Surrogate indices of insulin resistance using the Matsuda index as reference in adult men-a computational approach.

Background: Overweight and obesity, high blood pressure, hyperglycemia, hyperlipidemia, and insulin resistance (IR) are strongly associated with non-communicable diseases (NCDs), including type 2 diabetes, cardiovascular disease, stroke, and cancer. Different surrogate indices of IR are derived and validated with the euglycemic-hyperinsulinemic clamp (EHC) test. Thus, using a computational approach to predict IR with Matsuda index as reference, this study aimed to determine the optimal cutoff value and diagnosis accuracy for surrogate indices in non-diabetic young adult men. Methods: A cross-sectional descriptive study was carried out with 93 young men (ages 18-31). Serum levels of glucose and insulin were analyzed in the fasting state and during an oral glucose tolerance test (OGTT). Additionally, clinical, biochemical, hormonal, and anthropometric characteristics and body composition (DEXA) were determined. The computational approach to evaluate the IR diagnostic accuracy and cutoff value using difference parameters was examined, as well as other statistical tools to make the output robust. Results: The highest sensitivity and specificity at the optimal cutoff value, respectively, were established for the Homeostasis model assessment of insulin resistance index (HOMA-IR) (0.91; 0.98; 3.40), the Quantitative insulin sensitivity check index (QUICKI) (0.98; 0.96; 0.33), the triglyceride-glucose (TyG)-waist circumference index (TyG-WC) (1.00; 1.00; 427.77), the TyG-body mass index (TyG-BMI) (1.00; 1.00; 132.44), TyG-waist-to-height ratio (TyG-WHtR) (0.98; 1.00; 2.48), waist-to-height ratio (WHtR) (1.00; 1.00; 0.53), waist circumference (WC) (1.00; 1.00; 92.63), body mass index (BMI) (1.00; 1.00; 28.69), total body fat percentage (TFM) (%) (1.00; 1.00; 31.07), android fat (AF) (%) (1.00; 0.98; 40.33), lipid accumulation product (LAP) (0.84; 1.00; 45.49), leptin (0.91; 1.00; 16.08), leptin/adiponectin ratio (LAR) (0.84; 1.00; 1.17), and fasting insulin (0.91; 0.98; 16.01). Conclusions: The computational approach was used to determine the diagnosis accuracy and the optimal cutoff value for IR to be used in preventive healthcare.

Rhinorrhea and watery eyes in infancy and risk of attention-deficit hyperactivity disorder in school-age children.

Increased parasympathetic nervous system (PNS) activity is associated with attention-deficit/hyperactivity disorder (ADHD) inattentive symptoms, but not hyperactive-impulsive symptoms, and may contribute to inattentive subtype etiology. Guided by prior work linking infant rhinorrhea and watery eyes without a cold (RWWC) to PNS dysregulation, we examined associations between infant RWWC and childhood ADHD symptoms in a longitudinal cohort of Black and Latinx children living in the context of economic disadvantage (N = 301 youth: 158 females, 143 males). Infant RWWC predicted higher inattentive (relative risk [RR] 2.16, p < .001) but not hyperactive-impulsive (RR 1.53, p = .065) ADHD symptoms (DuPaul scale), administered to caregivers at child age 8-14 years. Stratified analyses revealed that these associations were present in females but not males, who were three times more likely to have higher ADHD current total symptoms if they had infant RWWC than if they did not. Additionally, associations between RWWC and inattention symptoms were observed only in females. RWWC may thus serve as a novel risk marker of ADHD inattentive-type symptoms, especially for females.

Recurrent hepatic artery pseudoaneurysm repair with overlapping tapered stent-graft technique.

Hepatic artery pseudoaneurysms (HAPs) are rare but life-threatening complications associated with hepatic artery infusion pump (HAIP) therapy for unresectable liver metastases. Traditional management options include open surgery or stent placement, but these approaches have drawbacks. We present a unique case of a dislodged stent embedded in a HAP, resulting in delayed type-I endoleak. To address this, we employed a novel technique using multiple overlapping tapered stents to reconstruct the hepatic artery. This approach successfully excluded the pseudoaneurysm without endoleak. Stent-graft placement emerges as a safer and more effective option for managing HAP, preserving hepatic arterial flow, and reducing morbidity compared to other methods. However, further research is needed to evaluate this technique's long-term outcomes and potential complications.

Neonatal rhinorrhea, heart rate variability, and childhood exercise-induced wheeze.

Background: There is increasing evidence linking infant rhinorrhea to school-age exercise-induced wheeze (EIW) via a parasympathetic nervous system pathway. The ratio of the root mean square of successive differences in heart beats (RMSSD) measured in quiet sleep versus active sleep (RMSSDQS:AS) is a novel biomarker in asthma. Objective: We tested the hypotheses that (1) neonatal rhinorrhea predicts childhood EIW independent of other neonatal respiratory symptoms, (2) neonatal RMSSDQS:AS predicts childhood EIW, and (3) RMSSDQS:AS mediates the association between neonatal rhinorrhea and childhood EIW. Methods: Participants from the Safe Passage/Environmental Influences on Child Health Outcomes (PASS/ECHO) prospective birth cohort had heart rate variability extracted from electrocardiogram traces acquired in the first month of life. Parents reported on rhinorrhea in their child at age 1 month and on EIW in their child at ages 4 to 11 years. Results: In models (N = 831) adjusted for potential confounders and covariates, including neonatal wheeze, cough and fever, neonatal rhinorrhea-predicted childhood EIW (relative risk [RR] = 2.22; P = .040), specifically, among females (RR = 3.38; P = .018) but not males (RR = 1.39; P = .61). Among participants contributing data in both active and quiet sleep (n = 231), RMSSDQS:AS predicted EIW (RR = 2.36; P = .003) and mediated the effect estimate of neonatal rhinorrhea predicting EIW among females. Half of the females with a higher RMSSDQS:AS and neonatal rhinorrhea (n = 5 of 10) developed EIW as compared with 1.8% of the other females (n = 2 of 109) (P < .001). Conclusions: Our findings support dysregulation of the parasympathetic nervous system in infancy as one of the possible underlying mechanisms for the development of EIW later in childhood among females, which could aid in the development of future interventions.

Fungal diversity in homes and asthma morbidity among school-age children in New York City.

BACKGROUND: Asthma development has been inversely associated with exposure to fungal diversity. However, the influence of fungi on measures of asthma morbidity is not well understood. OBJECTIVES: This study aimed to test the hypothesis that fungal diversity is inversely associated with neighborhood asthma prevalence and identify specific fungal species associated with asthma morbidity. METHODS: Children aged 7-8 years (n = 347) living in higher (11-18%) and lower (3-9%) asthma prevalence neighborhoods were recruited within an asthma case-control study. Fungal communities were analyzed from floor dust using high-throughput DNA sequencing. A subset of asthmatic children (n = 140) was followed to age 10-11 to determine asthma persistence. RESULTS: Neighborhood asthma prevalence was inversely associated with fungal species richness (P = 0.010) and Shannon diversity (P = 0.059). Associations between neighborhood asthma prevalence and diversity indices were driven by differences in building type and presence of bedroom carpet. Among children with asthma at age 7-8 years, Shannon fungal diversity was inversely associated with frequent asthma symptoms at that age (OR 0.57, P = 0.025) and with asthma persistence to age 10-11 (OR 0.48, P = 0.043). Analyses of individual fungal species did not show significant associations with asthma outcomes when adjusted for false discovery rates. DISCUSSION: Lower fungal diversity was associated with asthma symptoms in this urban setting. Individual fungal species associated with asthma morbidity were not detected. Further research is warranted into building type, carpeting, and other environmental characteristics which influence fungal exposures in homes.

Desmopressin as a Treatment in Patients With Von Willebrand Disease: A Systematic Review.

Von Willebrand disease (VWD) and hemophilia A are the most common inherited bleeding disorders. Quantitative or qualitative von Willebrand factor (VWF) anomalies cause this disorder in men and women. VWF, a plasma glycoprotein, relies on platelets for primary hemostasis. It also carries and stabilizes factor VIII in the blood. VWD has several categories. Types 1 and 3 have partial or total VWF quantitative deficiencies. However, type 2 and its subtypes have VWF quality issues. The major treatment is desmopressin (DDAVP), which replaces endogenous VWF and factor VIII (FVIII). Plasma-derived VWF/FVIII products may also be substituted exogenously. Treatment with plasma-derived or recombinant VWF concentrates without FVIII is also possible. The purpose of this retrospective, single-center research was to evaluate DDAVP's efficacy in treating VWD based on many criteria established in the current literature. We looked at the results on Google Scholar, the Cochrane Library, and PubMed/Medline. There were a total of 10 papers found, evaluated, and accepted for inclusion in this study. A comprehensive analysis of DDVAP's role in VWD was compiled from the aforementioned papers. Various aspects of DDVAP were captured by including an analysis of complementary treatments used in surgical and clinical settings. We also describe the treatment's intended impact on the different variations of the disease. Given these results, further investigation is required to determine the most effective method for managing VWD so that it may be included in standard clinical practice.

Entornos virtuales y posibilidades para una educación más inclusiva

Introducción: Los modelos educativos inclusivos forman parte actualmente de las políticas educacionales; estos modelos presuponen la utilización de métodos y procedimientos factibles para un aula heterogénea y están en el centro de los proyectos de la Organización de las Naciones Unidas para la Educación, la Ciencia y la Cultura y en los Objetivos de Desarrollo Sostenible para 2030. Objetivo: Describir algunas de las barreras existentes y las ventajas de la implementación del aula heterogénea a favor de una educación más inclusiva. Material y método: Se realiza un estudio descriptivo longitudinal retrospectivo sobre la relación de la educación inclusiva y los entornos virtuales de aprendizaje. Resultados: Las plataformas virtuales propician el avance de los sistemas educativos con flexibilidad en la aplicación de métodos y procedimientos que los hacen adaptables a diferentes individualidades y por tanto más inclusivos. Ello se percibe como visión de futuro donde todos gocen de los mismos derechos y oportunidades en igualdad de condiciones. Conclusiones: El desarrollo alcanzado por las Tecnologías de la Información y las Comunicaciones proporciona la base para que, a través de la virtualidad, se concrete y perfeccione la educación inclusiva.

Introduction: Inclusive educational models are currently part of educational policies; these models presuppose the use of feasible methods and procedures for a heterogeneous classroom and are at the core of the United Nations Educational, Scientific and Cultural Organization projects and in the Sustainable Development Goals 2030. Objective: To describe some of the existing barriers and the advantages of implementing the heterogeneous classroom in favor of a more inclusive education. Method: A retrospective longitudinal descriptive study was conducted on the relationship between inclusive education and virtual learning environments. Results: Virtual platforms promote the advancement of educational systems with flexibility in the application of methods and procedures that make them adaptable to different individualities and, therefore, more inclusive. This is perceived as a vision of the future where everyone enjoys the same rights and opportunities under equal conditions. Conclusions: The development achieved by Information and Communication Technologies provides the basis so that, through virtual platforms, inclusive education can be concretized and perfected.

Predictors of Outcomes After Coronary Artery Bypass Grafting: The Effect of Concomitant Mitral Repair.

Background Ischemic mitral regurgitation (IMR) or functional MR intensity with or without repair increases the risk of coronary artery bypass grafting (CABG), and if the contaminant is undertaken, it doubles the risk of the surgery. This study aimed to characterize patients with concomitant CABG and mitral valve repair (MVR) and assess the surgical and long-term outcomes. Methods We conducted a cohort study from 2014 to 2020 on 364 patients who underwent CABG. A total of 364 patients were enrolled and divided into two groups. Group I (n= 349) included patients with isolated CABG, and Group II included patients who underwent CABG with concomitant mitral valve repair (MVR) (n= 15). Results Regarding preoperative presentation, most patients were male: 289 (79.40%), hypertensive 306 (84.07%), diabetic 281 (77.20%), dyslipidemic 246 (67.58%), presenting with NYHA classes III-IV: 200 (54.95%), and upon angiography, found to have the three-vessel disease: 265 (73%). Regarding their age mean± SD and Log EuroSCORE median (Q1-Q3), they had a mean age of 60.94± 10.60 years and a median score of 1.87 (1.13-3.19). The most prevalent postoperative complications were low cardiac output 75 (20.66%), acute kidney injury (AKI) 63 (17.45%), respiratory complications 55 (15.32%), and atrial fibrillation (AF) 55 (15.15%). Regarding long-term outcomes, most patients reported class I NYHA 271 (83.13%) and an echocardiographic decrease in MR severity. Patients with a CABG + MVR were significantly younger (53.93± 15.02 vs. 61.24± 10.29 years; P= 0.009), had a lower ejection fraction (33.6 [25-50] vs. 50 [43-55] %; p= 0.032), and had a higher prevalence of LV dilation (32 [9.17%]). EuroSCORE was significantly higher in patients with mitral repair (3.59 [1.54-8.63] vs. 1.78 (1.13-3.11); P= 0.022). The mortality percentage was higher with MVR but did not attain statistical significance. Intraoperative CPB and ischemic durations were longer in the CABG + MVR group. Furthermore, neurological complications were higher in patients with mitral repair (4 (28.57%) vs. 30 (8.65%), P= 0.012). The study's follow-up duration median was 24 (9-36) months. The composite endpoint occurred more frequently in older patients (HR: 1.05 [95% CI: 1.02-1.09]; 0.001), patients with low ejection fraction (HR: 0.96 [95% CI: 0.93-0.99]; P= 0.006) and in patients with preoperative myocardial infarction (MI) (HR: 2.3 [95%: 1.14- 4.68]; P= 0.021). Conclusion Most IMR patients benefited from CABG and CABG + MVR, as evident by NYHA class and echocardiographic follow-up. CABG + MVR had a higher Log EuroSCORE risk with increased intraoperative cardiopulmonary bypass (CPB) and ischemic durations, which may have played a role in increasing the incidence of postoperative neurological complications. On follow-up, no differences were reported between the two groups. However, age, ejection fraction, and a history of preoperative MI were identified as factors affecting the composite endpoint.

A longitudinal study of free leptin index in pre-eclamptic pregnancies.

The ratio between circulating levels of leptin and soluble leptin receptor (sOB-R), the free leptin index (FLI), is used as a marker of leptin resistance. Therefore, the aim of our study was to investigate the FLI in mild pre-eclamptic pregnancies in a nested case-control study within a prospective observational study. Circulating levels of leptin and sOB-R levels rise significantly during pregnancy in healthy (p < 0.05) (n = 46) and pre-eclamptic pregnancies (p < 0.05) (n = 20). Serum levels of leptin were significantly higher in pre-eclamptic compared to healthy pregnancies at second and third trimesters of pregnancy (p < 0.05). Additionally, serum levels of sOB-R were significantly lower in pre-eclamptic pregnancies during the second and third trimesters of pregnancy compared to healthy pregnancies (p < 0.05). Moreover, we found that FLI did not vary significantly during pregnancy in healthy women (p > 0.05), while it increases in pre-eclamptic pregnancies (p < 0.05). Indeed, FLI was significantly higher at second and third trimesters of pregnancy in pre-eclamptic compared to healthy pregnancies (p < 0.05). In addition, FLI was significantly higher in the luteal phase compared with the follicular phase of the menstrual cycle in eumenorrheic women (p < 0.05). Receiver operating characteristic (ROC) curve analysis revealed the ability of leptin (AUC = 0.72) and FLI (AUC = 0.67) as a reliable predictor for mild pre-eclampsia during the second trimester of pregnancy. In conclusion, our findings show that FLI were significantly increased in mild pre-eclamptic pregnancies and allowed us to hypothesize that this rise might alter leptin bioavailability and bioactivity which might lead to the sympathetic hyperactivity and the hypertensive disorders during pregnancy.

A new approach to etching low-carbon microalloyed steels to reveal prior austenite grain boundaries and the dual-phase microstructure.

A modification to picric acid solutions has been undertaken to reveal the prior-austenite grain boundaries in microalloyed steels as a result of elemental segregation. It has been found the maximum addition of sodium dodecyl sulphate plus hydrochloric acid to fully reveal both the prior austenite grain boundaries and the final post-processed structures in these steels.

Estrategia para la formación investigativa de los estudiantes de Estomatología con el uso de las TIC

Introducción: El uso de las Tecnologías de la Información y las Comunicaciones (TIC) en el proceso de formación investigativa constituye una necesidad para el logro de cambios cualitativos esenciales en la adquisición de conocimientos y habilidades investigativas en los estudiantes. Diagnósticos desarrollados evidenciaron insuficiencias en el desarrollo de la formación investigativa, así como en la concepción de las tareas investigativas en el plan de estudio, que imposibilitan alcanzar los niveles deseados de creatividad. Objetivo: Diseñar una estrategia orientada al desarrollo de la formación investigativa del estudiante de Estomatología soportado en el uso de las TIC. Método: Se realizó una investigación educativa utilizando los métodos empíricos: observación, la encuesta y la entrevista, así como teóricos: inducción-deducción, análisis-síntesis, histórico-lógico, hermenéutico dialéctico, además, del taller de socialización para corroborar la factibilidad de la estrategia propuesta. Resultados: Se propuso una estrategia para la gestión investigativa con el uso de las TIC en la formación investigativa de estudiantes de Estomatología, integrada por tres momentos, etapas y acciones encaminadas al desarrollo de una cultura científico-investigativa-tecnológica sustentada en el uso de las TIC. Conclusiones: La instrumentación de esta propuesta en la práctica pedagógica ha demostrado su factibilidad y la contribución a la formación investigativa de los estudiantes para una mejor solución de los problemas profesionales y, por consiguiente, mayor calidad en la atención de los pacientes que acuden a los servicios estomatológicos.

Introduction: The use of Information and Communication Technologies (ICT) in the research training process constitutes basic needs for students to achieve the essential qualitative changes in the acquisition of knowledge and research skills required. Diagnostics produces carried out showed insufficiencies in the research training process, as well as in the real conception of research tasks implemented in the study program, reducing the possibility to reach the desired levels of creativity. Objective: Elaborate a design strategy aimed to develop the research training process of oral medicine students with the use of the ICT. Method: An educational research was carried out using empirical methods pointed as follow: observation, survey and interview, as well as the theoretical methods: induction-deduction, analysis-synthesis, historical-logical, dialectical hermeneutic, in addition a socialization workshop was used to corroborate the feasibility of the proposal strategy. Results: A strategy for research management with the use of ICTs in the research training of oral medicine students was proposed, consisting on three moments, stages and actions aimed at developing a scientific-research-technological culture based on the use of ICTs. Conclusions: The implementation of this proposal, as a pedagogical practice, has demonstrated its feasibility and contribution in the development of the student research training, and also for a better solution of professional problems and, consequently, higher quality in their care practice with the patients attended in dental services.

Introdução: A utilização das Tecnologias de Informação e Comunicação (TIC) no processo de formação em investigação é uma necessidade para alcançar mudanças qualitativas essenciais na aquisição de conhecimentos e competências de investigação nos alunos. Os diagnósticos desenvolvidos evidenciaram insuficiências no desenvolvimento da formação em investigação, bem como na conceção das tarefas de investigação no plano de estudos, que impossibilitam o alcance dos níveis de criatividade pretendidos. Objetivo: Desenhar uma estratégia orientada para o desenvolvimento da formação investigativa do estudante de Odontologia apoiada no uso das TIC. Método: Foi realizada uma investigação educacional utilizando métodos empíricos: observação, levantamento e entrevista, bem como teóricos: indução-dedução, análise-síntese, histórico-lógico, hermenêutica dialética, além da oficina de socialização para corroborar a viabilidade do estratégia proposta. Resultados: Foi proposta uma estratégia de gestão investigativa com uso de TIC na formação investigativa de estudantes de Odontologia, integrada por três momentos, etapas e ações voltadas para o desenvolvimento de uma cultura científico-investigativa-tecnológica apoiada no uso de TIC. Conclusões: A implementação dessa proposta na prática pedagógica tem demonstrado sua viabilidade e contribuição para a formação investigativa dos alunos para uma melhor solução dos problemas profissionais e, consequentemente, maior qualidade no atendimento aos pacientes que chegam aos hospitais e serviços estomatológicos.

Study of the Ghrelin/LEAP-2 Ratio in Humans and Rats during Different Phases of Pregnancy.

The Liver-Expressed Antimicrobial Peptide 2 (LEAP-2) has emerged as an endogenous GHS-R antagonist and blunts the orexigenic action of ghrelin. This study aimed to determine the Ghrelin/LEAP-2 ratio in humans and rats during pregnancy. In humans, we conducted a nested case-control study within an observational prospective cohort. Healthy and mild preeclamptic pregnant women were studied at each trimester of gestation and three months postpartum. In addition, a group of non-pregnant women was studied into the follicular and luteal phases of the menstrual cycle. Furthermore, Ghrelin/LEAP-2 ratio was investigated in non-pregnant rats and at different periods of rat pregnancy. Human and rat serum ghrelin and LEAP-2 levels were determined using the commercially available ELISA kits. The Ghrelin/LEAP-2 ratio peak around the second trimester of gestation in healthy pregnant women (p < 0.05). Additionally, there were no statistically significant differences in Ghrelin/LEAP-2 ratio between healthy and preeclamptic pregnant women at each trimester of gestation (p > 0.05). The Ghrelin/LEAP-2 ratio in pregnant rat reached the peak around mid-gestation with a similar pattern to the human pregnancy. LEAP-2 was visualized by immunohistochemistry in human term placenta and rat placentas on days 12, 16 and 21 of pregnancy. In conclusion, this study provides the first evidence of a Ghrelin/LEAP-2 ratio peak around the half-way point of pregnancy onwards during human and rat pregnancy, and it might be associated with increased rates of weight gain during pregnancy. Thus, this study suggests that LEAP-2 and Ghrelin/LEAP-2 ratio might play an important role in maternal physiology adaptation of weight gain during pregnancy.

Gestión de información en procesos académicos y asistenciales a través de la nube Infomed Santiago / Information management in academic and assistance processes through the cloud Infomed Santiago

Introducción: La gestión de información agiliza los procesos en diferentes ambientes laborales, para lo cual se emplean sistemas capaces de reunir, organizar y vincular la información almacenada. La nube se basa en tecnologías existentes, tales como virtualización y servicios web; constituye un hito informático y se adapta a diversos escenarios y contextos. Objetivo: Contribuir a la gestión de información relacionada con las bases de datos de la reacción en cadena de la polimerasa y los procesos de acreditación en la Universidad de Ciencias Médicas de Santiago de Cuba a través de la nube Infomed Santiago. Métodos: Se realizó una investigación aplicada de desarrollo tecnológico en el Centro Provincial de Información de Ciencias Médicas, la Universidad de Ciencias Médicas y el Centro Provincial de Higiene, Epidemiología y Microbiología de Santiago de Cuba, desde junio hasta diciembre del 2021. Se aplicaron encuestas a 19 profesionales del sector, quienes laboraban directamente en la gestión de información relacionada con las bases de datos antes citadas. Resultados: Los 19 encuestados (100,0 %) afirmaron que utilizaban el correo electrónico, el chat integrado, la nube y otras facilidades que esta herramienta ofrece para almacenar y compartir información. Conclusiones: La nube permitió la gestión de información relacionada con los procesos asistenciales y académicos durante el periodo más crítico de la COVID-19.

Introduction: The information management speeds up the processes in different labor atmospheres, for which systems able to gather, organize and link the stored information are used. The cloud is based on existent technologies, such as virtualization and web services; it constitutes a computer landmark and it is adapted to diverse scenarios and contexts. Objective: To contribute the information management related to the databases of the polymerase chain reaction and the accreditation processes in the University of Medical Sciences from Santiago de Cuba through the cloud Infomed Santiago. Methods: An applied investigation of technological development was carried out in the Provincial Information Center of Medical Sciences, the University of Medical Sciences and the Provincial Center of Hygiene, Epidemiology and Microbiology in Santiago de Cuba, from June to December, 2021. Surveys were applied to 19 professionals of the sector who worked directly in the administration of information related to the databases mentioned. Results: The 19 professionals interviewed (100.0 %) affirmed that they used the electronic mail, the integrated chat, the cloud and other facilities that this tool offers to store and share information. Conclusions: The cloud allowed the information management related to the assistance and academic processes during the most critical period of COVID-19.

Spring is associated with increased total and allergenic fungal concentrations in house dust from a pediatric asthma cohort in New York City.

Introduction: Asthma and allergy symptoms vary seasonally due to exposure to environmental sources of allergen, including fungi. However, we need an improved understanding of seasonal influence on fungal exposures in the indoor environment. We hypothesized that concentrations of total fungi and allergenic species in vacuumed dust vary significantly by season. Objective: Assess seasonal variation of indoor fungi with greater implications related to seasonal asthma control. Methods: We combined next-generation sequencing with quantitative polymerase chain reaction (qPCR) to measure concentrations of fungal DNA in indoor floor dust samples (n = 298) collected from homes participating in the New York City Neighborhood Asthma and Allergy Study (NAAS). Results: Total fungal concentration in spring was significantly higher than the other three seasons (p ≤ 0.005). Mean concentrations for 78% of fungal species were elevated in the spring (26% were significantly highest in spring, p < 0.05). Concentrations of 8 allergenic fungal species were significantly (p < 0.5) higher in spring compared to at least two other seasons. Indoor relative humidity and temperature were significantly highest in spring (p < 0.05) and were associated with total fungal concentration (R2 = 0.049, R2 = 0.11, respectively). Conclusion: There is significant seasonal variation in total fungal concentration and concentration of select allergenic species. Indoor relative humidity and temperature may underlie these associations.

Single Center Retrospective Review of Post-laparotomy CT Abdomen and Pelvis Findings and Trends.

Purpose: To identify common findings visualized on CT following damage control laparotomy, including post-surgical changes and additional injuries, and to determine change in frequency of post-laparotomy CT at our institution over time. Methods: Single institution, IRB-Exempt, retrospective review of the University of Kentucky trauma registry from 1/2006 to 2/2019 for all trauma patients undergoing exploratory laparotomy initially and subsequently undergoing CT of the abdomen and pelvis within 24 hours. Operative findings from surgical operation notes and findings reported on post-laparotomy CT were recorded, including vascular and solid organ injuries, operative changes, free intraperitoneal fluid/air, and retroperitoneal findings. Next steps in management were also recorded. Results: In total 1,047 patients underwent exploratory laparotomy initially at our institution between 1/2006-2/2019. Of those, only 96 had a diagnostic CT of the abdomen and pelvis within 24 h after initial surgery, first occurring in 2010. Among these 96, there were 71 blunt and 25 penetrating injuries. Most common injuries recognized during exploratory laparotomy were bowel/mesentery (55), spleen (34), and liver (26). Regarding CT findings, all patients (96/96, 100%) had residual pneumoperitoneum, 84/96 (87.5%) had residual hemoperitoneum, 36/96 (37.5%) noted post-surgical changes or additional injuries to the spleen, 36/96 (37.5%) to the bowel/mesentery, and 32/96 (33.3%) to the liver, and 34/96 (35.4%) were noted to have pelvic fractures. After CT, 31/96 (32.3%) went back to the OR for relook laparotomy and additional surgical intervention and 7/96 (7.3%) went to IR for embolization. Most common procedures during relaparotomy involved the bowel (8) and solid organs (6). Conclusions: CT examination within 24 h post damage control laparotomy was exceedingly rare at our institution prior to 2012 but has steadily increased. Frequency now averages 20.5% yearly. Damage control laparotomy is an uncommon clinical scenario; however, knowledge of frequent injuries and common post-operative changes will aid in radiologist detection of additional injuries helping shape next step management and provide adequate therapy.

Vishniacozyma victoriae (syn. Cryptococcus victoriae) in the homes of asthmatic and non-asthmatic children in New York City.

BACKGROUND: Indoor environments contain a broad diversity of non-pathogenic Basidiomycota yeasts, but their role in exacerbating adverse health effects has remained unclear. OBJECTIVE: To understand the role of Vishniacozyma victoriae exposure and its impact on human health. METHODS: A qPCR assay was developed to detect and quantify an abundant indoor yeast species, Vishniacozyma victoriae (syn. Cryptococcus victoriae), from homes participating in the New York City Neighborhood Asthma and Allergy Study (NAAS). We evaluated the associations between V. victoriae, housing characteristics, and asthma relevant health endpoints. RESULTS: V. victoriae was quantified in 236 of the 256 bedroom floor dust samples ranging from less than 300-45,918 cell equivalents/mg of dust. Higher concentrations of V. victoriae were significantly associated with carpeted bedroom floors (P = 0.044), mean specific humidity (P = 0.004), winter (P < 0.0001) and spring (P = 0.001) seasons, and the presence of dog (P = 0.010) and dog allergen Can f 1 (P = 0.027). V. victoriae concentrations were lower in homes of children with asthma vs. without asthma (P = 0.027), an association observed only among the non-seroatopic children.

Increased Heart Rate Variability Response Among Infants with Reported Rhinorrhea and Watery Eyes: A Pilot Study.

INTRODUCTION: Previously, we found that reported infant rhinorrhea and watery eyes without a cold (RWWC) predicted school age exercise-induced wheeze, emergency department visits, and hospitalizations. These findings were independent of allergic sensitization, and we theorized that increased parasympathetic tone underlay the association. We also reported that increased heart-rate variability (HRV) in infants predicted wheeze in 2-3 year-olds. In a convenience sample of children participating in a birth cohort study, we tested the hypothesis that infants with RWWC would have elevated HRV, indicating increased parasympathetic tone. METHODS: RWWC symptoms since birth were queried for 3-month-old children. At 4-months, HRV was assessed (root mean square of successive differences [RMSSD]) during a standardized infant-mother still-face paradigm, which included 2 minutes of mother/child play immediately followed by 2 minutes of the mother maintaining a still-face. RESULTS: Among participants (n=38), RWWC was common for girls (32%) and boys (21%). The children with the greatest decrease in RMSSD between play and still-face challenge (lowest tertile) had a higher prevalence of RWWC as compared with children in the higher tertiles (50% vs 16%, P=0.045). In a logistic regression model controlling for sex, age and time between HRV and RWWC assessment, children with greater decrease in HRV between play and still-face (lowest tertile) had greater odds of having RWWC (odds ratio=6.0, P=0.029). CONCLUSION: In this relatively small study, we demonstrated greater decreases in HRV in response to a stressor among children with reported RWWC, suggesting that these children might have increased parasympathetic tone and/or overall greater vagal reactivity.

The return of a forgotten harvestman: revalidation of Gonyleptes robustus Holmberg, 1876, as the second species of Acanthopachylus Roewer, 1913 (Arachnida, Opiliones, Gonyleptidae).

Gonyleptes robustus Holmberg, 1876 (Opiliones, Gonyleptidae), hitherto under the synonymy of Acanthopachylus aculeatus (Kirby, 1819) is revalidated. It is recognized as the second species of genus Acanthopachylus Roewer, 1913, currently monotypic, giving the new combination Acanthopachylus robustus (Holmberg, 1876) comb. nov. The huge synonymy formerly assigned to A. aculeatus is split among the newly identified entities. Diagnostic differences (male exomorphology) that underlie the taxonomic and nomenclatural decision are succinctly displayed. Brief historical references to the arachnological work of Eduardo L. Holmberg are also given.