Appropriateness of Ketoanalogues of Amino Acids, Calcium Citrate, and Inulin Supplementation for CKD Management: A RAND/UCLA Consensus.

BACKGROUND: Current treatment for chronic kidney disease (CKD) focuses on improving manifestations and delaying progression. Nutritional approaches play a crucial role in CKD management, and various supplements have become available. Ketoanalogues of amino acids (KAs), calcium citrate, and inulin have been proposed as suitable supplements, yet their widespread use has been limited due to insufficient evidence. This study aimed to generate general guidance statements on the appropriateness of these supplements through a RAND/UCLA consensus process. METHODS: A RAND/UCLA consensus panel was convened to evaluate the appropriateness of these supplements in different clinical scenarios. In this study, we present a subgroup analysis focusing on a panel of eleven clinical nephrologists from among the experts. RESULTS: Supplementation of low-protein diets (LPDs) and very low-protein diets (VLPDs) with KA was considered appropriate to reduce manifestations and delay CKD outcomes, supplementation with calcium citrate is considered appropriate to reduce CKD manifestations, and supplementation with inulin is considered appropriate to delay CKD outcomes and manage comorbidities. CONCLUSIONS: Based on a combination of clinical experience and scientific evidence, the panel reached a consensus that KA supplementation of LPD and VLPD, calcium citrate, and inulin are appropriate in patients with CKD across various scenarios.

A randomized, placebo-controlled trial of purified anthocyanins on cognitive function in individuals at elevated risk for dementia: Analysis of inflammatory biomarkers toward personalized interventions.

BACKGROUND: Dementia poses a significant global health challenge. Anthocyanins neutralize free radicals, modulate signaling pathways, inhibit pro-inflammatory genes, and suppress cytokine production and may thus have positive cognitive effects in people at increased risk of dementia. We aim to investigate the effects of purified anthocyanins on cognitive function in people at increased risk of dementia according to their inflammation status based on blood-based inflammatory biomarkers. METHODS: This is a secondary analysis of a 24-week randomized, double-blind, placebo-controlled trial. Cluster analysis was performed to categorize two groups based on their individual inflammatory biomarker profile using multiplex sandwich ELISA for the quantitative measurement of cytokines. Descriptive statistics and longitudinal models assessed cognitive outcomes. The primary comparison was the group difference at week 24 based on a modified intention-to-treat analysis. RESULTS: Cluster analysis revealed two distinct inflammatory biomarker profiles. In Cluster 1 (high levels of inflammation biomarkers), anthocyanin treatment showed a statistically significant improvement on cognitive function compared to placebo at 24 weeks. No significant differences were observed in Cluster 2 (low levels of inflammation biomarkers). The demographic characteristics, cognitive scores, and biomarker distributions were similar between treatment groups at baseline. However, cluster 1 exhibited higher BMI, diabetes prevalence, medication usage, and lower HDL cholesterol levels. CONCLUSION: Individuals with elevated levels of inflammation markers benefited from anthocyanin treatment to enhance cognitive performance, whereas those with lower levels did not. The anti-inflammatory and antioxidant properties of anthocyanins make them a promising intervention, and future prospective trials in people with increased inflammation are warranted.

Sarcoma de Ewing extraesquelético: reporte de caso / Extraskeletal Ewing's Sarcoma: a Case Report

Introducción: El sarcoma de Ewing es un tumor maligno de alto grado con localización principalmente ósea; se han reportado aproximadamente 12% con presentación extra-esquelética. Actualmente, existen alrededor de 20 casos descritos en la literatura con origen mediastinal y 10 casos con origen pulmonar. Caso clínico: Se presenta el caso de una mujer de 25 años con un mes de disnea y dolor torácico, con el hallazgo de derrame pleural masivo y tumoración mediastinal en hemitórax derecho. Se le realiza toracotomía anterior bilateral con esternotomía transversa de Clamshell, con resección parcial que demuestra, por patología, sarcoma monomórfico de alto grado e inmunohistoquímica concluyente de sarcoma de Ewing. Conclusión: Este caso es una entidad rara y conlleva un reto diagnóstico para el clínico; sin embargo, debe sospecharse considerando la presentación clínica y radiológica del paciente, buscando incrementar la tasa de supervivencia mediante el diagnóstico y tratamiento oportuno.

Introduction: Ewing's sarcoma is a high-grade malignant tumor with mainly bony lo-calization; approximately 12% have been reported with extraskeletal presentation. Currently, there are about 20 cases described in the literature with mediastinal origin and 10 pulmonary cases. Case Report: We present the case of a 25-year-old woman with one month of dysp-nea and chest pain, with massive pleural effusion and mediastinal tumor in the right hemithorax who underwent bilateral anterior thoracotomy with Clamshell transverse sternotomy, with partial resection demonstrating, by pathology, high-grade monomorphic sarcoma and conclusive immunohistochemistry of Ewing's sarcoma. Conclusion: This case is a rare entity and involves a diagnostic challenge for the clinician; however, it should be suspected considering the clinical and radiological presentation of the patient, seeking to increase the survival rate through timely diagnosis and treatment.

Trajectory, fate, and magnitude of continental microplastic loads to the inner shelf: A case study of the world's largest coastal shallow lagoon.

The Patos Lagoon estuary is a highly significant ecosystem where freshwater from a vast and densely populated area continuously flows into the Atlantic Ocean by coastal plumes, exporting not only freshwater but also sediment, nutrients, plastics, and other contaminants. In this work, numerical modeling tools together with field data were used to assess for the first time the capacity of the coastal plume to export microplastics (MPs) to the inner shelf under different hydrodynamic conditions. Two field surveys were conducted during plume events to quantify MP concentrations and validate the model approach. A bottom-up approach was employed to estimate the potential MP export from the estuary's domain to the Atlantic Ocean. MP concentration in surface plume waters ranged from 0.20 items m-3 to 1.37 items m-3, confirmed by FTIR as synthetic polymers in a 90 %, being Polypropylene (PP) and Polyethylene (PE) the most abundant in a 73 %. The accumulation pattern was observed on the plume's frontal system, consistent with simulation results. The estimated average MP potential export rate attained 9.0 million items day-1 during moderate plume events and 47.5 million items day-1 during high discharge plume events. Strong discharge events, coupled with intense northeast winds, facilitated rapid southwestward export of MPs. Conversely, moderate to weak discharge events retained MPs closer to the estuary's mouth, enabling either longer trajectories or earlier deposition. Significant MP accumulation hotspots were identified in the gyre between the jetties and Cassino beach, as well as in the saline front within the plume boundaries. These accumulation zones may function as reservoirs for MP particles, potentially posing threats to local ecosystems. Understanding these dynamics is crucial for ongoing monitoring efforts to assess potential harmful interactions over time.

Healthy aging meta-analyses and scoping review of risk factors across Latin America reveal large heterogeneity and weak predictive models.

Models of healthy aging are typically based on the United States and Europe and may not apply to diverse and heterogeneous populations. In this study, our objectives were to conduct a meta-analysis to assess risk factors of cognition and functional ability across aging populations in Latin America and a scoping review focusing on methodological procedures. Our study design included randomized controlled trials and cohort, case-control and cross-sectional studies using multiple databases, including MEDLINE, the Virtual Health Library and Web of Science. From an initial pool of 455 studies, our meta-analysis included 38 final studies (28 assessing cognition and 10 assessing functional ability, n = 146,000 participants). Our results revealed significant but heterogeneous effects for cognition (odds ratio (OR) = 1.20, P = 0.03, confidence interval (CI) = (1.0127, 1.42); heterogeneity: I2 = 92.1%, CI = (89.8%, 94%)) and functional ability (OR = 1.20, P = 0.01, CI = (1.04, 1.39); I2 = 93.1%, CI = (89.3%, 95.5%)). Specific risk factors had limited effects, especially on functional ability, with moderate impacts for demographics and mental health and marginal effects for health status and social determinants of health. Methodological issues, such as outliers, inter-country differences and publication bias, influenced the results. Overall, we highlight the specific profile of risk factors associated with healthy aging in Latin America. The heterogeneity in results and methodological approaches in studying healthy aging call for greater harmonization and further regional research to understand healthy aging in Latin America.

Assessing the validity of driver gene identification tools for targeted genome sequencing data.

Motivation: Most cancer driver gene identification tools have been developed for whole-exome sequencing data. Targeted sequencing is a popular alternative to whole-exome sequencing for large cancer studies due to its greater depth at a lower cost per tumor. Unlike whole-exome sequencing, targeted sequencing only enables mutation calling for a selected subset of genes. Whether existing driver gene identification tools remain valid in that context has not previously been studied. Results: We evaluated the validity of seven popular driver gene identification tools when applied to targeted sequencing data. Based on whole-exome data of 14 different cancer types from TCGA, we constructed matching targeted datasets by keeping only the mutations overlapping with the pan-cancer MSK-IMPACT panel and, in the case of breast cancer, also the breast-cancer-specific B-CAST panel. We then compared the driver gene predictions obtained on whole-exome and targeted mutation data for each of the seven tools. Differences in how the tools model background mutation rates were the most important determinant of their validity on targeted sequencing data. Based on our results, we recommend OncodriveFML, OncodriveCLUSTL, 20/20+, dNdSCv, and ActiveDriver for driver gene identification in targeted sequencing data, whereas MutSigCV and DriverML are best avoided in that context. Availability and implementation: Code for the analyses is available at https://github.com/SchmidtGroupNKI/TGSdrivergene_validity.

A parasite odyssey: An RNA virus concealed in Toxoplasma gondii.

We are entering a 'Platinum Age of Virus Discovery', an era marked by exponential growth in the discovery of virus biodiversity, and driven by advances in metagenomics and computational analysis. In the ecosystem of a human (or any animal) there are more species of viruses than simply those directly infecting the animal cells. Viruses can infect all organisms constituting the microbiome, including bacteria, fungi, and unicellular parasites. Thus the complexity of possible interactions between host, microbe, and viruses is unfathomable. To understand this interaction network we must employ computationally assisted virology as a means of analyzing and interpreting the millions of available samples to make inferences about the ways in which viruses may intersect human health. From a computational viral screen of human neuronal datasets, we identified a novel narnavirus Apocryptovirus odysseus (Ao) which likely infects the neurotropic parasite Toxoplasma gondii. Previously, several parasitic protozoan viruses (PPVs) have been mechanistically established as triggers of host innate responses, and here we present in silico evidence that Ao is a plausible pro-inflammatory factor in human and mouse cells infected by T. gondii. T. gondii infects billions of people worldwide, yet the prognosis of toxoplasmosis disease is highly variable, and PPVs like Ao could function as a hitherto undescribed hypervirulence factor. In a broader screen of over 7.6 million samples, we explored phylogenetically proximal viruses to Ao and discovered nineteen Apocryptovirus species, all found in libraries annotated as vertebrate transcriptome or metatranscriptomes. While samples containing this genus of narnaviruses are derived from sheep, goat, bat, rabbit, chicken, and pigeon samples, the presence of virus is strongly predictive of parasitic Apicomplexa nucleic acid co-occurrence, supporting the fact that Apocryptovirus is a genus of parasite-infecting viruses. This is a computational proof-of-concept study in which we rapidly analyze millions of datasets from which we distilled a mechanistically, ecologically, and phylogenetically refined hypothesis. We predict that this highly diverged Ao RNA virus is biologically a T. gondii infection, and that Ao, and other viruses like it, will modulate this disease which afflicts billions worldwide.

Complete mitochondrial genome of the introduced Indian walking stick Carausius morosus (Lonchodidae, Insecta) from California.

We present the complete mitochondrial genome of Carausius morosus from Salinas, CA. The mitochondrial genome of C. morosus is circular, AT rich (78.1%), and 16,671 bp in length. It consists of 13 protein-coding, 22 transfer RNA, and 2 ribosomal RNA genes and is identical in gene content to Carausius sp.

Comparing cefazolin/ metronidazole, piperacillin-tazobactam, or c efoxitin as surgical antibiotic prophylaxis in patients undergoing pancreaticoduodenectomy: A retrospective cohort study.

BACKGROUND: Preoperative antibiotic options for pancreaticoduodenectomy (PD) include cefoxitin (CX), piperacillin-tazobactam (PT), or combined cefazolin and metronidazole (CM). Recent studies suggest the superiority of PT over CX, but evidence for CM is unclear. OBJECTIVE: To explore the impact of preoperative antibiotic selection (CM vs. PT and CX vs. PT) on the development of surgical site infections (SSI). METHODS: Consecutive adult patients at one institution who underwent PD from November 2017 to December 2021 and received either CM, PT, or CX preoperatively, were included. The primary outcome was SSI. Secondary outcomes included postoperative infections and clinically significant postoperative pancreatic fistula (POPF). Logistic regression models were used. RESULTS: Among 127 patients included in the study, PT, CM, and CX were administered in 46 (36.2%), 44 (34.6%), and 37 (29.4%) patients, respectively. There were 32 (27.1%) SSI, 20 (36.1%) infections, and 21 (22.9%) POPF events. PT use was associated with reduced risk of SSI compared to CX (OR: 0.32, 95% CI: 0.11-0.89, p = 0.03), but there was no difference as compared to CM (OR: 0.75, 95% CI: 0.27-2.13, p = 0.59). There were no differences in secondary outcomes. CONCLUSION: PT reduced SSI rates compared to CX but was no different to CM among patients undergoing PD at our center.

Quality of life following perioperative optimization with nutritional supplements in patients undergoing gastrointestinal surgery for cancer: A randomized, placebo-controlled feasibility clinical trial.

BACKGROUND: Up to two thirds of patients presenting for abdominal cancer surgery are malnourished pre-operatively. Perioperative nutritional supplementation has been proposed to improve surgical outcomes, though its effect on quality of life (QoL) is not yet understood. METHODS: A randomized controlled feasibility trial for perioperative nutrition among patients undergoing major abdominal cancer surgery was conducted. Participants in the intervention group received supplements for 30 days before surgery. Participants completed two QoL questionnaires (EORTC-QLQ-C-30 and FACT-G) at baseline, then 4 and 12 weeks postoperatively. Participants were compared between and within groups at baseline, Weeks 4, and 12 using t tests. Minimal clinically important differences (MCIDs) were considered as a 10-point worsening from baseline. RESULTS: Sixty-six participants were available for analysis in this study, including 33 in the intervention and 30 in the control arms. Baseline demographics were balanced between groups except for different rates of pancreas cancer (36% intervention vs. 9% control) and colorectal cancer (19% intervention vs. 34% control). At baseline, participants in the intervention group had lower overall QoL (59% vs. 77%, p = 0.01), role functioning (72% vs 88%, p = 0.045), and cognitive functioning (79% vs 90%, p = 0.047). Following surgery, role and physical functioning worsened in the control group, without significant differences between groups. Role functioning was persistently worsened at 12 weeks in the control group. The rates of MCIDs were similar between both intervention and control groups. DISCUSSION: Perioperative nutrition was associated with preservation of QoL in the postoperative period following major abdominal cancer surgery compared to placebo. SUMMARY: Among patients undergoing surgery for cancer, the majority present at high risk for malnutrition. In this placebo-controlled randomized trial among patients undergoing major abdominal surgery for cancer, preoperative nutrition supplementation was associated with the preservation of QoL in the postoperative period.

Usual interstitial pneumopathy in a patient with hypersensitivity pneumonitis and microscopic polyangiitis. Case report.

One of the most frequent diffuse interstitial lung diseases is hypersensitivity pneumonitis. It is related to exposure to diverse antigens, causing fibrosis in advanced stages, making the differential diagnosis with interstitial pulmonary fibrosis difficult as it overlaps with the usual interstitial pneumonia pattern. On the other hand, there are interstitial lung diseases associated with ANCA, such as microscopic polyangiitis, which is also related to the usual interstitial pneumonia pattern. We present the case of a 74-year-old male patient with chronic dyspnea, history of smoking and exposure to organic particles, in addition to a pattern suggestive of moderately severe restriction. The diagnosis was confirmed by histology of hypersensitivity pneumonitis by presenting granules, however, anti MPO and p-ANCA positivity was found, integrating the simultaneous diagnosis of microscopic polyangiitis. This is a case of difficult diagnosis since these pathologies have not been previously reported to coexist.

Venom of the neotropical rattlesnake, Crotalus culminatus: Intraspecific variation, neutralization by antivenoms, and immunogenicity in rabbits.

Crotalus culminatus is a medically significant species of rattlesnake in Mexico [1]. While the proteomic composition of its venom has been previously reported for both juvenile and adult specimens, there has been limited research into its functional properties, with only a few studies, including one focusing on coagulotoxicity mechanisms. In this study, we aimed to compare the biochemical and biological activities of the venom of juvenile and adult snakes. Additionally, we assessed antibody production using the venoms of juveniles and adults as immunogens in rabbits. Our findings reveal lethality and proteolytic activity differences between the venoms of juveniles and adults. Notably, juvenile venoms exhibited high proportions of crotamine, while adult venoms displayed a reduction of this component. A commercially available antivenom demonstrated effective neutralization of lethality of both juvenile and adult venoms in mice. However, it failed to neutralize the paralytic activity induced by crotamine, which, in contrast, was successfully inhibited by antibodies obtained from hyperimmunized rabbits. These results suggest the potential inclusion of C. culminatus venom from juveniles in commercial antivenom immunization schemes to generate antibodies targeting this small myotoxin.

Unveiling Sticholysin II and plasmid DNA interaction: Implications for developing non-viral vectors.

Non-viral gene delivery systems offer significant potential for gene therapy due to their versatility, safety, and cost advantages over viral vectors. However, their effectiveness can be hindered by the challenge of efficiently releasing the genetic cargo from endosomes to prevent degradation in lysosomes. To overcome this obstacle, functional components can be incorporated into these systems. Sticholysin II (StII) is one of the pore-forming proteins derived from the sea anemone Stichodactyla helianthus, known for its high ability to permeabilize cellular and model membranes. In this study, we aimed to investigate the interaction between StII, and a model plasmid (pDNA) as an initial step towards designing an improved vector with enhanced endosomal escape capability. The electrophoretic mobility shift assay (EMSA) confirmed the formation of complexes between StII and pDNA. Computational predictions identified specific residues involved in the StII-DNA interaction interface, highlighting the importance of electrostatic interactions and hydrogen bonds in mediating the binding. Atomic force microscopy (AFM) of StII-pDNA complexes revealed the presence of nodular fiber and toroid shapes. These complexes were found to have a predominantly micrometer size, as confirmed by dynamic light scattering (DLS) measurements. Despite increase in the overall charge, the complexes formed at the evaluated nitrogen-to-phosphorus (N/P) ratios still maintained a negative charge. Moreover, StII retained its pore-forming capacity regardless of its binding to the complexes. These findings suggest that the potential ability of StII to permeabilize endosomal membranes could be largely maintained when combined with nucleic acid delivery systems. Additionally, the still remaining negative charge of the complexes would enable the association of another positively charged component to compact pDNA. However, to minimize non-specific cytotoxic effects, it is advisable to explore methods to regulate the protein's activity in response to the microenvironment.

Protocolo para el tratamiento de la recesión gingival con membrana de fibrina rica en plaquetas / Protocol for the Treatment of Gingival Recession with Platelet-rich Fibrin Membrane

Introducción: Es necesario la aplicación de protocolos de actuación como herramientas que permiten homogeneizar los procedimientos plásticos periodontales regenerativos y establecer las pautas de actuación del Periodontólogo para el abordaje de las recesiones gingivales con esta modalidad terapéutica de avanzada. Objetivo: Diseñar un protocolo para el tratamiento de la recesión gingival mediante la utilización de la membrana de fibrina rica en plaquetas, asociada al colgajo de avance coronal. Métodos: Se realizó una investigación con enfoque cualitativo en la Facultad de Estomatología de Villa Clara, de julio de 2020 a diciembre de 2021. Para el diseño del protocolo se empleó una fase de preparación y una de elaboración; dentro de esta última se estructuraron tres momentos: revisión sistemática de la literatura, aplicación de técnicas grupales (grupo focal y nominal) y conclusión del documento. Se realizó una valoración por criterios de especialistas externos antes de concluir la estructura definitiva del protocolo. Resultados: Se consultaron cinco guías para la confección de protocolos, cinco protocolos de atención médica y enfermería y 10 estomatológicos. La estructura del documento quedó conformada por: portada, introducción, objetivos, profesionales a quienes va dirigido, población diana, proceso de elaboración, procedimiento, algoritmo, fecha de implementación y revisión, proceso de implantación, indicadores de evaluación, glosario y referencias bibliográficas. Conclusiones: Se diseñó un protocolo de actuación que establece las pautas para la realización del proceder terapéutico regenerativo, desde la selección de los pacientes hasta la evolución de la terapéutica. El documento se valoró por especialistas externos como positivo(AU)

Introduction: It is necessary to apply action protocols as tools to homogenize regenerative periodontal plastic procedures and to establish the guidelines for the periodontist to approach gingival recession with this advanced therapeutic modality. Objective: To design a protocol for the treatment of gingival recession using platelet-rich fibrin membrane associated with coronal advancement flap. Methods: A research with a qualitative approach was carried out in the School of Stomatology of Villa Clara, from July 2020 to December 2021. For the design of the protocol, a preparation phase and an elaboration phase were used; within the latter, three moments were structured: systematic review of the literature, application of group techniques (focal and nominal group) and conclusion of the document. An evaluation by external specialists was carried out before finalizing the definitive structure of the protocol. Results: Five guides for the preparation of protocols, five medical and nursing care protocols and 10 stomatological protocols were consulted. The structure of the document consisted of: cover page, introduction, objectives, target professionals, target population, elaboration process, procedure, algorithm, implementation and revision date, implementation process, evaluation indicators, glossary and bibliographic references. Conclusions: An action protocol was designed that establishes the guidelines for carrying out the regenerative therapeutic procedure, from the selection of patients to the evolution of the therapy. The document was positively evaluated by external specialists(AU)

Impacto del uso de plataformas de video llamadas en las preocupaciones con la apariencia física en pacientes con Trastornos Alimentarios y de la población general durante la Pandemia por COVID 19 / Video call platforms impact on physical appearance concerns in patients with Eating Disorders and general population during the COVID 19 Pandemic

Resumen: Objetivo: Explorar el impacto del uso cotidiano de plataformas de videollamadas en las cogniciones, emociones y comportamientos relacionados con la autoimagen en pacientes con Trastornos del Comportamiento Alimentario (TCA) y personas de la población general, durante la pandemia por COVID-19. Métodos: Sesenta y ocho pacientes con TCA en tratamiento y 106 personas de la población general respondieron a un cuestionario diseñado para el estudio a través de Lime Survey; (98.5 y 79.2% respectivamente eran mujeres), con edad promedio de 17.6 (DE:3.47) y 33.5 (DE:9.35) respectivamente. Las pacientes discutieron y explicaron sus respuestas en cinco sesiones de terapia grupal presenciales dirigidas por un psiquiatra. Posteriormente, se realizó un análisis temático reflexivo con un enfoque inductivo para determinar las categorías. Resultados: Los pacientes reportaron una mayor incomodidad frente a la cámara, preocupación con la apariencia física, miedo a la crítica, vergüenza y sentimientos de vulnerabilidad, comparados con las personas de la población general. Predominaron los pensamientos negativos sobre la forma y el tamaño del rostro y otras partes del cuerpo y las conductas de chequeo y/o evitación de la imagen corporal, que interfirieron con la concentración y el rendimiento. Conclusión: además del impacto negativo de la pandemia de COVID-19 en la salud mental, la nueva virtualidad desafía a los clínicos a enfrentar dificultades adicionales con la imagen corporal en pacientes con TCA y alerta a la detección de nuevas preocupaciones dismórficas también en la población general.

Abstract: Objective: To explore the impact of video call platforms on physical appearance concerns (cognitions, emotions and behaviors) in Eating Disorders (ED) patients and in general population, during COVID 19 pandemic. Methods: Sixty-eight patients attending a treatment program for ED, and 106 people from the general population responded to a questionnaire designed for the study through Lime Survey; (98.5 and 79.2% respectively were women), with a mean age of 17.6 (SD:3.47) and 33.5 (SD:9.35) respectively. Patients discussed and explained their answers in five in vivo group therapy sessions directed by a psychiatrist. Then, a reflective thematic analysis with an inductive approach to determine the categories was performed. Results: Patients reported a higher discomfort in front of the camera, preoccupation with physical appearance, fear of criticism, embarrassment, and feelings of vulnerability, compared with general population. Negative thoughts about the shape and size of the face and other body parts predominated, as well as body image checking/avoidance behaviors that interfered with concentration and performance. Conclusion: In addition to the negative impact of the COVID-19 pandemic on mental health, the new virtuality challenges clinicians to face additional body image difficulties in ED patients and alerts on the detection of dysmorphic concerns in the general population as well.

Membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal tres años después

Fundamento la asociación de la membrana de fibrina rica en plaquetas con el colgajo de reposición coronal constituye una modalidad de la ingeniería de tejidos que aporta elementos regenerativos al proceso de reparación tisular. Objetivo evaluar la efectividad de la membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal en el tratamiento de la recesión periodontal tres años después. Métodos se realizó un cuasiexperimento en la facultad de Estomatología de Villa Clara, en el periodo marzo de 2017-julio de 2020, y con una población de estudio conformada por 46 pacientes portadores de recesión periodontal, quienes requerían recubrimiento radicular mediante el colgajo de reposición coronal. Se utilizó un muestreo no probabilístico intencional por criterios, y la muestra quedó conformada por 26 pacientes. Se establecieron sitios de estudio y sitios de control. Las variables estudiadas fueron: edad, sexo, largo de la recesión, clasificación de Miller, cobertura radicular, ancho y ganancia de la encía insertada, categorías de evaluación y efectividad del tratamiento. Resultados en el 88,68 % de los dientes ubicados en los sitios de estudio predominó la categoría de evaluación favorable. El porcentaje de efectividad a los tres años de la terapéutica fue superior en los sitios de estudio (54,71 %). Conclusiones se consideró más efectivo el tratamiento de la recesión periodontal con membrana de fibrina rica en plaquetas asociada al colgajo de reposición coronal a los tres años del proceder.

Foundation the association of the platelet-rich fibrin membrane with the coronal replacement flap constitutes a modality of tissue engineering that provides regenerative elements to the tissue repair process. Objective to evaluate the effectiveness of the platelet-rich fibrin membrane associated with the coronal repositioning flap in the treatment of periodontal recession three years later. Methods a quasi-experiment was carried out at the Villa Clara Dentistry Faculty, from March 2017 to July 2020, a study population of 46 patients with periodontal recession, who required root coverage using the replacement flap coronal. Intentional non-probabilistic sampling by criteria was used, and the sample of 26 patients. Study sites and control sites were established. The studied variables were: age, sex, recession length, Miller classification, root coverage, width and gain of the attached gingiva, evaluation categories and treatment effectiveness. Results in 88.68% of the teeth located in the study sites, the favorable evaluation category predominated. The effectiveness percentage three years after treatment was higher in the study sites (54.71%). Conclusions the treatment of periodontal recession with platelet-rich fibrin membrane associated with the coronal replacement flap was considered more effective three years after the procedure.

Competencies Development Strategy Using Augmented Reality for Self-Management of Learning in Manufacturing Laboratories (AR-ManufacturingLab).

Technological tools in education open new learning possibilities. This proposal describes integrating augmented reality and different educational elements to develop engineering competencies, specifically using specialized machinery in the manufacturing laboratory. It is necessary to encourage self-management of learning, where users interact with the devices employing an application that contains significant information about procedures to perform and essential elements to consider when manipulating the machinery. The machines involved include industrial robots, CNC (Computer Numerical Control) lathes and milling machines, and PLCs (Programmable Logic Controls). In a traditional training model, an instructor guides the users in learning how to manipulate the equipment. This proposal intends that the participants use their mobile devices to receive each machine's instruction and the necessary documentation. The participants' learning pace varies. So, the research aimed to reduce the deficit in the disciplinary competencies since, in the traditional methodology, there is no heterogeneity in understanding the contents. We designed a competency development strategy with six laboratory practices, integrating multimedia elements to address the significant learning content of each manufacturing cell device. Each lesson contained information about each device and a practice activity and self-evaluation to ensure learning the content.

Analysis of perceptions and emotional repercussions in Twitter users in Colombia during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has negatively impacted mental health. Up to a quarter of the population has reported mental health disorders. This has been studied mainly from a nosological perspective, according to diagnostic criteria. Nevertheless, we did not find studies that have explored the daily expressions of the population. Our objective was to evaluate the perceptions of the COVID-19 pandemic and its repercussions on the emotional well-being of the Colombian population. METHODS: We performed a Twitter metrics and trend analysis. Initially, in the trend analysis, we calculated the average duration in hours of the 20 most popular trending topics of the day in Colombia and we grouped them into trends related to COVID-19 and unrelated trends. Subsequently, we identified dates of events associated with the pandemic relevant to the country, and they were related to the behaviour of the trends studied. Additionally, we did an exploratory analysis of these, selected the tweets with the greatest reach and categorised them in an inductive way to analyse them qualitatively. RESULTS: Issues not related to COVID-19 were more far-reaching than those related to coronavirus. However, a rise in these issues was seen on some dates consistent with important events in Colombia. We found expressions of approval and disapproval, solidarity and accusation. Inductively, we identified categories of informative tweets, humour, fear, stigma and discrimination, politics and entities, citizen complaints, and self-care and optimism. CONCLUSIONS: The impact of the COVID-19 pandemic generates different reactions in the population, which increasingly have more tools to express themselves and know the opinions of others. Social networks play a fundamental role in the communication of the population, so this content could serve as a public health surveillance tool and a useful and accessible means of communication in the management of health crises.

Tracing last millennium cycles of Río de la Plata Plume Water input into the Southwestern Atlantic Ocean.

Recent studies established a strong connection between instrumental hydroclimatic changes in the Río de la Plata (RdlP) watershed and the influx of continental terrigenous material and productivity changes. This correspondence was further validated for the last millennium. Here, we identified centennial, multi-decadal, and interannual changes in diatom composition, as a proxy for La Plata Plume Water (PPW) discharge into the inner shelf. Core GeoB13813-4 diatom data were revisited, and grouped into freshwater, marine, and brackish categories for multivariate, timeseries, and correlation analyses. Such record exhibits a noteworthy resemblance to paleoclimatic and paleoceanographic variations throughout the past millennium. A Detrended Correspondence Analysis (DCA) on the dominant taxa, and Axis-1 revealed a salinity gradient over the past millennium. DCA1-scores exhibited significant correlation with reconstructions of El Niño Southern Oscillation (ENSO), the Pacific Decadal Oscillation (PDO), and the Atlantic Multidecadal Oscillation (AMO) over the same period. By plotting DCA1-scores, we inferred time intervals with varying levels of PPW influence. During ∼936-1500 CE, the PPW influence was weak, as the record was dominated by marine taxa, indicating lateral transport from the Brazilian upwelled water and a stronger influence of the Subtropical Shelf Water. After 1500 CE, a well-developed plume was inferred, with the highest influence occurring after 1800 CE, as evidenced by an increased presence of freshwater/brackish taxa. This increased PPW influence after 1500 CE can be attributed to the onset of more humid conditions and associated increased river discharge, particularly under El Niño conditions, with further ENSO intensification after 1800 CE. We identified significant centennial (250 years) and multidecadal cycles (25-50 years) in diatom community composition. These cycles are related to solar forcing, PDO, and AMO. During the 20th Century, cycles of 2 to 7 years were associated with interannual ENSO variability, while 40-year cycles were linked to AMO and PDO variability.

Pilot Monitoring of Lead in Umbilical Cord Blood of Newborns Associated With the Use of Glazed Ceramics from Guanajuato, Mexico.

The use of lead-glazed pottery for cooking and storing food, a widespread practice in Mexico, represents a risk of exposure to lead from the human intrauterine stage. Therefore, a pilot study was carried out by means of the measurement of lead in umbilical cord blood by inductively coupled plasma mass spectrometry (ICP-MS) including 69 newborns from the Mexican state capital of Guanajuato, Guanajuato City, where the use of glazed clay is still widespread. Lifestyle and sociodemographic data were collected by interviewing the participating mothers. Hematological parameters and the anthropometry of the newborns and their mothers were analyzed; likewise, the G177C polymorphism in the ALAD gene was genotyped by PCR-RFLP as a marker of genetic vulnerability to lead. The geometric mean of lead in umbilical cord blood was 0.7 µg/dL (< limit of detection = 0.01-28.22). Boys presented higher values than girls (p = 0.03). Only 5.8% of these were above the safety value of the US Centers for Disease Control and Prevention (CDC) of 3.5 µg/dL. Correlations among lead concentrations, maternal age, weeks of gestation, newborn anthropometry, and hematological parameters were not found; however, the participating mothers who reported using glazed ceramics for cooking or storing food had the highest cord-blood lead concentrations (p = 0.04). Regarding genotyping, 97% had ALAD 1, while 3% had ALAD 1, 2; unfortunately, the sample size did not allow analysis of genetic vulnerability to lead. The preparation and conservation of food in handcrafted clay pottery increased the risk of having cord-blood lead values higher than those recommended by the CDC of 3.5 µg/dL (OR = 5; 95% CI:1.3-23; p = 0.01). Our preliminary results suggest that there continues to be intrauterine exposure to lead in Guanajuato.