Feeding behavior modifies the circadian variation in RR and QT intervals by distinct mechanisms in mice.

Rhythmic feeding behavior is critical for regulating phase and amplitude in the ≈24-h variation of heart rate (RR intervals), ventricular repolarization (QT intervals), and core body temperature in mice. We hypothesized changes in cardiac electrophysiology associated with feeding behavior were secondary to changes in core body temperature. Telemetry was used to record electrocardiograms and core body temperature in mice during ad libitum-fed conditions and after inverting normal feeding behavior by restricting food access to the light cycle. Light cycle-restricted feeding modified the phase and amplitude of 24-h rhythms in RR and QT intervals, and core body temperature to realign with the new feeding time. Changes in core body temperature alone could not account for changes in phase and amplitude in the ≈24-h variation of the RR intervals. Heart rate variability analysis and inhibiting ß-adrenergic and muscarinic receptors suggested that changes in the phase and amplitude of 24-h rhythms in RR intervals were secondary to changes in autonomic signaling. In contrast, changes in QT intervals closely mirrored changes in core body temperature. Studies at thermoneutrality confirmed that the daily variation in QT interval, but not RR interval, primarily reflected daily changes in core body temperature (even in ad libitum-fed conditions). Correcting the QT interval for differences in core body temperature helped unmask QT interval prolongation after starting light cycle-restricted feeding and in a mouse model of long QT syndrome. We conclude feeding behavior alters autonomic signaling and core body temperature to regulate phase and amplitude in RR and QT intervals, respectively.NEW & NOTEWORTHY We used time-restricted feeding and thermoneutrality to demonstrate that different mechanisms regulate the 24-h rhythms in heart rate and ventricular repolarization. The daily rhythm in heart rate reflects changes in autonomic input, whereas daily rhythms in ventricular repolarization reflect changes in core body temperature. This novel finding has major implications for understanding 24-h rhythms in mouse cardiac electrophysiology, arrhythmia susceptibility in transgenic mouse models, and interpretability of cardiac electrophysiological data acquired in thermoneutrality.

Fisura labio palatina: revisión de la literatura / Cleft lip and palate: literature review

La formación del paladar ocurre entre la quinta y undécima semana de vida intrauterina producto de la unión del paladar primario y secundario. Por otra parte, la formación del labio superior ocurre entre la quinta y sexta semana del desarrollo, y se configura en su parte media por la fusión de los procesos nasales mediales y lateralmente, a expensas de los procesos maxilares. La prevalencia de las fisuras labiales y/o fisura palatina varía según las distintas etnias, con cifras entre 0,7 hasta 1,1 casos por 1000 nacidos vivos. El objetivo de este trabajo fue realizar una revisión bibliográfica sobre aspectos epidemiológicos, mecanismos genéticos moleculares y ambientales que influyen en la ocurrencia de la fisura labial, fisura palatina y fisura labio palatina. La búsqueda bibliográfica se realizó en las bases de datos PUBMED, SCOPUS, SPRINGER, SCIENCEDIRECT utilizando los términos en inglés "cleft lip and palate", "cleft lip", "cleft palate" y "embriology". Entre los criterios de inclusión se consideraron estudios realizados en humanos y animales, publicados entre los años 2015 y 2021. La búsqueda arrojó un total de 407 trabajos, de los cuales tras un filtro por título y resumen quedaron un total de 38 artículos, en los cuales se realizó un análisis de texto completo para finalmente seleccionar 26 artículos que abarcan temas genéticos-moleculares, ambientales, epidemiológicos y sindrómicos. Además se incorporaron por búsqueda manual, 6 documentos asociados a libros de texto, y artículos científicos, sin considerar el criterio inclusión de tiempo. Dentro de esta revisión se describe la fuerte asociación entre las fisuras orales y las mutaciones de genes Msx1, sonic hedgehog, proteínas morfogenéticas óseas y factor de crecimiento fibroblástico durante la migración de las células de la cresta neural y la modelación y formación del paladar. La ausencia de ácido fólico durante el desarrollo del paladar y la presencia de hipoxia por exposición a humo, son los factores ambientales observados con mayor frecuencia en malformaciones orofaciales.

SUMMARY: Palate formation occurs between the fifth and eleventh week of intrauterine life as a result of the union of the primary and secondary palate. On the other hand, the formation of the upper lip occurs between the fifth and sixth week of development, and is configured in its middle part by the fusion of the medial and lateral nasal processes, at the expense of the maxillary processes. The prevalence of cleft lips and / or cleft palate varies according to the different ethnic groups, with figures ranging from 0.7 to 1.1 cases per 1000 live births. The aim of this work was to carry out a literature review on epidemiological aspects, molecular and environmental genetic mechanisms that influence the occurrence of cleft lip, cleft palate and its embriology. The literature search was carried out in the databases PUBMED, SCOPUS, SPRINGER, SCIENCEDIRECT using the English terms "cleft lip and palate", "cleft lip", "cleft palate" and "embryology". Inclusion criteria included studies carried out in humans and animals, published between 2015 and 2021. The search yielded a total of 407 works, of which after a filter by title and abstract, a total of 38 articles remained, in which a text analysis was carried out complete to finally select 26 articles that cover genetic-molecular, environmental, epidemiological and syndromic topics. In addition, 6 documents associated with textbooks and scientific articles were incorporated by manual search, without considering the inclusion criterion of time. This review describes the strong association between oral fissures and mutations of genes Msx1, sonic hedgehog, bone morphogenetic proteins and fibroblast growth factor during migration of neural crest cells and palate shaping and formation. Lack of folic acid during palae development dar and the presence of hypoxia due to exposure to smoke, are the environmental factors most frequently observed in orofacial malformations.

Formación entre pares. Experiencia digital sincrónica en tiempos de pandemia / Peer to peer education among internal medicine residents using digital platforms

BACKGROUND: COVID-19 impacted all areas of our society, and we took advantage of new technologies such as telemedicine to deliver information. Peer education is another tool that can be used. AIM: To report the experience of peer education among residents using a digital platform. MATERIAL AND METHODS: A digital educational program was devised in which third year residents exposed different relevant topics in internal medicine to their first year peers using Zoom. The educational process was evaluated using a Likert scale. RESULTS: A high level of satisfaction was found among the respondents according to the scale. Conclusions: There was a high level of satisfaction with the used methodology among first-year residents. A more exhaustive evaluation of this educational program should be worthwhile.

Broadband, Ultra-High-Responsive Monolayer MoS2/SnS2 Quantum-Dot-Based Mixed-Dimensional Photodetector.

Atomically thin two-dimensional (2D) materials have gained significant attention from the research community in the fabrication of high-performance optoelectronic devices. Even though there are various techniques to improve the responsivity of the photodetector, the key factor limiting the performance of the photodetectors is constrained photodetection spectral range in the electromagnetic spectrum. In this work, a mixed-dimensional 0D/2D SnS2-QDs/monolayer MoS2 hybrid is fabricated for high-performance and broadband (UV-visible-near-infrared (NIR)) photodetector. Monolayer MoS2 is deposited on SiO2/Si using chemical vapor deposition (CVD), and SnS2-QDs are prepared using a low-cost solution-processing method. The high performance of the fabricated 0D/2D photodetector is ascribed to the band bending and built-in potential created at the junction of SnS2-QDs and MoS2, which enhances the injection and separation efficiency of the photoexcited charge carriers. The mixed-dimensional structure also suppresses the dark current of the photodetector. The decorated SnS2-QDs on monolayer MoS2 not only improve the performance of the device but also extends the spectral range to the UV region. Photoresponsivity of the device for UV, visible, and NIR region is found to be ∼278, ∼ 435, and ∼189 A/W, respectively. Fabricated devices showed maximum responsivity under the visible region attributed to the high absorbance of monolayer MoS2. The response time of the fabricated device is measured as ∼100 ms. These results reveal that the development of a mixed-dimensional (0D/2D) SnS2-QDs/MoS2-based high-performance and broadband photodetector is technologically promising for next-generation optoelectronic applications.

[Peer to peer education among internal medicine residents using digital platforms]. / Formación entre pares. Experiencia digital sincrónica en tiempos de pandemia.

BACKGROUND: COVID-19 impacted all areas of our society, and we took advantage of new technologies such as telemedicine to deliver information. Peer education is another tool that can be used. AIM: To report the experience of peer education among residents using a digital platform. MATERIAL AND METHODS: A digital educational program was devised in which third year residents exposed different relevant topics in internal medicine to their first year peers using Zoom. The educational process was evaluated using a Likert scale. RESULTS: A high level of satisfaction was found among the respondents according to the scale. CONCLUSIONS: There was a high level of satisfaction with the used methodology among first-year residents. A more exhaustive evaluation of this educational program should be worthwhile.

Functional and Aesthetic Lower Lip Reconstruction Using the Yotsuyanagy Flap.

ABSTRACT: Lower lip defects are a major challenge from a reconstructive perspective. The lower lip is an anatomical region formed by different types of tissue, and it is essential to obtain adequate functional and aesthetic results. When local tissue is available to be a donor area, it becomes the best option to repair the defect. This article's purpose is to present our experience in reconstruction of partial or transfixing total defects of the lower lip with the musculocutaneous flap of the depressor anguli oris described by Yotsuyanagi.

Traumatic Telecanthus and Posterior Lacrimal Crest Avulsion in a Six-Year-Old Child.

Pediatric facial fractures are uncommon, especially orbital fractures, which can be unnoticed in 30% of the cases. Any delay regarding either diagnosis or treatment implies the risk of long-term sequels. Limited data exists concerning craniofacial fractures in children, especially the ones compromising the orbital substructures. Distribution varies upon several series; however, there is inexistence of literature regarding specific and isolated fractures of the lacrimal skeletal system. Injuries to the medial orbital wall canthal tendon can lead to disinsertion/ruptures of the medial canthal tendon. A canthopexy is the most indicated treatment to restore the original canthal position and the re-establishment of palpebral normal function. This paper's purpose is to present an isolated posterior lacrimal crest fracture/avulsion case secondary to a high-energy trauma involving a 6-year-old girl and present an exhaust literature revision.

Comparación entre la técnica de multi-inyección y la inyección única con localización del nervio mediano en el bloqueo infraclavicular para cirugía del miembro superior / Multi-injection vs. single injection technique with localization of the medial nerve for infraclavicular block for upper limb surgery

Introducción: El propósito de este experimento clínico aleatorizado controlado y ciego para el observador es comparar la efectividad del bloqueo del plexo braquial por la via infraclavicular guiado por neuroestimulador luego de usar dos técnicas diferentes: la técnica de inyección múltiple con localización de tres cordones diferentes y la técnica de inyección única con localización del cordón medial. Métodos: Doscientos sesenta (260) pacientes programados para cirugía de miembro superior con anestesia regional fueron asignados de manera aleatoria en dos grupos: inyección múltiple IM (129) o inyección única IU (128). El desenlace primario que se evaluó fue la efectividad del bloqueo, entendida como la ausencia de de sedación fuera de unos límites establecidos o la necesidad de administrar anestesia general. Otros desenlaces evaluados fueron la satisfacción de los pacientes y la presencia de efectos secundarios. Resultados: Los grupos fueron comparables en sus características de base. El tiempo de colocación del bloqueo fue de 9,6 minutos (±5,9) en IU vs. 10,4 minutos (±3,8) en IM, el cual no fue clínicamente diferente. El desenlace primario mostro 7 fallas de 129 pacientes (5,43 %) en IM, mientras que en IU fueron 27 fallas de 128 pacientes analizados (21,09 %). Esta diferencia entre las dos técnicas da como resultado un RR: 3,89 con un IC (1,76 - 8,6) con una p< 0,0002. Conclusiones: Sobre una muestra significativa de pacientes y en un escenario controlado, se demostró que el bloqueo de plexo braquial realizado con la técnica convencional de inyección múltiple con uso de estimulador de nervio periférico es superior en efectividad a la técnica de inyección única guiada por estimulador de nervio periférico con localizacion del cordon medial.