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Mountain protection forests can prevent natural hazards by reducing their onset and propagation probabilities. In fact, individual trees act as natural barriers against hydrogeomorphic events. However, assessing the structural strength of trees against these hazards is challenging, especially in a context of climate change due to the intensification of extreme events and changes in forest dynamics. Here, we focus on the mechanical analyses of two of the most common tree species across the Pyrenees (Abies alba Mill. and Fagus sylvatica L.) growing in two different areas (Spain and France), and affected by recurrent snow avalanche and rockfall events. We first performed 53 pulling test on mature trees, where the root-plate stiffness and the modulus of elasticity of the stems were evaluated. To further analyse the impact of forest management and climate on protective forests, we yielded information on tree growth using dendroecology techniques. Then, we assessed structure and neighbourhood characteristics for each target tree to account for the surrounding forest structure. Finally, using linear and structured equation models we tested if the mechanical capacity of the trees is determined either by functional traits (e.g. species, tree growth, diameter and height) or forest structural traits (e.g. tree density, tree structure and slenderness) or both. Our results suggest that the forest neighbourhood influences tree mechanical capacity through two pathways, including both functional and structural traits. The individual stiffness parameter of trees is influenced by their functional traits, while their structural traits are more closely related with changes in the modulus of elasticity. Both species exhibit varying levels of dominance in different locations, which is related to their resilience to the diverse natural hazards they confront. Our findings provide relevant insights to anticipating management strategies for forests that serve as a protective barrier against natural hazards in the context of a changing climate.
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Cambio Climático , Bosques , España , Francia , Árboles , Conservación de los Recursos Naturales/métodos , Monitoreo del Ambiente , Agricultura Forestal/métodos , Fagus/crecimiento & desarrollo , NieveRESUMEN
BACKGROUND: In Colombia and worldwide, breast cancer (BC) is the most frequently diagnosed neoplasia and the leading cause of death from cancer among women. Studies predominantly involve hereditary and familial cases, demonstrating a gap in the literature regarding the identification of germline mutations in unselected patients from Latin-America. Identification of pathogenic/likely pathogenic (P/LP) variants is important for shaping national genetic analysis policies, genetic counseling, and early detection strategies. The present study included 400 women with unselected breast cancer (BC), in whom we analyzed ten genes, using Whole Exome Sequencing (WES), know to confer risk for BC, with the aim of determining the genomic profile of previously unreported P/LP variants in the affected population. Additionally, Multiplex Ligation-dependent Probe Amplification (MLPA) was performed to identify Large Genomic Rearrangements (LGRs) in the BRCA1/2 genes. To ascertain the functional impact of a recurrent intronic variant (ATM c.5496 + 2_5496 + 5delTAAG), a minigene assay was conducted. RESULTS: We ascertained the frequency of P/LP germline variants in BRCA2 (2.5%), ATM (1.25%), BRCA1 (0.75%), PALB2 (0.50%), CHEK2 (0.50%), BARD1 (0.25%), and RAD51D (0.25%) genes in the population of study. P/LP variants account for 6% of the total population analyzed. No LGRs were detected in our study. We identified 1.75% of recurrent variants in BRCA2 and ATM genes. One of them corresponds to the ATM c.5496 + 2_5496 + 5delTAAG. Functional validation of this variant demonstrated a splicing alteration probably modifying the Pincer domain and subsequent protein structure. CONCLUSION: This study described for the first time the genomic profile of ten risk genes in Colombian women with unselected BC. Our findings underscore the significance of population-based research, advocating the consideration of molecular testing in all women with cancer.
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Proteína BRCA2 , Neoplasias de la Mama , Predisposición Genética a la Enfermedad , Mutación de Línea Germinal , Humanos , Femenino , Mutación de Línea Germinal/genética , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Neoplasias de la Mama/epidemiología , Colombia/epidemiología , Persona de Mediana Edad , Adulto , Proteína BRCA2/genética , Proteína BRCA1/genética , Secuenciación del Exoma , Anciano , Pruebas Genéticas/métodos , Proteínas de la Ataxia Telangiectasia Mutada/genéticaRESUMEN
Colorectal cancer (CRC) is the second leading cause of cancer deaths globally. While ethnic differences in driver gene mutations have been documented, the South American population remains understudied at the genomic level, despite facing a rising burden of CRC. We analyzed tumors of 40 Chilean CRC patients (Chp) using next-generation sequencing and compared them to data from mainly Caucasian cohorts (TCGA and MSK-IMPACT). We identified 388 mutations in 96 out of 135 genes, with TP53 (45%), KRAS (30%), PIK3CA (22.5%), ATM (20%), and POLE (20%) being the most frequently mutated. TSC2 mutations were associated with right colon cancer (44.44% in RCRC vs. 6.45% in LCRC, p-value = 0.016), and overall frequency was higher compared to TCGA (p-value = 1.847 × 10-5) and MSK-IMPACT cohorts (p-value = 3.062 × 10-2). Limited sample size restricts definitive conclusions, but our data suggest potential differences in driver mutations for Chilean patients, being that the RTK-RAS oncogenic pathway is less affected and the PI3K pathway is more altered in Chp compared to TCGA (45% vs. 25.56%, respectively). The prevalence of actionable pathways and driver mutations can guide therapeutic choices, but can also impact treatment effectiveness. Thus, these findings warrant further investigation in larger Chilean cohorts to confirm these initial observations. Understanding population-specific driver mutations can guide the development of precision medicine programs for CRC patients.
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Neoplasias del Colon , Mutación , Proteína 2 del Complejo de la Esclerosis Tuberosa , Humanos , Chile/epidemiología , Proteína 2 del Complejo de la Esclerosis Tuberosa/genética , Masculino , Femenino , Persona de Mediana Edad , Neoplasias del Colon/genética , Neoplasias del Colon/epidemiología , Neoplasias del Colon/patología , Anciano , Adulto , Secuenciación de Nucleótidos de Alto Rendimiento , Anciano de 80 o más Años , Transducción de Señal/genéticaRESUMEN
Urease, a pivotal enzyme in nitrogen metabolism, plays a crucial role in various microorganisms, including the pathogenic Helicobacter pylori. Inhibiting urease activity offers a promising approach to combating infections and associated ailments, such as chronic kidney diseases and gastric cancer. However, identifying potent urease inhibitors remains challenging due to resistance issues that hinder traditional approaches. Recently, machine learning (ML)-based models have demonstrated the ability to predict the bioactivity of molecules rapidly and effectively. In this study, we present ML models designed to predict urease inhibitors by leveraging essential physicochemical properties. The methodological approach involved constructing a dataset of urease inhibitors through an extensive literature search. Subsequently, these inhibitors were characterized based on physicochemical properties calculations. An exploratory data analysis was then conducted to identify and analyze critical features. Ultimately, 252 classification models were trained, utilizing a combination of seven ML algorithms, three attribute selection methods, and six different strategies for categorizing inhibitory activity. The investigation unveiled discernible trends distinguishing urease inhibitors from non-inhibitors. This differentiation enabled the identification of essential features that are crucial for precise classification. Through a comprehensive comparison of ML algorithms, tree-based methods like random forest, decision tree, and XGBoost exhibited superior performance. Additionally, incorporating the "chemical family type" attribute significantly enhanced model accuracy. Strategies involving a gray-zone categorization demonstrated marked improvements in predictive precision. This research underscores the transformative potential of ML in predicting urease inhibitors. The meticulous methodology outlined herein offers actionable insights for developing robust predictive models within biochemical systems.
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Inhibidores Enzimáticos , Aprendizaje Automático , Ureasa , Ureasa/antagonistas & inhibidores , Ureasa/química , Ureasa/metabolismo , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/farmacología , Helicobacter pylori/enzimología , Helicobacter pylori/efectos de los fármacos , Algoritmos , HumanosRESUMEN
During the winter of 2023, Chile faced a complex situation related to the respiratory syncytial virus (RSV). After experiencing a decline in RSV circulation during the years of the SARS-CoV-2 pandemic, a late outbreak was observed in the spring of 2022 and an early onset of the outbreak in 2023, with a significant increase in the number of serious cases. The ineffectiveness of strategic planning and risk communication contributed to the complexity of the situation. To avoid the above next winter, measures such as active surveillance, unification of definitions for acute respiratory infections, identification of RSV variants, public education about infections and advance preparation regarding hospital beds and health personnel are suggested. The importance of immunization and intersectoral collaboration to acquire new preventive alternatives is highlighted, as well as the need for early communication about the importance of immunization and identification of high-risk groups, improvement in training of medical personnel and strategic planning of the Ministry of Health. seeking a proactive and collaborative approach to address the complex RSV situation in future winters. The Chilean Immunization Advisory Committee has already carried out an analysis and recommendation on a new prevention alternative. This working group will support any decision of the Ministry of Health in public policies that attempt a change in the paradigm of control of this disease for the health of the children of our country.
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Infecciones por Virus Sincitial Respiratorio , Virus Sincitial Respiratorio Humano , Infecciones del Sistema Respiratorio , Niño , Humanos , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones por Virus Sincitial Respiratorio/prevención & control , Inmunización , VacunaciónAsunto(s)
Ciudades , Planificación de Ciudades , Planificación Ambiental , Árboles , Abastecimiento de Agua , Unión Europea/organización & administración , Árboles/crecimiento & desarrollo , Árboles/metabolismo , Agua/metabolismo , Planificación de Ciudades/tendencias , Planificación Ambiental/tendencias , Región Mediterránea , BiodiversidadRESUMEN
Volume electron microscopy technologies such as serial block face scanning electron microscopy (SBF-SEM) allow the characterization of tissue organization and cellular content in three dimensions at nanoscale resolution. Here, we describe the procedure to process and image an air-liquid interface culture of human or mouse airway epithelial cells for visualization of the multiciliated epithelium by SBF-SEM in vertical or horizontal cross section.
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Imagenología Tridimensional , Microscopía Electrónica de Volumen , Animales , Humanos , Ratones , Imagenología Tridimensional/métodos , Microscopía Electrónica de Rastreo , Epitelio , Células EpitelialesAsunto(s)
Humanos , Femenino , Adulto , Antagonistas de los Receptores de Hormonas Antidiuréticas/uso terapéutico , Prolapso de Órgano Pélvico/complicaciones , Enfermedades Renales Poliquísticas/complicaciones , Enfermedades Renales Poliquísticas/tratamiento farmacológico , Tolvaptán/uso terapéuticoAsunto(s)
Prolapso de Órgano Pélvico , Riñón Poliquístico Autosómico Dominante , Humanos , Femenino , Tolvaptán/uso terapéutico , Riñón Poliquístico Autosómico Dominante/complicaciones , Riñón Poliquístico Autosómico Dominante/tratamiento farmacológico , Antagonistas de los Receptores de Hormonas Antidiuréticas/uso terapéutico , Tasa de Filtración GlomerularRESUMEN
OBJECTIVE: COVID-19 has tried out global health causing high mortality. There are some risk factors that associate greater severity and mortality from COVID-19; but their individual impact is unknown yet. There are also no fixed criteria for hospital admission. For this reason, this study aimed to analyze the factors associated with the severity of COVID-19 and create predictive models for the risk of hospitalization and death due to COVID-19. METHODS: A descriptive retrospective cohort study was made in Talavera de la Reina (Toledo, Spain). Data were collected through computerized records of Primary Care, Emergencies and Hospitalization. The sample consisted of 275 patients over eighteen years old diagnosed with COVID-19 in a centralized laboratory from March 1st to May 31st, 2020. Analysis was carried on using SPSS, creating two predictive models for the risk of hospitalization and death using linear regression. RESULTS: The probability of hospitalization increased independently with polypharmacy (OR 1.086; CI95% 1.009-1.169), the Charlson index (OR 1.613; CI95% 1.158-2.247), the history of acute myocardial infarction (AMI) (OR 4.358; 95% CI 1.114-17.051) and the presence of COVID symptoms (OR 7.001; 95% CI 2.805-17.475). The probability of death was independently associated with age, increasing 8.1% (OD 1.081; 95% CI 1.054- 1.110) for each year of the patient. CONCLUSIONS: Comorbidity, polypharmacy, history of AMI and the presence of COVID-19 symptoms predict the risk of hospitalization. The age of individuals predicts the risk of death. Detecting patients at high risk of hospitalization and death allows us to define the target population and define measures to implement.
OBJETIVO: La COVID-19 ha puesto a prueba la sanidad mundial, provocando una elevada mortalidad. Existen factores de riesgo que asocian mayor gravedad y mortalidad por COVID-19, pero se desconoce su impacto individual. Tampoco existen criterios fijos para un ingreso hospitalario. Por ello, este estudio pretendió analizar los factores asociados a la gravedad de la COVID-19 y crear modelos predictivos de riesgo de hospitalización y exitus por COVID-19. METODOS: Se realizó un estudio descriptivo de cohorte retrospectiva en Talavera de la Reina (Toledo, España). Los datos fueron recogidos mediante registros informatizados de Atención Primaria, Urgencias y Hospitalización. La muestra estuvo compuesta por 275 pacientes mayores de dieciocho años diagnosticados de COVID-19 en un laboratorio centralizado del 1 de marzo al 31 de mayo de 2020. Se ejecutó el análisis mediante SPSS, creándose sendos modelos predictivos de riesgo de hospitalización y exitus mediante regresión lineal. RESULTADOS: La probabilidad de hospitalización aumentó de forma independiente con la polifarmacia (OR 1,086; IC95% 1,009-1,169), el índice de Charlson (OR 1,613; IC95% 1,158-2,247), el antecedente de infarto agudo de miocardio (IAM) (OR 4,358; IC95% 1,114-17,051) y la presencia de síntomas COVID (OR 7,001; IC95% 2,805-17,475). La probabilidad de exitus se asoció de forma independiente con la edad, aumentando un 8,1% (OD 1,081; IC95% 1,054-1,110) por cada año del paciente. CONCLUSIONES: La comorbilidad, la polifarmacia, el antecedente de IAM y la presencia de síntomas de COVID-19 predicen un riesgo de hospitalización. La edad de los individuos predice el riesgo de exitus. Detectar los pacientes con alto riesgo de hospitalización y exitus nos permite delimitar la población diana y definir las medidas a implementar.
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COVID-19 , Humanos , Adolescente , COVID-19/epidemiología , SARS-CoV-2 , Estudios Retrospectivos , España/epidemiología , Hospitalización , Comorbilidad , Factores de RiesgoRESUMEN
FUNDAMENTOS: La COVID-19 ha puesto a prueba la sanidad mundial, provocando una elevada mortalidad. Existen factores deriesgo que asocian mayor gravedad y mortalidad por COVID-19, pero se desconoce su impacto individual. Tampoco existen criteriosfijos para un ingreso hospitalario. Por ello, este estudio pretendió analizar los factores asociados a la gravedad de la COVID-19 y crearmodelos predictivos de riesgo de hospitalización y exitus por COVID-19. MÉTODOS: Se realizó un estudio descriptivo de cohorte retrospectiva en Talavera de la Reina (Toledo, España). Los datos fueron re-cogidos mediante registros informatizados de Atención Primaria, Urgencias y Hospitalización. La muestra estuvo compuesta por 275pacientes mayores de dieciocho años diagnosticados de COVID-19 en un laboratorio centralizado del 1 de marzo al 31 de mayo de 2020. Se ejecutó el análisis medianteSPSS, creándose sendos modelos predictivos de riesgo de hospitalización y exitus mediante regresión lineal.RESULTADOS: La probabilidad de hospitalización aumentó de forma independiente con la polifarmacia (OR 1,086; IC95% 1,009-1,169), el índice de Charlson (OR 1,613; IC95% 1,158-2,247), el antecedente de infarto agudo de miocardio (IAM) (OR 4,358; IC95% 1,114-17,051) y la presencia de síntomas COVID (OR 7,001; IC95% 2,805-17,475). La probabilidad de exitus se asoció de forma independientecon la edad, aumentando un 8,1% (OD 1,081; IC95% 1,054-1,110) por cada año del paciente. CONCLUSIONES: La comorbilidad, la polifarmacia, el antecedente de IAM y la presencia de síntomas de COVID-19 predicen un ries-go de hospitalización. La edad de los individuos predice el riesgo de exitus. Detectar los pacientes con alto riesgo de hospitalizacióny exitus nos permite delimitar la población diana y definir las medidas a implementar.(AU)
BACKGROUND: COVID-19 has tried out global health causing high mortality. There are some risk factors that associate greater se-verity and mortality from COVID-19; but their individual impact is unknown yet. There are also no fixed criteria for hospital admission.For this reason, this study aimed to analyze the factors associated with the severity of COVID-19 and create predictive models for therisk of hospitalization and death due to COVID-19. METHODS: A descriptive retrospective cohort study was made in Talavera de la Reina (Toledo, Spain). Data were collected throughcomputerized records of Primary Care, Emergencies and Hospitalization. The sample consisted of 275 patients over eighteen years olddiagnosed with COVID-19 in a centralized laboratory from March 1st to May 31st, 2020. Analysis was carried on usingSPSS, creating twopredictive models for the risk of hospitalization and death using linear regression.RESULTS: The probability of hospitalization increased independently with polypharmacy (OR 1.086; CI95% 1.009-1.169), the Charlsonindex (OR 1.613; CI95% 1.158-2.247), the history of acute myocardial infarction (AMI) (OR 4.358; 95% CI 1.114-17.051) and the presence ofCOVID symptoms (OR 7.001; 95% CI 2.805-17.475). The probability of death was independently associated with age, increasing 8.1% (OD1.081; 95% CI 1.054- 1.110) for each year of the patient. CONCLUSIONS: Comorbidity, polypharmacy, history of AMI and the presence of COVID-19 symptoms predict the risk of hospitaliza-tion. The age of individuals predicts the risk of death. Detecting patients at high risk of hospitalization and death allows us to definethe target population and define measures to implement.(AU)
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Humanos , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Infecciones por Coronavirus/epidemiología , Pandemias , Infecciones por Coronavirus/mortalidad , Hospitalización , Población Rural , Factores de Riesgo , Salud Pública , Epidemiología Descriptiva , Estudios Retrospectivos , Estudios de Cohortes , EspañaRESUMEN
BACKGROUND: A complex high-risk indicated percutaneous coronary intervention (CHIP) score was recently developed from the British Cardiovascular Intervention Society (BCIS) database to define CHIP cases and their risk of in-hospital major adverse cardiac or cerebrovascular events (MACCE). OBJECTIVES: The authors sought to apply this score to a contemporary U.S. population for the prediction of adverse events at 1 year following percutaneous coronary intervention (PCI). METHODS: Consecutive patients undergoing PCI at a large tertiary care center between 2011 and 2020 were considered for inclusion. Patients were categorized into 4 groups based on their BCIS-CHIP score (0, 1-2, 3-4, ≥5). In each category, we assessed the 1-year risk of MACCE, a composite of all-cause death, myocardial infarction, and stroke. Secondary outcomes were the individual components of MACCE, and major bleeding at 1 year. RESULTS: Among 20,799 patients included, MACCE at 1 year occurred in 1.7% patients with score 0 (reference), 3.0% with score 1 or 2 (HR: 1.72; 95% CI: 1.32-2.24), 6.1% with score 3 or 4 (HR: 3.60; 95% CI: 2.78-4.66), and 12.0% with score ≥5 (HR: 7.40; 95% CI: 5.75-9.51). Each point increase of the BCIS-CHIP score conferred a 28.0% increase of MACCE risk. The BCIS-CHIP score demonstrated good discrimination for the prediction of 1-year MACCE (C-index 0.70). The risk of secondary outcomes also progressively increased with higher score values. CONCLUSIONS: In a large PCI registry, the BCIS-CHIP score had a good predictive value for MACCE at 1 year. The utilization of this score can facilitate an accurate risk stratification of patients undergoing PCI.
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Enfermedad de la Arteria Coronaria , Infarto del Miocardio , Intervención Coronaria Percutánea , Humanos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/terapia , Enfermedad de la Arteria Coronaria/etiología , Intervención Coronaria Percutánea/efectos adversos , Resultado del Tratamiento , Infarto del Miocardio/etiología , Reino UnidoRESUMEN
Natural polymers such as cellulose have interesting tribo- and piezoelectric properties for paper-based energy harvesters, but their low performance in providing sufficient output power is still an impediment to a wider deployment for IoT and other low-power applications. In this study, different types of celluloses were combined with nanosized carbon fillers to investigate their effect on the enhancement of the electrical properties in the final nanogenerator devices. Cellulose pulp (CP), microcrystalline cellulose (MCC) and cellulose nanofibers (CNFs) were blended with carbon black (CB), carbon nanotubes (CNTs) and graphene nanoplatelets (GNPs). The microstructure of the nanocomposite films was characterized by scanning electron and probe microscopies, and the electrical properties were measured macroscopically and at the local scale by piezoresponse force microscopy. The highest generated output voltage in triboelectric mode was obtained from MCC films with CNTs and CB, while the highest piezoelectric voltage was produced in CNF-CNT films. The obtained electrical responses were discussed in relation to the material properties. Analysis of the microscopic response shows that pulp has a higher local piezoelectric d33 coefficient (145 pC/N) than CNF (14 pC/N), while the macroscopic response is greatly influenced by the excitation mode and the effective orientation of the crystals relative to the mechanical stress. The increased electricity produced from cellulose nanocomposites may lead to more efficient and biodegradable nanogenerators.
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INTRODUCTION: Core strengthening, balance, and flexibility programs such as Pilates have been advocated to positively impact running mechanics and prevent lower extremity injuries. The purpose of this study was to assess the effects of a 12-week mat-based Pilates exercise program on dynamic knee valgus alignment in runners. METHODS: Thirty-four novice runners, including young male and female adults performed a running protocol at baseline. The protocol consisted of the participants running on a treadmill at a constant five miles per hour (mph) for 4 min. Post-examination, participants were randomly assigned to a Pilates or control group (n = 16 and n = 18, respectively). A certified Pilates instructor gave the Pilates group a 12-week home-based program. To ensure participants in the Pilates group performed exercises correctly, the Pilates instructor conducted the first session, and provided feedback to each participant. Participants in both groups performed the same running testing protocol every four weeks. Knee valgus was measured as the medial displacement of the knee joint center during the running stance phase. Repeated measures Analysis of Variance (RepANOVA) was calculated at baseline and 4-, 8-, and 12-weeks post examinations to compare knee valgus during running. RESULTS: Although a reduction in dynamic knee valgus was observed within the Pilates group, the RepANOVA analysis revealed this change was not statistically significant. CONCLUSIONS: Pilates mat-based exercises may improve knee valgus after 12 weeks but a larger sample size, longer intervention duration, or a supervised program should be considered for future research to evaluate its effectiveness.
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Técnicas de Ejercicio con Movimientos , Rodilla , Adulto , Humanos , Masculino , Femenino , Fenómenos Biomecánicos , Articulación de la Rodilla , Extremidad InferiorRESUMEN
Previous attempts to quantify tree abundance at global scale have largely neglected the role of local competition in modulating the influence of climate and soils on tree density. Here, we evaluated whether mean tree size in the world's natural forests alters the effect of global productivity on tree density. In doing so, we gathered a vast set of forest inventories including >3000 sampling plots from 23 well-conserved areas worldwide to encompass (as much as possible) the main forest biomes on Earth. We evidence that latitudinal productivity patterns of tree density become evident as large trees become dominant. Global estimates of tree abundance should, therefore, consider dependencies of latitudinal sources of variability on local biotic influences to avoid underestimating the number of trees on Earth and to properly evaluate the functional and social consequences.
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Bosques , Árboles , Ecosistema , Clima , Cambio ClimáticoRESUMEN
Recent findings in forests worldwide have demonstrated how directionality in the richness-abundance causality shifts along global climate gradients: The so-called more-species hypothesis (richness determines abundance) prevails in Earth's most productive climates, whereas the opposite, the so-called more-individuals hypothesis (abundance determines richness), is more likely to prevail in climatically harsh conditions. Since temporal variability is the norm, a critical question is whether this directionality shift is also a function of temporal climatic fluctuations locally. Here, we analyze whether directionality in the richness-abundance relationship is contingent on temporal variability over 10 annual consecutive realizations in ephemeral plant assemblages. Our results support the idea that the more-species hypothesis prevailed in the most benign years, whereas the more-individuals hypothesis did so during less productive years, which were significantly linked to the warmest years. These results support the idea that rising temperatures can reverse directionality in the richness-abundance relationship in these annual plant communities, and therefore, climate warming can have a significant effect on the relationship between diversity and ecosystem functions, such as productivity, by altering the prevalence of primary mechanisms involved in species assembly.
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Biodiversidad , Ecosistema , Humanos , Plantas , Bosques , TemperaturaRESUMEN
Allied health professions, including faculty within allied health professions education programs in the United States, are woefully misrepresentative of the US population. Regarding race and ethnicity, there is a substantial and unjust underrepresentation of persons from systemically excluded culture groups, including Latina/o, Black, Indigenous, and LGBTQ+ communities. There may also exist a relative underrepresentation by gender among faculty, especially above the junior academic ranks, and among leaders and administrators in academic allied health professions programs. These disparities in race, ethnicity, and gender among faculty yield significant consequences downstream regarding workforce diversity, and by extension, health inequities among persons from systemically excluded culture groups. Critical race theory, and broadly critical theories, seek to provide relevant sociohistorical context to the contribution of factors such as race, ethnicity, sexual orientation, and gender among a spectrum of apparent inequities, including within higher education and healthcare. Cultural taxation or the "minority tax" has been proposed as a systematic mechanism through which faculty from systemically excluded culture groups fail to attain academic ranks above assistant professor, often accompanying a denial of tenure. This can have far-reaching consequences and contribute to what is colloquially referred to as racial battle fatigue. Critical race theory and the phenomenon of cultural taxation are proposed as viable frameworks through which these problems can be examined and solutions developed. Solutions may range from pathway and mentoring programs to accreditation standards and benchmarks, and perhaps simply to a realization by all relevant stakeholders that many qualified individuals from systemically excluded culture groups are fully ready, willing, and capable of effectively operating at all levels of the academic, as well as administrative, ranks, certainly on par with our White male counterparts.
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Tutoría , Femenino , Humanos , Masculino , Empleos en Salud , Grupos MinoritariosRESUMEN
Case description: A case of a 37-year-old female patient suffering from refractory bilateral trigeminal neuralgia is presented, who underwent various interventions such as acupuncture, block therapies and even microvascular decompression without effective pain relief. Clinical findings: Paresthesias and shooting-like twinges of pain intensity 10/10 in bilateral maxillary and mandibular branches of the trigeminal nerve, with nasal and intraoral triggers that made eating impossible, becoming increasingly severe since refractoriness to microvascular decompression and carbamazepines, triggering the twinges even during sleep, generating somnolence, depressive mood and social isolation. Treatment and results: The patient was evaluated by an interdisciplinary neuro-oncology team, where, in accordance with the analysis of the brain magnetic resonance imaging and the patient's history, it was indicated to perform Cyberknife® radiosurgery in monofraction on the left trigeminal and subsequently treat the contralateral trigeminal. When treated with Cyberknife® radiosurgery, the patient reported absolute improvement in her pain for 2 years. Clinical relevance: Radiosurgery by CyberKnife is not yet the first line of management in trigeminal neuralgia, however, it should be considered since several studies have managed to demonstrate an increase in the quality of life of patients and pain relief in refractory or severe cases. of said pathology.
Descripción del caso: Se presenta un caso de paciente femenino de 37 años que padecía neuralgia del trigémino bilateral refractaria, tratada con terapias alternativas, cirugía de descompresión microvascular, analgesia multimodal y terapias de bloqueo sin alivio efectivo del dolor. Hallazgos clínicos: Parestesias y punzadas tipo disparo de intensidad del dolor 10/10 en ramas maxilar y mandibular bilaterales del nervio trigémino, con gatillos nasales e intraorales que imposibilitaban comer, tornándose cada vez más severa desde refractariedad a descompresión microvascular y carbamazepinas, desencadenándose las punzadas incluso en el sueño, provocando somnolencia, animo depresivo y aislamiento social. Tratamiento y resultados: La paciente fue sometida a valoración por equipo interdisciplinario de neurooncología, donde en concordancia con el análisis de la resonancia magnética cerebral y los antecedentes de la paciente, se indicó realización de radiocirugía por Cyberknife en monofracción sobre trigémino izquierdo y posteriormente tratar el contralateral. Al ser tratada con radiocirugía Cyberknife® la paciente refiere mejora absoluta de su dolor desde hace 2 años. Relevancia clínica: La Radiocirugía por Cyberknife aún no es primera línea de manejo en neuralgia del trigémino, sin embargo, debería considerarse ya que diversos estudios han logrado demostrar un aumento en la calidad de vida de los pacientes y alivio del dolor en casos refractarios o graves de dicha patología.
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Background: Currently, there are few studies that have analyzed the benefits of using lung ultrasound in the field of primary care, including in homes and nursing homes, for patients with suspected COVID-19 pneumonia and subsequent follow-ups. The aim of this study was to demonstrate that lung ultrasound is a useful technique for triaging these patients. Methods: An observational and retrospective study of individuals who presented with clinical suspicion of SARS-CoV-2 pneumonia was carried out during the months of March to June 2020 in Health Center number 2 of Ciudad Real and in homes of patients and nursing homes belonging to the Health Service of Castilla-La Mancha (Spain). Results: A total of 209 patients, of whom 86 (41.1%) were male, were included in the study. The most frequent ultrasound findings were bilateral B-lines, with a right predominance, specifically in the posterobasal region. Additionally, there was a statistical significance (p < 0.05) correlation between pathological positivity on lung ultrasound and PCR and chest X-ray positivity. When calculating the sensitivity and specificity of ultrasound and X-ray, ultrasound had a sensitivity of 93%, and X-ray had a sensitivity of 75%. Conclusion: Due to its high sensitivity and negative predictive value, lung ultrasound is very useful as a triage tool for patients with suspected SARS-CoV-2 pneumonia.
RESUMEN
The relationship between maternal gingival health status and low birth weight or preterm delivery is controversial. The aim of this study was to analyze the association between maternal oral knowledge and the level of oral health during pregnancy with the risk of obstetric complications and breastfeeding. A descriptive cross-sectional study was conducted after an oral health educational intervention in a consecutive sample of 97 pregnant women. Data collection consisted of a validated questionnaire, oral examination, the Caries Index (CAOD) and the Simplified Oral Hygiene Index (IHOS). The participants had a mean age of 32.5 ± 5.19 years and a predominantly university education (57.1%). The level of knowledge regarding oral health was fair (12.5 ± 3.56 correct answers). Older pregnant women (33.0 ± 4.80 years) practiced breastfeeding and had a higher number of correct answers to the questionnaire. Adequate IHOS was associated with higher birth-weight newborns (3333 ± 0.3), whereas poor oral hygiene control was associated with lower birth-weight newborns (2960 ± 0.1) (p < 0.05). A lower level of academic education was associated with worse oral hygiene (p < 0.05). In addition, the greater the number of children, the higher the CAOD. Finally, among non-smoking women, the weight of infants was 437 mg higher. Maternal oral hygiene and the week of delivery were associated with newborn weight (p < 0.05) in a multiple linear regression model. Smoking was also related to low birth weight (p < 0.05). Educational interventions in pregnancy are necessary to decrease the incidence of obstetric adverse effects and improve the oral health of mothers and their children.