Sperm functionality is differentially regulated by porcine oviductal extracellular vesicles from the distinct phases of the estrous cycle.

Context Extracellular vesicles (EVs) derived from the oviductal fluid (oEVs) play a critical role in various reproductive processes, including sperm capacitation, fertilisation, and early embryo development. Aims To characterise porcine oEVs (poEVs) from different stages of the estrous cycle (late follicular, LF; early luteal, EL; mid luteal, ML; late luteal, LL) and investigate their impact on sperm functionality. Methods poEVs were isolated, characterised, and labelled to assess their binding to boar spermatozoa. The effects of poEVs on sperm motility, viability, acrosomal status, protein kinase A phosphorylation (pPKAs), tyrosine phosphorylation (Tyr-P), and in in vitro fertility were analysed. Key results poEVs were observed as round or cup-shaped membrane-surrounded vesicles. Statistical analysis showed that poEVs did not significantly differ in size, quantity, or protein concentration among phases of the estrous cycle. However, LF poEVs demonstrated a higher affinity for binding to sperm. Treatment with EL, ML, and LL poEVs resulted in a decrease in sperm progressive motility and total motility. Moreover, pPKA levels were reduced in presence of LF, EL, and ML poEVs, while Tyr-P levels did not differ between groups. LF poEVs also reduced sperm penetration rate and the number of spermatozoa per penetrated oocyte (P Conclusions poEVs from different stages of the estrous cycle play a modulatory role in sperm functionality by interacting with spermatozoa, affecting motility and capacitation, and participating in sperm-oocyte interaction. Implications The differential effects of LF and LL poEVs suggest the potential use of poEVs as additives in IVF systems to regulate sperm-oocyte interaction.

Evaluation of a Vibrotactile Biofeedback System Targeting Stance Time Symmetry Ratio of Individuals With Lower-Limb Amputation: A Pilot Study.

Individuals with lower-limb amputation (LLA) often exhibit atypical gait patterns and asymmetries. These patterns can be corrected using biofeedback (BFB). Real-time BFB strategies have demonstrated to be effective to various degrees in BFB systems. However, no studies have evaluated the use of corrective vibrotactile BFB strategies to improve temporal gait symmetry of LLA. The aim of this study was to evaluate a wearable vibrotactile BFB system to improve stance time symmetry ratio (STSR) of LLA, and compare two corrective BFB strategies that activate either one or two vibrating motors at two different frequency and amplitude levels, based on a pre-set STSR target. Gait patterns of five unilateral LLA were assessed with and without BFB. Spatiotemporal and kinematic gait parameters were measured and assessed using a wearable motion capture system. Usability and workload were assessed using the System Usability Scale and NASA Task Load Index questionnaires, respectively. Results showed that participants significantly ( [Formula: see text]) improved STSR with BFB; however, this coincided with a reduction in gait speed and cadence compared to walking without feedback. Knee and hip flexion angles improved and changes in other parameters were variable. Immediate post-test retention effects were observed, suggesting that gait changes due to BFB were preserved for at least a short-time after feedback was withdrawn. System usability was found to be acceptable while using BFB. The outcomes of this study provide new insights into the development and implementation of clinically practical and viable BFB system. Future work should focus on assessing the long-term use and retention effects of BFB outside controlled-laboratory conditions.

Characterization of the 1-(5-(4,5-Dimethyl-1,3,2-dioxoborolan-2-yl)thiophen-2-yl)ethanone Using NMR 13C, 1H and 11B through the Density Functional Theory.

The use of computational methods that allow us to perform characterization on new compounds is not a novelty; nevertheless, the degree of complexity of the structures makes their study more challenging since new techniques and methods are required to adjust to the new structural model. The case of nuclear magnetic resonance characterization of boronate esters is fascinating because of its widespread use in materials science. In this paper, we use density functional theory to characterize the structure of the compound 1-[5-(4,5-Dimethyl-1,3,2-dioxaborolan-2-yl)thiophen-2-yl]ethanonea by means of nuclear magnetic resonance. We studied the compound in its solid form with the PBE-GGA and PBEsol-GGA functionals, with a set of plane wave functions and an augmented wave projector, which included gauge in CASTEP and its molecular structure with the B3LYP functional using the package Gaussian 09. In addition, we performed the optimization and calculation of the chemical shifts and isotropic nuclear magnetic resonance shielding of 1H, 13C, and 11B. Finally, we analyzed and compared the theoretical results with experimental diffractometric data observing a good approximation.

Trocar shortening for pediatric vitreoretinal surgery with a 3D printed trocar spacer: Report of two cases.

PURPOSE: To show the results of a trocar spacer for pediatric vitreoretinal surgery with a 3D printed trocar spacer in 2 cases. METHODS: We used standard 27 gauge (ga) and 25 ga trocars and cannulae, and prototyped 1.5 mm × 3 mm spacers with a Prusa MK3 3D printer (0.4 mm nozzle) with Fuse deposition melting (FDM) technology. Parts were printed with a 50 µm layer height in polylactic acid or polylactide (PLA). The spacer was placed in two places: between the blade's base and the trocar, and between the trocar and the sclera depending on the desired amount of shortening. This prototype was used in 2 vitrectomy cases in pediatric patients. RESULTS: We used this trocar spacer in 2 cases with positive results. CONCLUSIONS: This 3D printed spacer has proved to effectively shorten the introduced trocar into two different small eyes. More studies are needed to validate the efficacy and safety of this spacer in clinical practice.

Exploration of Vibrotactile Biofeedback Strategies to Induce Stance Time Asymmetries.

BACKGROUND: Gait symmetry is the degree of equality of biomechanical parameters between limbs within a gait cycle. Human gait is highly symmetrical; however, in the presence of pathology, gait often lacks symmetry. Biofeedback (BFB) systems have demonstrated the potential to reduce gait asymmetry, improve gait function, and benefit overall long-term musculoskeletal health. OBJECTIVES: The aim of this study was to develop a BFB system and evaluate three unique BFB strategies, including bidirectional control - constant vibration (BC), bidirectional control - variable vibration (BV), and unidirectional control - variable vibration (UV) relevant to gait symmetry. The assessed feedback strategies were a combination of vibration frequency/amplitude levels, vibration thresholds, and vibrotactile stimuli from one and two vibrating motors (tactors). Learning effect and short-term retention were also assessed. METHODOLOGY: Testing was performed using a custom BFB system that induces stance time asymmetries to modulate temporal gait symmetry. The BFB system continuously monitors specific gait events (heel-strike and toe-off) and calculates the symmetry ratio, based on the stance time of both limbs to provide real-time biomechanical information via the vibrating motors. Overall walking performance of ten (n=10) able-bodied individuals (age 24.8 ± 4.4 years) was assessed via metrics of symmetry ratio, symmetry ratio error, walking speed, and motor's vibration percentages. FINDINGS: All participants utilized BFB somatosensory information to modulate their symmetry ratio. UV feedback produced a greater change in symmetry ratio, and it came closer to the targeted symmetry ratio. Learning or short-term retention effects were minimal. Walking speeds were reduced with feedback compared to no feedback; however, UV walking speeds were significantly faster compared to BV and BC. CONCLUSION: The outcomes of this study provide new insights into the development and implementation of feedback strategies for gait retraining BFB systems that may ultimately benefit individuals with pathological gait. Future work should assess longer-term use and long-term learning and retention effects of BFB systems in the populations of interest.

Fruit Size and Structure of Zoochorous Trees: Identifying Drivers for the Foraging Preferences of Fruit-Eating Birds in a Mexican Successional Dry Forest.

Tropical dry forests (TDFs) are affected by land-use changes. These modifications impact their composition and arboreal structure, as well as the availability of food for several bird groups. In this study, we evaluated the foraging preferences in zoochorous trees of fruit-eating birds during the dry season of the year in three successional stages (early, intermediate, and mature) of TDFs in southern Mexico. The fruits of these trees are important in the diet of several birds during the dry season, a period during which food resources are significantly reduced in TDFs. We estimated foliar cover (FC) and foliage height diversity (FHD) of zoochorous trees in 123 circular plots. These variables were recognized as proxies of food availability and tree productivity. Foraging preferences were evaluated at the community level, by frugivore type, and by bird species. We evaluated the effect of the structural variables and the fruit size of zoochorous plants on fruit removal by birds and related the bird body mass and fruit size removed in the successional gradient. A total of 14 zoochorous tree species and 23 fruit-eating bird species were recorded along the successional gradient. Intermediate and mature stages showed greater fruit removal. The birds removed mainly B. longipes fruits across the three successional stages. The FHD and fruit size were important drivers in the selection of zoochorous trees and fruit removal by fruit-eating birds. Fruit size and bird body mass were positively related along the successional gradient. The results suggest that fruit removal by fruit-eating birds in the successional gradient can promote the demographic dynamics of several zoochorous tree species, especially of Bursera spp. along the TDFs.

Satisfaction and experience with colorectal cancer screening: a systematic review of validated patient reported outcome measures.

BACKGROUND: Patient satisfaction or experience with colorectal cancer screening can determine adherence to screening programs. An evaluation of validated patient reported outcome measures (PROMs) for measuring experience or satisfaction with colorectal cancer screening does not exist. Our objective was to identify and critically appraise validated questionnaires for measuring patient satisfaction or experience with colorectal cancer screening. METHODS: We conducted a systematic review following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology. We conducted searches on MEDLINE, EMBASE, PsychINFO, CINAHL and BiblioPRO and assessed the methodological quality of studies and measurement properties of questionnaires according to the COSMIN guidelines for systematic reviews of PROMs. PROSPERO registration number: CRD42019118527. RESULTS: We included 80 studies that used 75 questionnaires, of which only 5 were validated. Four questionnaires measured satisfaction with endoscopy: two in the context of colorectal cancer screening (for colonoscopy and sigmoidoscopy) and two for non-screening endoscopy. One questionnaire measured satisfaction with bowel preparation. The methodological quality of studies was variable. The questionnaires with evidence for sufficient content validity and internal consistency were: the CSSQP questionnaire, which measures safety and satisfaction with screening colonoscopy, and the Post-Procedure questionnaire which measures satisfaction with non-screening endoscopic procedures. CONCLUSIONS: This systematic review shows that a minority of existing PROMs for measuring patient satisfaction with colorectal cancer screening are validated. We identified two questionnaires with high potential for further use (CSSQP and the Post-Procedure questionnaire).

Normal Baseline Values for Isometric Shoulder Strength in Scaption for Healthy Filipino Individuals in the 20-30 year Age Group.

INTRODUCTION: Isometric shoulder strength is vital in the management of individuals suffering from shoulder diseases such as rotator cuff tears. Normal values for the working Filipino population who are at risk of developing shoulder problems are lacking. The objective of this study was to determine the isometric baseline isometric shoulder strengths in scaption of healthy Filipino individuals aged 20-30 years old without a history of a shoulder injury. MATERIAL AND METHODS: This is a cross-sectional descriptive study measuring the isometric strength values using the handheld IDO isometer of dominant and non-dominant shoulder of healthy Filipino individuals aged 20 to 30 years old. RESULTS: There is no significant difference in the mean isometric shoulder strength between the dominant and non-dominant arm for both sexes. The male gender scored higher values compared to the female gender and is statistically significant. CONCLUSION: There is no difference in isometric shoulder strength between the dominant and non-dominant shoulder. Strength differences favour the male gender.

Hallazgos ecográficos para la determinación de nódulos tiroideos malignos / Ultrasound findings for the determination of malignant thyroid nodules

Resumen Introducción: Los nódulos tiroideos son un crecimiento localizado en el tejido tiroideo, aproximadamente el 8 % son malignos, y el ultrasonido es el método ideal para detectarlos. Objetivo: Determinar cuáles son los hallazgos ecográficos que pueden sugerir una mayor probabilidad de malignidad del nódulo tiroideo. Metodología: Estudio descriptivo de tipo corte transversal en pacientes con nódulo tiroideo en una institución prestadora de salud de Neiva. Resultados: Se evaluaron 63 pacientes con un promedio de edad de 52 años, 95 % fueron femeninos y el 5 % masculinos. El 71 % presentaron nódulos tiroideos benignos, y el 10 % nódulos malignos. En el 100 % de los nódulos tiroideos malignos se encontró vascularidad aumentada, microcalcificaciones, adenopatías asociadas, bordes irregulares y componente sólido, y los hallazgos con respecto a hipoecogenicidad y diámetro anteroposterior mayor al transverso (más alto que ancho), se encontró en el 83 % siendo estadísticamente significativos. La sensibilidad de los hallazgos ecográficos supera el 80 %, excepto la variable "tamaño del nódulo mayor a 1 centímetro". Conclusiones: Los hallazgos ecográficos como adenopatías y el diámetro anteroposterior mayor al transverso son indicadores potenciales de nódulos tiroideos malignos, el tamaño mayor a un centímetro no siempre es predictor de malignidad, sin embargo debido al tamaño de la muestra en nuestro estudio no es posible generalizarlo como un factor determinante para la realización de biopsia, por ende recomendamos el seguimiento de los nódulos teniendo en cuenta los criterios ecográficos de malignidad y la clasificación TIRADS para tomar decisiones con respecto a las biopsias tiroideas.

Abstract Introduction: Thyroid nodules are a localized growth in the thyroid tissue, approximately 8% are malignant, and an ultrasound is the ideal method to detect them. Objective: Determine which are the ultrasound findings that may suggest an increased probability of thyroid nodule malignancy. Methodology: Descriptive cross-sectional study amongst patients with thyroid nodule in a healthcare institution in Neiva. Results: A total of 63 patients were evaluated with an average age of 52 years, 95% were female and 5% male. Seventy-one percent had benign thyroid nodules, and 10% malignant nodules. In 100% of malignant thyroid nodules, increased vascularity, microcalcifications, associated adenopathies, irregular borders and solid component were found, and the findings regarding hypoechogenicity and anteroposterior diameter greater than the transverse (higher than wide), were found in 83%, being statistically significant. The sensitivity of ultrasound findings exceeds 80%, except for the variable nodule size greater than 1 centimetre. Conclusions: Ultrasound findings such as adenopathies and anteroposterior diameters greater than the transverse one are potential indicators of malignant thyroid nodules, the size greater than one centimetre is not always a predictor of malignancy; however, due to the size of the sample in our study it is not possible to generalize it as a determining factor for biopsy. Therefore, we recommend monitoring the nodules considering the ultrasound criteria for malignancy and the TIRADS classification to make decisions regarding thyroid biopsies.

The urban contrast: A nationwide assessment of avian diversity in Mexican cities.

In this study we focused on urban bird diversity across Mexico, a megadiverse country, with a special focus on the relative role of urban greenspaces and heavily-built sites. We considered a country-wide approach, including 24 different sized Mexican cities. Our aims were to describe the urban bird diversity in focal cities and further assess the relationships between it and the biogeographic region where cities are located, their size, elevation, and annual rainfall. Additionally, we evaluated differences in the functional composition of bird communities in both studied urban scenarios (i.e., urban greenspaces, heavily-built sites). Our results confirm that urban greenspaces are home to a large proportion of species when contrasted with heavily-built sites. While total species richness and species richness of greenspaces were related with the cities' biogeographic region -with higher species richness in the Neotropical region and Transition Zone-, the relationship did not hold true in heavily-built sites. We found that annual rainfall was negatively related to bird richness in heavily-built sites, suggesting that species from arid systems can be more tolerant to urbanization. Regarding the bird functional group assessment, results show a clear differentiation between the functional groups of greenspaces and those of heavily-built sites, with granivores and omnivores associated with the latter and a highly diverse array of functional groups associated with urban greenspaces.

Psychosocial and pharmacologic interventions for methamphetamine addiction: protocol for a scoping review of the literature.

BACKGROUND: Methamphetamine use and harms are rising rapidly. Management of patients with methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU) is challenging, with no clearly established best approach; both psychosocial and pharmacologic interventions have been described. Furthermore, given the diversity of individuals that use methamphetamines, there is a need to assess evidence for treatments for subgroups including youths; gay, bisexual, and other men who have sex with men; individuals with mental health comorbidities; and individuals in correction services. Establishing awareness of the messages regarding treatment from recent clinical practice guidelines (CPG) in the field is also of value. The first study objective will be to establish a greater understanding of the methods, populations, and findings of controlled studies for psychosocial and pharmacologic treatments for MUD and PMU. Investigation of this information can help establish the potential for advanced syntheses of the evidence (such as network meta-analysis) to compare therapies for this condition and to identify gaps related to key populations where more primary research is needed. Summarizing the recommendations regarding treatment of MUD/PMU from recent CPGs and systematic reviews will be an important secondary objective. METHODS: A scoping review will be performed. Using the OVID platform, MEDLINE, Embase, PsycINFO, and relevant Cochrane databases from EBM Reviews will be searched (from databases' inception onwards). Eligibility criteria will include individuals described as having MUD or PMU, with designs of interest including randomized trials, non-randomized trials, and controlled cohort studies with three or more months of follow-up; systematic reviews and CPGs will also be sought. Two reviewers (with support from automation tools) will independently screen all citations, full-text articles, and chart data. Different approaches to handling and summarizing the data will be implemented for each type of study design. Tables and graphics will be used to map evidence sources and identify evidence gaps. DISCUSSION: This research will enhance awareness of evidence addressing the effects of psychosocial and pharmacologic interventions for MUD/PMU overall and in sub-populations, both in terms of recent CPGs/reviews and primary studies; inspection of the latter will also help establish the feasibility of future syntheses to compare treatments, such as network meta-analysis. SYSTEMATIC REVIEW PROTOCOL REGISTRATION: Open Science Framework ( https://osf.io/9wy8p ).

RELICT HUMID TROPICAL FOREST IN MEXICO PROMOTES DIFFERENTIATION IN BARRED WOODCREEPERS Dendrocolaptes (AVES: FURNARIIDAE).

Humid tropical forests in Mesoamerica are distributed along the Atlantic slope and, in scattered locations, along the Mexican Pacific slope. These poorly explored Mexican forests include microendemic bird species. Two species in the genus Dendrocolaptes occur in lowland and foothill humid tropical forests of Mesoamerica. One of these, D. sanctithomae, is comprised of four subspecies, of which the two that occur in Mexico, D. s. sanctithomae and D. s. sheffleri, are distinctly different morphologically, and the latter is a poorly known microendemic taxon of the Mexican Pacific humid tropical forest in the Sierra Madre del Sur. We used both nuclear (nDNA) and mitochondrial DNA (mtDNA) to evaluate the genetic variation of D. sanctithomae in Mexico, and complemented this with a quantitative analysis of phenotypic traits. We also conducted analyses of environmental niche models to test the hypothesis of niche differentiation of D. s. sheffleri from other taxa of D. sanctithomae. Our phylogenetic reconstructions of mtDNA consistently recovered D. s. sheffleri and D. s. sanctithomae as reciprocally monophyletic, while they shared alleles of nDNA. These mtDNA differences are comparable with differences reported between other Dendrocolaptes sister-taxa pairs. Our analysis of phenotypic traits also indicated that the taxa differ in measurements of hallux and feather barring. In contrast, niche differentiation tests suggest that the niches of both taxa are more similar than expected by chance. Our evidence leads us to propose species status for D. sheffleri. This is an additional example of recent speciation in Mexico that indicates active and peripatric evolutionary differentiation in the northern Neotropics.

3D printing of canine hip dysplasia: anatomic models and radiographs / Impressão 3D da displasia coxofemoral canina: modelos anatômicos e radiografias

Canine Hip Dysplasia (CHD) is a highly prevalent articular pathological condition. In this sense, radiography becomes an important diagnostic method to determine the presence and severity of the disease. The objective was to create 3D models and their respective radiographs representing the CHD (3D AMCHD). The research was carried out in the Laboratory of 3D Educational Technologies of UFAC, under no. 23107.007273/2017-49 (CEUA/UFAC). A canine skeleton (hip bone, femurs and patellae) was used without anatomical deformities compatible with DCF (pelvis, femurs and patella), which were scanned in order to obtain the files of the base model. In these files the deformations representing the different degrees of CHD were performed. Subsequently, the 3D AMCHD files were printed, mounted and X-rayed. The 3D AMCHD represented the bone deformations of the different degrees of CHD. In the radiographs of the 3D AMCHD it was possible to observe and determine each of the bones that constituted the hip joints. This allowed to reproduce the correct positioning to represent the CHD diagnosis and establish the precise points to determine the Norberg angle. In this way, it was evidenced that the 3D AMCHD can be a possible tool to be used in the Teaching of Veterinary Medicine.(AU)

A displasia coxofemoral canina (DCF) é uma condição patológica articular de grande prevalência. Nesse sentido, a radiografia torna-se um método de diagnóstico importante para determinar a presença e a gravidade da doença. O objetivo do presente trabalho foi criar modelos 3D e suas respectivas radiografias representando a DCF (MADCF 3D). A pesquisa foi realizada no Laboratório de Tecnologias Educacionais 3D da UFAC, sob o nº. 23107.007273/2017-49 (Ceua/Ufac). Foram utilizados esqueletos caninos (pelve, fêmures e patelas) sem deformidades anatômicas compatíveis com a DCF, os quais foram digitalizados a fim de se obterem os arquivos do modelo base. Nesses arquivos foram realizadas as deformações que representavam os diferentes graus da DCF. Posteriormente, os arquivos dos MADCF 3D foram impressos, montados e radiografados. Os MADCF 3D representaram as deformações ósseas dos diferentes graus da DCF. Nas radiografias dos MADCF 3D, foi possível observar e determinar cada um dos ossos que constituíam as articulações coxofemorais. Isso permitiu reproduzir o posicionamento correto para representação do diagnóstico DCF e estabelecer os pontos precisos para determinar o ângulo de Norberg. Dessa forma, evidenciou-se que os MADCF 3D podem ser uma possível ferramenta a ser empregada no ensino de medicina veterinária.(AU)

Patterns of Bird Diversity and Endemism Along an Elevational Gradient in the Southern Mexican Highlands.

Knowledge of bird species diversity along elevational gradients is key for understanding the distributional limits of species and, ultimately, for promoting measures that conserve biodiversity. In the present study, we evaluated changes in bird species richness, diversity, and endemism along an elevational gradient in the Sierra Madre del Sur in southern Mexico -a globally recognized biodiversity hotspot. Monthly bird surveys were carried out at localities with elevations of 1600, 1800, 2000, and 2200 m over the course of one year (2014-2015) covering an area of 2000 km2 (10 circular plots with a radius of 25 m per elevation site). Diversity was calculated in terms of effective number of species or Hill numbers, while the composition of bird species along the elevational gradient was analyzed by non-metric multidimensional scaling, and endemic bird species turnover was assessed with faunal congruence curves. Overall, a total of 118 bird species belonging to 35 families were recorded along the elevational gradient. Although we found that bird richness and diversity increased with increasing elevation, we also observed significant turnover in bird composition and endemic species, which were likely linked to forest types and conditions, as well as proximity of sites to urban centers. Assessing biodiversity patterns across elevational gradients in a well-recognized biodiversity reservoir advances both understanding of ecological patterns and aids conservation efforts and management of biological resources.

Manejo y desenlaces de la pancreatitis aguda en un hospital de cuarto nivel (Huila, Colombia), 3 años de experiencia / Outcomes of Three Years of Experience Managing Acute Pancreatitis at a Fourth Level Hospital in Huila, Colombia

Resumen Objetivo: describir el comportamiento clínico y quirúrgico de los pacientes con pancreatitis aguda manejados en un centro hospitalario de cuarto nivel. Método: se realizó un estudio descriptivo retrospectivo analítico de los pacientes con diagnóstico de pancreatitis aguda que ingresaron al Hospital Universitario de Neiva en el período comprendido entre el 1 de enero del 2015 al 31 de julio del 2017. Resultados: se identificaron 138 pacientes que ingresaron con impresión diagnóstica de pancreatitis aguda, de los cuales se confirmó el diagnóstico en 130 pacientes y se excluyeron 21 pacientes por no cumplir con los criterios de inclusión. Según la clasificación de Atlanta 2012, 73 (67 %) pacientes cursaban con una pancreatitis leve, 17 (16 %) con pancreatitis moderadamente severa y 19 (17 %) con pancreatitis severa. La principal causa de pancreatitis encontrada fue la biliar. La prueba de chi cuadrado (χ2) mostró una significancia estadística para la edad como factor de riesgo para pancreatitis severa (p = 0,04). De la totalidad de pacientes, en 8 pacientes se documentó necrosis pancreática, de los cuales 5 fueron manejados quirúrgicamente, con un abordaje por laparotomía en 3 pacientes y 2 por laparoscopia, con una mortalidad del 37,5 % en los pacientes con necrosis pancreática manejados quirúrgicamente. De los 109 pacientes incluidos en el estudio, 100 pacientes (91,74 %) resolvieron su cuadro de pancreatitis y egresaron vivos de la institución, para una mortalidad reportada en 9 pacientes (8,25 %), quienes cursaron con pancreatitis aguda severa. Conclusión: el estudio presentado es de tipo descriptivo estableciendo las características demográficas y el curso de la enfermedad de los pacientes con pancreatitis aguda incluidos las complicaciones y el manejo de estas. Con este estudio no se pretende estandarizar causalidad ni manejo de la patología descrita, solo se describe la experiencia realizada en un hospital de cuarto nivel tratando de contribuir con el desarrollo de estudios de cohortes y ensayos clínicos que permitan establecer guías de manejo con el fin de mejorar los desenlaces de los pacientes con pancreatitis aguda.

Abstract Objective: Our objective was to describe the clinical and surgical behavior of patients with acute pancreatitis managed at a fourth level hospital center. Method: This is a descriptive, retrospective and analytical study of patients diagnosed with acute pancreatitis who entered the University Hospital of Neiva in the period from January 1, 2015 to July 31, 2017. Results: We identified 138 patients who had been admitted with a diagnosis of acute pancreatitis. Of these, the diagnosis was confirmed for 130 patients, but 21 patients were excluded because they did not meet the inclusion criteria. According to the 2012 Atlanta classification, 73 (67%) patients had mild pancreatitis, 17 (16%) had moderately severe pancreatitis, and 19 (17%) had severe pancreatitis. The main cause of pancreatitis was biliary. The chi-square test showed statistical significance for age as a risk factor for severe pancreatitis (p = 0.04). Pancreatic necrosis was documented in 8 patients, five of whom were managed surgically. This included three laparotomies and two laparoscopic operations. The mortality rate for patients with surgically managed pancreatic necrosis was 37.5%. Of the 109 patients included in the study, the resolved their pancreatitis of 100 patients (91.74%) was resolved and they left the institution alive. Nine patients (8.25%), all of whom had severe acute pancreatitis, died. Conclusion: This descriptive study established the demographic characteristics and clinical course of patients with acute pancreatitis including complications and management of complications. This study is not intended to standardize causality or management of acute pancreatitis, but rather only describes the experience of a fourth level hospital in order to contribute to the development of cohort studies and clinical trials that will allow establishment of management guidelines to improve the outcomes of patients with acute pancreatitis.

Hallazgos audiológicos en personas menores de 65 años diagnosticadas con osteoporosis: estudio preliminar / Audiological findings in persons under age of 65 diagnosed with osteoporosis: preliminary study

RESUMEN Introducción: La osteoporosis afecta a 200 millones de personas en el mundo y corresponde a una enfermedad crónica que afecta más a mujeres que a hombres, con una prevalencia en Chile del 1,7% y 0,2%, respectivamente. Debido al gran porcentaje de pacientes que la padecen, se han llevado a cabo diversos estudios sobre los síntomas secundarios que pueden encontrarse en esta patología. En el último tiempo, se ha investigado la osteoporosis como un factor de riesgo para padecer pérdida auditiva. Objetivo: Comparar los resultados de umbrales auditivos aéreos, timpanometria y reflejos acústicos ipsilaterales entre pacientes con osteoporosis y pacientes sin osteoporosis, menores de 65 años sin otra patología de base. Material y método: Estudio preliminar de tipo observacional de caso y controles con alcance exploratorio. Se analizaron 28 oídos de una muestra conformada por un grupo estudio de 7 participantes con osteoporosis y un grupo control de 7 participantes sin osteoporosis. Se evaluó el sistema tímpano osicular con la timpanometria y el umbral del reflejo acústico estapedial ipsilateral, y el nivel auditivo por frecuencia con la audiometria tonal. Resultados: Se observaron diferencias estadísticamente significativas entre ambos grupos en los umbrales auditivos, con predominancia sensorioneural en el grupo estudio, y en los umbrales del reflejo acústico ipsilateral. Conclusión: La osteoporosis podría ser un factor de riesgo para padecer pérdida auditiva del tipo sensorioneural. Es necesario continuar el estudio para obtener resultados con mayor representatividad.

ABSTRACT Introduction: Osteoporosis affects over 200 million people in the world and corresponds to a chronic disease that affects more women than men, with a prevalence in Chile of 1.7% and 0.2% respectively. Due to the large percentage of patients who suffer it, several studies about the secondary symptoms that can be found in this pathology have been carried out. In the last time, osteoporosis has been investigated as a risk factor for hearing loss. Aim: To compare the results of air auditory thresholds, tympanometry, and ipsilateral acoustic reflexes in patients with osteoporosis versus patients without osteoporosis, under 65 years old without another underlying disease. Material and method: Preliminary study of observational type of case and controls with exploratory scope. We analyzed 28 ears of a sample consisted of a group study of 7 participants with osteoporosis and a control group of 7 participants without osteoporosis. The tympanic oscillating system and auditory level of each participant were evaluated with tympanometry, ipsilateral stapedial acoustic reflex threshold and tonal audiometry. Results: Statistically significant differences were observed between both groups in the auditory thresholds with a sensorineural predominance and in the ipsilateral stapedial acoustic reflex thresholds. Conclusions: The osteoporosis could be a risk factor for suffer hearing loss of sensorineural type. It is necessary to continue the study to obtain results with greater representativeness.

Seed predation increases from the Arctic to the Equator and from high to low elevations.

Species interactions have long been predicted to increase in intensity toward the tropics and low elevations because of gradients in climate, productivity, or biodiversity. Despite their importance for understanding global ecological and evolutionary processes, plant-animal interaction gradients are particularly difficult to test systematically across large geographic gradients, and evidence from smaller, disparate studies is inconclusive. By systematically measuring postdispersal seed predation using 6995 standardized seed depots along 18 mountains in the Pacific cordillera, we found that seed predation increases by 17% from the Arctic to the Equator and by 17% from 4000 meters above sea level to sea level. Clines in total predation, likely driven by invertebrates, were consistent across treeline ecotones and within continuous forest and were better explained by climate seasonality than by productivity, biodiversity, or latitude. These results suggest that species interactions play predictably greater ecological and evolutionary roles in tropical, lowland, and other less seasonal ecosystems.

Improvement in clinical outcomes and replacement factor VIII use in patients with haemophilia A after factor VIII pharmacokinetic-guided prophylaxis based on Bayesian models with myPKFiT®.

OBJECTIVES: Patients with severe haemophilia A (HA) receive factor VIII (FVIII) replacement therapy as prophylaxis. myPKFiT® is an online medical application that allows authorized users to simulate dosing regimens with patient pharmacokinetic (PK) profiles based on only 2 blood samples. Our aim was to assess the impact of using this medical device in routine practice in terms of FVIII consumption and clinical outcomes. METHODS: Thirty-six patients with severe HA on prophylaxis with Advate® were recruited in 3 centres in Spain. Annual bleeding rate (ABR), annual joint bleeding rate (AJBR) and annual FVIII consumption before and after adjustment were obtained using the patient's clinical history (12 months before) and prospectively recorded data (12 months after), respectively. Adjustment was based on PK parameters provided by myPKFiT® , joint status and relative risk associated with physical activity and bleeding phenotype. RESULTS: ABR and AJBR were significantly reduced after adjustment in the overall sample (-2.2 ± 1.3, P = .018 and -1.9 ± 1.2, P = .012, respectively) and in patients aged >15 years (-2.6 ± 1.4, P = .011 and -2.0 ± 1.2, P = .005, respectively). Adjustment had an effect on the individual FVIII consumption of most patients: annual amount was reduced in 18 cases and increased in 14. There was no significant effect on the mean amount (198 784 ± 110 387) compared to that used the year prior to myPKFiT® -adjusted prophylaxis (199 466 ± 103 670; P = .737). DISCUSSION: Our results suggest that PK-guided prophylaxis using myPKFiT® improved clinical outcomes and optimized FVIII consumption in the study population. This personalized approach may reduce bleeding rates without significantly increasing the overall cost of FVIII therapy.