Unusual Trisomy X Phenotype Associated with a Concurrent Heterozygous 16p11.2 Deletion: Importance of an Integral Approach for Proper Diagnosis.

Trisomy X is the most frequent sex chromosome anomaly in women, but it is often underdiagnosed postnatally because most patients do not show any clinical manifestation. It is estimated that only 10% of patients with trisomy X are diagnosed by clinical findings. Thus, it has been proposed that the clinical spectrum is not yet fully delimited, and additional uncommon or atypical clinical manifestations could be related to this entity. The present report describes a female carrying trisomy X but presenting atypical manifestations, including severe intellectual disability, short stature, thymus hypoplasia, and congenital hypothyroidism (CH). These clinical findings were initially attributed to trisomy X. However, chromosome microarray analysis (CMA) subsequently revealed that the patient also bears a heterozygous 304-kb deletion at 16p11.2. This pathogenic copy-number variant (CNV) encompasses 13 genes, including TUFM. Some authors recommend that when a phenotype differs from that described for an identified microdeletion, the presence of pathogenic variants in the non-deleted allele should be considered to assess for an autosomal recessive disorder; thus, we used a panel of 697 genes to rule out a pathogenic variant in the non-deleted TUFM allele. We discuss the possible phenotypic modifications that might be related to an additional CNV in individuals with sex chromosome aneuploidy (SCA), as seen in our patient. The presence of karyotype-demonstrated trisomy X and CMA-identified 16p11.2 deletion highlights the importance of always correlating a patient's clinical phenotype with the results of genetic studies. When the phenotype includes unusual manifestations and/or exhibits discrepancies with that described in the literature, as exemplified by our patient, a more extensive analysis should be undertaken to enable a correct diagnosis that will support proper management, genetic counseling, and medical follow-up.

Dimensions of reading: a study of the beliefs of language and literature preservice teachers.

This study aims to analyze the beliefs that future Language and Literature teachers hold regarding reading. This work is part of a broader research endeavor focused on the reading habits and practices of teachers in training and their role as prospective mediators since the way in which they perceive reading significantly impacts the mediation processes they undertake in their teaching practices to cultivate readers. To achieve these objectives, a multiple case study is conducted, involving interviews with 1st-year students (n = 15), 3rd-year students (n = 15), and 5th-year students (n = 15) enrolled in Language Pedagogy programs across three universities affiliated with the Chilean Council of Rectors. For data analysis, a content analysis approach is employed, supported by NVivo 12. The findings reveal that beliefs about reading primarily fall into two dimensions: academic and personal, with the former exhibiting clearer definition and characterization. This can be attributed to the influence of the disciplines integrated into their education, namely literature and linguistics. In conclusion, it is imperative to address the social dimension of reading during the initial teacher education program, as this aspect is not emphasized by preservice teachers, despite its pivotal role in shaping their identity as reading mediators within the context of their teaching practice.

Life Cycle Assessment of Raw and Fe-Modified Biochars: Contributing to Circular Economy.

Biochar is a carbonaceous material, which can be decorated with metals, that has been garnering attention to be used in the treatment of water due to its contribution to waste management and circular economy. This study presents the life cycle assessment (LCA) regarding the generation of Pinus patula raw biochar and its modification with iron (Fe-modified biochar). SimaPro 9.3.0.3 software was used to simulate the environmental impacts of both carbonaceous materials. The potential environmental effects obtained from the production of Pinus patula raw biochar were mainly ascribed to the source of energy utilized during this process. The potential impacts demonstrated that the generation of gases and polycyclic aromatic hydrocarbons are the main concern. In the case of Fe-modified biochar, the potential environmental effects differed only in the stage of the biomass modification with the metal. These effects are associated with the extraction of Fe and the generation of wastewater. These findings provide an insight into the environmental effects linked to the production of raw and Fe-modified biochar. However, further LCA research should be performed concerning other materials and compounds than can be generated during the biomass thermochemical conversion.

MELD 3.0 adequately predicts mortality and renal replacement therapy requirements in patients with alcohol-associated hepatitis.

Background & Aims: Model for End-Stage Liver Disease (MELD) score better predicts mortality in alcohol-associated hepatitis (AH) but could underestimate severity in women and malnourished patients. Using a global cohort, we assessed the ability of the MELD 3.0 score to predict short-term mortality in AH. Methods: This was a retrospective cohort study of patients admitted to hospital with AH from 2009 to 2019. The main outcome was all-cause 30-day mortality. We compared the AUC using DeLong's method and also performed a time-dependent AUC with competing risks analysis. Results: A total of 2,124 patients were included from 28 centres from 10 countries on three continents (median age 47.2 ± 11.2 years, 29.9% women, 71.3% with underlying cirrhosis). The median MELD 3.0 score at admission was 25 (20-33), with an estimated survival of 73.7% at 30 days. The MELD 3.0 score had a better performance in predicting 30-day mortality (AUC:0.761, 95%CI:0.732-0.791) compared with MELD sodium (MELD-Na; AUC: 0.744, 95% CI: 0.713-0.775; p = 0.042) and Maddrey's discriminant function (mDF) (AUC: 0.724, 95% CI: 0.691-0.757; p = 0.013). However, MELD 3.0 did not perform better than traditional MELD (AUC: 0.753, 95% CI: 0.723-0.783; p = 0.300) and Age-Bilirubin-International Normalised Ratio-Creatinine (ABIC) (AUC:0.757, 95% CI: 0.727-0.788; p = 0.765). These results were consistent in competing-risk analysis, where MELD 3.0 (AUC: 0.757, 95% CI: 0.724-0.790) predicted better 30-day mortality compared with MELD-Na (AUC: 0.739, 95% CI: 0.708-0.770; p = 0.028) and mDF (AUC:0.717, 95% CI: 0.687-0.748; p = 0.042). The MELD 3.0 score was significantly better in predicting renal replacement therapy requirements during admission compared with the other scores (AUC: 0.844, 95% CI: 0.805-0.883). Conclusions: MELD 3.0 demonstrated better performance compared with MELD-Na and mDF in predicting 30-day and 90-day mortality, and was the best predictor of renal replacement therapy requirements during admission for AH. However, further prospective studies are needed to validate its extensive use in AH. Impact and implications: Severe AH has high short-term mortality. The establishment of treatments and liver transplantation depends on mortality prediction. We evaluated the performance of the new MELD 3.0 score to predict short-term mortality in AH in a large global cohort. MELD 3.0 performed better in predicting 30- and 90-day mortality compared with MELD-Na and mDF, but was similar to MELD and ABIC scores. MELD 3.0 was the best predictor of renal replacement therapy requirements. Thus, further prospective studies are needed to support the wide use of MELD 3.0 in AH.

Análisis de los polimorfismos ECA y ACTN3 con la agilidad en seleccionados nacionales de deportes de conjunto de Costa Rica. Estudio piloto / ACE and ACTN3 polymorphisms analysis on agility test in national players in team sports of Costa Rica. Pilot study / Análise dos polimorfismos ECA e ACTN3 com agilidade em jogadores esportivos selecionados da seleção costarriquenha. Estudo piloto

Resumen: Objetivo: Analizar las diferencias de los polimorfismos de los genes ECA y ACTN3 en el rendimiento de una prueba de agilidad en jugadores élite de deportes colectivos pertenecientes a selecciones nacionales de Costa Rica. Metodología: Se contó con una muestra de 33 jugadores hombres, de deportes colectivos (fútbol sala, rugby, voleibol y balonmano). Para la evaluación de la agilidad se utilizó el test de Illinois. Se realizaron dos visitas, en la primera se obtuvo muestras de células por medio de un enjuague y en la segunda se aplicó la prueba de agilidad. Se utilizó la prueba de Chi-cuadrado (X2) para conocer las diferencias entre las frecuencias de los polimorfismos de los genes ECA y ACTN3 y el tipo de deporte. Resultados: La mayor distribución de los polimorfismos del gen ECA, de jugadores de selecciones nacionales de deportes de conjunto, se encuentra en el ID (X2= 6.87, p= .334) y en ACTN3 el RX (X2= 6.33, p= .388). Además, tampoco se encontraron diferencias significativas entre el tiempo efectuado en el test de Illinois y los polimorfismos del gen ECA (F= 2.150, p= .134), de igual forma para los polimorfismos del gen ACTN3 (F= .950, p= .339). Conclusiones: Los polimorfismos de los genes ECA y ACTN3 no se relacionaron estadísticamente con el tipo de deporte colectivo. La agilidad no se ve asociada por un tipo de polimorfismo, lo que indica que, de forma independiente al gen, esta cualidad física se puede entrenar y generar buenos resultados en la población en general.

Abstract: Objective: To analyze the differences in the polymorphisms of the ACE and ACTN3 genes on agility test performance in elite players of collective sports from National teams of Costa Rica. Methods: a sample of 33 male team sports players (futsal, rugby, volleyball, and handball). All subjects were tested with the Illinois Agility Test. Two days of measurements were made; on the first day, cell samples were obtained and on the second day, the agility test was applied. The Chi-square test (x2) was used to determine the differences between the frequencies of the polymorphisms of the ACE and ACTN3 genes and the type of sport. Results: The highest distribution of polymorphisms of the ECA gene of players from national teams of collective sports was found in the ACE ID (X2 = 6.87, p = .334), and in ACTN3 the RX (X2 = 6.33, p =. 388). Furthermore, no significant relationship was found between the Illinois test performance and the polymorphisms of the ECA gene (F = 2,150, p = .134). Conclusions: The ACE and ACTN3 genes polymorphisms were not statistically related to the type of team sport. Agility is not associated with the type of polymorphism, which indicates that regardless of the gene, this physical quality can be trained and generate good results in the general population.

Resumo: Objetivo: analisar as diferenças dos polimorfismos dos genes ECA e ACTN3 na realização de um teste de agilidade em jogadores de elite de equipes esportivas pertencentes a equipes nacionais costarriquenhas. Metodologia: foi utilizada uma amostra de 33 jogadores de futebol masculino (futsal, rúgbi, vôlei e handebol). O teste de Illinois foi usado para avaliar a agilidade. Foram feitas duas visitas; na primeira foram obtidas amostras de uma célula por lavagem e na segunda foi aplicado o teste de agilidade. O teste qui-quadrado (X2) foi usado para determinar as diferenças entre as frequências dos polimorfismos dos genes ECA e ACTN3 e o tipo de esporte. Resultados: A maior distribuição de polimorfismos do gene ECA em jogadores de equipes nacionais de esportes coletivos é encontrada no ID (X2= 6,87, p= 0,334) e no ACTN3 no RX (X2= 6,33, p= 0,388). Além disso, não foram encontradas diferenças significativas entre o tempo gasto no teste de Illinois e os polimorfismos do gene ECA (F= 2,150, p= 0,134), assim como para os polimorfismos do gene ACTN3 (F= 0,950, p= 0,339). Conclusões: Os polimorfismos dos genes ECA e ACTN3 não estavam estatisticamente relacionados com o tipo de esporte coletivo. A agilidade não está associada pelo tipo de polimorfismo, indicando que, independentemente do gene, essa qualidade física pode ser treinada e gerar bons resultados na população em geral.

Spatial variation of cardiovascular mortality in Cali, Colombia, between 2010 and 2017.

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality worldwide and in Colombia. The analysis of CVD mortality has been mainly relied on individual factors and rates, but occurrence is also related to contextual conditions. Understanding the distribution of CVD in a region will contribute to implement more focused-preventive and care interventions. METHODS: Using the national mortality register established by the Department of National Statistics, standardized rates and spatial distribution of CVD mortality were estimated for Cali, Colombia, between 2010-2017. Global and local spatial aggregation was assessed using the Geary's C test and for each district standardized mortality ratios smoothed by the Bayesian empirical were estimated. RESULTS: Over the period, CVD was the main cause of mortality with 28,804 deaths accounting for 23,8% of total deaths. The global CVD mortality rate varied from 235.9 to 257.4 per 100.000 habitants, with an average increase of 9.1% in the percentage change. The main cause of mortality were hypertensive diseases following by ischemic heart diseases and stroke. The standardized mortality ratios smoothed by the Bayesian empirical method showed that the districts 7, 13, 14, 15 and 16 located at the eastern area with the lowest socio-economic strata and the district 22 at the south of the city with the highest socio-economic strata had the high risks of CVD mortality. All these areas were at the boundary of the city. The the lowest risk was observed in districts 1 and 2 at the northwest area with the upper socio-economic strata. Over the study period, a spatial autocorrelation was found in the districts 1,9 10, 11, 12, 13, 14, 15, 19, and 21 by using the Geary's C test. The highest significant spatial association was found in the districts 1 and 21. CONCLUSION: Of 22 districts in Cali, the highest risk of CVD mortality was found in three at the lowest and one in the upper socio-economic strata between 2013 and 2017. Over the period a global spatial aggregation was identified due mainly to districts peripherical located suggesting that there could be contextual conditions influencing the risk. Therefore, there is a need for considering local conditions to prevent CVD mortality.

Preferencias alimentarias en tiempos de pandemia: El caso de personas mayores chilenas / Food preferences in times of pandemic. The case of chilean older people

Resumen: Objetivo: El aislamiento social originado por el COVID-19 ha potenciado modificaciones en los estilos de vida, afectando el bienestar de las personas mayores. Es por esto que el objetivo del estudio es el interpretar las influencias de factores emocionales y socioeconómicos en las preferencias alimentarias de personas mayores en Gran Concepción, Chile, en tiempos de pandemia. Materiales y Métodos: Para el logro de los propósitos, se realizó una investigación que responde al paradigma cualitativo con enfoque fenomenológico interpretativo de Heidegger. Los participantes existieron seleccionados mediante un muestreo intencional en base a los criterios de selección y considerando como tamaño muestras el resultante del punto de saturación. El estudio incluyó a un total de 12 personas mayores, las que fueron entrevistadas de manera virtual; los datos resultantes, se codificaron, reagruparon y analizaron mediante técnica de análisis de contenido. Resultados: Los platillos preferidos responden a los propios de la cultura local; por otra parte, aspectos emocionales y económicos no son reconocidos en la selección de alimentos y preferencias alimentarias. La comunicación lograda por el uso de redes sociales con sus familias es identificada como positiva y no influye en sus conductas alimentarias. Conclusiones: Para este grupo de personas mayores, la vivencia de aislamiento social por COVID-19, no fue suficiente para modificar las preferencias alimentarias.

Abstract: Objective: The social isolation caused by COVID-19 has promoted changes in lifestyles, affecting the well-being of the elderly. Therefore, the objective of the study is to interpret the influence of emotional and socioeconomic factors in food preferences of older people of the Gran Concepcion, Chile, in times of pandemic. Materials and methods: For the achievement of its purposes, an investigation was carried out that responds to the qualitative paradigm with the interpretive phenomenological approach of Heidegger. Participants were selected by intentional sampling based on the selection criteria and considering the sample size resulting from the saturation point. The study included a total of 12 elderly, who were interviewed virtually; the resulting data was coded, regrouped and analyzed using a content analysis technique. Results: The favorite dishes respond to those of the local culture; on the other hand, emotional and economic aspects are not recognized in the selection of food and food preferences. The communication achieved using social networks with their families is identified as positive and does not influence their eating behaviors. Conclusions: For this group of older people, the experience of social isolation due to COVID-19 was not enough to modify food preferences.

Dietary carbohydrate-to-protein ratio influences growth performance, hepatic health and dynamic of gut microbiota in atlantic salmon (Salmo salar).

Atlantic salmon (Salmo salar) fed a carbohydrate-rich diet exhibit suboptimal growth performance, along with other metabolic disturbances. It is well known that gut microbes play a pivotal role in influencing metabolism of the host, and these microbes can be modified by the diet. The main goal of the present study was to determine the effect of feeding graded levels of digestible carbohydrates to Atlantic salmon on the distal intestine digesta microbiota at 3 sampling times (i.e., weeks 4, 8 and 12), during a 12-week trial. A low carbohydrate-to-high protein diet (LC/HP, 0% wheat starch), a medium carbohydrate-to-medium protein diet (MC/MP, 15% wheat starch) or a high carbohydrate-to-low protein diet (HC/LP, 30% wheat starch) was fed to triplicate fish tanks (27 to 28 fish per tank). We performed an in-depth characterization of the distal intestine digesta microbiota. Further, growth parameters, liver histology and the expression of genes involved in hepatic neolipogenesis in fish were measured. Fish fed a HC/LP diet showed greater hepatosomatic and viscerosomatic indexes (P = 0.026 and P = 0.018, respectively), lower final weight (P = 0.005), weight gain (P = 0.003), feed efficiency (P = 0.033) and growth rate (P = 0.003) compared with fish fed the LC/HP diet. Further, feeding salmon a high digestible carbohydrate diet caused greater lipid vacuolization, steatosis index (P = 0.007) and expression of fatty acid synthase (fas) and delta-6 fatty acyl desaturase (d6fad) (P = 0.001 and P = 0.001, respectively) in the liver compared with fish fed the LC/HP diet. Although, the major impact of feeding a carbohydrate-rich diet to Atlantic salmon in beta diversity of distal intestine digesta microbiota was observed at week 4 (HC/LP vs MC/MP and HC/LP vs LC/HP; P = 0.007 and P = 0.008, respectively) and week 8 (HC/LP vs MC/MP; P = 0.04), no differences between experimental groups were detected after 12 weeks of feeding. Finally, at the end of the trial, there was a negative correlation between lactic acid bacteria (LAB) members, including Leuconostoc and Lactobacillus, with hepatic steatosis level, the hepatosomatic and viscerosomatic indexes as well as the expression of fas and d6fad. Weissella showed negative correlation with hepatic steatosis level and the hepatosomatic index. Finally, further research to explore the potential use of LAB as probiotics to improve liver health in carnivorous fish fed fatty liver-induced diet is warranted.

Human Biomonitoring of Polychlorinated Biphenyls (PCBs) in the Breast Milk of Colombian Mothers.

Polychlorinated biphenyls (PCBs) are persistent in the environment, bioaccumulate and biomagnify throughout the food chain, and may have adverse effects on human health and wildlife. PCB indicator (PCB 28, PCB 52, PCB 101, PCB 118, PCB 138, PCB 153, and PCB 180) were monitored in human milk using 68 samples from healthy and primiparous mothers from seven cities in Colombia, and the estimated daily intake (EDI) of infants was calculated. The PCB indicator with the highest concentration was PCB 153 with a value of 7.30 ng g-1 lipids. The maximum EDI was calculated as 0.257 µg kg-1 bw-1 day-1. In general, the PCB levels found in the 68 samples were low and did not represent a risk to breastfed infants. Additionally, these results could strengthen Colombia's efforts to increase the practice of breastfeeding. Finally, the results establish a general overview of population exposure and can be a scientific tool to improve environmental health policies in the country.

The establishment of public health policies and the burden of non-alcoholic fatty liver disease in the Americas.

Non-alcoholic fatty liver disease (NAFLD) affects 20-25% of the general population and is associated with morbidity, increased mortality, and elevated health-care costs. Most NAFLD risk factors are modifiable and, therefore, potentially amenable to being reduced by public health policies. To date, there is no information about NAFLD-related public health policies in the Americas. In this study, we analysed data from 17 American countries and found that none have established national public health policies to decrease NAFLD-related burden. There is notable heterogeneity in the existence of public health policies to prevent NAFLD-related conditions. The most common public health policies were related to diabetes (15 [88%] countries), hypertension (14 [82%] countries), cardiovascular diseases (14 [82%] countries), obesity (nine [53%] countries), and dyslipidaemia (six [35%] of countries). Only seven (41%) countries had a registry of the burden of NAFLD, and efforts to raise awareness in the Americas were scarce. The implementation of public health policies are urgently needed in the Americas to decrease the burden of NAFLD.

Iduronate-2-sulfatase interactome: validation by yeast two-hybrid assay.

Mucopolysaccharidosis type II (MPS II), also known as Hunter syndrome, is a rare X-linked recessive disease caused by a deficiency of the lysosomal enzyme iduronate-2-sulfatase (IDS), which activates intracellular accumulation of nonmetabolized glycosaminoglycans such as heparan sulfate and dermatan sulfate. This accumulation causes severe damage to several tissues, principally the central nervous system. Previously, we identified 187 IDS-protein interactions in the mouse brain. To validate a subset of these interactions, we selected and cloned the coding regions of 10 candidate genes to perform a targeted yeast two-hybrid assay. The results allowed the identification of the physical interaction of IDS with LSAMP and SYT1. Although the physiological relevance of these complexes is unknown, recent advances allow us to point out that these interactions could be involved in vesicular trafficking of IDS through the interaction with SYT1, as well as to the ability to form a transcytosis module between the cellular components of the blood-brain-barrier (BBB) through its interaction with LSAMP. These results may shed light on the role of IDS on cellular homeostasis and may also contribute to the understanding of MPS II physiopathology and the development of novel therapeutic strategies to transport recombinant IDS through the brain endothelial cells toward the brain parenchyma.

Microbiota composition and susceptibility to florfenicol and oxytetracycline of bacterial isolates from mussels (Mytilus spp.) reared on different years and distance from salmon farms.

Chilean aquaculture mainly produces salmonids and molluscs. Salmonid production has been questioned by its excessive use of antimicrobials. This study aimed to investigate the bacterial microbiota composition of Mytilus spp. cultivated near salmonid farms and to determine the minimum inhibitory concentration (MIC) to florfenicol and oxytetracycline of its culturable bacteria. Seven Mytilus farming sites classified according to their proximity to salmon farms as close (CSF) or distant (DSF) were sampled in two years. We analyzed Mytilus microbiota composition through culture-independent methods, and isolated culturable bacteria, and identified those isolates with MIC values ≥ 64 µg mL-1 to florfenicol or oxytetracycline. Results revealed that the alpha diversity was affected by sampling year but not by Mytilus farming site location or its interaction. Nevertheless, in 2018, we observed a significant negative correlation between the alpha diversity of Mytilus microbiota in each farm sites and the tonnes of florfenicol reported for each phytosanitary management area. We detected significant differences in beta diversity and relative abundance of specific bacterial taxa in Mytilus microbiota depending on the proximity to salmon farms and years. A higher proportion of isolates with MIC values ≥ 64 µg mL-1 to both antibiotics was detected in 2019 compared to 2018, but not significant differences were detected according to Mytilus farming site location. However, in 2019, isolates from CSF sites showed higher MIC values for both antibiotics than those from DSF. Bacterial genera corresponding to isolates with MIC values ≥ 64 µg mL-1 represented a low proportion of Mytilus microbiota identified with the culture-independent approach, reflecting the need to implement new methodologies in the study of antimicrobial resistance. These results suggest that the proximity to salmonid farms and sampling year influence the Mytilus microbiota and MIC values of their bacterial isolates; however, other environmental variables should be considered in further studies.

Occupational exposure to polychlorinated biphenyls (PCBs) in workers at companies in the Colombian electricity sector.

Polychlorinated biphenyls (PCBs) comprise a family of 209 congeners that have low electrical conductivity and high thermal resistance due to their physicochemical properties and are thus widely used as dielectric oils, among other applications. Although PCBs are no longer used in dielectric oils in Colombia as of several years ago, electric transformers in Colombia might still contain PCBs, and workers might carry PCBs due to exposure from when they were still used in dielectric fluid. Thus, occupational exposure in Colombia to PCBs was evaluated by determining their concentrations in the blood plasma samples of 115 workers in the electricity sector . The sum of the six PCB indicators was between

El papel de la publicación tradicional de pruebas clínicas en la era de las modernas plataformas mediáticas / Theroleoftraditionalpublishingofclinicalevidenceintheageofmodernsocialmediaplatforms

Las redes sociales han revolucionado el uso de Internet. Según el Informe Digital de Estadísticas Globales de abril de 2022, hay unos 4.650 millones de usuarios de redes sociales en todo el mundo. 1 Este número equivale al 58,7 % de la población mundial, muchos de los cuales utilizan las redes sociales como principal fuente de información. ), youtube (2,2 mil millones), WhatsApp (2 mil millones), Instagram (2 mil millones), TikTok (1 mil millones), Snapchat (538 millones ), Pinterest (444 millones), Reddit (430 millones), Linkedin (250 millones) y Twitter (217 millones). Los cirujanos que están subiendo de rango son usuarios ávidos de las plataformas modernas de redes sociales o, al menos, son conscientes de ellos.

Socialmediahaverevolutionizedtheuseoftheinternet.Accord-ingtotheDigital2022AprilGlobalStatshotReport,therearesome4.65billionsocialmediausersworldwide.1Thisnumberistheequivalentto58.7%oftheglobalpopulation,manyofwhomareusingsocialmediaasaprimarysourceofinformation.Accordingtotheactiveusernumbers,themostpopularsocialmediaplatformsin2022areFacebook(2.9billion),youtube(2.2billion),WhatsApp(2billion),Instagram(2billion),TikTok(1billion),Snapchat(538million),Pinterest(444million),Reddit(430million),Linkedin(250million),andTwitter(217million).1SocialmediaisnotjustaU.S.phenomenonwhere84%ofAmericanshaveatleastoneoftheabove-listedsocialmediaaccounts.Thereareover1billionsocialmediausersinChina,despite415millionofitscitizenshavingnointernetaccess.1Mostyoungergenerationsoforthopedicsur-geonscominguptheranksareeitheravidusersofmodernsocialmediaplatformsorareatleastawareofthem

Rompiendo el efecto ''techo de cristal'' en la generación de evidencia clínica de alto nivel en ortopedia y traumatología / Breaking the "glass ceiling" effect in the generation of high-level clinical evidence in orthopedics and traumatology

Introduction: In clinical studies involving common orthopedic problems and traumatic injuries, randomization methods are difficult to orchestrate. The lack of high-level clinical evidence based on prospective, randomized, double-blind studies is often cited as a major reason for rejecting proposed therapeutic advances in orthopedic surgery. Materials and methods: This opinion document summarizes the limitations of clinical trials in surgical subspecialties. A consensus is presented about how the practicing orthopedic surgeon can produce high-quality clinical evidence and thus make changes to their clinical practice protocols. Results: This literature review revealed that level of evidence classifications vary among surgical subspecialties. Research in orthopedics and traumatology is primarily directed toward diagnosis, preferred treatment, and economic decision analysis, while other prognostic classifications are preferred in other areas, such as plastic surgery. In orthopedics, double-blind controlled studies are rare and often impractical or even unethical. Crossover between randomized surgical trials of study groups is more common. Other difficulties in surgical trials range from: lack of organizational and financial support, institutional approval or ethics committee and registration requirements for clinical trials, and to insufficient time outside of an already busy clinical program to dedicate to this laborious task. uncompensated task. Conclusion: Orthopedic surgery is a subspecialty based on experience and skill. Many innovations begin with enterprising surgeons reporting opinion reports or retrospective cohort studies, many of which are biased. Prospective observational cohort studies with consistent results may offer higher grade clinical evidence than poorly executed randomized trials.

Correlation between urinary KIM-1 and kidney protein expression of p-ERK following damage in rats exposed to gentamicin or lead acetate.

Kidney injury molecule-1 (KIM-1) is a membrane receptor upregulated in the proximal tubule cells following various types of kidney injuries. Notably, studies have suggested a correlation between KIM-1 expression and extracellular signal-regulated kinase (ERK) activation. In this study, we aimed to investigate the association between the kidney overexpression pattern of cytoplasmic phosphorylated-ERK (p-ERK) protein and increased urinary KIM-1 levels in rats exposed to gentamicin or lead acetate, both at the end of toxic exposure and after a 4-week recovery period. Although other proteins were evaluated, only kidney overexpression of cytoplasmic p-ERK protein correlated with increased urinary KIM-1 levels. For both toxic substances, the increased urinary KIM-1 levels corresponded with kidney inflammation. Our results suggest that KIM-1 and p-ERK share a common mechanism in kidney injury mediated by both toxic substances that induce proximal tubule damage.

Impact of Public Health Policies on Alcohol-Associated Liver Disease in Latin America: An Ecological Multinational Study.

BACKGROUND AND AIMS: Alcohol-associated liver disease (ALD) is the leading cause of liver-related mortality in Latin America, yet the impact of public health policies (PHP) on liver disease is unknown. We aimed to assess the association between alcohol PHP and deaths due to ALD in Latin American countries. APPROACH AND RESULTS: We performed an ecological multinational study including 20 countries in Latin America (628,466,088 inhabitants). We obtained country-level sociodemographic information from the World Bank Open Data source. Alcohol-related PHP data for countries were obtained from the World Health Organization Global Information System of Alcohol and Health. We constructed generalized linear models to assess the association between the number of PHP (in 2010) and health outcomes (in 2016). In Latin America, the prevalence of obesity was 27% and 26.1% among male and female populations, respectively. The estimated alcohol per capita consumption among the population at 15 years old or older was 6.8 L of pure alcohol (5.6 recorded and 1.2 unrecorded). The overall prevalence of alcohol use disorders (AUD) was 4.9%. ALD was the main cause of cirrhosis in 64.7% of male and 40.0% of female populations. A total of 19 (95%) countries have at least one alcohol-related PHP on alcohol. The most frequent PHP were limiting drinking age (95%), tax regulations (90%), drunk-driving policies and countermeasures (90%), and government monitoring systems and community support (90%). A higher number of PHP was associated with a lower ALD mortality (PR, 0.76; 95% CI, 0.61-0.93; P = 0.009), lower AUD prevalence (PR, 0.80; 95% CI, 0.65-0.99; P = 0.045), and lower alcohol-attributable road traffic deaths (PR, 0.81; 95% CI, 0.65-1.00; P = 0.051). CONCLUSIONS: Our study indicates that in Latin America, countries with higher number of PHP have lower mortality due to ALD, lower prevalence of AUD, and lower alcohol-attributable road traffic mortality.

Mineralocorticoid receptor modulation by dietary sodium influences NAFLD development in mice.

INTRODUCTION AND OBJECTIVES: Nonalcoholic-fatty-liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome (MetS). Mineralocorticoid receptor (MR) activation is associated with increased risk of MetS but few studies have assessed the role of liver MR on NAFLD. We aimed to evaluate the effect of MR modulation by sodium intake in liver injury in experimental models of NAFLD. MATERIALS AND METHODS: C57BL/6J mice were fed either a high-fat-diet (HFD) or a choline/methionine deficient (MCD) diet with different sodium concentrations. Hepatic concentration of lipid species, serum aldosterone levels, expression of MR, proinflammatory and profibrotic markers and liver histology were assessed. RESULTS: Mice fed with High-Na+/HFD showed a lower MR expression in liver (p = 0.01) and less steatosis on histology (p = 0.04). Consistently, animals from this group exhibited lower levels of serum aldosterone (p = 0.028) and lower hepatic triglyceride content (p = 0.008). This associated to a reduced expression of lipogenic genes, significant changes in lipid subspecies, lower HOMA-IR (p < 0.05), and lower expression of pro-inflammatory and profibrotic markers compared to those mice fed a Low-Na+/HFD. Additionally, mice fed a High-Na+/HFD showed higher expression of salt-inducible kinase (SIK)-1 and lower expression of serum-and-glucocorticoid-inducible kinase (SGK)-1. Similar results were observed with the MCD diet model. CONCLUSION: We identified in two experimental models of NAFLD that High-Na+ diet content is associated to lower serum aldosterone levels and hepatic MR downregulation, associated to decreased steatosis and reduced de novo hepatic lipogenesis, proinflammatory and profibrotic markers. Decreased activation of hepatic MR seems to generate beneficial downstream inhibition of lipogenesis in experimental NAFLD.

Efecto de la crioterapia en la articulación tibiotarsiana en el área de sección transversa de los músculos tibial anterior y sóleo en ratas / Effects of cryotherapy on the tibiotarsal joint in the cross-sectional area of rat tibialis anterior and soleus muscles

Resumen Introducción. La crioterapia se usa para tratar la inflamación articular aguda, sin embargo su efecto sobre el músculo relacionado con la articulación inflamada aún no ha sido estudiado. Objetivo. Evaluar el efecto de la crioterapia sobre la articulación tibiotarsiana en el área de sección transversa (AST) de los músculos tibial anterior (TA) y sóleo en ratas con inflamación articular aguda. Materiales y métodos. Estudio experimental realizado en 32 ratas Wistar que fueron asignadas aleatoriamente a cuatro grupos: Control, Inflamación, Crioterapia-A y Crioterapia-B. El AST de las fibras de los músculos se midió 72 horas después de haberse iniciado el experimento. Resultados. En el músculo TA hubo una reducción significativa del AST de las fibras musculares en los grupos Inflamación y Crioterapia-B en comparación con el grupo Control, mientras que en el grupo Crioterapia-A no se observó una reducción significativa en dicha área al compararlo con el Control. En el caso del músculo sóleo, se observó una reducción significativa del área en todos los grupos experimentales. Conclusión. El uso de crioterapia una vez al día por tres días atenúa el efecto atrófico de la inflamación articular aguda sobre el músculo TA, lo que confirma su importancia en el control del efecto deletéreo de la inflamación aguda sobre músculos de contracción rápida.

Abstract Introduction: Cryotherapy is used to treat acute joint inflammation, but its effect on muscles associated with the injured joint has not yet been studied. Objective: To evaluate the effect of cryotherapy on the tibiotarsal joint in the cross-sectional area (CSA) of tibialis anterior (TA) and soleus muscles in rats with acute joint inflammation. Materials and methods: Experimental study conducted on 32 Wistar rats that were randomly assigned to four groups: Control, Inflammation, Cryotherapy-A and Cryotherapy-B. The CSA of muscle fibers was measured 72 hours after initiating the experiment. Results: In the case of the TA muscle, there was a significant reduction in the CSA muscle fibers in the Inflammation and Cryotherapy-B groups compared to the Control group, while no significant reduction was observed in the Cryotherapy-A group in relation to the Control group. Regarding the soleus muscle, a significant CSA reduction was observed in all experimental groups. Conclusion: The use of cryotherapy once a day for three days attenuates the atrophic effect of acute joint inflammation on the TA muscle, confirming its importance for controlling the deleterious effects of acute inflammation on fast-twitch muscles.

Conocimiento preventivo y su práctica entre la población de Colombia hacia la enfermedad por Coronavirus (COVID-19): una perspectiva de género / Preventive knowledge and its practice among Colombian population towards coronavirus disease (COVID-19): A Gender-Based Perspective

RESUMEN Este estudio investiga el conocimiento existente de la COVID-19 en ambos sexos y propone una práctica para prevenir la COVID-19. Se realizó un estudio transversal con una encuesta en línea recopilando datos en diferentes regiones de Colombia, a través de un cuestionario validado estructurado y de diseño propio basado en el asesoramiento público general de la Organización Mundial de la Salud (OMS) sobre la prevención de la COVID-19. Este estudio ha empleado la técnica de muestreo de bola de nieve, y contó con 445 participantes (46,5% hombres y 53,5% mujeres). Se identificó que las mujeres no solo tienen un mejor conocimiento, sino que su comportamiento en la práctica es mucho mejor que sus contrapartes masculinas. Aunque los resultados entre hombres y mujeres son muy similares, la pregunta de quedarse en casa es bastante concluyente a favor de las mujeres, quienes son más responsables. Finalmente, el estudio demuestra que las mujeres corren menos riesgo en comparación con los hombres, porque estas tienen mejores prácticas de prevención, como lo indican las estadísticas. Este estudio destaca aún más la idea de que las mujeres son menos propicias para contraer la infección de covid-19 debido a su mejor comportamiento de práctica que los hombres.

SUMMARY This study investigates the existing knowledge of covid-19 among both genders and a likely use of it in practice to combat COVID-19. Cross sectional study with an online survey and data was collected from Colombia, through a structured, self-design validated questionnaire was created based on the World Health Organization (WHO) general public advice towards COVID-19 prevention. This study has employed snow-ball sampling technique, counted on 445 participants (46.5% male and 53.5% female). This study has found out that women not only carry better knowledge, but their practicing behavior is far better than their male counterparts. Although the results between men and women are very similar, the question about staying at home is quite conclusive in favor of women, who are more responsible. Finally his study proves that women are on a less risk in comparison to men on the basis of prevention practices exercised better as the prevailing statistics indicate. This study highlighted the notion further that women are less conducive to infection of COVID-19 due to their better practicing behavior than men.