of OTS were withdrawn before 12 months. Conclusions: OTS removal after maxillofacial trauma has a low prevalence, the most affected site is the mandibular bone, within the first 12-24 months. The aetiology is variable, however, infection remains one of the main. The findings suggest that it would not be advisable to perform this procedure universally for all patients.

Air pollution and health prevention: A document of reflection.

Ambient air quality, pollution and its implication on health is a topic of enormous importance that is normally dealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For this reason, the Health Sciences Foundation, from its prevention area, has formulated a series of questions to people with very varied competences in the area of ambient air quality in order to obtain a global panorama of the problem and its elements of measurement and control. The answers have been produced by specialists in each subject and have been subjected to a general discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks: external ambient air, internal ambient air, mainly in the workplace, and hospital ambient air and the consequences of its poor control. Along with the definitions of each area and the indicators of good and bad quality, some necessary solutions have been pointed out. We have tried to know the current legislation on this problem and the competences of the different administrations on it. Despite its enormous importance, ambient air quality and health is not usually a topic of frequent presence in the general media and we have asked about the causes of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in the light of the events that the present pandemic raises. This work aims to provide objective data and opinions that will enable non-specialists in the field to gain a better understanding of this worrying reality.

α-Glucosidase inhibitory phenolics from Echeveria subrigida (B. L. Rob & Seaton) leaves.

Echeveria subrigida is native to Mexico and its methanol extract (ME) shows relevant biological activities for human health, including the α-glucosidase inhibitory (αGI) activity that suggests its antidiabetic potential. Fractionation of the ME based on the αGI activity (IC50 in µg/mL) showed that quercetin-3-O-ß-glucoside (131.1), isorhamnetin-3-O-ß-glucoside (166.4), and dimers to heptamers proanthocyanidins (9.6) were among the main responsible of αGI activity in the ME. The purified compounds showed better activity than acarbose (IC50 = 4426 µg/mL).

Comment on: What is the radiation before 5G? A correlation study between measurements in situ and in real time and epidemiological indicators in Vallecas, Madrid, by I. López, N. Félix, M. Rivera, A. Alonso, and C. Maestú.

We have read the article recently published by Lopez et al., 2020 (Lopez et al., 2021). This study aimed to find a possible relationship, if any, between exposure to RF-EMF with some health indicators such as sleep, headache, and fatigue collected through surveys, using maximum electromagnetic radiation peak-to-peak measurements. And after a detailed analysis of the study, we want to make some comments on said publication to clarify some aspects.

Sustainable tourism policies in Peru and their link with renewable energy: analysis in the main museums of the Moche route.

Tourism activity in Peru has been experiencing significant growth in the last ten years, positioning this economic sector as the third largest contributor to the National Gross Domestic Product (GDP). Likewise, Peru has a high ecological and climate diversity, which makes it the possessor of renewable energy potential, specifically solar and wind power. The rapid growth of tourism is leading to generating prospects for becoming a sustainable destination. In this sense, it is important to understand and evaluate the Peruvian legislative framework for sustainable tourism and the current state of the implementation of the scenarios provided by the governmental entity in terms of sustainability, and its link with tourism activity. Based on what has been described, this study is aimed at evaluating the four most relevant museums in the northern part of Peru; in addition, it contributes to the studies that exist at the intersection of tourism and sustainability in the chains of activities related to tourism and calls for rationality applied to tourism management in this region of Latin America. The results of the literature review of the Peruvian legal framework reveal a lack of specific laws and regulations on sustainable tourism; on the contrary, there are policies in force that contribute to promoting the development of sustainable tourism. The quantified evaluation of the solar and wind potentials of the geographical area under study indicates the minimum renewable energy potential necessary for its transformation and use in the development of sustainable museums and its contribution to sustainable tourism.

Clinical Factors Associated with High Glycemic Variability Defined by Coefficient of Variation in Patients with Type 2 Diabetes.

BACKGROUND: High glycemic Variability (HGV) has become a stronger predictor of hypoglycemia. However, clinical factors associate with HGV still are unknown. OBJECTIVE: To determine clinical variables that were associated with a coefficient of variation (CV) above 36% evaluated by continuous glucose monitoring (CGM) in a group of patients with diabetes mellitus. METHODS: A cohort of patients with type 2 diabetes (T2D) was evaluated. Demographic variables, HbA1c, glomerular filtration rate (GFR) and treatment regimen were assessed. A bivariate analysis was performed, to evaluate the association between the outcome variable (CV> 36%) and each of the independent variables. A multivariate model was constructed to evaluate associations after controlling for confounding variables. RESULTS: CGM data from 274 patients were analyzed. CV> 36% was present in 56 patients (20.4%). In the bivariate analysis, demographic and clinical variables were included, such as time since diagnosis, hypoglycemia history, A1c, GFR and treatment established. In the multivariate analysis, GFR <45 mL/min (OR 2.81; CI 1.27,6.23; p:0.01), A1c > 9% (OR 2.81; CI 1.05,7.51; p:0.04) and hypoglycemia history (OR 2.09; CI 1.02,4.32; p:0.04) were associated with HGV. Treatment with iDPP4 (OR 0.39; CI 0.19,0.82; p:0.01) and AGLP1 (OR 0.08; CI 0.01,0.68; p:0.02) was inversely associated with GV. CONCLUSION: Clinical variables such as GFR <45 mL/min, HbA1C>9% and a history of hypoglycemia are associated with a high GV. Our data suggest that the use of technology and treatments able to reduce glycemic variability could be useful in this population to reduce the risk of hypoglycemia and to improve glycemic control.

Geographic range estimates and environmental requirements for the harpy eagle derived from spatial models of current and past distribution.

Understanding species-environment relationships is key to defining the spatial structure of species distributions and develop effective conservation plans. However, for many species, this baseline information does not exist. With reliable presence data, spatial models that predict geographic ranges and identify environmental processes regulating distribution are a cost-effective and rapid method to achieve this. Yet these spatial models are lacking for many rare and threatened species, particularly in tropical regions. The harpy eagle (Harpia harpyja) is a Neotropical forest raptor of conservation concern with a continental distribution across lowland tropical forests in Central and South America. Currently, the harpy eagle faces threats from habitat loss and persecution and is categorized as Near-Threatened by the International Union for the Conservation of Nature (IUCN). Within a point process modeling (PPM) framework, we use presence-only occurrences with climatic and topographical predictors to estimate current and past distributions and define environmental requirements using Ecological Niche Factor Analysis. The current PPM prediction had high calibration accuracy (Continuous Boyce Index = 0.838) and was robust to null expectations (pROC ratio = 1.407). Three predictors contributed 96% to the PPM prediction, with Climatic Moisture Index the most important (72.1%), followed by minimum temperature of the warmest month (15.6%) and Terrain Roughness Index (8.3%). Assessing distribution in environmental space confirmed the same predictors explaining distribution, along with precipitation in the wettest month. Our reclassified binary model estimated a current range size 11% smaller than the current IUCN range polygon. Paleoclimatic projections combined with the current model predicted stable climatic refugia in the central Amazon, Guyana, eastern Colombia, and Panama. We propose a data-driven geographic range to complement the current IUCN range estimate and that despite its continental distribution, this tropical forest raptor is highly specialized to specific environmental requirements.

Intra-Annual Variation of Eddy Diffusion (k zz ) in the MLT, From SABER and SCIAMACHY Atomic Oxygen Climatologies.

Atomic oxygen (O) in the mesosphere and lower thermosphere (MLT) results from a balance between production via photo-dissociation in the lower thermosphere and chemical loss by recombination in the upper mesosphere. The transport of O downward from the lower thermosphere into the mesosphere is preferentially driven by the eddy diffusion process that results from dissipating gravity waves and instabilities. The motivation here is to probe the intra-annual variability of the eddy diffusion coefficient (k zz ) and eddy velocity in the MLT based on the climatology of the region, initially accomplished by Garcia and Solomon (1985, https://doi.org/10.1029/JD090iD02p03850). In the current study, the intra-annual cycle was divided into 26 two-week periods for each of three zones: the northern hemisphere (NH), southern hemisphere (SH), and equatorial (EQ). Both 16 years of SABER (2002-2018) and 10 years of SCIAMACHY (2002-2012) O density measurements, along with NRLMSIS® 2.0 were used for calculation of atomic oxygen eddy diffusion velocities and fluxes. Our prominent findings include a dominant annual oscillation below 87 km in the NH and SH zones, with a factor of 3-4 variation between winter and summer at 83 km, and a dominant semiannual oscillation at all altitudes in the EQ zone. The measured global average k zz at 96 km lacks the intra-annual variability of upper atmosphere density data deduced by Qian et al. (2009, https://doi.org/10.1029/2008JA013643). The very large seasonal (and hemispherical) variations in k zz and O densities are important to separate and isolate in satellite analysis and to incorporate in MLT models.

Chronic obstructive pulmonary disease (COPD) in Spain and the different aspects of its social impact: a multidisciplinary opinion document.

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent diseases in the World, and one of the most important causes of mortality and morbidity. In adults 40 years and older, it affects more than 10% of the population and has enormous personal, family and social burden. Tobacco smoking is its main cause, but not the only one, and there is probably a genetic predisposition that increases the risk in some patients. The paradigm of this disease is changing in Spain, with an increase of women that has occurred in recent years. Many of the physio pathological mechanisms of this condition are well known, but the psychological alterations to which it leads, the impact of COPD on relatives and caregivers, the limitation of daily life observed in these patients, and the economic and societal burden that they represent for the health system, are not so well-known. A major problem is the high under-diagnosis, mainly due to difficulties for obtaining, in a systematic way, spirometries in hospitals and health-care centers. For this reason, the Fundación de Ciencias de la Salud and the Spanish National Network Center for Research in Respiratory Diseases (CIBERES) have brought together experts in COPD, patients and their organizations, clinical psychologists, experts in health economics, nurses and journalists to obtain their opinion about COPD in Spain. They also discussed the scientific bibliometrics on COPD that is being carried out from the CIBERES and speculated on the future of this condition. The format of the meeting consisted in the discussion of a series of questions that were addressed by different speakers and discussed until a consensus conclusion was reached.

Estudio morfométrico del punto asterional y su relación con los senos venosos durales / Morphometric study of the asterional point and its relationship with the dural venous sinuses

INTRODUCCIÓN: la importancia de conocer las diferentes reparaciones anatómicas que involucran la parte ósea de la fosa posterior con estructuras neurovasculares, disminuye la incidencia de complicaciones relacionadas con su acceso dentro del procedimiento neuroquirúrgico. MATERIALES Y MÉTODOS: estudio descriptivo basado en la evaluación de 90 hemicráneas secas, del Museo de Anatomía de la Universidad Mayor de San Andrés. RESULTADOS: la prevalencia de asterión tipo I fue de 28.9%, mientras que la de tipo II fue de 71.1%. La prevalencia del número de venas emisarias fue: una vena 54.4%, dos venas 42.2% y tres venas 3.3%. Los promedios para las características morfométricas son los siguientes: de Asterion a protuberancia occipital externa de 68.8 mm, de Asterion a cresta suprameatal de 50.1 mm, de Asterion a vena emisaria de 54.1 mm, de Asterion a Vértice del proceso mastoideo de 54.1 mm y de asterion a plano horizontal de Francfort 14.6 mm. La ubicación del asterión en el seno transverso fue la siguiente: al mismo nivel del seno, 47.8% de los casos, en el codo en 13.3%, superior al seno 31.1% e inferior a este en el 7.8%. CONCLUSIONES: hay una diferencia en algunos resultados morfométricos del asterión con respecto a otros autores, lo que podría determinar una configuración craneal diferente para nuestra población. Esto debe considerarse para evitar complicaciones durante el período transoperatorio en una cirugía de fosa posterior. Estos resultados reflejan la necesidad de realizar un estudio con una población más grande para obtener resultados reales, estableciendo así parámetros de corte que nos permitirán tener nuestra propia bibliografía sobre cómo proceder en nuestra actividad quirúrgica.

INTRODUCTION: the importance of knowing the different anatomical repairs that involve the bony part of the posterior fossa with neurovascular structures, decreases the incidence of complications related to its access within the neurosurgical procedure. MATERIALS AND METHODS: descriptive study based on the evaluation of 90 dry hemicranial, from the Anatomy Museum of the Universidad Mayor de San Andrés. RESULTS: the prevalence of asterion type I was 28.9%, while that of type II was 71.1%. The prevalence of the number of emissary veins was: One vein 54.4%, Two veins 42.2% and Three veins 3.3%. The averages for morphometric characteristics are as follows: from Asterion to external occipital protuberance 68.8 mm, from Asterion to suprameatal crest 50.1 mm, from Asterion to emissary vein 54.1 mm, from Asterion to Vertex from the mastoid process 54.1 mm and from asterion to horizontal plane of Frankfurt 14.6 mm. The location of asterion in the transverse sinus was the following: at the same level of the sinus 47.8% of the cases, in the elbow in 13.3%, superior to the sinus 31.1% and inferior to this in the 7.8%. CONCLUSIONS: there is a difference in some morphometric results of the asterion with respect to other authors, which could determine a different cranial configuration for our population. This should be considered to avoid complications during the transoperative period in a posterior fossa surgery. These results reflect the need to carry out a study with a larger population, in order to have real results, thus establishing cutting parameters that will allow us to have our own bibliography on how to proceed in our surgical activity.

First Record of Stephanostomum Sp. Looss, 1899 (Digenea: Acanthocolpidae) Metacercariae Parasitising the Pleasure Oyster Crassostrea Corteziensis (Hertlein) from the Mexican Pacific Coast.

The aim of this investigation was to identify the parasites present in the largely understudied pleasure oyster Crassostrea corteziensis in Sinaloa state in the northwestern Mexican Pacific coast. Inspection of twenty-eight oysters collected on "Ceuta" lagoon revealed the presence of the digenean Stephanostomum sp. (Digenea: Acanthocolpidae) cysts. Metacercariae were found encapsulated and embedded in the digestive gland and mantle tissue of oysters. The prevalence of infection revealed that 84.6 % were infected, the abundance was 13.62, with a mean intensity of 16.09 per host. The members of this genus are characterized by a double crown of spines in the cephalic region surrounding the buccal opening of the worm. Significantly, we report the first incidence of the digenean Stephanostomum sp of the family Acanthocolpidae parasitizing Crassostrea corteziensis. Further we report that this bivalve is now considered a new intermediate host, and the northwestern Mexican Pacific coast is a new geographical distribution area for this digenean. The findings contribute to our understanding of the biology, biodiversity and host preference of these parasites, with implications for health risks posed by human consumption of the pleasure oyster.