Comparison of distance covered, physiological cost, and perceived exertion in four six-minute walk test protocols.

Objective: There is evidence that indicates that the Walked Distance (WD) in the 6-Minute Walk Test (6MWT) would be sensitive to the type of track and encouragement. The aim of study was compared the impact of track type and verbal encouragement provided in the 6MWT on WD, physiological cost, perceived exertion, and gait efficiency in healthy young adults unfamiliar with the test. Method: WD, heart rate, subjective sensation of dyspnea (SSD), and fatigue (SSF) were measured in four 6MWT protocols: i) 30 m linear track and protocolized encouragement (LT + PE), ii) 30 m linear track and constant encouragement (LT + CE), iii) 81 m elliptical track and protocolized encouragement (ET + PE), and iv) 81 m elliptical track and constant encouragement (ET + CE). In addition, the Gait Efficiency Index (GIE) associated with physiological cost, dyspnea and fatigue was calculated and compared between the different protocols. Results: The WD was significantly higher in the ET + CE protocol. The percentage of the heart rate reserve used (%HRRu) at minute 6 was higher in the ET + CE protocol. The SSD and SSD had difference in startup time between the protocols. The GEI was higher in %HRRu, SSD, and SSF for the ET + CE protocol. Conclusion: The ET + CE protocol showed a significant increase in WD during the 6MWT in healthy young adults. Although it obtained the highest physiological cost, it did not present perceptual differences when entering cardiopulmonary assessment windows relevant to a more efficient test for the participant. It is advisable to discuss, based on the findings, the fundamental objective of the 6MWT and national and international recommendations to achieve a result as close as possible to the real maximal effort.

New insights into the anticancer therapeutic potential of icaritin and its synthetic derivatives.

Icaritin is a natural prenylated flavonoid derived from the Chinese herb Epimedium. The compound has shown antitumor effects in various cancers, especially hepatocellular carcinoma (HCC). Icaritin exerts its anticancer activity by modulating multiple signaling pathways, such as IL-6/JAK/STAT3, ER-α36, and NF-κB, affecting the tumor microenvironment and immune system. Several clinical trials have evaluated the safety and efficacy of icaritin in advanced HCC patients with poor prognoses, who are unsuitable for conventional therapies. The results have demonstrated that icaritin can improve survival, delay progression, and produce clinical benefits in these patients, with a favorable safety profile and minimal adverse events. Moreover, icaritin can enhance the antitumor immune response by regulating the function and phenotype of various immune cells, such as CD8+ T cells, MDSCs, neutrophils, and macrophages. These findings suggest that icaritin is a promising candidate for immunotherapy in HCC and other cancers. However, further studies are needed to elucidate the molecular mechanisms and optimal dosing regimens of icaritin and its potential synergistic effects with other agents. Therefore, this comprehensive review of the scientific literature aims to summarize advances in the knowledge of icaritin in preclinical and clinical studies as well as the pharmacokinetic, metabolism, toxicity, and mechanisms action to recognize the main challenge, gaps, and opportunities to develop a medication that cancer patients can use. Thus, our main objective was to clarify the current state of icaritin for use as an anticancer drug.

Human adenovirus-associated health risk in the recreational waters of the Yal-ku lagoon in the Mexican Caribbean.

The study objective was to evaluate human faecal contamination impacts in the Yal-ku lagoon in the Mexican Caribbean and to estimate adenovirus infection and illness risks associated with recreational exposure during water activities. A total of 20 water samples (10 from each site × two sites) (50 L) were collected monthly over a period of 12 months from two selected sampling sites in the swimming area of the Yal-ku lagoon. The occurrence of faecal-associated viruses was explored, and human adenovirus (HAdV) and pepper mild mottle virus (PMMoV) concentrations were quantified. A quantitative microbial risk assessment (QMRA) model was used to estimate exposure and subsequent adenovirus infection and illness risk for 1 h of swimming or snorkelling. Somatic and F + -specific coliphages occurred in 100% of the samples. Both HAdV and PMMoV were detected at a 60% frequency thereby indicating persistent faecal inputs. PMMoV concentrations (44-370 GC/L) were relatively lower than the concentrations of HAdV (64-1,000 GC/L). Estimated mean adenovirus risks were greater for snorkelling than for swimming by roughly one to two orders of magnitude and estimated mean illness risks for snorkelling were >32/1,000. Human faecal contamination is frequent in the Yal-ku lagoon, which is associated with human gastrointestinal illness.

Internet of Things and citizen science as alternative water quality monitoring approaches and the importance of effective water quality communication.

The increasing demand for water and worsening climate change place significant pressure on this vital resource, making its preservation a global priority. Water quality monitoring programs are essential for effectively managing this resource. Current programs rely on traditional monitoring approaches, leading to limitations such as low spatiotemporal resolution and high operational costs. Despite the adoption of novel monitoring approaches that enable better data resolution, the public's comprehension of water quality matters remains low, primarily due to communication process deficiencies. This study explores the advantages and challenges of using Internet of Things (IoT) and citizen science as alternative monitoring approaches, emphasizing the need for enhancing public communication of water quality data. Through a systematic review of studies implemented on-field, we identify and propose strategies to address five key challenges that IoT and citizen science monitoring approaches must overcome to mature into robust sources of water quality information. Additionally, we highlight three fundamental problems affecting the water quality communication process and outline strategies to convey this topic effectively to the public.

3,3'-Diindolylmethane and indole-3-carbinol: potential therapeutic molecules for cancer chemoprevention and treatment via regulating cellular signaling pathways.

Dietary compounds in cancer prevention have gained significant consideration as a viable method. Indole-3-carbinol (I3C) and 3,3'-diindolylmethane (DIM) are heterocyclic and bioactive chemicals found in cruciferous vegetables like broccoli, cauliflower, cabbage, and brussels sprouts. They are synthesized after glycolysis from the glucosinolate structure. Clinical and preclinical trials have evaluated the pharmacokinetic/pharmacodynamic, effectiveness, antioxidant, cancer-preventing (cervical dysplasia, prostate cancer, breast cancer), and anti-tumor activities of I3C and DIM involved with polyphenolic derivatives created in the digestion showing promising results. However, the exact mechanism by which they exert anti-cancer and apoptosis-inducing properties has yet to be entirely understood. Via this study, we update the existing knowledge of the state of anti-cancer investigation concerning I3C and DIM chemicals. We have also summarized; (i) the recent advancements in the use of I3C/DIM as therapeutic molecules since they represent potentially appealing anti-cancer agents, (ii) the available literature on the I3C and DIM characterization, and the challenges related to pharmacologic properties such as low solubility, and poor bioavailability, (iii) the synthesis and semi-synthetic derivatives, (iv) the mechanism of anti-tumor action in vitro/in vivo, (v) the action in cellular signaling pathways related to the regulation of apoptosis and anoikis as well as the cell cycle progression and cell proliferation such as peroxisome proliferator-activated receptor and PPARγ agonists; SR13668, Akt inhibitor, cyclins regulation, ER-dependent-independent pathways, and their current medical applications, to recognize research opportunities to potentially use these compounds instead chemotherapeutic synthetic drugs.

Transsulfuration pathway: a targeting neuromodulator in Parkinson's disease.

The transsulfuration pathway (TSP) is a metabolic pathway involving sulfur transfer from homocysteine to cysteine. Transsulfuration pathway leads to many sulfur metabolites, principally glutathione, H2S, taurine, and cysteine. Key enzymes of the TSP, such as cystathionine ß-synthase and cystathionine γ-lyase, are essential regulators at multiple levels in this pathway. TSP metabolites are implicated in many physiological processes in the central nervous system and other tissues. TSP is important in controlling sulfur balance and optimal cellular functions such as glutathione synthesis. Alterations in the TSP and related pathways (transmethylation and remethylation) are altered in several neurodegenerative diseases, including Parkinson's disease, suggesting their participation in the pathophysiology and progression of these diseases. In Parkinson's disease many cellular processes are comprised mainly those that regulate redox homeostasis, inflammation, reticulum endoplasmic stress, mitochondrial function, oxidative stress, and sulfur content metabolites of TSP are involved in these damage processes. Current research on the transsulfuration pathway in Parkinson's disease has primarily focused on the synthesis and function of certain metabolites, particularly glutathione. However, our understanding of the regulation of other metabolites of the transsulfuration pathway, as well as their relationships with other metabolites, and their synthesis regulation in Parkinson´s disease remain limited. Thus, this paper highlights the importance of studying the molecular dynamics in different metabolites and enzymes that affect the transsulfuration in Parkinson's disease.

Morphological characteristics of astrocytes of the fastigial nucleus.

Astrocytes are a diverse and morphologically complex class of glial cells restricted to the central nervous system which have been implicated in the modulation of neuronal activity. The cerebellum is involved in planning movements and motor learning. Within the cerebellum three deep cerebellar nuclei (dentate, interposed and fastigial) provide the sole neuronal output. The fastigial nucleus participates in saccadic and vestibular function, and recent evidence disclosed neuronal projections to cognitive, affective, and motor areas. However, thus far there are no reliable descriptions of the distribution and morphological classifications of astrocytes in this nucleus. This work aims to describe the characteristics of astrocytes of the fastigial nucleus based on the expression of GFP in a transgenic mouse model.

Current Status of the Therapeutic Approach for Dysmenorrhea.

Dysmenorrhea is the combination of cramps and pain associated with the menstrual period, and the symptoms affect at least 30% of women worldwide. Tolerance to symptoms depends on each person's pain threshold; however, dysmenorrhea seriously affects daily activities and chronically reduces the quality of life. Some dysmenorrhea cases even require hospitalization due to unbearable symptoms of severe pain. Dysmenorrhea is an underestimated affectation and remains even in different first-world countries as a taboo subject, promoted by the establishment of an apparent policy of gender equality. A person with primary or secondary dysmenorrhea requires medical assistance in choosing the best treatment and an integral approach. This review intends to demonstrate the impact of dysmenorrhea on quality of life. We describe the pathophysiology of this disorder from a molecular point of view and perform a comprehensive compilation and analysis of the most critical findings in the therapeutic management of dysmenorrhea. Likewise, we propose an interdisciplinary approach to the phenomenon of dysmenorrhea at the cellular level in a concise way and the botanical, pharmacological, and medical applications for its management. Since dysmenorrhea symptoms can vary between individuals, medical treatment cannot be generalized and depends on each patient. Therefore, we hypothesized that a suitable strategy could result from the combination of pharmacological therapy aided by a non-pharmacological approach.

Alteration of the blood-brain barrier by COVID-19 and its implication in the permeation of drugs into the brain.

Diverse neurological symptoms have been reported in patients with SARS-CoV-2 disease (COVID-19), including stroke, ataxia, meningitis, encephalitis, and cognitive impairment. These alterations can cause serious sequelae or death and are associated with the entry of SARS-CoV-2 into the Central Nervous System (CNS). This mini-review discusses the main proposed mechanisms by which SARS-CoV-2 interacts with the blood-brain barrier (BBB) and its involvement in the passage of drugs into the CNS. We performed a search in PubMed with the terms "COVID-19" or "SARS-CoV-2" and "blood-brain barrier injury" or "brain injury" from the year 2019 to 2022. We found proposed evidence that SARS-CoV-2 infects neurovascular cells and increases BBB permeability by increasing the expression of matrix metalloproteinase-9 that degrades type IV collagen in the basement membrane and through activating RhoA, which induces restructuring of the cytoskeleton and alters the integrity of the barrier. The breakdown of the BBB triggers a severe inflammatory response, causing the cytokine storm (release of IL-1ß, IL-6, TNF-α, etc.) characteristic of the severe phase of COVID-19, which includes the recruitment of macrophages and lymphocytes and the activation of astrocytes and microglia. We conclude that the increased permeability of the BBB would allow the passage of drugs that would not reach the brain in a normal physiological state, thus enhancing certain drugs' beneficial or adverse effects. We hope this article will encourage research on the impact of drugs on patients with COVID-19 and recovered patients with sequelae, focusing mainly on possible dose adjustments and changes in pharmacokinetic parameters.

Lithium: A Promising Anticancer Agent.

Lithium is a therapeutic cation used to treat bipolar disorders but also has some important features as an anti-cancer agent. In this review, we provide a general overview of lithium, from its transport into cells, to its innovative administration forms, and based on genomic, transcriptomic, and proteomic data. Lithium formulations such as lithium acetoacetate (LiAcAc), lithium chloride (LiCl), lithium citrate (Li3C6H5O7), and lithium carbonate (Li2CO3) induce apoptosis, autophagy, and inhibition of tumor growth and also participate in the regulation of tumor proliferation, tumor invasion, and metastasis and cell cycle arrest. Moreover, lithium is synergistic with standard cancer therapies, enhancing their anti-tumor effects. In addition, lithium has a neuroprotective role in cancer patients, by improving their quality of life. Interestingly, nano-sized lithium enhances its anti-tumor activities and protects vital organs from the damage caused by lipid peroxidation during tumor development. However, these potential therapeutic activities of lithium depend on various factors, such as the nature and aggressiveness of the tumor, the type of lithium salt, and its form of administration and dosage. Since lithium has been used to treat bipolar disorder, the current study provides an overview of its role in medicine and how this has changed. This review also highlights the importance of this repurposed drug, which appears to have therapeutic cancer potential, and underlines its molecular mechanisms.

Multicentre observational study on multisystem inflammatory syndrome related to COVID-19 in Argentina.

BACKGROUND: The impact of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in low- and middle-income countries remains poorly understood. Our aim was to understand the characteristics and outcomes of PIMS-TS in Argentina. METHODS: This observational, prospective, and retrospective multicenter study enrolled patients younger than 18 years-old manifesting PIMS-TS, Kawasaki disease (KD) or Kawasaki shock syndrome (KSS) between March 2020 and May 2021. Patients were followed-up until hospital discharge or death (one case). The primary outcome was pediatric intensive care unit (PICU) admission. Multiple logistic regression was used to identify variables predicting PICU admission. RESULTS: Eighty-one percent, 82%, and 14% of the 176 enrolled patients fulfilled the suspect case criteria for PIMS-TS, KD, and KSS, respectively. Temporal association with SARS-CoV-2 was confirmed in 85% of the patients and 38% were admitted to the PICU. The more common clinical manifestations were fever, abdominal pain, rash, and conjunctival injection. Lymphopenia was more common among PICU-admitted patients (87% vs. 51%, p < 0.0001), who also showed a lower platelet count and higher plasmatic levels of inflammatory and cardiac markers. Mitral valve insufficiency, left ventricular wall motion alterations, pericardial effusion, and coronary artery alterations were observed in 30%, 30%, 19.8%, and 18.6% of the patients, respectively. Days to initiation of treatment, rash, lymphopenia, and low platelet count were significant independent contributions to PICU admission. CONCLUSION: Rates of severe outcomes of PIMS-TS in the present study agreed with those observed in high-income countries. Together with other published studies, this work helps clinicians to better understand this novel clinical entity.

Analysis of a cell niche with proliferative potential at the roof of the aqueduct of Sylvius.

The aqueduct of Sylvius connects the third with the fourth ventricle and is surrounded by the Periaqueductal Grey. Here, we report a novel niche of cells in the dorsal section of the aqueduct, hereby named dorsal aqueduct niche or DAN, by applying a battery of selective markers and transgenic mouse lines. The somata of DAN cells are located toward the lumen of the ventricle forming multiple layers in close association with the cerebrospinal fluid (CSF). A single process emerges from the soma and run with the blood vessels. Cells of the DAN express radial glia/stem cell markers such as GFAP, vimentin and nestin, and the glutamate transporter GLAST or the oligodendrocyte precursor/pericyte marker NG2, thereby suggesting their potential for the generation of new cells. Morphologically, DAN cells resemble tanycytes of the third ventricle, which transfer biochemical signals from the CSF to the central nervous system and display proliferative capacity. The aqueduct ependymal lining can proliferate as observed by the integration of BrdU and expression of Ki67. Thus, the dorsal section of the aqueduct of Sylvius possesses cells that may act a niche of new glial cells in the adult mouse brain.

Prácticas socioformativas para la gestión de competencias investigativas en el médico general integral utilizando Telegram / Socioformative practices for the management of investigative skills in the comprehensive general practitioner using Telegram

Fundamento: las tecnologías de la información y las comunicaciones ofrecen herramientas que facilitan la formación de competencias investigativas en los médicos generales integrales con la utilización de Telegram en el contexto de la sociedad del conocimiento. Objetivo: valorar la efectividad en la transformación de la práctica socioformativa para la gestión de las competencias investigativas en el médico general integral, haciendo uso de Telegram en el curso de Metodología de la Investigación durante el periodo septiembre 2021-2022. Métodos: se realizó un estudio cuasiexperimental, en la Filial de Ciencias Médicas "Julio Trigo López" de Palma Soriano. Se utilizaron métodos teóricos: histórico-lógico, análisis-síntesis, enfoque de sistema, abstracción-concreción y el hermenéutico-dialéctico; empíricos: análisis documental, observación, cuestionario y el criterio de expertos. Resultados: se alcanzó mayor eficiencia en la transformación de la práctica socioformativa para la gestión de las competencias investigativas en el médico general integral, haciendo uso de Telegram en los aspectos relacionados con la realización de tareas grupales, interacción promotora y conocimientos sobre cómo confeccionar el proyecto de investigación para la solución de los problemas en la comunidad. Conclusiones: se valora como factible y novedosa la transformación de la práctica socioformativa para la gestión de las competencias investigativas en el médico general integral, haciendo uso de Telegram como herramienta para el aprendizaje colaborativo como protagonista en este entorno virtual de interacción.

Background: information and communication technologies offer tools that facilitate the formation of investigative skills in comprehensive general practitioners in the context of the knowledge society. Objective: to assess the effectiveness in the transformation of the socioformative practice for the management of investigative skills in the comprehensive general practitioner, using Telegram in the Research Methodology course during the period September 2021-2022. Methods: a quasi-experimental study was carried out at the "Julio Trigo López" Medical Sciences Branch in Palma Soriano. Theoretical methods were used: historical-logical, analysis-synthesis, system approach, abstraction-concretion and hermeneutic-dialectical; Empirical: documentary analysis, observation, questionnaire and expert criteria. Results: greater efficiency was achieved in the transformation of the socio-formative practice for the management of investigative skills in the comprehensive general practitioner, making use of Telegram in aspects related to carrying out group tasks, promoting interaction and knowledge on how to prepare the project. Research to solve problems in the community. Conclusions: the transformation of the socio-formative practice for the management of investigative skills in the comprehensive general practitioner is valued as feasible and novel, making use of Telegram as a tool for collaborative learning as a protagonist in this virtual environment of interaction.

Información, narrativas y vivencias de los equipos de salud del Hospital Vilardebó ante la nueva Ley de Salud Mental No 19529 / Information, narratives and experiences of the health teams of the Hospital Vilardebó before the new Law of Mental Health N.o 19.529

La nueva Ley de Salud Mental N.o 19.529 promueve el cierre paulatino de los establecimientos asilares y monovalentes en todo el país. Dentro del sector público se encuentra el Hospital Vilardebó. En esta investigación se exploraron los significados que los equipos de salud de dicho hospital construyen sobre la implementación de la Ley N.o 19.529. Para esto se diseñó un estudio descriptivo. A partir de un muestreo teórico estratificado, la población quedó conformada por 69 personas con formación en medicina general, psiquiatría, psicología, trabajo social y enfermería. A través de un cuestionario autoadministrado, se indagó la información sobre la nueva ley, el reconocimiento de cambios institucionales, la modificación de las prácticas laborales, y los afectos movilizados. De los resultados se destaca un manejo heterogéneo de la información sobre la nueva normativa. Se advierte, asimismo, un proceso de transición institucional donde se observan narrativas contradictorias sobre los cambios en curso.

The new Mental Health Law N 19.529 promotes gradual closure of asylums and monovalent institutions throughout the country. Hospital Vilardebó is the public health psychiatric hospital. This research explores the meanings that health teams assign to this law's implemen tation by means of a descriptive study. Based on a theoretical stratified sample, 69 workers with training in general medicine, psychiatry, psychology, social work and nursing answered a self-administered questionnaire regarding the new law, institutional and work practice changes, and affects involved. The results highlight a heterogeneous handling of information on new regulations. Likewise, an institutional transitional process is noted, with contradictory narratives regarding ongoing changes.

Organization of the ventricular zone of the cerebellum.

The roof of the fourth ventricle (4V) is located on the ventral part of the cerebellum, a region with abundant vascularization and cell heterogeneity that includes tanycyte-like cells that define a peculiar glial niche known as ventromedial cord. This cord is composed of a group of biciliated cells that run along the midline, contacting the ventricular lumen and the subventricular zone. Although the complex morphology of the glial cells composing the cord resembles to tanycytes, cells which are known for its proliferative capacity, scarce or non-proliferative activity has been evidenced in this area. The subventricular zone of the cerebellum includes astrocytes, oligodendrocytes, and neurons whose function has not been extensively studied. This review describes to some extent the phenotypic, morphological, and functional characteristics of the cells that integrate the roof of the 4V, primarily from rodent brains.

Indole-3-Carbinol, a Phytochemical Aryl Hydrocarbon Receptor-Ligand, Induces the mRNA Overexpression of UBE2L3 and Cell Proliferation Arrest.

Cervical cancer (CC) is one of the most common cancers in women, and is linked to human papillomavirus (HPV) infection. The virus oncoprotein E6 binds to p53, resulting in its degradation and allowing uncontrolled cell proliferation. Meanwhile, the HPV E7 protein maintains host cell differentiation by targeting retinoblastoma tumor suppressor. The host cell can ubiquitinate E6 and E7 through UBE2L3, whose expression depends on the interaction between the aryl hydrocarbon receptor (AhR) with Xenobiotic Responsive Elements (XREs) located in the UBE2L3 gene promoter. In this study, we used cell culture to determine the effect of indole-3-carbinol (I3C) over cellular viability, apoptosis, cell proliferation, and mRNA levels of UBE2L3 and CYP1A1. In addition, patients' samples were used to determine the mRNA levels of UBE2L3 and CYP1A1 genes. We found that I3C promotes the activation of AhR and decreases cell proliferation, possibly through UBE2L3 mRNA induction, which would result in the ubiquitination of HPV E7. Since there is a strong requirement for selective and cost-effective cancer treatments, natural AhR ligands such as I3C could represent a novel strategy for cancer treatment.

Probiotic Characteristics and Antimicrobial Potential of a Native Bacillus subtilis Strain Fa17.2 Rescued from Wild Bromelia sp. Flowers.

In the present study, we identified the Bacillus subtilis strain annotated Fa17.2 isolated from Bromelia flower inflorescences collected from the subtropical humid mesothermal region, Santo Domingo de Los Tsachilas Province, Ecuador. The probiotic capacity and antimicrobial potential against four foodborne pathogens were assessed. The cell culture of Fa17.2 is highly resistant to synthetic gastric acid (pH 2.5, 3.0, and 3.5), bile salts (0.3%), tolerating different sodium chloride concentrations (1, 3, and 5%), and growth conditions (15 °C and 45 °C), suggesting its potential probiotic features. The isolate showed no antibiotic resistance and was considered safe as no hemolysis was detected on sheep blood agar. The optimum medium for bacterial growth and the release of antimicrobial compounds was MRS with 10% glucose. The active components released in the neutralized crude extract (NCE) were insensitive to organic solvents, surfactants, and nonproteolytic enzymes and sensitive to proteolytic enzymes suggesting their proteinaceous nature. The antimicrobial activity was enhanced by heat and maintained active over a wide range of pH (2.0-8.0). Moreover, the crude extract (CE) showed inhibitory activity against several Gram-negative and Gram-positive bacteria. The molecular weight of partially purified precipitated bacteriocin-like substances (BLISs) was about 14 kDa in 20% Tricine-SDS-PAGE. The CE obtained from Fa17.2 inhibits the growth of four foodborne pathogens, Staphylococcus aureus, Escherichia coli, Kosaconia cowanii, and Shigella dysenteriae, which implies its potential as an antimicrobial producer strain.

LKB-1 Expression and High-Risk Histopathology are Independent Prognostic Factors for Patients with Oral Cavity Carcinoma.

BACKGROUND: The expression of liver kinase B1 (LKB-1) has been associated with prognosis in squamous cell carcinoma of the oral cavity (SCCOC). This study aimed to define the prognostic role of LKB-1 expression for patients with SCCOC and the suitability of its integration into a multivariate prognostic model. METHODS: A retrospective cohort study of patients with SCCOC was conducted in a cancer center. Expression of LKB-1 was evaluated by immunohistochemistry, and multivariate analysis defined prognostic factors associated with recurrence, recurrence-free survival (RFS), and overall survival (OS). The logistic regression model was used to construct a predictive computer software program. RESULTS: Of the 201 patients in this study, 104 (51.7%) experienced recurrence of their disease. Lower expression of LKB-1, high-risk histopathology, and advanced tumor-node-metastasis (TNM) stages were independent factors via multivariate analysis associated with the increased recurrence risk, poor RFS, and poor OS. If lack of LKB-1 expression is considered the reference category, the factors independently associated with recurrence were low (odds ratio [OR], 0.157; 95% confidence interval [CI], 0.044-0.557), intermediate (OR, 0.073; 95% CI, 0.017-0.319), and intense (OR, 0.047; 95% CI, 0.007-0.304) expression of LKB-1. This model permitted construction of a computer software program capable of prediction with receiver operating characteristic analysis (area under the curve, 0.925) and led to the definition of five prognostic groups with a biologic gradient. CONCLUSION: These results suggest that LKB-1 expression in patients with SCCOC is of robust prognostic value and complements the TNM staging system. The proposed model requires external validation in prospective observational studies.

Anxiety and COVID-19: Coronavirus Anxiety Scale scores in medical and non-medical personnel in urban hospitals in Guadalajara. A cross-sectional survey study.

The world is facing the worst health crisis in modern history. In addition to general concerns about the effects of COVID-19 on health, hospital personnel are developing numerous mental health conditions. This cross-sectional survey study evaluated the prevalence and severity of anxiety caused by the COVID-19 pandemic using the Coronavirus Anxiety Scale (CAS) in 2136 hospital employees. For the employees who presented scores ranging from 1-20 (n = 1090, 51%), the CAS mean score was 4.22 (SD = 3.95). The mean score was higher in women than men. By work category, non-clinical hospital personnel presented the highest CAS scores.