Bioactivity of synthetic peptides from Ecuadorian frog skin secretions against Leishmania mexicana, Plasmodium falciparum, and Trypanosoma cruzi.

Chagas disease, leishmaniasis, and malaria are major parasitic diseases disproportionately affecting the underprivileged population in developing nations. Finding new, alternative anti-parasitic compounds to treat these diseases is crucial because of the limited number of options currently available, the side effects they cause, the need for long treatment courses, and the emergence of drug-resistant parasites. Anti-microbial peptides (AMPs) derived from amphibian skin secretions are small bioactive molecules capable of lysing the cell membrane of pathogens while having low toxicity against human cells. Here, we report the anti-parasitic activity of five AMPs derived from skin secretions of three Ecuadorian frogs: cruzioseptin-1, cruzioseptin-4 (CZS-4), and cruzioseptin-16 from Cruziohyla calcarifer; dermaseptin-SP2 from Agalychnis spurrelli; and pictuseptin-1 from Boana picturata. These five AMPs were chemically synthesized. Initially, the hemolytic activity of CZS-4 and its minimal inhibitory concentration against Escherichia coli, Staphylococcus aureus, and Candida albicans were determined. Subsequently, the cytotoxicity of the synthetic AMPs against mammalian cells and their anti-parasitic activity against Leishmania mexicana promastigotes, erythrocytic stages of Plasmodium falciparum and mammalian stages of Trypanosoma cruzi were evaluated in vitro. The five AMPs displayed activity against the pathogens studied, with different levels of cytotoxicity against mammalian cells. In silico molecular docking analysis suggests this bioactivity may occur via pore formation in the plasma membrane, resulting in microbial lysis. CZS-4 displayed anti-bacterial, anti-fungal, and anti-parasitic activities with low cytotoxicity against mammalian cells. Further studies about this promising AMP are required to gain a better understanding of its activity.IMPORTANCEChagas disease, malaria, and leishmaniasis are major tropical diseases that cause extensive morbidity and mortality, for which available treatment options are unsatisfactory because of limited efficacy and side effects. Frog skin secretions contain molecules with anti-microbial properties known as anti-microbial peptides. We synthesized five peptides derived from the skin secretions of different species of tropical frogs and tested them against cultures of the causative agents of these three diseases, parasites known as Trypanosoma cruzi, Plasmodium falciparum, and Leishmania mexicana. All the different synthetic peptides studied showed activity against one of more of the parasites. Peptide cruzioseptin-4 is of special interest since it displayed intense activity against parasites while being innocuous against cultured mammalian cells, which indicates it does not simply hold general toxic properties; rather, its activity is specific against the parasites.

Incidence of major cardiovascular events at 1, 2, and 5 years and mortality in incident patients on peritoneal dialysis regarding their nutritional status by bioimpedanciometry: A multicenter study in Colombia.

BACKGROUND: The nutritional status of incident patients on peritoneal dialysis (PD) has been associated with survival outcomes. Bioimpedanciometry (BCM) enables to establish a nutritional diagnosis, the volume status, and correlates these findings with survival. METHODS: This study used a retrospective multicenter historical cohort. RESULTS: In this study, which included 420 incident patients on peritoneal dialysis with a 5-year follow-up, a cumulative incidence of major adverse cardiovascular events (MACE) of 28.8% was found, being higher in the diabetic population at 36.8%. In regard to the nutritional status in this population, it was found that approximately 44% had altered nutritional status; 34% were found to be in sarcopenia; 6.7% sarcopenic obesity; and 2.8% in obesity (p < 0.001). In the survival analysis, a lower probability of survival was found in patients with overhydration (OH) greater than 3 L (p < 0.001) and in patients with altered nutritional status due to sarcopenia, sarcopenic obesity, and obesity (p 0.016). According to survival in the subgroup of the diabetic population, a lower probability of survival was found in this group of patients (p: 0.011). The overall mortality of the study population was 18%, being higher in the first 2 years, with the most important causes of mortality being cardiovascular. Of the deceased population, 51% were diabetic patients (p: 0.012). CONCLUSION: In incident patients on peritoneal dialysis, sarcopenic obesity, sarcopenia, overhydration status determined by BCM, and having a diagnosis of diabetes are related to a lower probability of survival; MACE outcomes are more frequent in the diabetic population.

Modulation of the activation of endothelial nitric oxide synthase and nitrosative stress biomarkers by aspirin triggered lipoxins: A possible mechanism of action of aspirin in the antiphospholipid syndrome.

PROBLEM: Antiphospholipid syndrome (APS) is characterized by the clinical manifestation of vascular thrombosis (VT) or pregnancy morbidity (PM) and antiphospholipid antibodies (aPL) that can modify the nitric oxide production. Low-dose aspirin is used in the prevention and treatment of diverse alterations of pregnancy. One of the mechanisms of action of aspirin is to induce the production of aspirin-triggered-lipoxins (ATL). The aim of this study was to evaluate the modulatory effect of ATL over the activation of endothelial nitric oxide synthase (eNOS) and nitrosative stress biomarkers induced by aPL. METHODS: We used polyclonal IgG and sera from women with aPL and PM/VT or VT only, and from women with PM only and positive for non-criteria aPL (SN-OAPS). In these sera, biomarkers of nitrosative stress (nitrites and nitrotyrosine) were measured. The protein expression of nitrotyrosine and the phosphorylation of eNOS (at Ser1177) were estimated in human umbilical vein endothelial cells (HUVECs) stimulated with polyclonal IgG with or without ATL. RESULTS: Women with SN-OAPS showed increased circulating levels of nitrites and nitrotyrosine. Likewise, polyclonal IgG from either SN-OAPS or VT patients stimulated nitrotyrosine expression in HUVECs. ATL decreased the nitrotyrosine expression induced by polyclonal IgG from the SN-OAPS group. ATL also recovered the reduced eNOS phosphorylation at Ser1177 in HUVECs stimulated with polyclonal IgG from women with PM/VT or SN-OAPS. CONCLUSIONS: Increased nitrosative stress present in serum of women with SN-OAPS is associated with IgG-mediated impaired endothelial NO synthesis in endothelial cells. ATL prevent these cellular changes.

Ptr1 and ZAR1 immune receptors confer overlapping and distinct bacterial pathogen effector specificities.

Some nucleotide-binding and leucine-rich repeat receptors (NLRs) indirectly detect pathogen effectors by monitoring their host targets. In Arabidopsis thaliana, RIN4 is targeted by multiple sequence-unrelated effectors and activates immune responses mediated by RPM1 and RPS2. These effectors trigger cell death in Nicotiana benthamiana, but the corresponding NLRs have yet not been identified. To identify N. benthamiana NLRs (NbNLRs) that recognize Arabidopsis RIN4-targeting effectors, we conducted a rapid reverse genetic screen using an NbNLR VIGS library. We identified that the N. benthamiana homolog of Ptr1 (Pseudomonas tomato race 1) recognizes the Pseudomonas effectors AvrRpt2, AvrRpm1, and AvrB. We demonstrated that recognition of the Xanthomonas effector AvrBsT and the Pseudomonas effector HopZ5 is conferred independently by the N. benthamiana homolog of Ptr1 and ZAR1. Interestingly, the recognition of HopZ5 and AvrBsT is contributed unequally by Ptr1 and ZAR1 in N. benthamiana and Capsicum annuum. In addition, we showed that the RLCK XII family protein JIM2 is required for the NbZAR1-dependent recognition of AvrBsT and HopZ5. The recognition of sequence-unrelated effectors by NbPtr1 and NbZAR1 provides an additional example of convergently evolved effector recognition. Identification of key components involved in Ptr1 and ZAR1-mediated immunity could reveal unique mechanisms of expanded effector recognition.

The oxidative potential of airborne particulate matter in two urban areas of Chile: More than meets the eye.

Oxidative potential (OP) has gained attention as a parameter that can reveal the ability of different properties of particulate matter (PM) to generate reactive oxygen species (ROS) as one single value. Moreover, OP is also believed to be a predictor of toxicity and hence the health effects of PM. This study evaluated the OP of PM10, PM2.5,and PM1.0samples using dithiothreitol assays in two cities of Chile (Santiago and Chillán). The results showed that the OP was different between cities, PM size fractions, and seasons. Additionally, OP was strongly correlated with certain metals and meteorological variables. Higher mass-normalized OP was observed during cold periods in Chillán and warm periods in Santiago and was associated with PM2.5 and PM1. On the other hand, volume-normalized OP was higher during winter in both cities and for PM10. Additionally, we compared the OP values to the Air Quality Index (AQI) scale and found cases of days that were classified as having "good" air quality (supposed to be less harmful to health) showing extremely high OP values that were similar to those on days that were classified as "unhealthy". Based on these results,we suggest using the OP as a complementary measure to the PM mass concentration because it includes important new information related to PM properties and compositions that could help improvecurrent air quality management tools.

Post-Intensive Care Unit Multidisciplinary Approach in Patients with Severe Bilateral SARS-CoV-2 Pneumonia.

Background: Short and long-term sequelae after admission to the intensive care unit (ICU) for coronavirus disease 2019 (COVID-19) are to be expected, which makes multidisciplinary care key in the support of physical and cognitive recovery. Objective: To describe, from a multidisciplinary perspective, the sequelae one month after hospital discharge among patients who required ICU admission for severe COVID-19 pneumonia. Design: Prospective cohort study. Environment: Multidisciplinary outpatient clinic. Population: Patients with severe COVID-19 pneumonia, post- ICU admission. Methods: A total of 104 patients completed the study in the multidisciplinary outpatient clinic. The tests performed included spirometry, measurement of respiratory muscle pressure, loss of body cell mass (BCM) and BCM index (BCMI), general joint and muscular mobility, the short physical performance battery (SPPB or Guralnik test), grip strength with hand dynamometer, the six-minute walk test (6-MWT), the functional assessment of chronic illness therapy-fatigue scale (FACIT-F), the European quality of life-5 dimensions (EQ-5D), the Barthel index and the Montreal cognitive assessment test (MoCA). While rehabilitation was not necessary for 23 patients, 38 patients attended group rehabilitation sessions and other 43 patients received home rehabilitation. Endpoints: The main sequelae detected in patients were fatigue (75.96%), dyspnoea (64.42%) and oxygen therapy on discharge (37.5%). The MoCA showed a mean score compatible with mild cognitive decline. The main impairment of joint mobility was limited shoulder (11.54%) and shoulder girdle (2.88%) mobility; whereas for muscle mobility, lower limb limitations (16.35%) were the main dysfunction. Distal neuropathy was present in 23.08% of patients, most frequently located in lower limbs (15.38%). Finally, 50% of patients reported moderate limitation in the EQ-5D, with a mean score of 60.62 points (SD 20.15) in perceived quality of life. Conclusions: Our findings support the need for a multidisciplinary and comprehensive evaluation of patients after ICU admission for COVID-19 because of the wide range of sequelae, which also mean that these patients need a long-term follow-up. Impact on clinical rehabilitation: This study provides data supporting the key role of rehabilitation during the follow-up of severe patients, thus facilitating their reintegration in society and a suitable adaptation to daily living.

Discovery and validation of dominantly inherited Alzheimer's disease mutations in populations from Latin America.

BACKGROUND: In fewer than 1% of patients, AD is caused by autosomal dominant mutations in either the presenilin 1 (PSEN1), presenilin 2 (PSEN2), or amyloid precursor protein (APP) genes. The full extent of familial AD and frequency of these variants remains understudied in Latin American (LatAm) countries. Due to the rare nature of these variants, determining the pathogenicity of a novel variant in these genes can be challenging. Here, we use a systematic approach to assign the likelihood of pathogenicity in variants from densely affected families in Latin American populations. METHODS: Clinical data was collected from LatAm families at risk for DIAD. Symptomatic family members were identified and assessed by local clinicians and referred for genetic counseling and testing. To determine the likelihood of pathogenicity among variants of unknown significance from LatAm populations, we report pedigree information, frequency in control populations, in silico predictions, and cell-based models of amyloid-beta ratios. RESULTS: We identified five novel variants in the presenilin1 (PSEN1) gene from Brazilian and Mexican families. The mean age at onset in newly identified families was 43.5 years (range 36-54). PSEN1 p.Val103_Ser104delinsGly, p.Lys395Ile, p.Pro264Se, p.Ala275Thr, and p.Ile414Thr variants have not been reported in PubMed, ClinVar, and have not been reported in dominantly inherited AD (DIAD) families. We found that PSEN1 p.Val103_Ser104delinsGly, p.Lys395Ile, p.Pro264Se, and p.Ala275Thr produce Aß profiles consistent with known AD pathogenic mutations. PSEN1 p.Ile414Thr did not alter Aß in a manner consistent with a known pathogenic mutation. CONCLUSIONS: Our study provides further insights into the genetics of AD in LatAm. Based on our findings, including clinical presentation, imaging, genetic, segregations studies, and cell-based analysis, we propose that PSEN1 p.Val103_Ser104delinsGly, p.Lys395Ile, p.Pro264Se, and p.Ala275Thr are likely pathogenic variants resulting in DIAD, whereas PSEN1 p.Ile414Thr is likely a risk factor. This report is a step forward to improving the inclusion/engagement of LatAm families in research. Family discovery is of great relevance for the region, as new initiatives are underway to extend clinical trials and observational studies to families living with DIAD.

Cervical Spine Evaluation by Telephone and Video Visit.

As telecommunication technologies advance, efforts are being made to mitigate direct patient contact in the COVID-19 pandemic due to the risk of contagion. The ability to host telephone and video visits within patient portals within health care institutions will only become increasingly valuable. Neck pain, a common complaint seen in primary care clinics, is well-suited to telemedicine evaluation, as related etiologies are often comparatively straightforward. A good assessment of the cervical spine by telephone or video is possible with the right knowledge and practice. The purpose of this article is to propose questions and maneuvers that can be used to evaluate the cervical spine via telephone or video, as well as likely diagnoses that can be reached through these. Phone and video evaluation of the cervical spine can result in valuable data regarding symmetry, range of motion, functional movement patterns, modified strength testing, and provocative testing. The skill set necessary to do telephone and video visits should be included in the curriculum of physician learners.

Análisis bibliométrico sobre la producción científica de Chile en Oncología entre los años 2010 y 2019 / Bibliometric analysis of Chilean scientific production about oncology in the period 2010-2019

Esta investigación tuvo como objetivo analizar la producción científica chilena sobre Oncología indexada en Clarivate Web of Science desde el año 2010 hasta 2019. Se realizó un estudio bibliométrico en el que se efectuó la recuperación retrospectiva de documentos, utilizando una estrategia de búsqueda basada en etiquetas de campo de categoría y país, aplicando además el filtro de fechas. Se identificaron 1 266 documentos, 590 de ellos fueron artículos originales. El idioma principal de las publicaciones fue el inglés; se contabilizaron 182 revistas en las que fueron publicados los artículos, entre las cuales Journal of Clinical Oncology presentó la mayor cantidad de trabajos publicados, con 117 documentos. Los autores chilenos han publicado en colaboración con autores de otros 101 países; entre ellos, Estados Unidos fue el que obtuvo el mayor número de colaboraciones (474 publicaciones). La institución chilena con más publicaciones fue la Pontificia Universidad Católica de Chile, con 364 artículos. El tipo de cáncer más estudiado se relacionó con el sistema digestivo. Se concluye que la producción científica chilena en Oncología ha aumentado sistemáticamente en el periodo 2010-2019, y tiende a incrementar en gran medida el número de publicaciones de artículos originales, principalmente en idioma inglés, ya que facilita la colaboración internacional. A pesar de la amplia cooperación de investigadores e instituciones chilenas y la alta productividad en el área, no existen investigadores o instituciones chilenas que sean responsables de los artículos más citados, por lo cual el impacto de la ciencia y de las publicaciones realizadas en Chile sigue siendo bajo, por lo que resulta necesario potenciar el trabajo de los investigadores chilenos(AU)

The purpose of the study was to analyze Chilean scientific production about oncology indexed in Clarivate Web of Science from 2010 to 2019. A bibliometric analysis was performed which included retrospective retrieval of documents applying a search strategy based on field labels for category and country, as well as a date filter. A total 1 266 documents were identified, 590 of which were original articles. English was the most common language of publication. Articles were retrieved from 182 journals, among which the Journal of Clinical Oncology had the largest number of published articles, with 117. Chilean authors have published in collaboration with authors from another 101 countries, the largest number of them from the United States, with 474 publications. The most productive Chilean institution was the Pontifical Catholic University of Chile, with 364 articles. Gastrointestinal cancer was the type most commonly addressed. It is concluded that Chilean scientific production about oncology has systematically increased in the period 2010-2019, and tends to considerably increase the number of original articles published, mainly in English, to foster international collaboration. Despite the great cooperation of Chilean researchers and institutions and the high productivity in the area, articles by Chilean researchers and institutions were not among the most citated, as a result of which the impact of Chilean science and publications continues to be low. It is therefore necessary to strengthen the work of Chilean researchers(AU)

Obstetric Antiphospholipid Syndrome: An Approach from Glycans of the Immunoglobulin G.

This is a case report of women with pregnancy morbidity (PM), some of them associated with antiphospholipid syndrome (APS), in which the glycan patterns of immunoglobulin G (IgG) were investigated based on the theory of alteration of glycosylation in autoimmunity. We used lectin blot to determine changes in terminal glycosylation of polyclonal IgG from women with antiphospholipid (aPL) antibodies and PM plus vascular thrombosis (PM/VT) and seronegative-obstetric APS (SN-OAPS). In addition, we analyzed IgG from women with PM without aPL (PM/aPL-) and healthy women, as controls. Even though the SN-OAPS and PM/VT groups share the PM, only the SN-OAPS group showed a decreased expression of galactose compared to the healthy group. We also found the presence of mannosylated oligosaccharides in IgG from all patients being significantly higher in IgG from women of the PM/aPL- group. The differences in glycans presented here could relate to pathological mechanisms of PM associated with APS.

Impact of an RN-led Medicare Annual Wellness Visit on Preventive Services in a Family Medicine Practice.

OBJECTIVE: To evaluate the impact of a registered nurse (RN)-led Medicare annual wellness visit (AWV) on preventive services in a family medicine clinic. PATIENTS AND METHODS: A retrospective chart review was performed on patients who underwent an RN-led AWV and patients who underwent a standard assessment (SA) between October 2017 and October 2018. A total of 630 patients (330 AWV and 300 SA) were included in this study. RESULTS: There were seven preventive services examined for in women and five preventive services examined for in men. Each service was used more often by patients in the AWV group than the SA group (all odds ratios ≥1.64; all P values ≤.004). CONCLUSION: The RN-led AWV is an effective way to assist Medicare beneficiaries in meeting their preventive needs while allowing physicians more time to focus on chronic and acute needs.

Local Air Quality Issues and Research Priorities Through the Lenses of Chilean Experts: An Ontological Analysis.

Air pollution problems can be large, complex, and ill-structured. They can vary from location to location and combine many complex components: urban expansion, increasing vehicles and industrial emissions, biomass burning, geographic and meteorological conditions, cultural aspects, and economic effects. However, the existing research, accumulated knowledge, and local research priorities are spread over many disciplines and lack a systematic mapping to help manage and develop new strategies for researchers and policy makers. Ontological analysis can be used as a tool to capture this complexity through simple natural-language descriptions and a structured terminology. We describe the development of an ontological framework for "Air Quality Management in Chile" and its application to evaluate the current state of the research. The process was based on focus groups and validated by a panel of multidisciplinary experts. We used the developed framework to highlight the topics that have been heavily emphasized, lightly emphasized, or overlooked in the Chilean research. The framework developed can help researchers, practitioners, and policy makers systematically navigate the domain and provide the opportunity to correct blind spots by enabling more informed hypotheses that deal with air quality issues at a national level. We believe that applying this same process to different countries will yield different results (due to differences in local knowledge and experience). The framework presented could be used to evaluate other important stakeholders (government, media, NGOs, etc.), which will provide a complete picture of how local societies deal with air quality issues at different levels. Additionally, local government institutions will benefit from this analysis by improving funding allocation and opening new research opportunities to improve the distribution of the local body of knowledge. Integr Environ Assess Manag 2021;17:273-281. © 2020 SETAC.

Effectiveness and satisfaction in non-critical surface cleaning and disinfection using quaternary ammonium-based spray and wipe formats / Efectividad y satisfacción en la limpieza y desinfección de superficies no críticas utilizando amonio cuaternario en formatos de aerosol y toallitas húmedas

OBJECTIVE: To compare the effectiveness and satisfaction with the use of sprays and wipes formats under healthcare facilities conditions. METHODS: Randomized crossover experimental study in four hospitals in the Region of Madrid. A quaternary ammonium formula in spray and wipe formats in a crossover manner over two weeks in all the units. The effectiveness was evaluated by means of relative light unit (RLU). The variables of effectiveness, method of use and satisfaction were taken into account. RESULTS: Samples were taken from 162 surfaces and no differences were found after disinfection, 60.00 (17.00-148.00) RLU for sprays and 67.00 (36.00-139.00) RLU for wipes (p = 0.271). A wider range of uses and results was found for sprays. 70.96% of the staff (n = 93) preferred wipes over sprays. CONCLUSIONS: Being equally effective, disinfection with wipes generated greater satisfaction with less variety in the results than sprays

OBJETIVO: Comparar la efectividad y satisfacción con el uso de aerosoles y formatos de toallitas húmedas en las condiciones de los centros de salud. MÉTODOS: Estudio experimental aleatorizado, cruzado en cuatro hospitales de la Comunidad de Madrid. Una fórmula de amonio cuaternario en formato aerosol y toallitas de forma cruzada durante dos semanas en todas las unidades. La efectividad se evaluó mediante Unidades Relativas de Luz (RLU). Se tuvieron en cuenta las variables de efectividad, método de uso y satisfacción. RESULTADOS: Se tomaron muestras de 162 superficies y no se encontraron diferencias después de la desinfección, 60,00 (17,00-148,00) RLU para aerosoles y 67,00 (36,00-139,00) RLU para toallitas (p = 0,271). Se encontró una gama más amplia de usos y resultados para los aerosoles. El 70,96% del personal (n = 93) prefirió las toallitas húmedas a los aerosoles. CONCLUSIONES: Siendo igualmente eficaz, la desinfección con toallitas generó mayor satisfacción con menos variedad en los resultados que los aerosoles

Significados de los procesos educativos para profesionales de la salud que se desempeñan en un centro de diálisis / Meaning of the educational processes for health professionals who work in a dialysis centre

OBJETIVO: Cuando un paciente ingresa a diálisis se generan importantes cambios que afectan el estilo de vida de ellos y su familia. Para abordar este ingreso, los profesionales de la salud deben implementar procesos de enseñanza orientados a mejorar la calidad de vida de los pacientes, además de salvarla. OBJETIVO: Debido a lo relevante de estos procesos educativos, el estudio que se presenta a continuación buscó comprender los significados que otorgan los profesionales de la salud a los procesos educativos que desarrollan en usuarios con insuficiencia renal crónica en un centro de diálisis. MATERIAL Y MÉTODO: La investigación de tipo cualitativa, de diseño fenomenológico e interpretativo. La información generada a través de entrevistas en profundidad a profesionales médicos y de enfermería, fue analizada por medio del método de análisis de contenidos. RESULTADOS: Los resultados obtenidos permitieron comprender significados asociados a los periodos de educación, métodos utilizados y principalmente los elementos que facilitaban y obstaculizaban estos procesos. CONCLUSIÓN: Se concluye que los profesionales de la salud trabajan en base a un método no formalizado, donde el diálogo y la experiencia o trayectoria resultan fundamentales para generar estos procesos de enseñanza

INTRODUCTION: The patient's admission to dialysis causes important changes that impact their lifestyle and family. To address this admission, health professionals must implement teaching processes aimed at improving the quality of life of patients, as well as save. OBJECTIVE: Due to the relevance of educational processes, the present study sought to understand the meanings that health professionals give to educational processes, which they implement in users with chronic kidney disease in a dialysis centre. MATERIAL AND METHOD: Qualitative research, phenomenological and interpretive design. The information generated through in-depth interviews with medical and nursing professionals was analysed using the content analysis method. RESULTS: The results obtained allow to understand meanings associated with periods of education, methods and mainly the elements that facilitated and hindered these processes. CONCLUSION: It is concluded that health professionals work based on a non-formalized method, where dialogue and experience or trajectory are essential to generate these teaching processes

Establishing Mayo Clinic's Coronavirus Disease 2019 Virtual Clinic: A Preliminary Communication.

The coronavirus disease 2019 (COVID-19) pandemic is taking a massive toll on health care systems globally. We developed the COVID-19 virtual clinic (CVC) in conjunction with drive through testing to cope with this situation. There are two arms of the CVC: (1) a screening arm and (2) positive patient arm. Screening is performed over the phone based on the Centers for Disease Control and Prevention screening guideline. Positive patients are followed at regular intervals by video appointments where concerns can be addressed by a provider while also tracking symptom progression. We enrolled 63 positive patients out of 1,153 screened for COVID-19 as of this writing. The CVC continues to address patients' concerns and symptoms in an effort to minimize emergency department and hospital patient volumes, as incidence increases. Drive through testing in conjunction with a virtual clinic allows us to provide high-quality care in an anxious time without consuming excessive personal protective equipment or unnecessarily exposing health care workers. This article could serve as a model to guide other practices to cope with this and future pandemics.

Dithiothreitol-based oxidative potential for airborne particulate matter: an estimation of the associated uncertainty.

Oxidative stress is considered as one of the main mechanisms by which airborne particles produce adverse health effects. Several methods to estimate the oxidative potential (OP) of particulate matter (PM) have been proposed. Among them, the dithiothreitol (DTT) assay has gained popularity due to its simplicity and overall low implementation cost. Usually, the estimations of OPDTT are based on n-replicates of a set of samples and their associated standard deviation. However, interlaboratory comparisons of OPDTT can be difficult and lead to misinterpretations. This work presents an estimation of the total uncertainty for the OPDTT measurement of PM10 and PM2.5 samples collected in Santiago (Chile), based on recommendations by the Joint Committee for Guides in Metrology and Eurachem. The expanded uncertainty expressed as a percentage of the mass-normalized OPDTT measurements was 18.0% and 16.3% for PM10 and PM2.5 samples respectively. The dominating contributor to the total uncertainty was identified (i.e., DTT consumption rate, related to the regression and repeatability of experimental data), while the volumetric operations (i.e., pipettes) were also important. The results showed that, although the OP measured following the DTT assay has been successfully used to estimate the potential health impacts of airborne PM, uncertainty estimations must be considered before interpreting the results.

Ciências cognitivas e neuroética / Cognitive sciences and neuroethics / Ciencias cognitivas y la neuroética

Resumo O artigo parte da discussão entre a visão representacional computacional da cognição contraposta ao enfoque enativo da ciência cognitiva, que defende que o conhecimento é fruto da afetação do corpo pelo ambiente. Discute as consequências dessa visão enativa para a compreensão da neuroética, entendida não como conjunto de parâmetros éticos para as experiências científicas nas neurociências, mas como compreensão neuronal científica do agir moral. A explicação neuronal da ética parte de neuroimagens como expressões de emoção, mas reduzir a moralidade às emoções é discutível, pois juízos emocionais, baseados na proximidade afetiva, destoam de normas éticas de base universal. Outro ponto crítico dessa visão é o artificialismo de suas experimentações, devido ao esquecimento do mundo cotidiano de afetações do corpo, enfoque trazido pelo enativismo da ciência cognitiva.

Abstract This article starts with the discussion between the representational computational cognitive framework versus the enactive perspective of the cognitive science, which argues that knowledge is the result of the body's interaction with its environment. It discusses the consequences of this enactive perspective for the understanding of neuroethics, read not as a set of ethical parameters for scientific experiments in neurosciences, but as a neural scientific understanding of the moral action. The neural explanation of ethics comprehends neuroimaging as expressions of emotion, but reduce morality to emotions is debatable, since emotional judgments, based on affective proximity, diverge from ethical and universal norms. Another critical point of this framework is the artificiality of its tests, caused by neglecting the environmental effects on daily life, approach brought by the enactive approach.

Resumen El articulo parte de la discusión acerca de la visión representacional de la cognición contrapuesta a un enfoque enactivo de la ciencia cognitiva, que defiende que el conocimiento se origina de la afectación del cuerpo por el mundo ambiente. En una segunda parte discute las consecuencias de esta visión enactiva para la comprensión de la neuroética, entendida no como parámetros éticos para las experiencias científicas en las neurociencias, sino como comprensión neuronal científica del actuar moral. Interesa discutir esta segunda concepción. La explicación neuronal de la ética parte de neuroimágenes, como expresiones de emociones. Reducir la moralidad a las emociones es discutible, porque existen disonancias entre juicios emocionales, basados en la proximidad afectiva, y normas éticas de base universal. Otro punto crítico de esta visión es el carácter artificial de sus experimentaciones, causado por el olvido del mundo cotidiano de las afectaciones, enfoque traído por el enactivismo de la ciencia cognitiva.

Remodelación autóloga mamaria. Importancia de la transferencia grasa y uso de los colgajos dermograsos locales en las grandes pérdidas ponderales / Autologous breast remodeling. Importance of fat transfer and use of local dermal-fat flaps in the massive weigth loss

INTRODUCCIÓN Y OBJETIVO: El aumento de la cirugía bariátrica como alternativa al tratamiento tanto del síndrome metabólico como de la obesidad y el sobrepeso, conlleva múltiples deformidades corporales, entre las que unas de las más complejas son las alteraciones mamarias. Su tratamiento quirúrgico depende de un diagnóstico y técnica adecuados, capaces de remodelar la estética mamaria. El objetivo de esta investigación es definir la importancia del injerto de grasa como procedimiento previo a la mamoplastia en pacientes que han sufrido grandes pérdidas ponderales. MATERIAL Y MÉTODO: Realizamos un estudio retrospectivo, lineal, en 124 pacientes sometidas a 158 procedimientos quirúrgicos consecutivos entre enero de 2009 y diciembre de 2019, con rango de edad entre 18 y 72 años. Evaluamos los procedimientos para la corrección de las diversas deformidades mamarias tales como, hipotrofia o atrofia mamaria, ptosis, asimetrías, posicionamiento lateralizado del complejo areola pezón, pérdida de la proyección del polo superior, flacidez cutánea asociada a lipodistrofia corporal persistente, cirugías previas de contorno corporal, así como la edad y el índice de masa corporal (IMC). RESULTADOS: El mayor porcentaje de procedimientos correspondió a la triple interposición de colgajos (28%, 44 procedimientos), seguida del injerto de grasa mamaria (27%, 42 procedimientos) y la triple interposición de colgajos con implante de silicona (19%, 30 procedimientos). Se realizó injerto graso mamario en un 40.50% de los procedimientos realizados, con una media de volumen graso infiltrado de 450.60 ml. CONCLUSIONES: Recomendamos la realización de injertos de grasa en todas las pacientes sometidas a cirugía de remodelación mamaria secundaria a pérdida masiva de peso con el fin de recomponer volumétricamente la mama y reconstruir estructuras cutáneas, parenquimatosas y musculares, siendo la transferencia de grasa mamaria la única forma de relleno definitiva del polo superior. Los colgajos locales representan no solo una forma de aumento volumétrico de la mama sino también una posibilidad de mejorar el contorno mamario y el segmento superior del cuerpo

BACKGRAUND AND OBJECTIVE: The increase in bariatric surgery as an alternative to the treatment of both the metabolic syndrome and obesity and overweight leads to multiple bodily deformities, among these one of the most complex are mammary alterations. The surgical treatment of these alterations depends on an adequate diagnosis and a suitable technique able to reshape the mammary aesthetics. The objective of this research is to define the importance of fat grafting as a procedure prior to breast-plasty in patients with post-weight loss. METHODS: A retrospective and linear study was performed in 124 patients, who underwent 158 consecutive procedures between January 2009 and December 2019, age range between 18 and 72 years. The evaluated procedures allowed correction of different breast deformities such as hypotrophy or breast atrophy, ptosis, asymmetries, lateral positioning of the nipple areola complex, loss of the upper pole projection, skin flaccidity associated with persistent body lipodystrophy, previous body contour surgeries, and patient's age and body mass index (BMI). RESULTS: A total of 158 procedures were performed which the highest percentage was of triple flap interposition (28%, 44 procedures), followed by breast fat grafting (27%, 42 procedures) and triple flap interposition with silicone implants (19%, 30 procedures). The fat graft to breast was performed in 40.50% of the total procedures performed, with a mean infiltrated fat volume corresponded to 450.60 ml. CONCLUSIONS: We recommend performing fat grafts in all patients undergoing breast remodeling procedures after massive weight loss in order to volumetrically recompose the breast and rebuild skin, parenchymal and muscular structures, with breast fat transfer being the only way definitive filling of the upper pole. In addition, local flaps represent not only a form of volumetric augmentation of the breast but also a possibility of improving the breast contour and upper body segment

Ptr1 evolved convergently with RPS2 and Mr5 to mediate recognition of AvrRpt2 in diverse solanaceous species.

The Ptr1 (Pseudomonas tomato race 1) locus in Solanum lycopersicoides confers resistance to strains of Pseudomonas syringae pv. tomato expressing AvrRpt2 and Ralstonia pseudosolanacearum expressing RipBN. Here we describe the identification and phylogenetic analysis of the Ptr1 gene. A single recombinant among 585 F2 plants segregating for the Ptr1 locus was discovered that narrowed the Ptr1 candidates to eight nucleotide-binding leucine-rich repeat protein (NLR)-encoding genes. From analysis of the gene models in the S. lycopersicoides genome sequence and RNA-Seq data, two of the eight genes emerged as the strongest candidates for Ptr1. One of these two candidates was found to encode Ptr1 based on its ability to mediate recognition of AvrRpt2 and RipBN when it was transiently expressed with these effectors in leaves of Nicotiana glutinosa. The ortholog of Ptr1 in tomato and in Solanum pennellii is a pseudogene. However, a functional Ptr1 ortholog exists in Nicotiana benthamiana and potato, and both mediate recognition of AvrRpt2 and RipBN. In apple and Arabidopsis, recognition of AvrRpt2 is mediated by the Mr5 and RPS2 proteins, respectively. Phylogenetic analysis places Ptr1 in a distinct clade compared with Mr5 and RPS2, and it therefore appears to have arisen by convergent evolution for recognition of AvrRpt2.

Bibliometric analysis of core journals which publish articles of physical therapy on aging.

OBJECTIVE: Increase in population's longevity has led to considerable efforts worldwide on physical therapy aging research. The aim of this study is to identify which are the main scientific journals, as well as the most productive authors, institutions and keywords related to the journals, that have published about physical therapy and aging. METHODS: Original articles published from 1990 to 2014 were retrieved from the bibliographic database Science Citation Index Expanded of Web of Science Core Collection. After standardization of the bibliographic information, a series of bibliometric indicators was obtained regarding authors, institutions, citation and keywords of the core journals using bibliometric software. The PAJEK network analysis program was used for graphic representation. RESULTS: A total of 2,237 original articles are included in this analysis. The number of identified journals is 573, with an average growth of publishing journals throughout the studied period of 9.41%. Bradford's distribution shows 12 core journals, out of which 41.67% have published constantly all throughout the 25-year period, being the most productive one Physical Therapy. Fritz, Julie M is the most productive author, and University of Sydney the most productive institution. The keyword exercise is used in an outstanding way. CONCLUSIONS: The productivity trends provided an indication of the greater scientific interest of physical therapy in aging as a line of research. Collectively, the data indicated that physical therapy-specific journals are being consolidated but non-specific are still a significant research source, and that a fundamental element of their research includes exercise and movement.