Robotic sacrocolpopexy for the treatment of pelvic organ prolapse in elderly women: comparative analysis of safety and efficacy versus younger women.

INTRODUCTION: Pelvic organ prolapse is a condition with high prevalence in elderly women. With increasing life expectancy and a desire for improved quality of life, a rise in the frequency of surgical treatments for these women is anticipated. The aim is to compare complication, success, and satisfaction rates among elderly patients (aged >70 years) in comparison to younger women undergoing robotic sacrocolpopexy, thereby assessing the safety and efficacy of this surgery in this group of patients. METHOD: A prospective observational comparative study of 123 robotic sacrocolpopexies conducted between December 2016 and June 2022. Patients were stratified by age (cutoff point: 70 years). Baseline characteristics, type, and grade of prolapse, intra and postoperative data, complications, functional and anatomical outcomes, and satisfaction levels were collected. RESULTS: Among the 123 patients, 62.6% were under 70 years old, while 37.4% were 70 years or older, exhibiting similar baseline characteristics, prolapse grade, and type. The percentages of intraoperative (6.5%) and postoperative complications (4.4-9%) were comparable in both age groups. Furthermore, success and satisfaction rates exceeded 90%, with no significant differences between women under and over 70 years during a two-year follow-up. CONCLUSION: Robotic sacrocolpopexy is at least as effective and safe in women aged 70 years or older as in younger individuals, with no higher rates of intra and postoperative complications and similar rates of anatomical and subjective success.

Needle­based gastrocnemius lengthening: a novel ultrasound­guided noninvasive technique: part II-clinical results.

BACKGROUND: Isolated gastrocnemius contracture has been associated with more than 30 lower limb disorders, including plantar heel pain/plantar fasciitis, Achilles tendinosis, equinus foot, adult flatfoot, and metatarsalgia. Although many techniques are available for gastrocnemius recession, potential anesthetic, cosmetic, and wound-related complications can lead to patient dissatisfaction. Open and endoscopic recession techniques usually require epidural or general anesthesia, exsanguination of the lower extremities and stitches and can damage the sural nerve, which is not under the complete control of the surgeon at all stages of the procedure. The purpose of this study is to evaluate the clinical results of a surgical technique for gastrocnemius lengthening with a needle, as previously described in cadaver specimens. METHODS AND RESULTS: We performed a prospective study of ultrasound-guided gastrocnemius tendon lengthening in level II using a needle in 24 cases (19 patients) of gastrocnemius contracture. The study population comprised 12 males and 7 females. Mean age was 41 years (18-64). All but 5 recessions were bilateral and occurred simultaneously. The indication for the procedure was gastrocnemius contracture; although the patients also presented other conditions such as non-insertional Achilles tendinopathy in 6 patients (2 were bilateral), insertional Achilles calcifying enthesitis in 4 (1 was bilateral), metatarsalgia in 4, flexible flat foot in 1 and plantar fasciitis in 5 (2 were bilateral). The inclusion criteria were the failure of a previous conservative protocol, that the Silfverskiöld test was positive, and that the pathology suffered by the patient was within the indications for surgical lengthening of the patients and were described in the scientific literature. The exclusion criteria were that the inclusion criteria were not met, and patients with surgical risk ASA 3 or more and children. In these patients, although possible, it is preferable to perform the procedure in the operating room with monitoring, as well as in children since they could be agitated during the procedure at the office. We used the beveled tip of an Abbocath needle as a surgical scalpel. All patients underwent recession of the gastrocnemius tendon, as in an incomplete Strayer release. We evaluated pre- and postoperative dorsiflexion, outcomes, and procedural pain (based on a visual analog scale and the American Orthopedic Foot and Ankle Society scores), as well as potential complications. No damage was done to the sural bundle. RESULTS: Ankle dorsiflexion increased on average by 17.89°. The average postoperative visual analog score for pain before surgery was 5.78, 5.53 in the first week, 1.89 at 1 month, and 0.26 at 3 months, decreasing to 0.11 at 9 months. The mean postoperative American Orthopedic Foot and Ankle Society Ankle-Hindfoot score the average was 50.52 before surgery, 43.42 at 1 week, 72.37 at 1 month, 87.37 at 3 months, and 90.79 at 9 months. CONCLUSION: Ultrasound-guided needle lengthening of the gastrocnemius tendon is a novel, safe, and effective technique that enables the surgeon to check all the structures clearly, thus minimizing the risk of neurovascular damage. The results are encouraging, and the advantages of this approach include absence of a wound and no need for stitches. Recovery is fast and relatively painless. A specific advantage of ultrasound-guided needle lengthening of the gastrocnemius tendon is the fact that it can be performed in a specialist's office, with a very basic instrument set and local anesthesia, thus reducing expenses.

Polymorphisms of CCR5, IL-6, IFN-γ and IL-10 genes in Cuban HIV/AIDS patients.

INTRODUCTION: Genetic studies have shown associations of several single nucleotide polymorphisms (SNP) with different rates of progression and variation in susceptibility to HIV infection. This study aimed to estimate the frequency of ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A and IL-10-1082A/G polymorphisms in Cuban HIV-infected patients and a group of sero-discordant couples to assess their influence on risk and disease progression. METHODS: A cross-sectional study was carried out on 120 subjects registered at the Institute of Tropical Medicine «Pedro Kour¼ (IPK) and the Ameijeiras Hospital from June 2018 until December 2019. The amplification of fragments of the ccr5, IL-6, IFN-γ and IL-10 genes was performed by polymerase chain reaction followed by identification of polymorphisms using the restriction fragment length polymorphism analysis for IL-6 with the restriction enzymes Nla III. Amplification Refractory Mutation System was used for IFN-γ and IL-10 genes. RESULTS: The allelic and genotypic distributions of the genes ccr5, IL-6, IFN-γ and IL-10 did not differ significantly between the two groups. Cell counts and plasma viral load values did not differ significantly between genotypes of the ccr5, IL-6, IFN-γ and IL-10 genes. Only the IL-6 GC genotype was associated with higher viral load values. The combination of alleles of the four considered SNPs showed a highly significant increase in the risk of HIV infection for one of them, but with a very low frequency (<1%). CONCLUSION: This study contributes to evaluating the frequency of these polymorphisms and their influence on biomarkers of the progression of HIV infection in the Cuban HIV-population.

Comparison of methods to estimate ruminal degradation and intestinal digestibility of protein in hydrolyzed feather meal with or without blood.

Hydrolyzed feather meal (HFM) is a feedstuff high in rumen undegraded protein (RUP) that can be used as an effective source of metabolizable protein for dairy cattle. Because the production process may vary, the rumen degradability and intestinal digestibility of HFM may also vary. Additionally, some processes may incorporate additional blood into the final product to result in feather meal with poultry blood. To determine the rumen degradability and intestinal digestibility of these products, several laboratory assays can be used; the common assays are the mobile bag (MOB), modified three-step (MTS), and Ross (ROS) assays. Although all 3 assays determine RUP digestibility, they vary in whether they are performed in situ, in vitro, or both. The objective of this study was to evaluate the ruminal degradability and intestinal digestibility of HFM originating from processes that differ in their inclusion of blood, and to compare the MOB, MTS, and ROS assays. Ten samples of HFM, which were identified by the suppliers as HFM with little blood (n = 5) and with more blood (n = 5), were spot-sampled, collected from 10 production plants across the United States, and subjected to all 3 assays. Assay type had an effect on RUP, total-tract crude protein (CP) digestibility, and the amount of RUP digested. A significant effect was observed on RDP and RUP concentrations for blood inclusion; no effect was detected for total-tract CP digestibility. We found no difference in RUP digestibility for assay or blood inclusion. There was also no interaction of the effect of assay or blood inclusion. Results suggest that even though there are differences in chemical composition in HFM associated with the inclusion of blood, such as ash and crude fat, few if any differences are observed in intestinal digestion of protein. Although the assays varied in their estimates of rumen undegraded protein, MOB and MTS yielded the most similar values. However, all 3 assays resulted in similar estimates of RUP digestibility.

Increases in Future AR Count and Size: Overview of the ARTMIP Tier 2 CMIP5/6 Experiment.

The Atmospheric River (AR) Tracking Method Intercomparison Project (ARTMIP) is a community effort to systematically assess how the uncertainties from AR detectors (ARDTs) impact our scientific understanding of ARs. This study describes the ARTMIP Tier 2 experimental design and initial results using the Coupled Model Intercomparison Project (CMIP) Phases 5 and 6 multi-model ensembles. We show that AR statistics from a given ARDT in CMIP5/6 historical simulations compare remarkably well with the MERRA-2 reanalysis. In CMIP5/6 future simulations, most ARDTs project a global increase in AR frequency, counts, and sizes, especially along the western coastlines of the Pacific and Atlantic oceans. We find that the choice of ARDT is the dominant contributor to the uncertainty in projected AR frequency when compared with model choice. These results imply that new projects investigating future changes in ARs should explicitly consider ARDT uncertainty as a core part of the experimental design.

[Sleep-related movement and behavioural disorders in adults]. / Trastornos del movimiento y de la conducta durante el sueño en el adulto.

Sleep-related movement and behaviour disorders may have an impact on sleep quality and lead to daytime symptoms. These groups of conditions include diseases such as restless legs syndrome, periodic leg movements, and REM and NREM parasomnias. The knowledge of their clinical features and management is of utmost importance for the neurologist and sleep specialist. Frequently, these patients are referred to such specialists and it is relevant to know that certain sleep disorders may be associated with other neurological conditions.

TITLE: Trastornos del movimiento y de la conducta durante el sueño en el adulto.Los trastornos del movimiento y de la conducta durante el sueño pueden tener un impacto en la calidad del sueño del paciente y dar lugar a síntomas diurnos. En estos grupos de enfermedades se incluyen entidades como el síndrome de piernas inquietas, los movimientos periódicos de las piernas y las parasomnias del sueño de movimientos oculares rápidos (REM) y no REM. El conocimiento de sus características clínicas y nociones sobre su manejo es de gran importancia para el neurólogo y especialista en sueño por su frecuencia e impacto en la calidad del sujeto. Con frecuencia, estos pacientes son referidos a dichos especialistas, y es relevante conocer que ciertos trastornos del sueño pueden asociarse a otras enfermedades neurológicas.

Terapias adyuvantes a la terapia antifibrótica en la fibrosis pulmonar idiopática: importancia del manejo multidisciplinario / Adjuvant therapies to antifibrotic therapy in IPF: importance of multidisciplinary management

La fibrosis pulmonar idiopática (FPI) se caracteriza por presentar una capacidad funcional reducida, disnea e hipoxia inducida por el ejercicio, lo que disminuye su tolerancia al esfuerzo y limita su capacidad de realizar actividades diarias. Las comorbilidades son frecuentes y su presencia contribuyen al empeoramiento de la calidad de vida y aumento de la mortalidad. Por lo anterior, es que además de las terapias antifibróticas, los pacientes con FPI se benefician de un enfoque integral de la atención que puede incluir: pesquisa, diagnóstico y tratamiento de comorbilidades, ingreso a protocolos de investigación, manejo sintomático, cuidados paliativos, oxígeno suplementario, rehabilitación pulmonar, educación y apoyo por un equipo multidisciplinario.

Idiopathic pulmonary fibrosis (IPF) is characterized by reduced functional capacity, dyspnea and exercise-induced hypoxia, which decreases tolerance to exertion and limits the ability to perform daily activities. Comorbidities are frequent and their presence contribute to worsening quality of life and increased mortality. Therefore, in addition to antifibrotic therapies, patients with IPF benefit of a comprehensive approach to care that may include: screening, diagnosis and treatment of comorbidities, admission to research protocols, symptomatic management, palliative care, supplementary oxygen, pulmonary rehabilitation, education and support by a multidisciplinary team.

Long-term efficacy of 6-month therapy with isoniazid and rifampin compared with isoniazid, rifampin, and pyrazinamide treatment for pleural tuberculosis.

Research into anti-tuberculosis treatment has mainly focused on pulmonary tuberculosis (TB), with few studies on pleural-TB. The aim of the study is to compare the long-term efficacy of a 6-month treatment regimen with isoniazid and rifampicin (6HR) with treatment regimen of isoniazid, rifampicin, and pyrazinamide (6HR2Z) for pleural-TB. A case-control study of 200 HIV-negative patients with pleural-TB prospectively followed in our TB-unit from 1995 to 2018. The primary resistance to isoniazid is < 4% in our geographic area. Pleural-TB diagnosis was based on a positive culture for M. tuberculosis (84 patients), presence of caseating granulomas in pleural biopsy (28), or characteristics of pleural fluid (88). A comparative study of demographic and clinical characteristics between the treatment groups was carried out. Out of the 200 patients followed, (112 males, 88 females; mean age 32.9 ± 18.4 years), 99 patients were treated with 6HR regimen and 101 with 6HR2Z. The groups were comparable, except the 6HR2Z had larger size of pleural effusion. All patients completed the treatment. The group treated with 6HR presented fewer adverse effects (15.3%) than 6HR2Z group (33%), p = 0.005, and lower frequency of severe hepatic toxicity (5% vs 10.9%). Four patients died from causes other than TB during treatment with 6HR2Z, and all other patients were cured during a monitoring period for 8.4 years (IQRs, 3.3-14.3). Six patients in 6HR and 10 in 6HR2Z developed residual pachypleuritis. 6HR is as effective as 6HR2Z treatment for pleural-TB, with fewer adverse effects.

Neurocognitive Disorders in Heart Failure: Novel Pathophysiological Mechanisms Underpinning Memory Loss and Learning Impairment.

Heart failure (HF) is a major public health issue affecting more than 26 million people worldwide. HF is the most common cardiovascular disease in elder population; and it is associated with neurocognitive function decline, which represent underlying brain pathology diminishing learning and memory faculties. Both HF and neurocognitive impairment are associated with recurrent hospitalization episodes and increased mortality rate in older people, but particularly when they occur simultaneously. Overall, the published studies seem to confirm that HF patients display functional impairments relating to attention, memory, concentration, learning, and executive functioning compared with age-matched controls. However, little is known about the molecular mechanisms underpinning neurocognitive decline in HF. The present review round step recent evidence related to the possible molecular mechanism involved in the establishment of neurocognitive disorders during HF. We will make a special focus on cerebral ischemia, neuroinflammation and oxidative stress, Wnt signaling, and mitochondrial DNA alterations as possible mechanisms associated with cognitive decline in HF. Also, we provide an integrative mechanism linking pathophysiological hallmarks of altered cardiorespiratory control and the development of cognitive dysfunction in HF patients. Graphical Abstract Main molecular mechanisms involved in the establishment of cognitive impairment during heart failure. Heart failure is characterized by chronic activation of brain areas responsible for increasing cardiac sympathetic load. In addition, HF patients also show neurocognitive impairment, suggesting that the overall mechanisms that underpin cardiac sympathoexcitation may be related to the development of cognitive disorders in HF. In low cardiac output, HF cerebral infarction due to cardiac mural emboli and cerebral ischemia due to chronic or intermittent cerebral hypoperfusion has been described as a major mechanism related to the development of CI. In addition, while acute norepinephrine (NE) release may be relevant to induce neural plasticity in the hippocampus, chronic or tonic release of NE may exert the opposite effects due to desensitization of the adrenergic signaling pathway due to receptor internalization. Enhanced chemoreflex drive is a major source of sympathoexcitation in HF, and this phenomenon elevates brain ROS levels and induces neuroinflammation through breathing instability. Importantly, both oxidative stress and neuroinflammation can induce mitochondrial dysfunction and vice versa. Then, this ROS inflammatory pathway may propagate within the brain and potentially contribute to the development of cognitive impairment in HF through the activation/inhibition of key molecular pathways involved in neurocognitive decline such as the Wnt signaling pathway.

Construction of a synthetic protein using PCR with a high essential amino acid content for nutritional purposes.

Ovalbumin is considered a protein of high nutritional value because it contains essential amino acids and is highly digestible. Therefore, it has a high biological value. Currently, the high food demand requires worldwide attention because food production is insufficient. Therefore, other alternatives are necessary to satisfy food demands, such as protein engineering. In this work, a protein with a high essential amino acid content similar to ovalbumin was synthesized by protein engineering, expressed, and digested in vitro. The assembly and sequential overlap extension PCR strategy was used to synthesize a 345-bp gene that encodes a high essential amino acid content protein (HEAAP). The 345-bp product was cloned into the vector pBAD TOPO®, and expressed in Escherichia coli BL21. PCR reactions and sequencing demonstrated the presence, orientation, and correct sequence of the insert. HEAAP expression was induced by L-arabinose and then purified using Ni-NTA affinity chromatography. The expression in E. coli was low and barely detected by Western blot assay. The in vitro multienzyme digestibility of HEAAP was around 79%, which suggests that the protein is potentially nutritious. Virtual analysis classifies the protein as unstable and hydrophilic, with a half-life in E. coli of 10 h. The recombinant HEAAP was successfully synthesized, but it is necessary to improve the digestibility and to optimize expression including selecting other expression models.

Relationships between protein and energy consumed from milk replacer and starter and calf growth and first-lactation production of Holstein dairy cows.

The objective was to determine relationships between protein and energy consumed from milk replacer and starter and calf growth and first-lactation production of Holstein heifer calves. Milk replacer and starter protein intake and metabolizable energy (ME) intake data were collected from 4,534 Holstein heifer calves for growth and 3,627 Holstein cows for production from birth year of 2004 through 2014. Calves from 3 commercial dairy farms were assigned to 45 different calf research trials at the University of Minnesota Southern Research and Outreach Center, Waseca, Minnesota, from 3 to 195 d of life. Calves were moved to heifer growers at 6 mo of age, and calves were returned to their farm of birth a few weeks before calving. Most calves (85%) were fed a 20% crude protein and 20% fat milk replacer at a rate of 0.57 kg/calf daily. Metabolizable energy and protein consumed from milk replacer and starter were calculated for each individual calf for 6 and 8 wk of age. Mixed model analyses were conducted to determine the effect of protein and energy consumed from both milk replacer and starter on calf growth and first-lactation 305-d production of milk, fat, and protein, adjusting for herd, season of birth, year, average daily gain (ADG), and calf trial. Calves with ADG >0.80 kg/d consumed more combined protein and ME than calves with lower ADG. Protein and ME intake from calf starter affected growth more than protein and ME intake from milk replacer because most calves were fed the same fixed amount of milk replacer. Calves born during the fall and winter had greater combined protein and ME intake than calves born during the spring and summer. Milk replacer protein and ME intake did not have a relationship with first-lactation 305-d milk, fat, and protein production. However, starter protein and ME intake during the first 6 and 8 wk of age had a significant positive relationship with first-lactation 305-d milk, fat, and protein production. Consequently, combined protein and combined ME intake had a positive effect on 305-d milk, fat, and protein production. Variance in protein and ME intake was high, suggesting that additional factors affect calf growth during the first 8 wk of life and milk production in first lactation.

Meropenem antimicrobial stewardship program: clinical, economic, and antibiotic resistance impact.

There are few prospective studies with sufficient duration in time to evaluate clinical and antibiotic resistance impact of antibiotic stewardship programs (ASP). This is a descriptive study between January 2012 and December 2017, pre-post intervention. A meropenem ASP was initiated in January 2015; in patients who started treatment with meropenem, an infectious disease physician performed treatment recommendations to prescribers. Prospective information was collected to evaluate adequacy of meropenem prescription to local guidelines and to compare results between cases with accepted or rejected intervention. Analysis was performed to verify variables associated with intervention acceptance and with any significant change in meropenem consumption, hospital-acquired multidrug-resistant (MDR) bloodstream infections (BSIs), and 30-day all-cause crude death in MDR BSIs. Adequacy of meropenem prescription and de-escalation from meropenem treatment to narrower-spectrum antibiotic improved progressively over time, after ASP implementation (p < 0.001). Interventions on prescription were performed in 330 (38.7%) patients without meropenem justified treatment; in 269, intervention was accepted and in 61 not. Intervention acceptance was associated with shorter duration of treatment, cost, and inpatient days (p < 0.05); intervention rejection was not associated with severity of patient. During the period 2015-2017, meropenem consumption decreased compared with 2012-2014 (rate ratio [RR] 0.67; 95% CI 0.58-0.77, p < 0.001). Also decreased were hospital-acquired MDR BSI rate (RR 0.63; 95% CI 0.38-1.02, p = 0,048) and 30-day all-cause crude death in MDR BSIs (RR 0.45; 95% CI 0.14-1.24, p = 0.096), coinciding in time with ASP start-up. The decrease and better use of meropenem achieved had a sustained clinical, economic, and ecological impact, reducing costs and mortality of hospital-acquired MDR BSIs.

Validez y confiabilidad de los instrumentos de percepción de barreras y de beneficios para el ejercicio en adolescentes colombianos / Validity and reliability of the perceiving barriers and benefits of exercising instruments for Colombian adolescents / Validação e confiabilidade dos instrumento para perceber barreiras e benefícios do exercício em adolescentes colombianos

Objetivo: validar en el contexto colombiano los instrumentos de percepción de barreras y de beneficios asociados a la realización\r\nde ejercicio en adolescentes basados en el modelo de promoción de la salud de Nola J. Pender. Metodología: los instrumentos\r\nseleccionados fueron sometidos a estos procedimientos: permisos, traducción y pruebas de validez facial, de contenido, de constructo\r\ny de confiabilidad. Resultados: el instrumento de percepción de barreras para el ejercicio tiene un índice de Lawshe\r\nmodificado de 0,83 y un kappa de Fleiss de 0,59 para relevancia y de 0,53 para pertinencia. El instrumento de percepción de\r\nbeneficios por el ejercicio presenta un índice de Lawshe modificado de 0,93 y un kappa de Fleiss para relevancia 0,70 y de 0,91\r\npara pertinencia. El análisis factorial identificó en cada uno de los instrumentos dos factores: barreras para la salud física y afectivas o emocionales; en cuanto a los beneficios se relacionaron con las condiciones ambientales y el tiempo disponible para\r\nrealizar el ejercicio, y la confiabilidad se encontró en 0,82 y 0,83 para la percepción de barreras y de beneficios, respectivamente.\r\nConclusiones: los instrumentos de percepción de barreras y de beneficios para la realización de ejercicio adaptados al contexto\r\ncolombiano son válidos y confiables. Por lo anterior, se consideran apropiados para evaluar y diseñar estrategias que contribuyan\r\na mejorar la realización de actividad física en los adolescentes.

Objective: To validate the instruments for perceiving barriers\r\nand benefits of exercising for Colombian adolescents based on\r\nthe health promotion model of Nola Pender. Methodology:\r\nThe instruments for perceiving barriers and benefits of exercising\r\nwere subject to the following procedures: permits, translation,\r\nback translation, and validity tests: facial, content, and construction.\r\nResults: The instruments for perceiving barriers and\r\nbenefits of exercising have a modified Lawshe index of 0.83 and\r\nFleiss Kappa of 0.59 for relevance and pertinence of 0.53. The\r\ninstruments for perceiving barriers and benefits of exercising\r\nalso present a modified Lawshe index of 0.93 and Fleiss Kappa\r\nfor relevance 0.70 and for pertinence 0.91. The factor analysis\r\nidentified in each of the instruments 2 factors: barriers to physical\r\nand affective or emotional health; in terms of benefits, they\r\nwere related to environmental conditions and the time available\r\nto perform the exercise, and reliability was found in 0.82 and 0.83\r\nfor the barrier and benefits perceptions, respectively. Conclusions:\r\nThe instruments for perceiving barriers and benefits of\r\nexercising adapted to the Colombian context are valid and reliable.\r\nTherefore, they are considered appropriate for evaluating\r\nand designing strategies that contribute to improving the\r\nperformance of physical activity in adolescents.

Objetivo: validar no contexto colombiano os instrumentos de\r\npercepção de barreiras e benefícios para a realização de exercício\r\nem adolescentes com base no modelo de promoção da saúde\r\nde Nola Pender. Metodologia: os instrumentos de percepção\r\nde barreiras e benefícios para o exercício foram submetidos aos\r\nprocedimentos: autorizações, tradução, e testes de validade\r\nfacial, conteúdo e construto e confiabilidade. Resultados: o\r\ninstrumento de Percepção de Barreiras para o exercício possui\r\num índice de Lawshe modificado de 0,83 e Kappa de Fleiss de\r\n0,59 para relevância e pertinência de 0,53. O instrumento de\r\npercepção de benefícios para o exercício também apresenta\r\num índice de Lawshe modificado de 0,93 e Kappa de Fleiss para\r\nrelevância de 0,70 e para pertinência de 0,91. A análise fatorial\r\nidentificou em cada um dos instrumentos 2 fatores: barreiras à\r\nsaúde física e afetiva ou emocional; em termos de benefícios,\r\neles foram relacionados às condições ambientais e ao tempo\r\ndisponível para a realização do exercício, e a confiabilidade\r\nse encontrou em 0,83 e 0,83 para a percepção de barreiras e\r\nbenefícios respectivamente. Conclusões: os instrumentos\r\nde percepção de barreiras e benefícios para a realização de\r\nexercícios adaptados ao contexto colombiano são válidos e\r\nconfiáveis. Por isso, são considerados adequados para avaliar e\r\ndesenhar estratégias que contribuam para melhorar o desempenho\r\nda atividade física em adolescentes.

Positive emotional induction interferes with the reconsolidation of negative autobiographical memories, in women only.

After reactivation, a previously consolidated memory can enter into a labile state followed by a re-stabilization process defined as reconsolidation. The aim of this study was to explore whether an existing negative autobiographical memory can be modified by using a non-invasive interference (audiovisual positive preparation) after reactivation and to determine if this effect could be dependent on the reconsolidation process. We found that the presentation of a positive inductor after a negative autobiographical memory reactivation may lead to a change in the emotional information of the original trace and that such effect can be mediated by the reconsolidation process. The modification of the memory has been shown in women only. These results suggest that a positive audiovisual induction may play a potential role in psychotherapeutic techniques for the modification of dysfunctional autobiographical memories.

Comparative Hemolymph Proteomic and Enzymatic Analyses of Two Strains of Rhipicephalus (Boophilus) microplus Ticks Resistant and Susceptible to Ixodicides.

The cattle tick Rhipicephalus (Boophilus) microplus is one of the most harmful ectoparasites affecting bovines worldwide. It represents a major threat to livestock industry due to the economic losses caused and diseases associated with these ticks. The most important tick control strategy has been the use of ixodicides, resulting in chemically resistant tick populations. It is necessary to understand the mechanisms that result in resistance so as to create new strategies increasing the lifespan of ixodicides or finding alternative targets to produce new acaricides. In this paper, in order to obtain an insight into the mechanisms that govern ixodicides resistance, we will compare the hemolymph proteome of two tick R. microplus strains, one susceptible (MJ) and one resistant (SA) to ixodicides, using HPLC and 2D electrophoresis. Significant differences were found in protein content between strains using HPLC. 2D electrophoresis revealed that 68 hemolymph protein spots were common between strains; however, 26 spots were unique to the susceptible strain MJ and 5 to the resistant strain SA. The most distinctive protein spots on the preparative gels were selected for further analyses. Nine protein spots were identified by mass fingerprinting, revealing proteins that may have a role in the ixodicides resistance or susceptibility. In this paper, we present the tick hemolymph proteome revealing a set of proteins which suggest a possible role in tick detoxification.

LY2603618, a selective CHK1 inhibitor, enhances the anti-tumor effect of gemcitabine in xenograft tumor models.

Pharmacological inhibition of CHK1 in the absence of p53 functionality leads to abrogation of the S and G2/M DNA damage checkpoints. We report the preclinical therapeutic activity of LY2603618 (CHK1 inhibitor) at inhibiting CHK1 activation by gemcitabine and enhancing in vivo efficacy. The in vivo biochemical effects of CHK1 inhibition in the absence or presence of DNA damage were measured in human tumor xenograft models. Colon, lung and pancreatic xenografts models were treated with gemcitabine, LY2603618, or gemcitabine plus LY2603618. Gemcitabine treatment alone induced a significant increase in CHK1 autophosphorylation over untreated tumors. Co-administration of LY2603618 with gemcitabine showed a clear inhibition of CHK1 autophosphorylation for at least 24 h. Combining LY2603618 with gemcitabine resulted in an increase in H2AX serine 139 phosphorylation, indicating a corresponding increase in damaged DNA in the tumors. LY2603618 abrogated the S-phase DNA damage checkpoint in Calu-6 xenograft tumors treated with gemcitabine but did not significantly alter the G2/M checkpoint. Combining gemcitabine with LY2603618 resulted in a significant increase in tumor growth inhibition in Calu-6, HT-29 and PAXF 1869 xenografts over gemcitabine treatment alone. The best combination efficacy occurred when LY2603618 was given 24 h following dosing with gemcitabine. LY2603618 worked effectively to remove the S-phase DNA damage checkpoint and increase the DNA damage and the antitumor activity of gemcitabine treatment.

LY2606368 Causes Replication Catastrophe and Antitumor Effects through CHK1-Dependent Mechanisms.

CHK1 is a multifunctional protein kinase integral to both the cellular response to DNA damage and control of the number of active replication forks. CHK1 inhibitors are currently under investigation as chemopotentiating agents due to CHK1's role in establishing DNA damage checkpoints in the cell cycle. Here, we describe the characterization of a novel CHK1 inhibitor, LY2606368, which as a single agent causes double-stranded DNA breakage while simultaneously removing the protection of the DNA damage checkpoints. The action of LY2606368 is dependent upon inhibition of CHK1 and the corresponding increase in CDC25A activation of CDK2, which increases the number of replication forks while reducing their stability. Treatment of cells with LY2606368 results in the rapid appearance of TUNEL and pH2AX-positive double-stranded DNA breaks in the S-phase cell population. Loss of the CHK1-dependent DNA damage checkpoints permits cells with damaged DNA to proceed into early mitosis and die. The majority of treated mitotic nuclei consist of extensively fragmented chromosomes. Inhibition of apoptosis by the caspase inhibitor Z-VAD-FMK had no effect on chromosome fragmentation, indicating that LY2606368 causes replication catastrophe. Changes in the ratio of RPA2 to phosphorylated H2AX following LY2606368 treatment further support replication catastrophe as the mechanism of DNA damage. LY2606368 shows similar activity in xenograft tumor models, which results in significant tumor growth inhibition. LY2606368 is a potent representative of a novel class of drugs for the treatment of cancer that acts through replication catastrophe.

Caracterización de estudiantes de nutrición de la Universidad del Mar de Talca según composición de capital cultural y social / Characterization of nutrition students of the Universidad del Mar of Talca according to cultural and social capital composition

Considering the increase in higher education institutions that offer the Nutrition program and the paradigm shift in the healthcare area oriented to a bio psychosocial approach, which can be understood as a holistic look at the principal actors in the educational process and whose development is not only technical and professional, but also educational. The aim of this article was to describe the composition of the cultural and social capital of the students enrolled in the Nutrition and Dietetics program at the University del Mar of Talca. This was a quantitative, non-experimental, cross-sectional and descriptive study; a survey with close ended question was applied to 45 students. The descriptive statistics results were analyzed using SPSS v.20 and indicated the composition of cultural and social capital of the universe of this study, allowing characterization of each individual whose program training implies a search for social mobility, security, notions of self-expression, and valoric composition proper to modernity.

Considerando el incremento de instituciones de educación superior que ofertan la Carrera de Nutrición, y el cambio paradigmático en el área de salud orientado a un enfoque biopsicosocial, el que podemos entender como una mirada holística hacia los actores en este proceso educativo, cuyo desarrollo no es sólo técnico y profesional, sino también formativo; el presente artículo pretende describir la composición del capital cultural y social de estudiantes de la carrera de Nutrición y Dietética de la Universidad del Mar de Talca. Estudio cuantitativo, no experimental, transversal y descriptivo, con muestra de 45 estudiantes a quienes se les aplicó un cuestionario con preguntas cerradas. Los resultados analizados con estadística descriptiva y utilizando el programa SPSS v.20, indican que la composición del capital cultural y social de los sujetos, permite caracterizar a un estudiante cuya formación disciplinar implica una búsqueda de movilidad social, seguridad, generando nociones de autoexpresión, y una composición valórica muy propia de la modernidad.

Preclinical analyses and phase I evaluation of LY2603618 administered in combination with pemetrexed and cisplatin in patients with advanced cancer.

LY2603618 is an inhibitor of checkpoint kinase 1 (CHK1), an important regulator of the DNA damage checkpoints. Preclinical experiments analyzed NCI-H2122 and NCI-H441 NSCLC cell lines and in vitro/in vivo models treated with pemetrexed and LY2603618 to provide rationale for evaluating this combination in a clinical setting. Combination treatment of LY2603618 with pemetrexed arrested DNA synthesis following initiation of S-phase in cells. Experiments with tumor-bearing mice administered the combination of LY2603618 and pemetrexed demonstrated a significant increase of growth inhibition of NCI-H2122 (H2122) and NCI-H441 (H441) xenograft tumors. These data informed the clinical assessment of LY2603618 in a seamless phase I/II study, which administered pemetrexed (500 mg/m(2)) and cisplatin (75 mg/m(2)) and escalating doses of LY2603618: 130-275 mg. Patients were assessed for safety, toxicity, and pharmacokinetics. In phase I, 14 patients were enrolled, and the most frequently reported adverse events included fatigue, nausea, pyrexia, neutropenia, and vomiting. No DLTs were reported at the tested doses. The systemic exposure of LY2603618 increased in a dose-dependent manner. Pharmacokinetic parameters that correlate with the maximal pharmacodynamic effect in nonclinical xenograft models were achieved at doses ≥240 mg. The pharmacokinetics of LY2603618, pemetrexed, and cisplatin were not altered when used in combination. Two patients achieved a confirmed partial response (both non-small cell lung cancer), and 8 patients had stable disease. LY2603618 administered in combination with pemetrexed and cisplatin demonstrated an acceptable safety profile. The recommended phase II dose of LY2603618 was 275 mg.

Use of flocculants for increasing permeate flux in anaerobic membrane bioreactors.

Biomass retention, required for high rate anaerobic wastewater treatment, can be accomplished coupling an anaerobic bioreactor with membrane filtration. However, low flux seems to be a common factor when operating anaerobic membrane bioreactors (AnMBRs). Modification of biomass properties may represent a strategy for improving membrane flux. The addition of flocculants was tested as a tool for flux increase. Six different products were tested in dead-end filtration experiments. Based on the results, two products were selected for cross-flow tests. The one presenting better performance (Nalco MPE50) was tested in a laboratory-scale continuous AnMBR. Results show that the flocculant was able to substantially increase flux. Indeed, the flux-increasing effect was observed for several weeks after flocculant addition. Therefore, the use of flocculants seems to be an interesting tool to cope with temporary increases in required flux.