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Aftereffects of non-invasive brain stimulation techniques may be brain state-dependent. Either continuous theta-burst stimulation (cTBS) as transcranial static magnetic field stimulation (tSMS) reduce cortical excitability. Our objective was to explore the aftereffects of tSMS on a M1 previously stimulated with cTBS. The interaction effect of two inhibitory protocols on cortical excitability was tested on healthy volunteers (n = 20), in two different sessions. A first application cTBS was followed by real-tSMS in one session, or sham-tSMS in the other session. When intracortical inhibition was tested with paired-pulse transcranial magnetic stimulation, LICI (ie., long intracortical inhibition) increased, although the unconditioned motor-evoked potential (MEP) remained stable. These effects were observed in the whole sample of participants regardless of the type of static magnetic field stimulation (real or sham) applied after cTBS. Subsequently, we defined a group of good-responders to cTBS (n = 9) on whom the unconditioned MEP amplitude reduced after cTBS and found that application of real-tSMS (subsequent to cTBS) increased the unconditioned MEP. This MEP increase was not found when sham-tSMS followed cTBS. The interaction of tSMS with cTBS seems not to take place at inhibitory cortical interneurons tested by LICI, since LICI was not differently affected after real and sham tSMS. Our results indicate the existence of a process of homeostatic plasticity when tSMS is applied after cTBS. This work suggests that tSMS aftereffects arise at the synaptic level and supports further investigation into tSMS as a useful tool to restore pathological conditions with altered cortical excitability.
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Potencial Evocado Motor , Córtex Motor , Plasticidade Neuronal , Estimulação Magnética Transcraniana , Humanos , Estimulação Magnética Transcraniana/métodos , Masculino , Feminino , Adulto , Potencial Evocado Motor/fisiologia , Plasticidade Neuronal/fisiologia , Adulto Jovem , Córtex Motor/fisiologia , Homeostase/fisiologia , Inibição Neural/fisiologia , Ritmo Teta/fisiologiaRESUMO
Antler is one of the primary animal raw materials exploited for technical purposes by the hunter-gatherer groups of the Eurasian Upper Palaeolithic (UP) all over the ecological range of deers, and beyond. It was exhaustively employed to produce one of the most critical tools for the survival of the UP societies: hunting weapons. However, antler implements can be made from diverse deer taxa, with different ecological requirements and ethological behaviours. Identifying the antler's origin at a taxonomic level is thus essential in improving our knowledge of humans' functional, practical and symbolic choices, as well as the human-animal interface during Prehistoric times. Nevertheless, palaeogenetics analyses have focused mainly on bone and teeth, with genetic studies of antler generally focused on modern deer conservation. Here we present the results of the first whole mitochondrial genome ancient DNA (aDNA) analysis by means of in-solution hybridisation capture of antlers from pre-Holocene archaeological contexts. We analysed a set of 50 Palaeolithic and Neolithic (c. 34-8ka) antler and osseous objects from South-Western Europe, Central Europe, South-Western Asia and the Caucasus. We successfully obtained aDNA, allowing us to identify the exploited taxa and demonstrate the archaeological relevance of those finds. Moreover, as most of the antlers were sampled using a minimally-invasive method, further analyses (morphometric, technical, genetic, radiometric and more) remain possible on these objects.
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[This corrects the article DOI: 10.1371/journal.pone.0163591.].
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The Airway section of the Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) present the Guidelines for the integral management of difficult airway in adult patients. This document provides recommendations based on current scientific evidence, theoretical-educational tools and implementation tools, mainly cognitive aids, applicable to the treatment of the airway in the field of anesthesiology, critical care, emergencies and prehospital medicine. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations and optimization in the progression of the application of strategies to preserve adequate alveolar oxygenation in order to improve safety and quality of care.
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Plastic debris is a significant and rapidly developing ecological issue in coastal marine ecosystems, especially in areas where it accumulates. This study introduces "plasticlusters", a new form of floating debris agglomeration found in the Yasmine Hammamet marina (Tunisia, North-Africa), loosely attached to pontoon ropes around the water surface level. The analysis of two samples revealed that they were formed primarily by average 2.11 mm polystyrene fragments, 3.43 mm fibers, 104 mm polypropylene and polyethylene sheets, and 122 mm decomposing seagrass leaves. They were inhabited by several taxa, including at least 2 cryptogenic and 5 non-indigenous species (NIS). Unlike other plastic formations, plasticlusters provide a novel and potentially temporal microhabitat to fouling assemblages due to their loose and unconsolidated structure which, combined with marinas being NIS hubs, could enhance NIS dispersion. The results of this study raise concerns about the combined ecological effects of debris accumulation and biocontamination inside marinas.
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Ecossistema , Plásticos , Tunísia , Plásticos/análise , Monitoramento Ambiental , Resíduos/análiseRESUMO
Head and neck cancer, the seventh most common cancer worldwide, often affects the larynx, with a higher incidence in men. Total laryngectomy, a common treatment, results in the loss of phonation, and tracheoesophageal voice rehabilitation is the current rehabilitation method of choice. Despite ongoing debates regarding the timing of tracheoesophageal puncture (TEP), a crucial procedure for voice prosthesis placement, the secondary puncture continues to be the preferred choice in the majority of cases. This underscores the persistent controversy and the absence of consensus in this field. The aim of this manuscript was to define evidence-based recommendations regarding the procedure of primary TEP with voice prosthesis placement, establish the conditions and requirements for performing primary TEP, determine the indications and contraindications of primary TEP, as well as to define the complications and management of primary TEP. A total of 19 statements were formulated, with 78.95% of them having a Level of Evidence 4 and a Grade of Recommendation C. There is not sufficient evidence comparing the outcomes of primary TEP versus secondary TEP. Future studies with robust methodologies are needed to clarify the role of primary and secondary TEP in the rehabilitation of patients undergoing total laryngectomy.
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In the last decade, fatigue in clinical populations has been re-conceptualized, including dimensions such as perceived fatigue (trait and state fatigue) and fatigability. The aim of this study was to evaluate different expressions of fatigue in Spinal Cord Injury (SCI) and Multiple Sclerosis (MS) participants compared to able-bodied controls, during activities of daily living, especially during gait. A total of 67 participants were included in this study (23 with SCI, 23 with MS, and 21 able-bodied controls). All participants performed two functional tests (6-Minute Walk Test and 10-Meter Walk Test) and they completed the Fatigue Severity Scale (FSS). The rate of trait fatigue was different between groups, with MS participants showing the highest rate. Moreover, scores on functional tests and state fatigue were different between groups after the tests. Our results indicate that trait fatigue and state fatigue in individuals with SCI and MS are different with respect to able-bodied population. Both SCI and MS groups experienced more trait fatigue than control group in daily life. In addition, walking tasks produced similar levels of state fatigue between healthy people and patients with MS/SCI. However, these tests induced longer-lasting levels of state fatigue in the patients.
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Esclerose Múltipla , Traumatismos da Medula Espinal , Humanos , Teste de Caminhada , Atividades Cotidianas , Traumatismos da Medula Espinal/complicações , Caminhada , Fadiga/etiologiaRESUMO
Cave heritage is often threatened by tourism or even scientific activities, which can lead to irreversible deterioration. We present a preventive conservation monitoring protocol to protect caves with rock art, focusing on La Garma Cave (Spain), a World Heritage Site with valuable archaeological materials and Palaeolithic paintings. This study assessed the suitability of the cave for tourist use through continuous microclimate and airborne particles monitoring, biofilm analysis, aerobiological monitoring and experimental visits. Our findings indicate several factors that make it inadvisable to adapt the cave for tourist use. Human presence and transit within the cave cause cumulative effects on the temperature of environmentally very stable and fragile sectors and significant resuspension of particles from the cave sediments. These environmental perturbations represent severe impacts as they affect the natural aerodynamic control of airborne particles and determine bacterial dispersal throughout the cave. This monitoring protocol provides part of the evidence to design strategies for sustainable cave management.
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Cavernas , Pinturas , Humanos , Cavernas/microbiologia , Espanha , Microclima , BactériasRESUMO
La miocardiopatía hipertrófica (MCH) es la miocardiopatía hereditaria más frecuente, su principal expresión fenotípica consiste en hipertrofia ventricular izquierda (HVI) en ausencia de condiciones de carga que la justifiquen. Cuando existe una variante genética patogénica se denomina MCH sarcomérica. Los criterios diagnósticos más aceptados son HVI ≥ 15 mm en cualquier segmento o ≥ 13 en ciertas condiciones, criterios que tienen tres inconvenientes: 1) La HCM es una patología donde la HVI es evolutiva, existiendo otros elementos más precoces, pero menos precisos, como criptas, bandas musculares y alteraciones de la válvula mitral y músculos papilares; 2) Pacientes de baja estatura pueden no alcanzar estos umbrales; 3) La MCH apical no queda siempre bien representada usando estos grosores, requiriendo indexar por tamaño del paciente y/o considerar la HVI relativa (relación grosor apical / basal que no debe superar 1). Presentamos una serie de casos con genotipo confirmado para MCH que no cumplen los criterios de HVI aceptados para MCH y donde se debe individualizar el diagnóstico considerando los tres elementos señalados.
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac condition; its phenotypic expression consists of ventricular hypertrophy (LVH) unrelated to loading conditions. In patients with a genetic pathogenic variant, the condition is termed sarcomeric HCM. Current diagnostic criteria are based on absolute left ventricular thickness, requiring ≥15 mm in any segment or ≥13 mm in particular conditions. These criteria have three pitfalls: 1) HCM is an evolving disease where LVH occurs gradually, with other early -but less precisephenotypic expressions such as myocardial crypts, muscular bands, or mitral and papillary muscle alterations; 2) Patients with short stature tend to have less LVH and do not reach the proposed thickness threshold. 3) Apical HCM is not correctly addressed in this cut-off as the heart tapers from base to apex, warranting indexing wall thickness to body size and using relative LVH in the apex (ratio from apex/base, abnormal,>1). This small case series includes three patients with a pathogenic genetic variant for HCM that doesn't satisfy the current criteria of LVH. For its precise assessment, the aforementioned points must be considered.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Cardiomiopatia Hipertrófica/genética , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Fenótipo , Cardiomiopatia Hipertrófica/fisiopatologia , Ecocardiografia Doppler , Testes Genéticos , Coração/anatomia & histologiaRESUMO
This study provides comprehensive quantitative evidence suggesting that adaptations to extreme temperatures and pH imprint a discernible environmental component in the genomic signature of microbial extremophiles. Both supervised and unsupervised machine learning algorithms were used to analyze genomic signatures, each computed as the k-mer frequency vector of a 500 kbp DNA fragment arbitrarily selected to represent a genome. Computational experiments classified/clustered genomic signatures extracted from a curated dataset of [Formula: see text] extremophile (temperature, pH) bacteria and archaea genomes, at multiple scales of analysis, [Formula: see text]. The supervised learning resulted in high accuracies for taxonomic classifications at [Formula: see text], and medium to medium-high accuracies for environment category classifications of the same datasets at [Formula: see text]. For [Formula: see text], our findings were largely consistent with amino acid compositional biases and codon usage patterns in coding regions, previously attributed to extreme environment adaptations. The unsupervised learning of unlabelled sequences identified several exemplars of hyperthermophilic organisms with large similarities in their genomic signatures, in spite of belonging to different domains in the Tree of Life.
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Extremófilos , Extremófilos/genética , Genômica/métodos , Bactérias/genética , Archaea/genética , Genoma Arqueal/genéticaRESUMO
Purpose: To assess the clinical course, structural changes, and choroidal neovascularization detection by SS-OCTA in long-standing and resolved patients with chronic central serous chorioretinopathy (cCSC) after successful half-fluence photodynamic therapy (hf-PDT) treatment. Methods: Twenty-four eyes presenting with cCSC were examined with SS-OCTA and were classified as choroidal neovascular (CNV) or non-choroidal neovascular (non-CNV) cCSC depending on the vascular pattern detected by SS-OCTA after one, two, and three years after hf-PDT. Two groups were compared based on the following clinical findings: demographic characteristics, time of clinical signs, best corrected visual acuity (BCVA), central retinal thickness (CRT), central choroidal thickness (CFT), subretinal fluid (SRF), flat, irregular pigment epithelial detachment (FIPED), and features of fluorescein angiography (FA) and vascular pattern by SS-OCTA. Results: All patients showed resolved cCSC during follow-up after hf-PDT. A total of 5 of 24 (20.8%) eyes showed a neovascular pattern by SS-OCTA. No differences between BCVA, CRT, SRF, FIPED, or FA features were found between both groups (p > 0.05). However, CFT and older age were associated with a neovascular pattern by SS-OCTA (p < 0.05) in follow-up. No signs of neovascular activity were detected by SS-OCT during follow-up in CNV cCSC patients, and no antiVEGF treatment was required for three-year follow-ups. Conclusions: Despite patients with cCSC showing a favorable clinical response after hf-PDT, lower foveal thickness and older age were associated with CNV patterns by SS-OCTA during follow-up.
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SUMMARY: We present an interactive Deep Learning-based software tool for Unsupervised Clustering of DNA Sequences (iDeLUCS), that detects genomic signatures and uses them to cluster DNA sequences, without the need for sequence alignment or taxonomic identifiers. iDeLUCS is scalable and user-friendly: its graphical user interface, with support for hardware acceleration, allows the practitioner to fine-tune the different hyper-parameters involved in the training process without requiring extensive knowledge of deep learning. The performance of iDeLUCS was evaluated on a diverse set of datasets: several real genomic datasets from organisms in kingdoms Animalia, Protista, Fungi, Bacteria, and Archaea, three datasets of viral genomes, a dataset of simulated metagenomic reads from microbial genomes, and multiple datasets of synthetic DNA sequences. The performance of iDeLUCS was compared to that of two classical clustering algorithms (k-means++ and GMM) and two clustering algorithms specialized in DNA sequences (MeShClust v3.0 and DeLUCS), using both intrinsic cluster evaluation metrics and external evaluation metrics. In terms of unsupervised clustering accuracy, iDeLUCS outperforms the two classical algorithms by an average of â¼20%, and the two specialized algorithms by an average of â¼12%, on the datasets of real DNA sequences analyzed. Overall, our results indicate that iDeLUCS is a robust clustering method suitable for the clustering of large and diverse datasets of unlabeled DNA sequences. AVAILABILITY AND IMPLEMENTATION: iDeLUCS is available at https://github.com/Kari-Genomics-Lab/iDeLUCS under the terms of the MIT licence.
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Aprendizado Profundo , Sequência de Bases , Algoritmos , Archaea , Análise por ConglomeradosRESUMO
BACKGROUND: Esophageal duplication cysts are rare congenital tumors usually diagnosed and treated during childhood. Most of them are located in the mediastinum and appear as a mass besides the esophagus. Unfortunately, symptoms are non-specific and depend on the size and location of the mass; therefore, they can easily be missed. If symptoms appear, surgical resection is necessary to prevent troublesome complications. CASE PRESENTATION: We present the case of a 60-year-old woman who presented with severe progressive dysphagia and epigastric pain. After further evaluation, a paraesophageal cystic mass was found, and surgery was required. Non-communicating esophageal duplication cyst was the final diagnosis. CONCLUSION: Esophageal duplication cysts are a rare pathology in adults; their symptoms will vary depending on their size and location. Preoperative diagnosis is difficult as symptoms are non-specific and can be missed. If severe dysphagia, pain, or any other complication appears, surgery should not be delayed.
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Transtornos de Deglutição , Cisto Esofágico , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Transtornos de Deglutição/etiologia , Cisto Esofágico/complicações , Cisto Esofágico/diagnóstico , Cisto Esofágico/cirurgia , Esofagoscopia , DorRESUMO
Neurodynamic techniques have yielded good clinical results in the treatment of various pathologies. The objective of this study is to examine the short-term effects of neurodynamic techniques of the sciatic nerve on hip ROM (range of motion) and on the amplitude and latency of the soleus H-reflex and M-waves, in young asymptomatic subjects. In a double-blind controlled trial design, 60 young asymptomatic participants were randomly assigned into six groups with different levels of manipulation of the sciatic nerve. The passive straight leg raise test was used to evaluate the hip ROM amplitude. All evaluations were performed before, 1 min after, and 30 min after intervention. For each time-point, spinal and muscle excitability were also tested. ROM increased in all groups, but none of the treatment groups had superior effects than the group with no treatment. This means that ROM testing maneuvers increased ROM amplitude, with no add-on effect of the proposed neurodynamic techniques. Neurophysiological responses changed similarly in all groups, showing that the aftereffects were not intervention-specific. We observed a significant negative association between the change in limb temperature and the change in latencies of all potentials. ROM-testing procedures performed repeatedly increase ROM amplitude. This observation should be considered when evaluating the aftereffects of therapeutic interventions on ROM amplitude. None of the explored neurodynamic techniques produced acute aftereffects on hip ROM amplitude, spinal or muscle excitability different to the induced by the ROM testing maneuver.
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Reflexo H , Exercícios de Alongamento Muscular , Humanos , Amplitude de Movimento Articular/fisiologia , Músculo Esquelético/fisiologia , Método Duplo-CegoRESUMO
This paper conducts quantitative research on the levels of stress generated in Latin American professors due to the abrupt digitalization of higher education resulting from the COVID-19 pandemic. Specifically, the differences in this digital stress between professors from private and public universities are analyzed. For this purpose, a validated questionnaire has been used and passed to a sample of 750 professors from 20 different Latin American countries, whose responses have been statistically analyzed. As results, it has been obtained that there are no significant differences between the average levels of digital stress of professors of private and public universities due to the pandemic. However, the way in which this digital stress has affected Latin American professors according to gender and age is different depending on the university tenure. As a consequence, some implications and recommendations derived from the results are presented.
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The study sought to identify family conditions and school actions associated with academic self-efficacy and emotional well-being of adolescents during the COVID-19 pandemic in Chile. School closures are likely to have affected students' sense of academic efficacy and emotional well-being by removing support factors such as teacher and peer support for both academic and social tasks. At the same time, family stressors caused by the pandemic are also likely to have affected children. Data were collected by a Chilean school district about the family conditions and well-being of 5th-12th-grade students (N = 1,941) during lockdown. Exploratory factor analysis and latent profile analysis were applied to parents' and students' reports about family processes and material conditions. Family profiles and school responses to lockdown were used to predict students' academic self-efficacy and emotions. Family profiles were mainly differentiated by parenting processes, material conditions, and parenting stress. Regression analyses showed that the family profile predicted students' negative emotions and low self-efficacy. Specifically, children of families with higher scores in all dimensions were less at risk of reporting low academic self-efficacy and negative emotions, but the two average profiles-with high and low stress-were not different in this regard. Student gender and age were predictors of negative emotions but not self-efficacy. In contrast to family factors, school actions during the pandemic did not predict academic self-efficacy and well-being. Results suggest that family processes continue to be relevant beyond early infancy. Implications for the targeting of policies to support parenting are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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COVID-19 , Pandemias , Criança , Humanos , Adolescente , Controle de Doenças Transmissíveis , Emoções/fisiologia , Instituições Acadêmicas , Fatores de RiscoRESUMO
Pleuropulmonary blastoma (PPB) is the most common pediatric malignant primary lung tumor. It's associated with the DICER1 gene pathogenic germline variants. Antenatal presentation is infrequent and poses a challenge in the differential diagnosis of congenital pulmonary airway malformation (CPAM). OBJECTIVE: to report a case of unusual presentation of PPB associated with DICER1 syndrome and to describe the difficulty in differentiating it from CPAM. CLINICAL CASE: Male patient with prenatal diagnosis of hypervascular left lung lesion, with mediastinal shift and progressive growth, initially interpreted as CPAM. He was born at 38 weeks, requiring transitory treatment with positive pressure due to ventilatory impairment. A CT scan with contrast showed a large multilocular cystic mass containing air causing mass effect, requiring open left upper lobectomy. Histology results were compatible with type I PPB, with negative margins, and positive genetic study for DICER1 syndrome. Seven weeks post-resection, an aerial image was detected in the upper left side of the chest, with progressive growth, requiring a new tumor resection and upper segmentectomy, with biopsy corresponding to recurrence of type I PPB with negative margins. He received adjuvant treatment with chemotherapy, with follow-up for 2 years, remaining asymptomatic, without recurrence, and with negative screening for other neoplasms associated with DICER1 syndrome. Among the family history, the mother had papillary thyroid cancer and tested positive for the mutation. CONCLUSION: PPB is a rare cancer, difficult to distinguish from CPAM, especially in its antenatal presentation. Nowing its association with DICER1 syndrome and performing a genetic study are key to the early detection of BPP and the search for other tumors associated with the syndrome.
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Neoplasias Pulmonares , Blastoma Pulmonar , Feminino , Humanos , Masculino , Gravidez , RNA Helicases DEAD-box/genética , Diagnóstico Diferencial , Pulmão/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/genética , Ribonuclease III/genética , Recém-NascidoRESUMO
Resumen Introducción: las neoplasias sólidas pseudopapilares de páncreas representan alrededor del 3% de los tumores pancreáticos quísticos resecados. Se presentan con mayor frecuencia en mujeres jóvenes entre la segunda y tercera décadas de la vida. Es un tumor con poco potencial maligno que se ubica principalmente en la cola; sin embargo, puede encontrarse en cualquier localización anatómica pancreática. Métodos: se presentan 5 casos de cuatro mujeres y un hombre, entre 16 y 36 años, que consultaron principalmente por dolor abdominal. Resultados: cuatro pacientes fueron llevados a pancreatectomía distal sin esplenectomía por laparoscopia, y una paciente a pancreatoduodenectomía por laparotomía. Se logró extraer por completo y satisfactoriamente el tumor a los cinco pacientes. No se evidenció metástasis. Los tumores se localizaron en la cabeza (1), cuello (1) y predominantemente en cuerpo y cola (3). El reporte histopatológico posoperatorio confirmó el diagnóstico en los cinco casos, en la paciente más joven se había realizado una biopsia percutánea previa a la intervención quirúrgica. Conclusiones: la resección quirúrgica completa del tumor con preservación del bazo es el tratamiento de elección en pacientes con neoplasia sólida pseudopapilar de páncreas.
Abstract Introduction: Solid pseudopapillary neoplasms of the pancreas represent around 3% of resected cystic pancreatic tumors. They occur more frequently in young women between the second and third decades of life. It is a tumor with little malignant potential located mainly in the tail; however, it can be found in any pancreatic anatomical location. Materials and methods: We reported five cases of four women and one man, between 16 and 36 years of age, who consulted mainly for abdominal pain. Results: Four patients underwent distal pancreatectomy without laparoscopic splenectomy, and one underwent laparotomy pancreatoduodenectomy. The tumor was completely and satisfactorily removed from all five patients. No metastasis was found. The tumors were located on the head (1), neck (1), and predominantly on the body and tail (3). The postoperative histopathological report confirmed the diagnosis in all five cases; in the youngest patient, a percutaneous biopsy had been performed before surgical intervention. Conclusions: Complete surgical resection of the tumor with preservation of the spleen is the treatment of choice in patients with solid pseudopapillary neoplasm of the pancreas.
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Marinas are hot spots of non-indigenous marine species (NIS). Introductions of NIS, regardless of their actual or potential impacts, can be considered as a biocontamination of the ecosystem. To characterize the biocontamination status of a marina it is important to know which habitats and major taxa can provide the most useful information. To address this issue, we analyze the associated macrofaunal community associated to soft substrate (sediment; SS) and artificial hard substrate (lateral surface of pontoons; AHS) of six marinas from Southern Spain. 9 NIS were found, including 8 crustaceans (7 peracarids) and 1 polychaete; 8 NIS were found on AHS and 4 in sediments. Indeed, site-specific BioContamination Index (SBCI) showed higher values in AHS than SS. Our results indicate peracarids in AHS should be the primary target for assessing the level of biocontamination in marinas. This may help scientists and environmental managers to stablish strategies for monitoring marine bioinvasions.