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2.
Phys Rev Lett ; 132(11): 116601, 2024 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-38563950

RESUMEN

Ultrathin bismuth exhibits rich physics including strong spin-orbit coupling, ferroelectricity, nontrivial topology, and light-induced structural dynamics. We use ab initio calculations to show that light can induce structural transitions to four transient phases in bismuth monolayers. These light-induced phases exhibit nontrivial topological character, which we illustrate using the recently introduced concept of spin bands and spin-resolved Wilson loops. Specifically, we find that the topology changes via the closing of the electron and spin band gaps during photoinduced structural phase transitions, leading to distinct edge states. Our study provides strategies to tailor electronic and spin topology via ultrafast control of photoexcited carriers and associated structural dynamics.

3.
J Immunother ; 2024 Apr 26.
Artículo en Inglés | MEDLINE | ID: mdl-38664936

RESUMEN

SUMMARY: Standard of care treatment for metastatic cutaneous adnexal carcinomas is not well established. In this case report, we highlight the successful use of anti-programmed cell death protein 1 (anti-PD-1) therapy in treating a patient with low tumor mutation burden, microsatellite stable, high programmed death-ligand 1 (PD-L1) gene expression, metastatic primary cutaneous adnexal carcinoma with significant radiographic, and circulating tumor DNA response with durable benefit. Immune checkpoint inhibitors hold promise as a future treatment option in rare instances of metastatic disease from primary skin adnexal carcinoma. Further studies are needed to identify better immune checkpoint inhibitor predictive biomarkers for rare, advanced-stage non-melanoma skin cancers.

4.
Cell Rep Med ; 5(4): 101490, 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38574736

RESUMEN

While neurodegeneration underlies the pathological basis for permanent disability in multiple sclerosis (MS), predictive biomarkers for progression are lacking. Using an animal model of chronic MS, we find that synaptic injury precedes neuronal loss and identify thinning of the inner plexiform layer (IPL) as an early feature of inflammatory demyelination-prior to symptom onset. As neuronal domains are anatomically segregated in the retina and can be monitored longitudinally, we hypothesize that thinning of the IPL could represent a biomarker for progression in MS. Leveraging our dataset with over 800 participants enrolled for more than 12 years, we find that IPL atrophy directly precedes progression and propose that synaptic loss is predictive of functional decline. Using a blood proteome-wide analysis, we demonstrate a strong correlation between demyelination, glial activation, and synapse loss independent of neuroaxonal injury. In summary, monitoring synaptic injury is a biologically relevant approach that reflects a potential driver of progression.


Asunto(s)
Esclerosis Múltiple , Animales , Humanos , Esclerosis Múltiple/patología , Retina/patología , Neuronas/patología , Modelos Animales , Atrofia/patología
5.
Work ; 77(4): 1285-1294, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38489209

RESUMEN

BACKGROUND: During periods of high-volume vigorous exercise, United States Marine Corps recruits often experience musculoskeletal injuries. While the program of instruction (POI) for basic training is a defined training volume, the total workload of boot camp, including movements around the base, is unknown. OBJECTIVE: The present study aimed to quantify the daily total workload, energy expenditure, and sleep during basic recruit training at Marine Corps Recruit Depot (MCRD) San Diego. METHODS: Eighty-four male recruits from MCRD San Diego wore wrist wearable physiological monitors to capture their complete workload (mileage from steps), energy expenditure, and sleep throughout the 10-week boot camp. RESULTS: Marine recruits traveled an average of 11.5±3.4 miles per day (M±SD), expended 4105±823 kcal per day, and slept an average of 5 : 48±1 : 06 hours and minutes per night. While the POI designates a total of 46.3 miles of running and hiking, the actual daily average miles yielded approximately 657.6±107.2 miles over the 10-week boot camp. CONCLUSION: Recruit training requires high physical demand and time under tension due to the cumulative volume of movements around base in addition to the POI planned physical training.


Asunto(s)
Personal Militar , Carga de Trabajo , Humanos , Masculino , Estados Unidos , Ejercicio Físico , Metabolismo Energético
7.
J Sleep Res ; : e14161, 2024 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-38308529

RESUMEN

The detrimental effects of sleep loss on overall decision-making have been well described. Due to the complex nature of decisions, there remains a need for studies to identify specific mechanisms of decision-making vulnerable to sleep loss. Bayesian perspectives of decision-making posit judgement formation during decision-making occurs via a process of integrating knowledge gleaned from past experiences (priors) with new information from current observations (likelihoods). We investigated the effects of sleep loss on the ability to integrate multiple sources of information during decision-making by reporting results from two experiments: the first implementing both sleep restriction (SR) and total sleep deprivation (TSD) protocols, and the second implementing an SR protocol. In both experiments, participants were administered the Bayes Decisions Task on which optimal performance requires the integration of Bayesian prior and likelihood information. Participants in Experiment 1 showed reduced reliance on both information sources after SR, while no significant change was observed after TSD. Participants in Experiment 2 showed reduced reliance on likelihood after SR, especially during morning testing sessions. No accuracy-related impairments resulting from SR and TSD were observed in both experiments. Our findings show SR affects decision-making through altering the way individuals integrate available sources of information. Additionally, the ability to integrate information during SR may be influenced by time of day. Broadly, our findings carry implications for working professionals who are required to make high-stakes decisions on the job, yet consistently receive insufficient sleep due to work schedule demands.

8.
Emotion ; 24(3): 894-911, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37956091

RESUMEN

The valence of an individual's emotional response to an event is often thought to depend on their prior expectations for the event: better-than-expected outcomes produce positive affect and worse-than-expected outcomes produce negative affect. In recent years, this hypothesis has been instantiated within influential computational models of subjective affect that assume the valence of affect is driven by reward prediction errors. However, there remain a number of open questions regarding this association. In this project, we investigated the moderating effects of outcome valence and decision context (Experiment 1: free vs. forced choices; Experiment 2: trials with vs. trials without counterfactual feedback) on the effects of reward prediction errors on subjective affect. We conducted two online experiments (N = 300 in total) of general-population samples recruited via Prolific to complete a risky decision-making task with an embedded high-resolution sampling of subjective affect. Hierarchical Bayesian computational modeling revealed that both outcome amount and reward prediction errors influenced subjective affect, but that the effects of reward prediction errors were moderated by both outcome valence and decision context. Specifically, we found evidence that only negative reward prediction errors (worse-than-expected outcomes) influenced subjective affect, with no significant effect of positive reward prediction errors (better-than-expected outcomes). Moreover, these effects were only apparent on trials in which participants made a choice freely (but not on forced-choice trials) and when counterfactual feedback was absent (but not when counterfactual feedback was present). These results deepen our understanding of the effects of reward prediction errors on subjective affect. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Toma de Decisiones , Recompensa , Humanos , Toma de Decisiones/fisiología , Teorema de Bayes , Retroalimentación
10.
Brain Behav Immun ; 116: 349-361, 2024 02.
Artículo en Inglés | MEDLINE | ID: mdl-38142918

RESUMEN

Maternal immune activation (MIA) during pregnancy increases the risk for the unborn foetus to develop neurodevelopmental conditions such as autism spectrum disorder and schizophrenia later in life. MIA mouse models recapitulate behavioural and biological phenotypes relevant to both conditions, and are valuable models to test novel treatment approaches. Selenium (Se) has potent anti-inflammatory properties suggesting it may be an effective prophylactic treatment against MIA. The aim of this study was to determine if Se supplementation during pregnancy can prevent adverse effects of MIA on offspring brain and behaviour in a mouse model. Selenium was administered via drinking water (1.5 ppm) to pregnant dams from gestational day (GD) 9 to birth, and MIA was induced at GD17 using polyinosinic:polycytidylic acid (poly-I:C, 20 mg/kg via intraperitoneal injection). Foetal placenta and brain cytokine levels were assessed using a Luminex assay and brain elemental nutrients assessed using inductively coupled plasma- mass spectrometry. Adult offspring were behaviourally assessed using a reinforcement learning paradigm, the three-chamber sociability test and the open field test. MIA elevated placental IL-1ß and IL-17, and Se supplementation successfully prevented this elevation. MIA caused an increase in foetal brain calcium, which was prevented by Se supplement. MIA caused in offspring a female-specific reduction in sociability, which was recovered by Se, and a male-specific reduction in social memory, which was not recovered by Se. Exposure to poly-I:C or selenium, but not both, reduced performance in the reinforcement learning task. Computational modelling indicated that this was predominantly due to increased exploratory behaviour, rather than reduced rate of learning the location of the food reward. This study demonstrates that while Se may be beneficial in ameliorating sociability deficits caused by MIA, it may have negative effects in other behavioural domains. Caution in the use of Se supplementation during pregnancy is therefore warranted.


Asunto(s)
Trastorno del Espectro Autista , Efectos Tardíos de la Exposición Prenatal , Selenio , Ratones , Animales , Femenino , Embarazo , Masculino , Humanos , Conducta Animal/fisiología , Selenio/farmacología , Placenta , Modelos Animales de Enfermedad , Poli I-C/farmacología , Suplementos Dietéticos
11.
J Sports Sci Med ; 22(4): 658-666, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38045749

RESUMEN

Wearables are lightweight, portable technology devices that are traditionally used to monitor physical activity and workload as well as basic physiological parameters such as heart rate. However recent advances in monitors have enabled better algorithms for estimation of caloric expenditure from heart rate for use in weight loss as well as sport performance. can be used for estimating energy expenditure and nutritional demand. Recently, the military has adopted the use of personal wearables for utilization in field studies for ecological validity of training. With popularity of use, the need for validation of these devices for caloric estimates is needed to assist in work-rest cycles. Thus the purpose of this effort was to evaluate the Polar Grit X for energy expenditure (EE) for use in military training exercises. Polar Grit X Pro watches were worn by active-duty elite male operators (N = 16; age: 31.7 ± 5.0 years, height: 180.1 ± 6.2 cm, weight: 91.7 ± 9.4 kg). Metrics were measured against indirect calorimetry of a metabolic cart and heart rate via a Polar heart rate monitor chest strap while exercising on a treadmill. Participants each performed five 10-minute bouts of running at a self-selected speed and incline to maintain a heart rate within one of five heart rate zones, as ordered and defined by Polar. Polar Grit X Pro watch had a good to excellent interrater reliability to indirect calorimetry at estimating energy expenditure (ICC = 0.8, 95% CI = 0.61-0.89, F (74,17.3) = 11.76, p < 0.0001) and a fair to good interrater reliability in estimating macronutrient partitioning (ICC = 0.49, 95% CI = 0.3-0.65, F (74,74.54) = 2.98, p < 0.0001). There is a strong relationship between energy expenditure as estimated from the Polar Grit X Pro and measured through indirect calorimetry. The Polar Grit X Pro watch is a suitable tool for estimating energy expenditure in free-living participants in a field setting and at a range of exercise intensities.


Asunto(s)
Personal Militar , Humanos , Masculino , Adulto , Proyectos Piloto , Reproducibilidad de los Resultados , Ejercicio Físico/fisiología , Metabolismo Energético/fisiología
12.
PLoS Comput Biol ; 19(12): e1011707, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38127874

RESUMEN

Positive and negative affective states are respectively associated with optimistic and pessimistic expectations regarding future reward. One mechanism that might underlie these affect-related expectation biases is attention to positive- versus negative-valence features (e.g., attending to the positive reviews of a restaurant versus its expensive price). Here we tested the effects of experimentally induced positive and negative affect on feature-based attention in 120 participants completing a compound-generalization task with eye-tracking. We found that participants' reward expectations for novel compound stimuli were modulated in an affect-congruent way: positive affect induction increased reward expectations for compounds, whereas negative affect induction decreased reward expectations. Computational modelling and eye-tracking analyses each revealed that these effects were driven by affect-congruent changes in participants' allocation of attention to high- versus low-value features of compounds. These results provide mechanistic insight into a process by which affect produces biases in generalized reward expectations.


Asunto(s)
Motivación , Pesimismo , Humanos , Emociones , Generalización Psicológica , Recompensa
13.
Ther Adv Urol ; 15: 17562872231206239, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37868369

RESUMEN

Background: The ideal surgical approach for the management of varicocele in children and adolescents remains controversial. Several techniques are available including artery- or lymphatic-sparing with optical magnification (via open inguinal or sub-inguinal approach), laparoscopic, antegrade and retrograde embolization/sclerotherapy. Objectives: We aimed to appraise the clinical outcomes of these techniques in children and adolescents. Data Sources and Methods: A systematic review was conducted (1997-2023). Meta-analysis or proportional meta-analysis for non-comparative studies (Freeman-Tukey transformation) using the random effects model was conducted. Results are expressed as overall proportion % and 95% confidence interval (CI). Results: We identified 1910 studies; 632 duplicates were removed, 1278 were screened, 203 were reviewed and 56 were included, with 12 reporting on 2 different techniques (total of 68 data sets). Optical magnification via inguinal approach (498 cases): recurrence 2.5% (0.6-5.6), hydrocele 1.6% (0.47-3.4), testicular atrophy 1% (0.3-2.0), complications 1.1% (0.2-2.6); optical magnification via sub-inguinal approach (592 cases): recurrence 2.1% (0.7-4.4), hydrocele 1.26% (0.5-2.3), testicular atrophy 0.5% (0.1-1.3), complications 4% (1.0-8.8). Laparoscopic with mass-ligation/division (1943 cases): recurrence 2.9% (1.5-4.6), hydrocele 11.4% (8.3-14.9); complications 1.5% (0.6-2.9); laparoscopic with lymphatic-sparing (974 cases): recurrence 2.4% (1.5-3.5), hydrocele 1.2% (0.45-3.36), complications 1.2% (0.05-3.9); laparoscopic with artery-sparing (228 cases): recurrence 6.6% (2.3-12.9), hydrocele 6.5% (2.6-12.0). Antegrade embolization/sclerotherapy (403 cases): recurrence 7.6% (5.2-10.4), hydrocele 0.8% (0.17-1.9), technical failure 0.6% (0.1-1.6), complications 4.0% (2.3-6.1); retrograde embolization/sclerotherapy (509 cases): recurrence 6.9% (4.6-9.5), hydrocele 0.8% (0.05-2.5), technical failure 10.2% (4.6-17.6), and complications 4.8% (1.0-11.2). Conclusion: The recurrence rate varies between 2.1% and 7.6% and is higher with the embolization/sclerotherapy techniques. Post-operative hydrocele rate varies between 0.8% and 11.4% and is higher with the laparoscopic mass-ligation/division technique. Testicular atrophy has not been reported with the laparoscopic and embolization/sclerotherapy techniques. The retrograde embolization technique is associated with 10% technical failure (inability to complete the procedure). The laparoscopic lymphatic-sparing technique is characterized by the lowest recurrence rate, incidence of hydrocele and other complications, and no reports of testicular atrophy.

14.
Case Rep Pathol ; 2023: 2960965, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37822715

RESUMEN

Diffuse large B-cell lymphoma, not otherwise specified (DLBCL NOS) is the most common lymphoid malignancy in the Western world and classically presents as a rapidly enlarging nodal or extranodal mass. Cutaneous involvement by systemic DLBCL NOS is an infrequent clinical presentation, encountered in only 1.5-3.5% of cases, while disseminated cutaneous disease with multiple subcutaneous nodules at the time of diagnosis is unusual and can present a diagnostic challenge. The differential diagnosis when encountering a high-grade B-cell malignancy at a cutaneous site is broad and includes primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT), high-grade B-cell lymphoma with MYC and BCL2 rearrangements (HGBCL-MYC/BCL2), and other potential entities which must all be carefully considered before rendering a final diagnosis. In this report, we describe the case of a 69-year-old man who was seen at our hospital due to generalized weakness and was found to have multiple subcutaneous nodules representing disseminated DLBCL NOS. The case was complicated by concurrent monoclonal B-cell lymphocytosis involving the bone marrow.

15.
Artículo en Inglés | MEDLINE | ID: mdl-37754657

RESUMEN

The In Conversation: Boundary, Spanners, Thinkers and Policy Actors Round Table Series provides a platform for researchers, policy actors, and implementation experts to elevate discussion on emerging issues, present new and upcoming research, and facilitate conversations around impacts and possible solutions. This brief report, on trees, climate change, and health, reflects a conversation between the authors of this paper, along with supporting literature. It explores the potential of green spaces and trees as a viable strategy to address climate change challenges and simultaneously improve population health, well-being, and health equity. In particular, it highlights the public health benefits of trees and green space, the challenges faced in urban areas, and opportunities for the protection, maintenance and regeneration of urban green space.


Asunto(s)
Planificación de Ciudades , Árboles , Humanos , Cambio Climático , Comunicación
16.
J Cutan Pathol ; 50(11): 963-970, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37649312

RESUMEN

Pilomatricomas (PMs) are common benign adnexal tumors that show a predilection for the head and neck region and are characterized at the molecular level by activating mutations in the beta-catenin (CTNNB1) gene. Giant PMs are a rare histopathological variant, according to the World Health Organization, which are defined by a size greater than 4 cm and are reported to show upregulation of yes-associated protein compared to PMs of typical 1-3 cm size. We describe the case of a 67-year-old man with an 8 cm giant PM involving his temporal scalp, whose PM we characterized by 10X spatial gene expression analysis. This revealed five total transcriptomic clusters, including four distinct clusters within the giant PM, each with a unique transcriptional pattern of hair follicle-related factors, keratin gene expression, and beta-catenin pathway activity.


Asunto(s)
Enfermedades del Cabello , Pilomatrixoma , Neoplasias Cutáneas , Masculino , Humanos , Anciano , Pilomatrixoma/patología , beta Catenina/genética , beta Catenina/metabolismo , Transcriptoma , Enfermedades del Cabello/patología , Neoplasias Cutáneas/patología , Perfilación de la Expresión Génica
17.
Nat Hum Behav ; 7(10): 1667-1681, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37414886

RESUMEN

Although online samples have many advantages for psychiatric research, some potential pitfalls of this approach are not widely understood. Here we detail circumstances in which spurious correlations may arise between task behaviour and symptom scores. The problem arises because many psychiatric symptom surveys have asymmetric score distributions in the general population, meaning that careless responders on these surveys will show apparently elevated symptom levels. If these participants are similarly careless in their task performance, this may result in a spurious association between symptom scores and task behaviour. We demonstrate this pattern of results in two samples of participants recruited online (total N = 779) who performed one of two common cognitive tasks. False-positive rates for these spurious correlations increase with sample size, contrary to common assumptions. Excluding participants flagged for careless responding on surveys abolished the spurious correlations, but exclusion based on task performance alone was less effective.

18.
J Vis Exp ; (196)2023 06 02.
Artículo en Inglés | MEDLINE | ID: mdl-37335112

RESUMEN

Functional site-directed fluorometry has been the technique of choice to investigate the structure-function relationship of numerous membrane proteins, including voltage-gated ion channels. This approach has been used primarily in heterologous expression systems to simultaneously measure membrane currents, the electrical manifestation of the channels' activity, and fluorescence measurements, reporting local domain rearrangements. Functional site-directed fluorometry combines electrophysiology, molecular biology, chemistry, and fluorescence into a single wide-ranging technique that permits the study of real-time structural rearrangements and function through fluorescence and electrophysiology, respectively. Typically, this approach requires an engineered voltage-gated membrane channel that contains a cysteine that can be tested by a thiol-reactive fluorescent dye. Until recently, the thiol-reactive chemistry used for the site-directed fluorescent labeling of proteins was carried out exclusively in Xenopus oocytes and cell lines, restricting the scope of the approach to primary non-excitable cells. This report describes the applicability of functional site-directed fluorometry in adult skeletal muscle cells to study the early steps of excitation-contraction coupling, the process by which muscle fiber electrical depolarization is linked to the activation of muscle contraction. The present protocol describes the methodologies to design and transfect cysteine-engineered voltage-gated Ca2+ channels (CaV1.1) into muscle fibers of the flexor digitorum brevis of adult mice using in vivo electroporation and the subsequent steps required for functional site-directed fluorometry measurements. This approach can be adapted to study other ion channels and proteins. The use of functional site-directed fluorometry of mammalian muscle is particularly relevant to studying basic mechanisms of excitability.


Asunto(s)
Cisteína , Músculo Esquelético , Ratones , Animales , Cisteína/química , Músculo Esquelético/fisiología , Fibras Musculares Esqueléticas/fisiología , Canales Iónicos , Fluorometría/métodos , Mamíferos
19.
J Neurosci ; 43(31): 5693-5709, 2023 08 02.
Artículo en Inglés | MEDLINE | ID: mdl-37369587

RESUMEN

The trial-unique nonmatching to location (TUNL) touchscreen task shows promise as a translational assay of working memory (WM) deficits in rodent models of autism, ADHD, and schizophrenia. However, the low-level neurocognitive processes that drive behavior in the TUNL task have not been fully elucidated. In particular, it is commonly assumed that the TUNL task predominantly measures spatial WM dependent on hippocampal pattern separation, but this proposition has not previously been tested. In this project, we tested this question using computational modeling of behavior from male and female mice performing the TUNL task (N = 163 across three datasets; 158,843 trials). Using this approach, we empirically tested whether TUNL behavior solely measured retrospective WM, or whether it was possible to deconstruct behavior into additional neurocognitive subprocesses. Overall, contrary to common assumptions, modeling analyses revealed that behavior on the TUNL task did not primarily reflect retrospective spatial WM. Instead, behavior was best explained as a mixture of response strategies, including both retrospective WM (remembering the spatial location of a previous stimulus) and prospective WM (remembering an anticipated future behavioral response) as well as animal-specific response biases. These results suggest that retrospective spatial WM is just one of a number of cognitive subprocesses that contribute to choice behavior on the TUNL task. We suggest that findings can be understood within a resource-rational framework, and use computational model simulations to propose several task-design principles that we predict will maximize spatial WM and minimize alternative behavioral strategies in the TUNL task.SIGNIFICANCE STATEMENT Touchscreen tasks represent a paradigm shift for assessment of cognition in nonhuman animals by automating large-scale behavioral data collection. Their main relevance, however, depends on the assumption of functional equivalence to cognitive domains in humans. The trial-unique, delayed nonmatching to location (TUNL) touchscreen task has revolutionized the study of rodent spatial working memory. However, its assumption of functional equivalence to human spatial working memory is untested. We leveraged previously untapped single-trial TUNL data to uncover a novel set of hierarchically ordered cognitive processes that underlie mouse behavior on this task. The strategies used demonstrate multiple cognitive approaches to a single behavioral outcome and the requirement for more precise task design and sophisticated data analysis in interpreting rodent spatial working memory.


Asunto(s)
Hipocampo , Memoria a Corto Plazo , Humanos , Ratones , Masculino , Femenino , Animales , Memoria a Corto Plazo/fisiología , Estudios Prospectivos , Estudios Retrospectivos , Hipocampo/fisiología , Trastornos de la Memoria , Sesgo
20.
WMJ ; 122(2): 146-148, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37141484

RESUMEN

INTRODUCTION: Fremanezumab is a humanized monoclonal antibody administered through a subcutaneous injection. It is used for treatment of migraines, and occasional injection site reactions have developed after usage. CASE PRESENTATION: This case report describes a nonimmediate injection site reaction on the right thigh of a 25-year-old female patient after starting treatment with fremanezumab. The injection site reaction presented as 2 warm, red annular plaques 8 days following a second injection of fremanezumab and about 5 weeks following the first injection. She was prescribed a 1-month course of prednisone that relieved her symptoms of redness, itching, and pain. DISCUSSION: Similar nonimmediate injection site reactions have been reported before, but this particular injection site reaction was significantly more delayed. CONCLUSIONS: Our case illustrates that injection site reactions to fremanezumab can be delayed after the second dose and may require systemic therapy to alleviate symptoms.


Asunto(s)
Reacción en el Punto de Inyección , Trastornos Migrañosos , Femenino , Humanos , Adulto , Reacción en el Punto de Inyección/tratamiento farmacológico , Anticuerpos Monoclonales/efectos adversos , Trastornos Migrañosos/tratamiento farmacológico , Trastornos Migrañosos/diagnóstico , Inyecciones Subcutáneas , Resultado del Tratamiento
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