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BACKGROUND: Chronic obstructive pulmonary disease (COPD) exacerbation (ECOPD) alters the natural course of the disease. To date, only C-reactive protein has been used as a biomarker in ECOPD, but it has important limitations. The mitochondria release peptides (Humanin (HN), FGF-21, GDF-15, MOTS-c and Romo1) under certain metabolic conditions. Here, we aimed to evaluate the pathophysiologic, diagnostic and prognostic value of measuring serum mitochondrial peptides at hospital admission in patients with ECOPD. METHODS: A total of 51 consecutive patients admitted to our hospital for ECOPD were included and followed for 1 year; in addition, 160 participants with stable COPD from our out-patient clinic were recruited as controls. RESULTS: Serum FGF-21 (p < .001), MOTS-c (p < .001) and Romo1 (p = .002) levels were lower, and GDF-15 (p < .001) levels were higher, in patients with ECOPD than stable COPD, but no differences were found in HN. In receiver operating characteristic analysis, MOTS-c (AUC 0.744, 95% CI 0.679-0.802, p < .001) and GDF-15 (AUC 0.735, 95% CI 0.670-0.793, p < .001) had the best diagnostic power for ECOPD, with a diagnostic accuracy similar to that of C-RP (AUC 0.796 95% IC 0.735-0.848, p < .001). FGF-21 (AUC 0.700, 95% CI 0.633-0.761, p < .001) and Romo1 (AUC 0.645 95% CI 0.573-0.712, p = .001) had lower diagnostic accuracy. HN levels did not differentiate patients with ECOPD versus stable COPD (p = .557). In Cox regression analysis, HN (HR 2.661, CI95% 1.009-7.016, p = .048) and MOTS-c (HR 3.441, CI95% 1.252-9.297, p = .016) levels exceeding mean levels were independent risk factors for re-admission. CONCLUSIONS: Most mitochondrial peptides are altered in ECOPD, as compared with stable COPD. MOTS-c and GDF15 levels have a diagnostic accuracy similar to C-RP for ECOPD. HN and MOTS-c independently predict future re-hospitalization.
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Factor 15 de Diferenciación de Crecimiento , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Progresión de la Enfermedad , Estudios Prospectivos , Hospitalización , Mitocondrias , HospitalesRESUMEN
Integral controllers are commonly employed in astronomical adaptive optics. This work presents a novel tuning procedure for integral controllers in adaptive optics systems which relies on information about the measured disturbances. This tuning procedure consists of two main steps. First, it models and identifies measured disturbances as continuous-time-damped oscillators using Whittles´s likelihood and the wavefront sensor output signal. Second, it determines the integral controller gain of the adaptive optics system by minimizing the output variance. The effectiveness of this proposed method is evaluated through theoretical examples and numerical simulations conducted using the Object-Oriented Matlab Adaptive Optics toolbox. The simulation results demonstrate that this approach accurately estimates the disturbance model and can reduce the output variance. Our proposal results in improved performance and better astronomical images even in challenging atmospheric conditions. These findings significantly contribute to adaptive optics system operations in astronomical observatories and establish our procedure as a promising tool for fine-tuning integral controllers in astronomical adaptive optics systems.
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Interactions between species within an ecosystem (e.g. predation and herbivory) play a vital role in sustaining the ecosystem functionality, which includes aspects like pest control and nutrient cycling. Unfortunately, human activities are progressively disrupting these trophic relationships, thereby contributing to the ongoing biodiversity decline. Additionally, certain human activities like urbanization may further impact the intensity of these trophic interactions, which are already known to be influenced by latitudinal gradients. The aim of this study was to test the hypothesis of whether the impact of human population, used as a proxy for human pressure, differs between latitudes. To test it, we selected 18 study sites at two latitudes (i.e. ~53°N and ~50°N) with varying human population density (HPD). We used artificial caterpillars placed on European beech branches to assess bird predation and took standardized pictures of the leaves to estimate insect herbivory. Remote sensing techniques were used to estimate human pressure. We found that the intensity of bird predation varied in response to HPD, with opposite trends observed depending on the latitude. At our upper latitude, bird predation increased with HPD, while the opposite was observed at the lower latitude. Herbivory was not affected by urbanization and we found higher levels of herbivory in the lower compared to the higher latitude. At the lower latitude, certain species may experience a disadvantage attributed to the urban heat island effect due to their sensitivity to temperature fluctuations. Conversely, at the higher latitude, where minimum temperatures can be a limitation, certain species may benefit from milder winters. Overall, this study highlights the complex and dynamic nature of trophic relationships in the face of human-driven changes to ecosystems. It also emphasizes the importance of considering both human pressure and latitudinal gradients when assessing the ecological consequences of future climate change scenarios, especially in urban environments.
Las interacciones entre especies dentro de un ecosistema (p. ej., depredación y herbivoría) juegan un papel vital en el mantenimiento de la funcionalidad del ecosistema, incluyendo aspectos como el control de plagas y el ciclo de nutrientes. Desafortunadamente, las actividades humanas están interrumpiendo progresivamente estas relaciones tróficas, contribuyendo así a la continua disminución de la biodiversidad. Además, ciertas actividades humanas, como la urbanización, pueden afectar aún más la intensidad de estas interacciones tróficas, que ya se sabe que están influenciadas por gradientes latitudinales. El objetivo de este estudio fue probar la hipótesis de si el impacto de la población humana, utilizada como indicador de la presión humana, difiere entre latitudes. Para probarlo, seleccionamos 18 sitios de estudio en dos latitudes (es decir, ~53°N y ~50°N) con densidad de población humana (HPD) variable. Utilizamos orugas artificiales colocadas en ramas de haya común para evaluar la depredación de aves y tomamos fotografías estandarizadas de las hojas para estimar la herbivoría de los insectos. Se utilizaron técnicas de teledetección para estimar la presión humana. Descubrimos que la intensidad de la depredación de las aves varió en respuesta al HPD, observándose tendencias opuestas según la latitud. En nuestra latitud superior, la depredación de aves aumentó con HPD, mientras que se observó lo contrario en la latitud inferior. La herbivoría no se vio afectada por la urbanización y encontramos niveles más altos de herbivoría en la latitud inferior en comparación con la superior. En latitudes bajas, ciertas especies pueden experimentar una desventaja atribuida al efecto de isla de calor urbano debido a su sensibilidad a las fluctuaciones de temperatura. Por el contrario, en latitudes más altas, donde las temperaturas mínimas pueden ser una limitación, ciertas especies pueden beneficiarse de inviernos más suaves. En general, este estudio destaca la naturaleza compleja y dinámica de las relaciones tróficas frente a los cambios en los ecosistemas provocados por el hombre. También enfatiza la importancia de considerar tanto la presión humana como los gradientes latitudinales al evaluar las consecuencias ecológicas de los futuros escenarios de cambio climático, especialmente en entornos urbanos.
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The diversity of life sensu lato comprises both biological and cultural diversity, described as "biocultural diversity." Similar to plant and animal species, cultures and languages are threatened by extinction. Since drylands are pivotal systems for nature and people alike, we use oases in the Sahara Desert as model systems for examining spatial patterns and trends of biocultural diversity. We identify both the underlying drivers of biodiversity and the potential proxies that are fundamental for understanding reciprocal linkages between biological and cultural diversity in oases. Using oases in Algeria as an example we test current indices describing and quantifying biocultural diversity and identify their limitations. Finally, we discuss follow-up research questions to better understand the underlying mechanisms that control the coupling and decoupling of biological and cultural diversity in oases.
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Biodiversidad , Diversidad Cultural , Animales , África del Norte , Argelia , LenguajeRESUMEN
El quiste odontogénico ortoqueratinizado es un quiste odontogénico de desarrollo poco común. Los maxilares son el sitio más común de afectación. Los quistes mandibulares con queratinización, el queratoquiste odontogénico (OKC) y el quiste odontogénico ortoqueratinizado (OOC) son los que han atraído una mayor atención. Se presenta el caso de una paciente de sexo femenino de 34 años de edad, con historia de 2 meses de evolución de tumefacción de crecimiento progresivo en región de seno maxilar izquierdo acompañado de rinorrea mucopurulenta y salida se secreción purulenta por fístula oroantral. Se realiza cirugía bajo anestesia general, se constata una lesión quística de contenido queratínico en seno maxilar cuya histopatología retorna compatible con Quiste odontogénico ortoqueratinizado.
The orthokeratinized odontogenic cyst is an odontogenic cyst of uncommon development. The jaws are the most common site of involvement. Cysts of the jaw with keratinization, the odontogenic keratocyst (OKC), and the orthokeratinized odontogenic cyst (OOC) have attracted the most attention. The case of a 34-year-old female patient is presented, with a 2-month history of progressively growing swelling in the region of the left maxillary sinus accompanied by mucopurulent rhinorrhea and purulent discharge from an oroantral fistula. Surgery is performed under general anesthesia, a cystic lesion with keratin content is verified in the maxillary sinus whose histopathology returns compatible with orthokeratinized odontogenic cyst.
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El quiste odontogénico ortoqueratinizado es un quiste odontogénico de desarrollo poco común. Los maxilares son el sitio más común de afectación. Los quistes mandibulares con queratinización, el queratoquiste odontogénico (OKC) y el quiste odontogénico ortoqueratinizado (OOC) son los que han atraído una mayor atención. Se presenta el caso de una paciente de sexo femenino de 34 años de edad, con historia de 2 meses de evolución de tumefacción de crecimiento progresivo en región de seno maxilar izquierdo acompañado de rinorrea mucopurulenta y salida se secreción purulenta por fístula oroantral. Se realiza cirugía bajo anestesia general, se constata una lesión quística de contenido queratínico en seno maxilar cuya histopatología retorna compatible con Quiste odontogénico ortoqueratinizado.
The orthokeratinized odontogenic cyst is an odontogenic cyst of uncommon development. The jaws are the most common site of involvement. Cysts of the jaw with keratinization, the odontogenic keratocyst (OKC), and the orthokeratinized odontogenic cyst (OOC) have attracted the most attention. The case of a 34-year-old female patient is presented, with a 2-month history of progressively growing swelling in the region of the left maxillary sinus accompanied by mucopurulent rhinorrhea and purulent discharge from an oroantral fistula. Surgery is performed under general anesthesia, a cystic lesion with keratin content is verified in the maxillary sinus whose histopathology returns compatible with orthokeratinized odontogenic cyst.
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Background: MOTS-c and Romo1 are mitochondrial peptides that are modulated by oxidative stress. No previous studies have explored circulating levels of MOTS-c in patients with chronic obstructive pulmonary disease (COPD). Methods: We enrolled 142 patients with stable COPD and 47 smokers with normal lung function in an observational cross-sectional study. We assessed serum levels of both MOTS-c and Romo1 and associated these findings with clinical characteristics of COPD. Results: Compared with smokers with normal lung function, patients with COPD had lower levels of MOTS-c (p = 0.02) and higher levels of Romo1 (p = 0.01). A multivariate logistic regression analysis revealed that above-median MOTS-c levels were positively associated with Romo1 levels (OR 1.075, 95% CI 1.005-1.150, p = 0.036), but no association was found with other COPD characteristics. Below-median levels of circulating MOTS-c were associated with oxygen desaturation (OR 3.25 95% CI 1.456-8.522, p = 0.005) and walking <350 meters (OR 3.246 95% CI 1.229-8.577, p = 0.018) in six-minute walk test. Above-median levels of Romo1 were positively associated with current smoking (OR 2.756, 95% CI 1.133-6.704, p = 0.025) and negatively associated with baseline oxygen saturation (OR 0.776 95% CI 0.641-0.939, p = 0.009). Conclusions: Reduced levels of circulating MOTS-c and increased levels of Romo1 were detected in patients diagnosed with COPD. Low levels of MOTS-c were associated with oxygen desaturation and poorer exercise capacity using 6 min walk test. Romo1 was associated with current smoking and baseline oxygen saturation. Trial registration: www.clinicaltrials.gov; No.: NCT04449419; URL: www.clinicaltrials.gov. Date of registration: June 26, 2020.
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Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide. Epidemiological studies indicate that pre-menopausal women are more protected against the development of CVDs compared to men of the same age. This effect is attributed to the action/effects of sex steroid hormones on the cardiovascular system. In this context, estrogen modulates cardiovascular function in physiological and pathological conditions, being one of the main physiological cardioprotective agents. Here we describe the common pathways and mechanisms by which estrogens modulate the retrograde and anterograde communication between the nucleus and mitochondria, highlighting the role of genomic and non-genomic pathways mediated by estrogen receptors. Additionally, we discuss the presumable role of bromodomain-containing protein 4 (BRD4) in enhancing mitochondrial biogenesis and function in different CVD models and how this protein could act as a master regulator of estrogen protective activity. Altogether, this review focuses on estrogenic control in gene expression and molecular pathways, how this activity governs nucleus-mitochondria communication, and its projection for a future generation of strategies in CVDs treatment.
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Mitokines (Humanin (HN), GDF15 and FGF21) are produced as a result of mitochondrial dysfunction and may have major roles in chronic inflammation, malnutrition and exercise capacity in people with COPD. Except for GDF15, studies on this subject are lacking. A total of 165 patients with stable COPD and 49 smokers without COPD were enrolled. We assessed their serum mitokine levels and clinical characteristics at baseline. We recorded moderate and severe exacerbation for the next 12 months. Baseline serum HN (p = 0.037) and GDF-15 (p = 0.013) levels were higher in the COPD group. High HN levels were independently associated with a high risk of exacerbation (HRE) (OR 2.798, 95% CI 1.266-6.187, p = 0.011), malnutrition (OR 6.645, 95% CI 1.859-23.749, p = 0.004), and 6MWD (OR 0.995, 95% CI 0.991-0.999, p = 0.008), and future moderate (HR 1.826, 95% CI 1.181-2.822, p = 0.007) and severe exacerbations (HR 3.445, 95% CI 1.357-8.740, p = 0.009). High GDF15 levels were associated with HRE (OR 3.028, 95% CI 1.134-8.083, p = 0.027), 6MWD (OR 0.995, 95% CI 0.990-0.999, p = 0.017) and predicted desaturation in 6MWT (OR 3.999, 95% CI 1.487-10.757, p = 0.006). High FGF21 levels were associated with HRE (OR 2.144, 95% CI 1.000-4.600, p = 0.05), and predicted future severe exacerbation (HR 4.217, 95% CI 1.459-12.193, p = 0.008). The mitokine levels were higher in patients with COPD than smokers without COPD, and were associated with important clinical outcomes such as exercise capacity and COPD exacerbation. Among the mitokines, HN showed the strongest association with COPD and may serve as a future risk biomarker in this disease.Trial registation NCT04449419.
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Desnutrición , Enfermedad Pulmonar Obstructiva Crónica , Biomarcadores , Progresión de la Enfermedad , Factor 15 de Diferenciación de Crecimiento , Humanos , Estudios ProspectivosRESUMEN
Most Neotropical Malpighiaceae species are characterized by having zygomorphic flowers and oil glands in the sepals called elaiophores; these floral characteristics are associated with a particular pollination syndrome through oil-collecting bees. This work proposes a study about the structural characteristics of elaiophores in 18 species of Malpighiaceae present in Argentina. The main objectives are to describe the morphology and anatomy of the elaiophores, to detect variation in the number of glands, to compare similarities or differences in elaiophores of species belonging to different lineages, and to know about the potential pollinators and their association with the structural traits of the elaiophores. The morphology and the anatomy were studied using traditional methods of scanning electron and bright-field microscopes. Field trips were carried out to capture oil-collecting bee species on flowers, in different natural populations. Different measurements were taken in the flowers, elaiophores, and oil-collecting bees and were statistically analyzed. Although elaiophores showed a common pattern, some particularities in number, morphology, and anatomy were detected; few of these seem to be restricted to some groups of species phylogenetically related. As regards pollinators, a positive tendency was observed between the size of the flowers, elaiophores, and oil-collecting bees. However, the thickness of the cuticle presented a negative association with the size of the elaiophore and consequently with the floral diameter, which could be presumably related to the foraging behavior and/or the structure of oil-collecting apparatus of the bee species.
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Malpighiaceae , Animales , Abejas , Flores/anatomía & histología , Fenotipo , PolinizaciónRESUMEN
RESUMEN Introducción: La tomografía computarizada es el estudio Gold standard para complementar a la endoscopia en el estudio de patologías laríngeas. Por lo tanto, se debe tener conocimiento de la anatomía normal de la laringe. Metodología: Se realizó un estudio observacional descriptivo, de corte transversal retrospectivo. Se recolecto los datos a través del análisis tomográfico, se analizaron 26 tomografías de pacientes que acudieron al Servicio de Imágenes del Hospital de Clínicas sin patología laríngea. Las variables investigadas fueron características tomográficas como: Calcificación cartílagos laríngeos, Altura cartílago tiroideo, Distancia tiro-aritenoidea, Distancia interaritenoidea, Altura y diámetro del espacio preepiglótico. Resultados: Se lograron identificar cada una de las características anatómicas radiológicas buscadas. Además, se realizaron las mediciones correspondientes, detallando el promedio de cada una de las mediciones y clasificándolo por sexo. La altura de cartílago tiroideo la media en hombres fue 28.05±1.2 mm y en mujeres fue 27.8±0.92 mm, para la distancia Tiro-aritenoidea en hombres fue 12.3±1.3 y en mujeres 10.97±0.95 mm, para el diámetro transversal del cartílago tiroideo en hombres fue 16.63±1.58 mm y en mujeres 17.96±1.11 mm. Conclusión: Los promedios de las mediciones realizadas fueron mayor en hombres excepto en el diámetro transversal del cartílago tiroideo, La prevalencia de calcificación de cartílagos laríngeos fue del 54% de los pacientes estudiados.
ABSTRACT Introduction: Computed tomography is the Gold standard study to complement endoscopy in the study of laryngeal pathologies. Therefore, knowledge of the normal anatomy of the larynx is required. Methodology: A retrospective cross-sectional descriptive observational study was carried out. Data were collected through tomographic analysis, 26 tomographies of patients who attended the Imaging Service of the Hospital de Clínicas without laryngeal pathology were analyzed. The variables investigated were tomographic characteristics such as: laryngeal cartilage calcification, thyroid cartilage height, thyro-arytenoid distance, interarytenoid distance, height and diameter of the pre-epiglottic space. Results: Each of the radiological anatomical characteristics sought were identified. In addition, the corresponding measurements were taken, detailing the average of each of the measurements and classifying them by sex. The average thyroid cartilage height in men was 28.05±1.2 mm and in women was 27.8±0.92 mm, for the thyro-arytenoid distance in men was 12.3±1.3 and in women 10.97±0.95 mm, for the transverse diameter of the thyroid cartilage in men was 16.63±1.58 mm and in women 17.96±1. 11 mm. Conclusions: The averages of the measurements taken were higher in men except for the transverse diameter of the thyroid cartilage. The prevalence of laryngeal cartilage calcification was 54% of the patients studied.
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Filtering and smoothing algorithms are key tools to develop decision-making strategies and parameter identification techniques in different areas of research, such as economics, financial data analysis, communications, and control systems. These algorithms are used to obtain an estimation of the system state based on the sequentially available noisy measurements of the system output. In a real-world system, the noisy measurements can suffer a significant loss of information due to (among others): (i) a reduced resolution of cost-effective sensors typically used in practice or (ii) a digitalization process for storing or transmitting the measurements through a communication channel using a minimum amount of resources. Thus, obtaining suitable state estimates in this context is essential. In this paper, Gaussian sum filtering and smoothing algorithms are developed in order to deal with noisy measurements that are also subject to quantization. In this approach, the probability mass function of the quantized output given the state is characterized by an integral equation. This integral was approximated by using a Gauss-Legendre quadrature; hence, a model with a Gaussian mixture structure was obtained. This model was used to develop filtering and smoothing algorithms. The benefits of this proposal, in terms of accuracy of the estimation and computational cost, are illustrated via numerical simulations.
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Algoritmos , Funciones de Verosimilitud , Distribución NormalRESUMEN
In control and monitoring of manufacturing processes, it is key to understand model uncertainty in order to achieve the required levels of consistency, quality, and economy, among others. In aerospace applications, models need to be very precise and able to describe the entire dynamics of an aircraft. In addition, the complexity of modern real systems has turned deterministic models impractical, since they cannot adequately represent the behavior of disturbances in sensors and actuators, and tool and machine wear, to name a few. Thus, it is necessary to deal with model uncertainties in the dynamics of the plant by incorporating a stochastic behavior. These uncertainties could also affect the effectiveness of fault diagnosis methodologies used to increment the safety and reliability in real-world systems. Determining suitable dynamic system models of real processes is essential to obtain effective process control strategies and accurate fault detection and diagnosis methodologies that deliver good performance. In this paper, a maximum likelihood estimation algorithm for the uncertainty modeling in linear dynamic systems is developed utilizing a stochastic embedding approach. In this approach, system uncertainties are accounted for as a stochastic error term in a transfer function. In this paper, we model the error-model probability density function as a finite Gaussian mixture model. For the estimation of the nominal model and the probability density function of the parameters of the error-model, we develop an iterative algorithm based on the Expectation-Maximization algorithm using the data from independent experiments. The benefits of our proposal are illustrated via numerical simulations.
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Algoritmos , Funciones de Verosimilitud , Distribución Normal , Reproducibilidad de los Resultados , Procesos Estocásticos , IncertidumbreRESUMEN
Modern large telescopes are built based on the effectiveness of adaptive optics systems in mitigating the detrimental effects of wavefront distortions on astronomical images. In astronomical adaptive optics systems, the main sources of wavefront distortions are atmospheric turbulence and mechanical vibrations that are induced by the wind or the instrumentation systems, such as fans and cooling pumps. The mitigation of wavefront distortions is typically attained via a control law that is based on an adequate and accurate model. In this paper, we develop a modelling technique based on continuous-time damped-oscillators and on the Whittle's likelihood method to estimate the parameters of disturbance models from wavefront sensor time-domain sampled-data. On the other hand, when the model is not accurate, the performance of the minimum variance controller is affected. We show that our modelling and identification techniques not only allow for more accurate estimates, but also for better minimum variance control performance. We illustrate the benefits of our proposal via numerical simulations.
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BACKGROUND: Hypovitaminosis D has been linked to deterioration in clinical parameters and lung function in COPD. As a response to low levels of vitamin D serum Parathyroid Hormone (iPTH) is increased in some, but not all, patients. The aim of this study was to determine whether COPD patients with elevated PTH levels are at higher risk of COPD exacerbations and hospitalizations. METHODS: 166 COPD outpatients were randomly preselected. Clinical and analytical characteristics were assessed at baseline. After excluding patients with other conditions known to disturb calcium metabolism 141 patients were identified. Except one, all patients were prospectively followed for 12 months after obtaining the blood samples. Hypovitaminosis D was considered when serum 25(OH)D < 30 ng/mL. Secondary hyperparathyroidism was considered when serum iPTH was higher than normal (50 pg/mL) in patients with hypovitaminosis D. COPD exacerbations and hospital admissions were recorded during the follow-up. RESULTS: Prevalence of hypovitaminosis D in COPD patients was 89.3%, prevalence of secondary hyperparathyroidism associated with hypovitaminosis D was 22,9%. Cox proportional risk analysis showed that patients belonging to the high iPTH-low 25(OH)D group were at a higher risk of moderate COPD exacerbations (HR 1.81 (CI95% 1.043-3.127), p = 0.035) and hospital admissions (HR 5.45 (CI95% 2.018-14.720), p = 0.002) as compared with those with normal iPTH-low 25(OH)D levels. CONCLUSIONS: COPD patients with hypovitaminosis D and elevated iPTH have higher risk of moderate exacerbations and hospitalizations than those with hypovitaminosis D and normal iPTH.
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Hiperparatiroidismo Secundario/etiología , Hormona Paratiroidea/sangre , Enfermedad Pulmonar Obstructiva Crónica/etiología , Deficiencia de Vitamina D/complicaciones , Vitamina D/sangre , Anciano , Biomarcadores/sangre , Progresión de la Enfermedad , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Hiperparatiroidismo Secundario/diagnóstico , Hiperparatiroidismo Secundario/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Riesgo , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/epidemiologíaRESUMEN
RESUMEN Introducción: el cine puede ser una herramienta útil para la educación médica. En la Psiquiatría, específicamente, el cine permite explorar las representaciones de diferentes trastornos mentales, cómo es vivir con una enfermedad mental, el estigma, la ética médica, la relación psiquiatra/paciente, entre otros. El objetivo de este estudio fue determinar la presencia de algún tipo de psicopatología en películas producidas en Paraguay, con el fin de que las mismas puedan ser utilizadas como herramientas didácticas en la enseñanza de la Psicopatología. Metodología: el diseño de esta investigación fue de tipo cualitativo exploratorio. Se seleccionaron, por conveniencia, 10 películas paraguayas, producidas entre los años 2010 y 2019. Las películas se eligieron tomando en cuenta su disponibilidad de visualización en las plataformas Netflix, Amazon Prime Video, HBO GO, Apple TV+, YouTube, y en formato DVD. Resultados: se analizaron en busca de Psicopatología las siguientes películas Universo Servilleta (2010), Cuchillo de Palo (2010), 7 cajas (2012), La Enamorada (2012), Latas Vacías (2014), La Chiperita (2015), Los Buscadores (2017), Leal (2018), Las Herederas (2018), y El Supremo Manuscrito (2019). En las películas seleccionadas se encontraron personajes con signos y síntomas que pueden resultar útiles para enseñar algunos de los principales síndromes psiquiátricos: trastornos depresivos, ansiedad, intentos de suicidio, rasgos obsesivo-compulsivos, trastornos de la personalidad, ideas delirantes, alteraciones del control de los impulsos y adicciones. Conclusión: el cine paraguayo, cada vez más rico y diverso, además de ser una fuente de inspiración y entretenimiento, puede ayudar en la enseñanza de la Medicina en general, y de la Psiquiatría en particular.
ABSTRACT Introduction: Cinema can be a useful tool for medical education. In Psychiatry, specifically, cinema allows us to explore representations of different mental disorders, what it is like to live with mental illness, stigma, medical ethics, the psychiatrist/patient relationship, among others. The objective of this study was to determine the presence of some type of psychopathology in films produced in Paraguay, so that they can be used as didactic tools in the teaching of Psychopathology. Methodology: The design of this research was qualitative and exploratory. For convenience, 10 Paraguayan films, produced between 2010 and 2019, were selected. The films were chosen taking into account their availability for viewing on Netflix, Amazon Prime Video, HBO GO, Apple TV+, and YouTube platforms, and in DVD format. Results: The following films were analyzed in search of psychopathology Universo Servilleta (2010), Cuchillo de Palo (2010), 7 cajas (2012), La Enamorada (2012), Latas Vacías (2014), La Chiperita (2015), Los Buscadores (2017), Leal (2018), Las Herederas (2018), and El Supremo Manuscrito (2019). In the selected films, characters with signs and symptoms that may be useful to teach some of the main psychiatric syndromes were found: depressive disorders, anxiety, suicide attempts, obsessive-compulsive traits, personality disorders, delusions, impulse control disorders, and addictions. Conclusion: Paraguayan cinema, increasingly rich and diverse, in addition to being a source of inspiration and entertainment, can help in the teaching of Medicine in general, and Psychiatry in particular.
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Introducción: Diversos estudios demuestran que la tasa de complicaciones asociadas a craneoplastías ha sido subestimada. A mediados de 2016 advertimos una serie de complicaciones asociadas a este procedimiento en nuestro Hospital. Por esto, se decidió cambiar el material que se utilizaba hasta entonces (i.e. polimetilmetracrilato de metilo, PMMAM) por otro distinto (i.e. Titanio). El objetivo del presente trabajo es analizar los resultados post-operatorios obtenidos con PMMAM versus Titanio. Materiales y Métodos: Estudio retrospectivo que incluye a 99 pacientes a los que se les realizó una craneoplastia en nuestro Hospital desde octubre de 2015 a octubre de 2018. Criterios de inclusión: defecto óseo causado tras una craniectomía post-TEC cerrado, sin signos infecciosos, operados en la misma sala operatoria, por el mismo quirúrgico y utilizando la misma técnica para cada material. Para el análisis estadístico se dividió a la muestra en 2 grupos: PMMAM (n= 44) versus Titanio (n=55). Resultados: El 85% (n=86) eran de sexo masculino y la edad promedio fue 29 años (rango: 17-63 años). Se observó una diferencia estadísticamente significativa respecto a los pacientes que desarrollaron determinadas complicaciones entre el grupo PMMAM y el grupo Titanio: colección líquida inflamatoria epidural (14% vs 0%; p=0,006); infección del sitio quirurgico (9% vs 0%; p=0,036) y remoción quirúrgica de la plaqueta (16% vs 0%; p=0,003). Conclusión: Con el uso de malla de titanio se disminuyeron significativamente las complicaciones post-operatorias, respecto al uso de PMMAM
Introduction: Various studies show that the rate of complications associated with cranioplasties has been underestimated. In mid 2016 we noticed a series of complications associated with this procedure in our Hospital. For this reason, it was decided to change the material used until then (i.e. methyl polymethylmethacrylate, PMMAM) for a different one (i.e. Titanium). The objective of this work is to analyze the post-operative results obtained with PMMAM versus Titanium. Materials and Methods: Retrospective study including 99 patients undergoing cranioplasty in our Hospital from October 2015 to October 2018. Inclusion criteria: bone defect was caused after a closed post-TEC craniectomy, without infectious signs, operated in the same operating room, by the same surgeon and using the same technique for each material. For statistical analysis, the sample was divided into two groups: PMMAM (n= 44) versus Titanium (n=55). Results: 85% (n=86) were male and the average age was 29 years (range: 17-63 years). A statistically significant difference was observed with respect to patients who developed certain complications between the PMMAM group and the Titanium group: epidural inflammatory liquid collection (14% vs 0%; p=0.006); surgical site infection (9% vs 0%; p=0.036) and surgical removal of the platelet (16% vs 0%; p=0.003). Conclusion: The use of titanium mesh significantly reduced post-operative complications with respect to the use of PMMAM
Asunto(s)
Humanos , Craneotomía , Titanio , Procedimientos de Cirugía Plástica , Lesiones Traumáticas del EncéfaloRESUMEN
BACKGROUND: In chronic obstructive pulmonary disease (COPD), low muscle mass has been associated with several clinical outcomes such as low exercise capacity, hospital admission, and mortality. The Sarcopenia Index (SI) is a novel way to estimate muscle mass based on the ratio of serum creatinine (produced exclusively by muscle)/cystatin C (produced by all nucleated body cells). OBJECTIVES: This study aims to assess the SI in stable COPD outpatients, as compared with a healthy control group, to quantify its relationship with several important clinical features in COPD, and to study its potential usefulness to predict COPD exacerbations and hospital admissions. METHODS: The SI was calculated in 18 healthy control subjects and 65 stable COPD outpatients were included in the study. Patients were prospectively followed for 1 year after being enrolled in the study. RESULTS: COPD patients had a lower SI than controls, that is lower muscle mass. Furthermore, patients with a modified Medical Research Council dyspnea score ≥2, patients with a COPD Assessment Test score ≥10, and patients with a high risk of exacerbation had lower levels of SI compared with patients without these characteristics. SI correlated with FEV1 (r = 0.491, p < 0.001), the 6-min walking test (r = 0.560, p = 0.001), and the Fat-Free Mass Index (r = 0.431, p = 0.017). Univariate and multivariate Cox proportional risk analysis showed that a low SI is an independent predictor of hospital admission in COPD outpatients followed for 1 year (HR 5.16, p = 0.025). CONCLUSIONS: The ratio serum creatinine/serum cystatin C correlates with several COPD characteristics, and it can be used to predict COPD hospitalization.
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Creatinina/sangre , Cistatina C/sangre , Hospitalización/estadística & datos numéricos , Enfermedad Pulmonar Obstructiva Crónica/sangre , Sarcopenia/sangre , Anciano , Estudios de Casos y Controles , Progresión de la Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Estudios Prospectivos , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Sarcopenia/complicaciones , Índice de Severidad de la EnfermedadRESUMEN
Single particle tracking (SPT) is a powerful class of methods for studying the dynamics of biomolecules inside living cells. The techniques reveal both trajectories of individual particles, with a resolution well below the diffraction limit of light, and the parameters defining the motion model, such as diffusion coefficients and confinement lengths. Existing algorithms assume these parameters are constant throughout an experiment. However, it has been demonstrated that they often vary with time as the tracked particles move through different regions in the cell or as conditions inside the cell change in response to stimuli. In this work we apply the method of local Maximum Likelihood (ML) estimation to the SPT application combined with change detection. Local ML uses a sliding window over the data, estimating the model parameters in each window. Once we have found the values for the parameters before and after the change, we apply offline change detection to know the exact time of the change. Then, we reestimate these parameters and show that there is an improvement in the estimation of key parameters found in SPT. Preliminary results using simulated data with a basic diffusion model with additive Gaussian noise show that our proposed algorithm is able to track abrupt changes in the parameters as they evolve during a trajectory.
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The strength of biotic interactions is generally thought to increase toward the equator, but support for this hypothesis is contradictory. We explored whether predator attacks on artificial prey of eight different colors vary among climates and whether this variation affects the detection of latitudinal patterns in predation. Bird attack rates negatively correlated with model luminance in cold and temperate environments, but not in tropical environments. Bird predation on black and on white (extremes in luminance) models demonstrated different latitudinal patterns, presumably due to differences in prey conspicuousness between habitats with different light regimes. When attacks on models of all colors were combined, arthropod predation decreased, whereas bird predation increased with increasing latitude. We conclude that selection for prey coloration may vary geographically and according to predator identity, and that the importance of different predators may show contrasting patterns, thus weakening the overall latitudinal trend in top-down control of herbivorous insects.