Electrical Brain Activity during Human Walking with Parametric Variations in Terrain Unevenness and Walking Speed.

Mobile brain imaging with high-density electroencephalography (EEG) can provide insight into the cortical processes involved in complex human walking tasks. While uneven terrain is common in the natural environment and poses challenges to human balance control, there is limited understanding of the supraspinal processes involved with traversing uneven terrain. The primary objective of this study was to quantify electrocortical activity related to parametric variations in terrain unevenness for neurotypical young adults. We used high-density EEG to measure brain activity when thirty-two young adults walked on a novel custom-made uneven terrain treadmill surface with four levels of difficulty at a walking speed tailored to each participant. We identified multiple brain regions associated with uneven terrain walking. Alpha (8 - 13 Hz) and beta (13 - 30 Hz) spectral power decreased in the sensorimotor and posterior parietal areas with increasing terrain unevenness while theta (4 - 8 Hz) power increased in the mid/posterior cingulate area with terrain unevenness. We also found that within stride spectral power fluctuations increased with terrain unevenness. Our secondary goal was to investigate the effect of parametric changes in walking speed (0.25 m/s, 0.5m/s, 0.75 m/s, 1.0 m/s) to differentiate the effects of walking speed from uneven terrain. Our results revealed that electrocortical activities only changed substantially with speed within the sensorimotor area but not in other brain areas. Together, these results indicate there are distinct cortical processes contributing to the control of walking over uneven terrain versus modulation of walking speed on smooth, flat terrain. Our findings increase our understanding of cortical involvement in an ecologically valid walking task and could serve as a benchmark for identifying deficits in cortical dynamics that occur in people with mobility deficits.

Real-time on-site detection of the three 'Candidatus Liberibacter' species associated with HLB disease: a rapid and validated method.

Huanglongbing (HLB) is a devastating disease that affects all commercial citrus species worldwide. The disease is associated with bacteria of three species of the genus 'Candidatus Liberibacter' transmitted by psyllid vectors. To date, HLB has no cure, so preventing its introduction into HLB-free areas is the best strategy to control its spread. For that, the use of accurate, sensitive, specific, and reliable detection methods is critical for good integrated management of this serious disease. This study presents a new real-time recombinase polymerase amplification (RPA) protocol able to detect the three 'Ca. Liberibacter' species associated with HLB in both plant and insect samples, validated according to European and Mediterranean Plant Protection Organization (EPPO) guidelines and tested on 365 samples from nine different geographic origins. This new protocol does not require nucleic acid purification or specialized equipment, making it ideal to be used under field conditions. It is based on specific primers and probe targeting a region of fusA gene, which shows a specificity of 94%-100%, both in silico and in vitro, for the 'Ca. Liberibacter' species associated with HLB. The analytical sensitivity of the new protocol is excellent, with a reliable detection limit in the order of 101 copies per microliter in HLB-infected plant and insect material. The repeatability and reproducibility of the new methods showed consistent results. Diagnostic parameters of the new RPA protocol were calculated and compared with the gold standard technique, a quantitative real-time PCR, in both crude extracts of citrus plants and insect vectors. The agreement between the two techniques was almost perfect according to the estimated Cohen's kappa index, with a diagnostic sensitivity and specificity of 83.89% and 100%, respectively, and a relative accuracy of 91.59%. Moreover, the results are obtained in less than 35 min. All these results indicate the potential of this new RPA protocol to be implemented as a reliable on-site detection kit for HLB due to its simplicity, speed, and portability.

Single incision laparoscopic appendectomy with surgical-glove port is cost-effective and reliable in complicated acute appendicitis: A casecontrol multicenter study in Colombia.

Background: The single-port (SPL) and multi-port (MPL) laparoscopic approach are the gold standard of management of acute appendicitis, due to its multiple advantages over open surgery, mainly because of its direct effects on recovery, esthetics and costs of the procedure. However, in third-world countries, the laparoscopic approach is not yet fully reproducible due to the costs of the technique. The surgical-glove port single incision laparoscopic appendectomy (SGP-SILA) has been proposed as a viable option. However, it has never been studied in Colombia. Objective: To evaluate the cost-effectiveness and reliability of SGP-SILA in the management of complicated acute appendicitis, compared to traditional MPL approach. Materials and methods: A retrospective case control study was carried out comparing patients undergoing laparoscopic appendectomy by SGP-SILA vs. MPL, evaluating operating costs associated with intraoperative and postoperative variables in two tertiary centers in Bogota, Colombia. The data were analyzed and expressed according to their nature and distribution. Results: 116 patients were included (SGP-SILA: 62 and MPL: 54). The median surgical time for SGP-SILA was 60 min vs. 39 min for MPL. SGP-SILA was shown to cause lower frequency of surgical site infection (4 vs. 8 patients; p = 0.047). It was found a significant correlation between Grade III surgical site infection and surgery time (p = 0.047) in the MPL group; also, with hospital stay (p < 0.001). Also, a lower risk of surgical site infection was found with the SGP-SILA technique (22% vs. 31%). SGP-SILA generated a reduction in both direct and indirect operating costs of approximately 10% (616 USD vs. 683 USD). Conclusion: SGP-SILA and MPL are feasible and comparable procedures in the resolution of complicated acute appendicitis. SGP-SILA turns out to be more cost-effective compared to MPL, due to the use of more easily accessible instruments. This may be a reproducible technique in low- and middle-income countries.

Mycobacterium leprae and Mycobacterium lepromatosis Infection: a Report of Six Multibacillary Cases of Leprosy in the Dominican Republic.

The causative agents of leprosy are Mycobacterium leprae and M. lepromatosis. Mycobacterium lepromatosis was found in 2008 to cause diffuse lepromatous leprosy in Mexican patients. This study aimed to identify M. leprae and M. lepromatosis in paraffin-embedded skin samples from Caribbean patients with leprosy. A total of six skin samples were obtained from the Dominican Republic. All cases presented the multibacillary form; five were nodular lepromatous leprosy, and one was borderline lepromatous leprosy. All patients received multidrug therapy. Molecular identification was achieved using the M. leprae-specific repetitive element for M. leprae and the hemN gene for M. lepromatosis. Mycobacterium leprae was identified in two lepromatous leprosy cases, and one borderline lepromatous leprosy case; M. lepromatosis was found in one nodular lepromatous leprosy case. Both Mycobacterium species were present in two nodular lepromatous leprosy cases. This is the first report of M. lepromatosis in the Dominican Republic.

Interstitial Cystitis: Diagnosis and Treatment in a Pregnant Patient.

Interstitial cystitis or painful bladder syndrome is a chronic condition characterized by severe and acyclic pelvic pain lasting for a period of at least six weeks. Although this condition is not accompanied by urinary infection, the patient's daily activities are impeded. The most common symptoms are urinary frequency, dysuria, suprapubic pain, nycturia, and dyspareunia. The etiology of interstitial cystitis is unclear, and its diagnosis is infrequent because of the low number of cases. A definitive diagnosis is based on cystoscopic findings and typical histopathological evidence, such as Hunner's ulcers. Herein, we describe the diagnosis and treatment of a clinical case of interstitial cystitis in a patient who started presenting symptoms during pregnancy. A 42-year-old woman at 27.2 weeks of pregnancy began showing symptoms at 10 weeks of gestation. She presented with dysuria and hypogastric pain with an intensity of 9/10, which hindered her daily activities. Physical examination revealed tenderness to deep and superficial hypogastric palpation. Routine urinalysis and urine culture test yielded negative results. She was started on symptomatic treatment from 10 weeks of gestation, but it did not result in any improvement. Therefore, intraoperative diagnostic cystoscopy was performed to obtain biopsy samples. Histopathological analysis of the samples showed evidence of interstitial cystitis. Accordingly, she was started on intravesical instillation of hyaluronic acid, which improved her condition. On the basis of the case findings, we recommend that interstitial cystitis should be considered a differential diagnosis in patients with pelvic pain and urinary symptoms unrelated to a urinary infection.

Factors influencing mercury uptake by leaves of stone pine (Pinus pinea L.) in Almadén (Central Spain).

The use of trees for biomonitoring of mercury (Hg) and other atmospheric pollutants is of increasing importance today. Leaves from different species have been the most widely used plant organ for this purpose, but only pine bark, and not leaves, was used to monitor Hg pollution. In Almadén (South Central Spain), the largest cinnabar (HgS) deposits in the world have been mined for over 2000 years to obtain metallic Hg and this activity has caused the widespread dispersion of this toxic element in the local environment. A strip of pine trees, 2750 m in length, adjacent and to the South of the mining town has been studied in order to evaluate pine tree needles as monitors for Hg contamination in this heavily polluted area. The study involved the collection of pine tree leaves from several discrete sites along the strip, as well as samples from other nearby locations, together with soil samples and monitoring of atmospheric Hg in the area during both the day and night. Leaves and soils were analyzed for total Hg concentration by means of atomic absorption spectrometry; the leachable fraction of soil Hg was also analyzed by the CV-AFS technique. The results indicate that soils from the investigated area were not directly affected by mining related pollution, with low total Hg levels (3-280 mg kg-1) found in comparison with the nearby Almadén metallurgical precinct and very low leachable Hg contents (0.27-59.65 mg kg-1) were found. Moreover, pine tree needles have a low uptake capacity, with lower THg levels (0.03-6.68 mg kg-1) when compared to those of olive trees in Almadén. However, pine needles do show significant variability with regard to the distance from the source. Gaseous Hg exhibits a similar pattern, with higher levels close to the source, especially during night time (225 ng m-3). A multiple linear regression analysis (MLRA) revealed that gaseous Hg in the nocturnal period is the prime factor that influences the amount of Hg uptake by pine tree needles. This finding makes pine needles a promising candidate to biomonitor gaseous Hg on a local or regional scale worldwide. Almadén pine tree needles have been exposed to a number of different Hg sources, including the primary one, namely the old mine dump, and secondary sources such as polluted roads or illegal urban residual waste. The secondary sources cause some minor discrepancies in the model established by the MRLA. The biomonitoring capacity of pine needles needs to be evaluated in areas far from the source. The process involved in gaseous Hg uptake by pine needles appears more likely to involve sorption in the external part of the needle than uptake through stomas, thus making this process strongly dependent on high atmospheric Hg concentrations.

Política y garantía de calidad en la captación de pacientes sintómaticos respiratorios en el centro de salud Preventiva Sud Santa Cruz de la Sierra Julio 2004 a Junio 2005

Nuestro objetivo es identificar los factores que influyen en la baja captación de sintomáticos respiratorios en el centro de salud. La metodología aplicada cuantitativa, cualitativa y longitudinal. Los resultados obtenidos y las conclusiones son: escasos recursos humanos en salud, no todo el personal maneja el progarma de tuberculosis, los insumos son escasos: la población desconoce la enfermedad y su magnitud y el servicio de salud no se proyecta a la comunidad

Estudio comparativo de la eficacia del tratamiento de la dermatitis del pañal con fototerapia solar y oxido de zinc / Comparative study of the effectiveness of the treatment of dermatitis of the dipen with solar phototherapy and zinc oxide

Se estudiaron 36 niños en total, de los cuales 18 se trataron con fototerapia solar y 18 con terapia de óxido de zinc, la distribución al azar de los niños en grupos determina que el grupo de fototerapia solar y el grupo con terapia de pomada de óxido de zinc cuentan con los tres tipos de dermatitis del pañal, es decir, grave, moderada y leve, el porcentaje de dermatitis leve es casi igual en ambos grupos, la dermatitis moderada el porcentaje es mayor en la terapia con pomada óxido de zinc, pero el porcentaje de niños que presentaron dermatitis grave es mayor en el tratamiento con fototerapia solar