A pseudonymized corpus of occupational health narratives for clinical entity recognition in Spanish.

Despite the high creation cost, annotated corpora are indispensable for robust natural language processing systems. In the clinical field, in addition to annotating medical entities, corpus creators must also remove personally identifiable information (PII). This has become increasingly important in the era of large language models where unwanted memorization can occur. This paper presents a corpus annotated to anonymize personally identifiable information in 1,787 anamneses of work-related accidents and diseases in Spanish. Additionally, we applied a previously released model for Named Entity Recognition (NER) trained on referrals from primary care physicians to identify diseases, body parts, and medications in this work-related text. We analyzed the differences between the models and the gold standard curated by a physician in detail. Moreover, we compared the performance of the NER model on the original narratives, in narratives where personal information has been masked, and in texts where the personal data is replaced by another similar surrogate value (pseudonymization). Within this publication, we share the annotation guidelines and the annotated corpus.

Memory complaint in a middle-income country: a four-year longitudinal study in a cohort with low-education.

BACKGROUND: Memory complaints are frequent in older adults and are associated with higher risk of cognitive decline. OBJECTIVE: To investigate the functional outcome of individuals with memory complaints followed up at primary care centers. METHODS: Data were collected between 2016 e 2020 in primary health care centers in Brazil. Patients underwent the Brief Cognitive Screening Battery, and the Functional Activities Questionnaire. RESULTS: The initial sample (2016) comprised 91 individuals classified into those with subjective cognitive decline (SCD, n = 15), mild cognitive impairment (MCI, n = 45), or dementia (n = 31). During follow-up, 8 individuals (8.8% of the initial sample) died and 26 (28.5% of the initial sample) were not found. Fifty-seven participants underwent clinical reassessment. Of 15 individuals with SCD, 7 were not found (46.7%), 4 (26.7%) progressed to MCI, and 4 (26.7%) remained stable. Of 45 individuals with MCI, 11 were not found (24.4%), 2 (4.4%) died, 6 (13.4%) progressed to dementia, 12 (26.7%) regressed to SCD, and 14 (31.1%) remained stable. Of 31 individuals with dementia, 8 were not found (25.8%), 6 (19.4%) died, 2 (6.5%) regressed to SCD, 7 (22.6%) regressed to MCI, and 8 remained stable (25.8%). Clinical improvement was due to the treatment of reversible causes, such as B12 hypovitaminosis and mood disorders. Older age, lower Mini-Mental State Examination, and higher scores of memory complaint, but not the use of benzodiazepines and of proton pump inhibitors, were predictors of functional status. CONCLUSION: Despite their limits (short sample size, missing data), these results support the idea that adequate screening, follow-up, and treatment of reversible causes of dementia in primary care are essential.

ANTECEDENTES: Queixas de memória são frequentes em idosos e estão associadas ao maior risco de declínio cognitivo. OBJETIVO: Investigar o desfecho funcional de indivíduos com queixas de memória acompanhados em centros atenção primária. MéTODOS: Os dados foram coletados entre 2016 e 2020 em centros de atenção primária à saúde no Brasil. Os pacientes foram submetidos à Bateria Cognitiva Breve e ao Questionário de Atividades Funcionais. RESULTADOS: A amostra inicial (2016) foi composta por 91 indivíduos, classificados como tendo declínio cognitivo subjetivo (DCS, n = 15), comprometimento cognitivo leve (CCL, n = 45), ou demência (n = 31). Durante o seguimento, 8 indivíduos (8,8% da amostra inicial) faleceram e 26 (28,5% da amostra inicial) não foram encontrados. Cinquenta e sete participantes foram submetidos à reavaliação clínica. Dos 15 indivíduos com DCS, 7 não foram encontrados (46,7%), 4 (26,7%) declinaram para CCL e 4 (26,7%) permaneceram estáveis. Dos 45 indivíduos com CCL, 11 não foram encontrados (24,4%), 2 (4,4%) morreram, 6 (13,4%) declinaram para demência, 12 (26,7%) evoluíram para DCS e 14 (31,1%) permaneceram estáveis. Dos 31 indivíduos com demência, 8 não foram encontrados, (25,8%), 6 (19,4%) morreram, 2 (6,5%) evoluíram para DCS e 7 (22,6%) para CCL; e 8 permaneceram estáveis (25,8%). A melhora clínica deveu-se ao tratamento de causas reversíveis, como hipovitaminose B12 e transtornos de humor. A idade avançada, a baixa pontuação no Mini-Exame do Estado Mental e os escores de queixa de memória mais altos, mas não o uso de benzodiazepínicos e inibidores da bomba de prótons, foram preditores de declínio funcional. CONCLUSãO: Apesar de suas limitações (amostra pequena, dados ausentes), esses resultados corroboram que a triagem adequada, o acompanhamento e o tratamento de causas reversíveis de demência na atenção primária são essenciais.

Assessing the water quality in a World Heritage Site using biomarkers in top fish predators.

The use of biomarkers in fish for biomonitoring is a valuable approach to reveal effects of human impacts on biota health. Top predator fish are effective models for monitoring human activities' impacts on aquatic ecosystems. The Guaraguaçu River is the largest river-system on coastal region of South Brazil and a World Heritage site. The river receives contaminants from disorderly urban growth, including discharges of domestic sewage and small fishery boats, particularly during the tourist season. Our study aimed to assess impact of anthropogenic activities on water quality in the Guaraguaçu River by analyzing environmental contamination biomarkers in the top fish predator Hoplias malabaricus. Fish were collected using a fyke net trap across sectors representing a gradient of anthropic impact: sector 1 - pristine; sector 2 - impacted; and sector 3 - less impacted. Water samples were collected to analyze the presence of trace elements and pesticide. Biomarkers of the antioxidant system, histopathology, genotoxicity, neurotoxicity, and concentration of trace elements were analyzed in fish tissues. In water samples Al, Fe and Mn were detected, but no pesticides were found. In fish muscle, zinc and iron were detected. Brain acetylcholinesterase activity decreased in impacted sectors, indicating neurotoxic effects. The antioxidant system increased activity in gills and liver, and damage from lipoperoxidation was observed, particularly in sector 2 when compared to sector 1, suggesting oxidative stress. Histopathological biomarkers revealed lesions in the liver and gills of fish in impacted sectors. Micronuclei, a genotoxicity biomarker, were observed in organisms from all sectors. Our results demonstrate detrimental effects of poor water quality on biota health, even when contaminants are not detected in water.

Impact of Nonpharmaceutical Interventions during the COVID-19 Pandemic on the Prevalence of Respiratory Syncytial Virus in Hospitalized Children with Lower Respiratory Tract Infections: A Systematic Review and Meta-Analysis.

During the COVID-19 pandemic, nonpharmaceutical interventions (NPIs) were implemented in order to control the transmission of SARS-CoV-2, potentially affecting the prevalence of respiratory syncytial virus (RSV). This review evaluated the impact of NPIs on RSV-related hospitalizations in children during the lockdown (2020-2021) compared to the pre-pandemic (2015-2020) and post-lockdown (2021-2022) periods. In this systematic review and meta-analysis, we searched through PubMed, Scopus, and Web of Science for studies published in English between 1 January 2015 and 31 December 2022. Additionally, we conducted hand searches of other records published between 1 January 2023 and 22 January 2024. Our target population was hospitalized children aged 0-18 years with RSV-related lower respiratory tract infections confirmed through immunofluorescence, antigen testing, or molecular assays. We focused on peer-reviewed observational studies, analyzing the primary outcome of pooled RSV prevalence. A generalized linear mixed model with a random-effects model was utilized to pool each RSV prevalence. Heterogeneity was assessed using Cochran's Q and I2 statistics, while publication bias was evaluated through funnel plots and Egger's tests. We identified and analyzed 5815 publications and included 112 studies with 308,985 participants. Notably, RSV prevalence was significantly lower during the lockdown period (5.03% [95% CI: 2.67; 9.28]) than during the pre-pandemic period (25.60% [95% CI: 22.57; 28.88], p < 0.0001). However, RSV prevalence increased notably in the post-lockdown period after the relaxation of COVID-19 prevention measures (42.02% [95% CI: 31.49; 53.33] vs. 5.03% [95% CI: 2.67; 9.28], p < 0.0001). Most pooled effect estimates exhibited significant heterogeneity (I2: 91.2% to 99.3%). Our findings emphasize the effectiveness of NPIs in reducing RSV transmission. NPIs should be considered significant public health measures to address RSV outbreaks.

A Copper-Mediated Radical α-Heteroarylation of Nitriles with Azobis(alkylcarbonitriles).

A new practical method has been developed for the α-heteroarylation of aliphatic nitriles with heteroarenes and azobis(alkylcarbonitriles) using Cu(OAc)2 as an oxidizing agent. This method allows the easy construction of nitrile-, aryl-, and dialkyl-bearing quaternary carbon centers from readily available building blocks, without requiring prefunctionalization steps. This reaction is based on adding cyanodialkyl radicals onto heteroarenes, including benzofurans, furans, pyrroles, and indoles. The resulting α-heteroaryl nitriles are useful synthetic intermediates and pharmacophores in biologically active molecules.

Spatio-temporal trends of mercury levels in alluvial gold mining spoils areas monitored between rainy and dry seasons in the Peruvian Amazon.

Artisanal and small-scale gold mining (ASGM) in the Amazon has degraded tropical forests and escalated mercury (Hg) pollution, affecting biodiversity, ecological processes and rural livelihoods. In the Peruvian Amazon, ASGM annually releases some 181 tons of Hg into the environment. Despite some recent advances in understanding the spatial distribution of Hg within gold mine spoils and the surrounding landscape, temporal dynamics in Hg movement are not well understood. We aimed to reveal spatio-temporal trends of soil Hg in areas degraded by ASGM.,. We analyzed soil and sediment samples during the dry and rainy seasons across 14 ha of potentially contaminated sites and natural forests, in the vicinities of the Native community of San Jacinto in Madre de Dios, Peru. Soil Hg levels of areas impacted by ASGM (0.02 ± 0.02 mg kg-1) were generally below soil environmental quality standards (6.60 mg kg-1). However, they showed high variability, mainly explained by the type of natural cover vegetation, soil organic matter (SOM), clay and sand particles. Temporal trends in Hg levels in soils between seasons differed between landscape units distinguished in the mine spoils. During the rainy season, Hg levels decreased up to 45.5% in uncovered soils, while in artificial pond sediments Hg increased by up to 961%. During the dry season, uncovered degraded soils were more prone to lose Hg than sites covered by vegetation, mainly due to higher soil temperatures and concomitantly increasing volatilization. Soils from natural forests and degraded soil covered by regenerating vegetation showed a high capacity to retain Hg mainly due to the higher plant biomass, higher SOM, and increasing concentrations of clay particles. Disturbingly, our findings suggest high Hg mobility from gold mine spoil to close by sedimentary materials, mainly in artificial ponds through alluvial deposition and pluvial lixiviation. Thus, further research is needed on monitoring, and remediation of sediments in artificial to design sustainable land use strategies.

Memory complaint in a middle-income country: a four-year longitudinal study in a cohort with low-education / Queixa de memória na comunidade em um país de renda média: um estudo longitudinal de quatro anos em uma coorte de baixa escolaridade

Abstract Background Memory complaints are frequent in older adults and are associated with higher risk of cognitive decline. Objective To investigate the functional outcome of individuals with memory complaints followed up at primary care centers. Methods Data were collected between 2016 e 2020 in primary health care centers in Brazil. Patients underwent the Brief Cognitive Screening Battery, and the Functional Activities Questionnaire. Results The initial sample (2016) comprised 91 individuals classified into those with subjective cognitive decline (SCD, n = 15), mild cognitive impairment (MCI, n = 45), or dementia (n = 31). During follow-up, 8 individuals (8.8% of the initial sample) died and 26 (28.5% of the initial sample) were not found. Fifty-seven participants underwent clinical reassessment. Of 15 individuals with SCD, 7 were not found (46.7%), 4 (26.7%) progressed to MCI, and 4 (26.7%) remained stable. Of 45 individuals with MCI, 11 were not found (24.4%), 2 (4.4%) died, 6 (13.4%) progressed to dementia, 12 (26.7%) regressed to SCD, and 14 (31.1%) remained stable. Of 31 individuals with dementia, 8 were not found (25.8%), 6 (19.4%) died, 2 (6.5%) regressed to SCD, 7 (22.6%) regressed to MCI, and 8 remained stable (25.8%). Clinical improvement was due to the treatment of reversible causes, such as B12 hypovitaminosis and mood disorders. Older age, lower Mini-Mental State Examination, and higher scores of memory complaint, but not the use of benzodiazepines and of proton pump inhibitors, were predictors of functional status. Conclusion Despite their limits (short sample size, missing data), these results support the idea that adequate screening, follow-up, and treatment of reversible causes of dementia in primary care are essential.

Resumo Antecedentes Queixas de memória são frequentes em idosos e estão associadas ao maior risco de declínio cognitivo. Objetivo Investigar o desfecho funcional de indivíduos com queixas de memória acompanhados em centros atenção primária. Métodos Os dados foram coletados entre 2016 e 2020 em centros de atenção primária à saúde no Brasil. Os pacientes foram submetidos à Bateria Cognitiva Breve e ao Questionário de Atividades Funcionais. Resultados A amostra inicial (2016) foi composta por 91 indivíduos, classificados como tendo declínio cognitivo subjetivo (DCS, n = 15), comprometimento cognitivo leve (CCL, n = 45), ou demência (n = 31). Durante o seguimento, 8 indivíduos (8,8% da amostra inicial) faleceram e 26 (28,5% da amostra inicial) não foram encontrados. Cinquenta e sete participantes foram submetidos à reavaliação clínica. Dos 15 indivíduos com DCS, 7 não foram encontrados (46,7%), 4 (26,7%) declinaram para CCL e 4 (26,7%) permaneceram estáveis. Dos 45 indivíduos com CCL, 11 não foram encontrados (24,4%), 2 (4,4%) morreram, 6 (13,4%) declinaram para demência, 12 (26,7%) evoluíram para DCS e 14 (31,1%) permaneceram estáveis. Dos 31 indivíduos com demência, 8 não foram encontrados, (25,8%), 6 (19,4%) morreram, 2 (6,5%) evoluíram para DCS e 7 (22,6%) para CCL; e 8 permaneceram estáveis (25,8%). A melhora clínica deveu-se ao tratamento de causas reversíveis, como hipovitaminose B12 e transtornos de humor. A idade avançada, a baixa pontuação no Mini-Exame do Estado Mental e os escores de queixa de memória mais altos, mas não o uso de benzodiazepínicos e inibidores da bomba de prótons, foram preditores de declínio funcional. Conclusão Apesar de suas limitações (amostra pequena, dados ausentes), esses resultados corroboram que a triagem adequada, o acompanhamento e o tratamento de causas reversíveis de demência na atenção primária são essenciais.

Satisfaction level and correlation between performance and self-evaluation of physical therapy students in an objective structured clinical examination (OSCE) designed to assess clinical reasoning / Nivel de satisfacción y correlación entre el desempeño y la autoevaluación de los estudiantes de fisioterapia en una evaluación clínica objetiva estructurada (ECOE) diseñada para evaluar el razonamiento clínico

Abstract Introduction: The Objective Structured Clinical Evaluation (OSCE) is an instrument that allows evaluating clinical reasoning among physical therapy students, considering that knowing the correlation between their performance and their self-evaluation, as well as their level of satisfaction with this instrument, is essential. Objectives: To determine the correlation between performance and self-evaluation (perceived performance) of physical therapy students in an OSCE designed to assess clinical reasoning, and to evaluate their level of satisfaction with this instrument. Materials and methods: Analytical cross-sectional study conducted in 159 physical therapy students from a university in Chile who participated in an 11-station OSCE. Performance checklists and answer sheets were used for performance evaluation (passing score: 70% of the maximum score per station and in the OSCE). Two perception surveys were also used, one for self-evaluation of performance (for each station) and another to determine the students' level of satisfaction with the OSCE. The correlation between performance in the OSCE (overall score, score by station, and score by type of station) and perceived performance was determined using the Spearman's correlation coefficient. Results: The level of satisfaction with the OSCE was high in 57.23% of the students. The correlation between the total score in the OSCE and perceived performance was significant, but weak (Rho=0.31; p<0.001). In students with a low satisfaction level with the OSCE, the correlation between performance and perceived performance was not significant (Rho=0.15; p=0.23), while in those with high satisfaction level it was significant and moderate (Rho=0.48; p<0.001). Conclusions: Most students reported a high level of satisfaction with the OSCE. However, in most stations, the correlation between observed and perceived performance was weak and very weak.

Resumen Introducción. La Evaluación Clínica Objetiva Estructurada (ECOE) es un instrumento que permite evaluar el razonamiento clínico en estudiantes de fisioterapia, por lo que saber la correlación entre su desempeño y su autoevaluación, así como su nivel de satisfacción con esta herramienta, es esencial. Objetivos. Determinar la correlación entre el desempeño y la autoevaluación (desempeño percibido) de estudiantes de fisioterapia en una ECOE diseñada para evaluar el razonamiento clínico, y evaluar su nivel de satisfacción con esta herramienta. Materiales y métodos. Estudio transversal analítico realizado en 159 estudiantes de fisioterapia de una universidad de Chile que participaron en una ECOE de 11 estaciones. Se utilizaron listas de verificación de desempeño y hojas de respuesta para la evaluación del desempeño (nota aprobatoria: 70% de la nota máxima por estación y de la ECOE) y 2 encuestas de percepción, una para la autoevaluación del desempeño (para cada estación) y otra para determinar el nivel de satisfacción de los estudiantes con la ECOE. La correlación entre el desempeño en la ECOE (puntuación global, por estaciones y por tipo de estación) y el desempeño percibido (autoevaluación) se determinó mediante el coeficiente de correlación de Spearman. Resultados. El nivel de satisfacción con la ECOE fue alto en el 57.23% de los estudiantes. La correlación entre el puntaje total en la ECOE y el desempeño percibido fue significativa, pero débil (Rho=0.31; p<0.001). En estudiantes con nivel de satisfacción bajo, la correlación entre el desempeño y el desempeño percibido no fue significativa (Rho=0.15; p=0.23), mientras que en aquellos con un nivel de satisfacción alto fue significativa y moderada (Rho=0.48; p<0.001). Conclusiones. La mayoría de los estudiantes manifestaron tener un alto nivel de satisfacción con la ECOE. Sin embargo, en la mayoría de las estaciones la correlación entre el desempeño observado y el percibido fue débil y muy débil.

PD-L1 expression complements CALGB prognostic scoring system in malignant pleural mesothelioma.

Background: Programmed death ligand-1 (PD-L1) expression is a predictive biomarker in patients with lung cancer, but its role in malignant pleural mesothelioma (MPM) remains unclear. Evidence suggests that higher PD-L1 expression is correlated with worse survival. CALGB is the main scoring system used to predict the benefit of chemotherapy treatment. This study aimed to determine the prognostic value of PD-L1 expression and its addition to CALGB scoring system in patients with MPM. Methods: In this retrospective analysis, we evaluated samples with confirmed locally advanced or metastatic MPM. PD-L1 Tumor Proportional Score (TPS) was determined by immunohistochemistry at diagnosis. Results: 73 patients were included in this study. A cutoff value of 15 was set for a high or low PD-L1 TPS. In total, 71.2% (n=52) and 28.8% (n=21) of individuals harbored low or high PD-L1 expression, respectively. PD-L1High was associated with worse median progression-free Survival (mPFS) [4.9 vs. 10.8 months; HR 2.724, 95% CI (1.44-5.14); p = 0.002] and Overall Survival (OS) [6.0 vs. 20.9 months; HR 6.87, 95% CI (3.4-8.7); p<0.001] compared to patients with PD-L1Low. Multivariate analysis confirmed that PD-L1 expression was an independent factor for PFS and OS in patients with MPM and CALGB score of 5-6. Conclusion: PD-L1 addition to CALGB scale improves its prognostic estimation of MPM survival and should be considered in future research.

Perilesional edema diameter associated with brain metastases as a predictive factor of response to radiotherapy in non-small cell lung cancer.

Background: Different prognostic scales exist in patients with brain metastasis, particularly in lung cancer. The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA index) for brain metastases is a powerful prognostic tool that effectively identifies patients at different risks. However, these scales do not include perilesional edema diameter (PED) associated with brain metastasis. Current evidence suggests that PED might compromise the delivery and efficacy of radiotherapy to treat BM. This study explored the association between radiotherapy efficacy, PED extent, and gross tumor diameter (GTD). Aim: The aim of this study was to evaluate the intracranial response (iORR), intracranial progression-free survival (iPFS), and overall survival (OS) according to the extent of PED and GT. Methods: Out of 114 patients with BM at baseline or throughout the disease, 65 were eligible for the response assessment. The GTD and PED sum were measured at BM diagnosis and after radiotherapy treatment. According to a receiver operating characteristic (ROC) curve analysis, cutoff values were set at 27 mm and 17 mm for PED and GT, respectively. Results: Minor PED was independently associated with a better iORR [78.8% vs. 50%, OR 3.71 (95% CI 1.26-10.99); p = 0.018] to brain radiotherapy. Median iPFS was significantly shorter in patients with major PED [6.9 vs. 11.8 months, HR 2.9 (95% CI 1.7-4.4); p < 0.001] independently of other prognostic variables like the Lung-molGPA and GTD. A major PED also negatively impacted the median OS [18.4 vs. 7.9 months, HR 2.1 (95% CI 1.4-3.3); p = 0.001]. Conclusion: Higher PED was associated with an increased risk of intracranial progression and a lesser probability of responding to brain radiotherapy in patients with metastatic lung cancer. We encourage prospective studies to confirm our findings.

Optimization of a Validated Protocol That Determines Bioavailable Fluoride in Toothpastes.

A validated protocol used to determine how much of total fluoride is bioavailable in toothpaste formulations was evaluated if it could be simplified regarding the following parameters: (1) concentration of the slurry (0.25-4%), (2) centrifugation speed (1,000-12,000 g) and time (1-10 min), and (3) incubation time for FPO32- ion hydrolysis and insoluble-F dissolution (15-60 min). Fresh and aged Na2FPO3/CaCO3 and fresh NaF/SiO2-based toothpastes were analyzed (n = 9). The improvements were the centrifugation at 1,000 g for 5 min is enough to separate insoluble-F and the time for FPO32- ion hydrolysis and insoluble-F dissolution can be shortened to 30 min.

Examining the Interaction between Exercise, Gut Microbiota, and Neurodegeneration: Future Research Directions.

Physical activity has been demonstrated to have a significant impact on gut microbial diversity and function. Emerging research has revealed certain aspects of the complex interactions between the gut, exercise, microbiota, and neurodegenerative diseases, suggesting that changes in gut microbial diversity and metabolic function may have an impact on the onset and progression of neurological conditions. This study aimed to review the current literature from several databases until 1 June 2023 (PubMed/MEDLINE, Web of Science, and Google Scholar) on the interplay between the gut, physical exercise, microbiota, and neurodegeneration. We summarized the roles of exercise and gut microbiota on neurodegeneration and identified the ways in which these are all connected. The gut-brain axis is a complex and multifaceted network that has gained considerable attention in recent years. Research indicates that gut microbiota plays vital roles in metabolic shifts during physiological or pathophysiological conditions in neurodegenerative diseases; therefore, they are closely related to maintaining overall health and well-being. Similarly, exercise has shown positive effects on brain health and cognitive function, which may reduce/delay the onset of severe neurological disorders. Exercise has been associated with various neurochemical changes, including alterations in cortisol levels, increased production of endorphins, endocannabinoids like anandamide, as well as higher levels of serotonin and dopamine. These changes have been linked to mood improvements, enhanced sleep quality, better motor control, and cognitive enhancements resulting from exercise-induced effects. However, further clinical research is necessary to evaluate changes in bacteria taxa along with age- and sex-based differences.

Effect of high-intensity laser therapy in patients with non-specific chronic neck pain: study protocol for a randomized controlled trial.

BACKGROUND: Chronic non-specific neck pain (CNNP) is a prevalent musculoskeletal disorder known for its significant disability and economic burden, ranking second only to low back pain in musculoskeletal conditions. Physical therapy offers effective interventions for CNNP, including low-level laser therapy (LLLT). High-intensity laser therapy (HILT) is a recent treatment for musculoskeletal pain, but studies that support its use in CNNP are limited. The objective of this study is to assess the effect of high-intensity laser therapy on pain intensity in patients with CNNP, given the existing evidence on LLLT for this condition. METHODS: This is a 2-arm, randomized, placebo-controlled trial with blinded evaluators. The research will be carried out in the laboratory of physical agents at the Andrés Bello University, Campus Casona de las Condes. Eligible participants include the entire internal and external community associated with Andrés Bello University suffering from chronic non-specific NP. Participants will be stratified by sex (4 subgroups) and randomized into 2 study groups: group 1 (HILT and stretching exercises) and group 2 (sham HILT and stretching exercises). Treatments will be performed twice a week for 4 weeks with 3 assessments: before treatment (T0), at the end of treatment (T1), and 12 weeks after treatment (follow-up) (T2). The main outcomes will be pain intensity at rest, pain intensity at movement (active cervical movements: flexion, extension, right and left side bending, and right and left rotation), and pain pressure threshold (average obtained for six evaluation points). Secondary outcome measures will include neck range of motion in the sagittal, coronal, and transverse planes and neck disability. DISCUSSION: In this study, HILT's effects on patients with non-specific NP will be compared to those of a sham laser intervention. This RCT will offer new evidence regarding the potential benefits of HILT in terms of pain intensity, range of movement, and disability in people suffering with non-specific NP. TRIAL REGISTRATION: ClinicalTrials.gov NCT05689788. January 19, 2023.

Clinical and Epidemiologic Characteristics of Infants Hospitalized with Respiratory Syncytial Virus Infection During the 2022-2023 Season in Mexico.

In 2022, several countries reported an increase in respiratory syncytial virus (RSV) infections. We assessed the clinical characteristics and outcomes of infants hospitalized with RSV and compared them with infants hospitalized between 2009 and 2015. No significant differences in underlying disorders, intensive care unit admission rates and mortality were observed suggesting currently circulating RSV strains do not show heightened virulence.

Evolución del parto por cesárea en la provincia del Neuquén, 2000-2020 / Caesarean section rate evolution in Neuquén province, 2000 to 2020

RESUMEN INTRODUCCIÓN: El nacimiento por cesárea se encuentra en aumento en todo el mundo, con diferencias significativas entre regiones. El objetivo fue determinar la situación del porcentaje de cesárea en mujeres con parto en la provincia del Neuquén en 2000-2020, buscando diferencias entre subsectores, zonas sanitarias, localidades e instituciones de salud . MÉTODOS: Se analizaron las estadísticas del Sistema Informático Perinatal referentes a vía de parto, recién nacidos y mujeres con partos entre 2000 y 2020. Se realizó un análisis estratificado del porcentaje de cesáreas, describiendo medidas de tendencia central, de dispersión y velocidad promedio de incremento anual . RESULTADOS: Las características sociodemográficas de madres gestantes se han modificado, con un descenso del embarazo adolescente y un aumento de madres de más de 35 años. Se observó un mayor porcentaje de bajo peso al nacer en el subsector privado y una importante disminución de la tasa bruta de natalidad, con mayor descenso en el interior provincial. Se encontró un aumento sostenido, así como diferencias crecientes y muy significativas entre subsectores (y dentro de estos entre las distintas instituciones) . DISCUSIÓN: Existen diferencias muy significativas en los resultados si se comparan los diferentes subsectores e instituciones respecto al nacimiento por cesárea. Estos resultados son un aporte para la construcción de políticas acordes a la realidad epidemiológica de la provincia y de cada institución de salud.

ABSTRACT INTRODUCTION: Cesarean delivery is increasing all over the world, with significant differences between regions. The aim was to determine the cesarean section rate in women giving birth between 2000 and 2020 in Neuquén province, seeking for differences between sub-sectors, health zones, cities and health institutions . METHODS: Statistics from the Perinatal Information System were analyzed regarding type of delivery, newborns and women delivering between 2000 and 2020. A stratified analysis of the cesarean section rate was conducted, describing central tendency and dispersion measures, and the average annual rate of increase . RESULTS: Maternal sociodemographic characteristics have changed, with adolescent pregnancy decrease and a higher number of mothers older than 35 years of age. The percentage of low birth weight was higher in the private sub-sector, with a significant decrease of gross birth rate, mainly inside the province. There was a steady increase as well as growing and very significant differences between sub-sectors (and within them between the different institutions) . DISCUSSION: The results show very significant differences when comparing sub-sectors and institutions regarding cesarean birth, and contribute to building policies tailored to the epidemiological situation of the province and each health institution.

Effect of Processing Methods of Human Saliva on the Proteomic Profile and Protein-Mediated Biological Processes.

The use of saliva as a protein source prior to microbiological and biological assays requires previous processing. However, the effect of these processing methods on the proteomic profile of saliva has not been tested. Stimulated human saliva was collected from eight healthy volunteers. Non-processed saliva was compared with 0.22 µm filtered, 0.45 µm filtered, and pasteurized saliva, by liquid chromatography-mass spectrometry. Data are available via ProteomeXchange with identifier PXD039248. The effect of processed saliva on microbial adhesion was tested using bacterial and fungus species and in biological cell behavior using HaCaT immortalized human keratinocytes. Two hundred and seventy-eight proteins were identified in non-processed saliva, of which 54 proteins (≈19%) were exclusive. Saliva processing reduced identified proteins to 222 (≈80%) for the 0.22 µm group, 219 (≈79%) for the 0.45 µm group, and 201 (≈72%) for the pasteurized saliva, compared to non-processed saliva. The proteomic profile showed similar molecular functions and biological processes. The different saliva processing methods did not alter microbial adhesion (ANOVA, p > 0.05). Interestingly, pasteurized saliva reduced keratinocyte cell viability. Saliva processing methods tested reduced the proteomic profile diversity of saliva but maintained similar molecular functions and biological processes, not interfering with microbial adhesion and cell viability, except for pasteurization, which reduced cell viability.

The race for the optimal antimicrobial surface: perspectives and challenges related to plasma electrolytic oxidation coating for titanium-based implants.

Plasma electrolytic oxidation (PEO) is a low-cost, structurally reliable, and environmentally friendly surface modification method for orthopedic and dental implants. This technique is successful for the formation of porous, corrosion-resistant, and bioactive coatings, besides introducing antimicrobial compounds easily. Given the increase in implant-related infections, antimicrobial PEO-treated surfaces have been widely proposed to surmount this public health concern. This review comprehensively discusses antimicrobial implant surfaces currently produced by PEO in terms of their in vitro and in vivo microbiological and biological properties. We present a critical [part I] and evidence-based [part II] review about the plethora of antimicrobial PEO-treated surfaces. The mechanism of microbial accumulation on implanted devices and the principles of PEO technology to ensure antimicrobial functionalization by one- or multi-step processes are outlined. Our systematic literature search showed that particular focus has been placed on the metallic and semi-metallic elements incorporated into PEO surfaces to facilitate antimicrobial properties, which are often dose-dependent, without leading to cytotoxicity in vitro. Meanwhile, there are concerns over the biocompatibility of PEO and its long-term antimicrobial effects in animal models. We clearly highlight the importance of using clinically relevant infection models and in vivo long-term assessments to guarantee the rational design of antimicrobial PEO-treated surfaces to identify the 'finish line' in the race for antimicrobial implant surfaces.

Clinical performance of and patient satisfaction with conventional complete dentures with different occlusal schemes: A systematic review of systematic reviews.

STATEMENT OF PROBLEM: The complete denture occlusal scheme may influence clinical performance and patient satisfaction. However, a consensus on which occlusal scheme should be used for complete denture users is lacking. As a result, many dentists choose the scheme based on their preferences and clinical experience. PURPOSE: The purpose of this review was to assess the methodological quality and summarize the scientific evidence from secondary studies about the influence of occlusal schemes on the clinical performance of and patient satisfaction with complete dentures. MATERIAL AND METHODS: Ten sources were surveyed according to the patient, intervention, comparison, outcome (PICO) strategy. Systematic reviews that evaluated the clinical performance and patient satisfaction (O) of rehabilitated edentulous patients with conventional complete dentures (P) under different occlusal schemes (I/C) were included. Methodological quality was assessed by using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 tool by 2 authors independently. The effect of each occlusal scheme in comparison with others was summarized and classified as positive, neutral, negative, or inconclusive based on the conclusions of the systematic review concerning clinical performance and patient satisfaction outcomes. RESULTS: The search led to the inclusion of 10 systematic reviews. Seven were classified as of critically low, 2 as low, and 1 as moderate methodological quality. The following occlusal designs were included and analyzed: bilateral balanced occlusion, lingualized occlusion, canine guidance, group function, and monoplane occlusion. Bilateral balanced occlusion and canine guidance obtained satisfactory results for both outcomes. Lingualized occlusion showed a trend toward better results than other occlusal schemes for normal and resorbed ridges. Group function presented mainly inconclusive results, and monoplane occlusion did not deliver satisfactory outcomes. CONCLUSIONS: The present overview concluded that occlusal schemes might interfere with the clinical performance of and patient satisfaction with complete dentures. Lingualized, bilateral balanced, and canine guidance are preferred compared with monoplane occlusion, but lingualized occlusion tends to show better results in some reviews. However, the results should be carefully considered because of the low quality of the systematic reviews included.

Body Composition Profiles of Applicants to a Physical Education and Sports Major in Southeastern Mexico.

This study aimed to determine the body composition profile of candidates applying for a Physical Education and Sports major. 327 young adults (F: 87, M: 240) participated in this cross-sectional study. Nutritional status and body composition analysis were performed, and the profiles were generated using an unsupervised machine learning algorithm. Body mass index (BMI), percentage of fat mass (%FM), percentage of muscle mass (%MM), metabolic age (MA), basal metabolic rate (BMR), and visceral fat level (VFL) were used as input variables. BMI values were normal-weight although VFL was significantly higher in men (<0.001; η2 = 0.104). MA was positively correlated with BMR (0.81 [0.77, 0.85]; p < 0.01), BMI (0.87 [0.84, 0.90]; p < 0.01), and VFL (0.77 [0.72, 0.81]; p < 0.01). The hierarchical clustering analysis revealed two significantly different age-independent profiles: Cluster 1 (n = 265), applicants of both sexes that were shorter, lighter, with lower adiposity and higher lean mass; and, Cluster 2 (n = 62), a group of overweight male applicants with higher VFL, taller, with lower %MM and estimated energy expended at rest. We identified two profiles that might help universities, counselors and teachers/lecturers to identify applicants in which is necessary to increase physical activity levels and improve dietary habits.

Design and implementation of a digital textbook about physical agents as a learning resource in the training process of Chilean physical therapy students in the context of the COVID-19 pandemic

The COVID-19 pandemic has had a strong impact on education, forcing the implementation of distance learning methodologies using information and communication technologies (ICT). The digital textbook is a didactic resource used to guide the training process of students; besides, its interactivity allows systematic work, favoring metacognition and the construction of self-learning. The aim of this paper is to describe, through a descriptive cross-sectional design, the design, review, digitization and implementation phases of a digital textbook about physical agents as a learning resource to support distance education in the training process of physical therapy students enrolled in the physical agents course offered by Universidad Andres Bello in Santiago, Chile, in the context of the human mobility restriction measures implemented due to the COVID-19 pandemic. The textbook consists of thirteen thematic sections and once it was reviewed and validated by peers and by the editorial committee of the university it was digitalized and indexed into the digital resource database of the university, where it was made available to the entire cohort of students enrolled in the physical agents course during the first semester of2020 (n=115).The digital textbook was successfully implemented as a didactic resource to guide the autonomous and distance learning of students during the time human mobility restriction measures were established in Chile due to the pandemic. Future studies should focus on reporting the students' satisfaction and perception of this tool and its effect on learning outcomes in order to obtain effective feedback.

La pandemia por COVID-19 ha tenido un fuerte impacto en la educación, por lo que ha sido necesario implementar metodologías de aprendizaje a distancia basadas en tecnologías de la información y las comunicaciones (TIC). El libro de texto digital es un recurso didáctico utilizado para guiar el proceso de formación de los estudiantes; además, su interactividad permite el trabajo sistemático, lo que favorece la metacognición y la construcción del aprendizaje autónomo. El objetivo de este estudio fue describir, mediante un diseño transversal descriptivo, las fases de diseño, revisión, digitalización e implementación de un libro de texto digital sobre agentes físicos como recurso de aprendizaje para apoyar la educación a distancia en el proceso de formación de estudiantes de fisioterapia inscritos en el curso de Agentes Físicos ofrecido por la Universidad Andrés Bello en Santiago, Chile, en el contexto de las medidas de restricción de movilidad humana implementadas por la pandemia por COVID-19. El libro de texto consiste de 13 secciones temáticas y, una vez revisado y validado por pares y por el comité editorial de la universidad, fue digitalizado e indexado en la base de datos de recursos digitales de la universidad, donde se puso a disposición de toda la cohorte de estudiantes matriculados en el curso durante el primer semestre de 2020 (n=115). El libro de texto digital se implementó satisfactoriamente como recurso didáctico para guiar el aprendizaje autónomo y no presencial de los estudiantes en el periodo en que se instauraron las medidas de restricción de la movilidad humana en Chile debido a la pandemia. Estudios futuros deben centrarse en reportar la satisfacción y percepción de los estudiantes con esta herramienta y su efecto en los resultados del aprendizaje para obtener una retroalimentación efectiva.