Reparación percutánea de insuficiencia mitral primaria con técnica borde a borde: primer reporte de caso en Uruguay / Percutaneous edge-to-edge repair of primary mitral regurgitation: first case report in Uruguay / Correção percutânea de regurgitação mitral primária com técnica "edge-to-edge": primeiro caso reportado em Uruguai

La insuficiencia mitral (IM) es una enfermedad frecuente. La degeneración mixomatosa es la principal causa de IM primaria en los países desarrollados. Si no se corrige, conduce a la disfunción ventricular y a la insuficiencia cardíaca congestiva, con elevada morbimortalidad. La cirugía de reparación valvular es el tratamiento recomendado en la IM primaria severa y sintomática. En los pacientes con alto riesgo quirúrgico las opciones terapéuticas son limitadas. El surgimiento de la reparación percutánea borde a borde ha permitido ofrecer alternativas terapéuticas para estos pacientes, y se han demostrado buenos resultados. Se presenta el caso clínico de un paciente añoso con IM primaria severa. Por su elevado riesgo quirúrgico se optó por realizar reparación percutánea con técnica borde a borde, con excelentes resultados clínicos y ecocardiográficos. Se trata del primer reporte de caso de estas características en nuestro país.

Mitral regurgitation (MR) is a common disease. Myxomatous degeneration is the main cause of primary MR in developed countries. If not corrected, it leads to ventricular dysfunction and congestive heart failure, with high morbidity and mortality. Valve repair surgery is the recommended treatment for severe and symptomatic primary MR. In patients with high surgical risk, therapeutic options are limited. The emergence of edge-to-edge percutaneous repair has made it possible to offer therapeutic alternatives for these patients, and good results have been demonstrated. We present the clinical case of an elderly patient with severe primary MR. Due to his high surgical risk, it was decided to perform percutaneous repair with edge-to-edge technique, with excellent clinical and echocardiographic results. It is the first case report of these characteristics in our country.

A regurgitação mitral (RM) é uma doença frequente. A degeneração mixomatosa é a principal causa de RM primária em países desenvolvidos. Se não for corrigido, leva à disfunção ventricular e insuficiência cardíaca congestiva, com alta morbimortalidade. A cirurgia de reparo valvular é o tratamento recomendado na RM primária grave. Em pacientes com alto risco cirúrgico, as opções terapêuticas são limitadas. O surgimento do reparo percutâneo com plicatura dos segmentos é uma opção terapêutica alternativa, com bons resultados demonstrados. Apresentamos o caso clínico de um paciente doente por RM primária grave. Devido ao seu alto risco cirúrgico, optou-se pela correção percutânea com técnica "edge-to-edge", com excelentes resultados clínicos e ecocardiográficos. Este é o primeiro caso publicado com a técnica em Uruguai.

Importance of Microbiome of Fecal Samples Obtained from Adolescents with Different Weight Conditions on Resistance Gene Transfer.

Antimicrobial resistance (AMR) is a relevant public health problem worldwide, and microbiome bacteria may contribute to the horizontal gene transfer associated with antimicrobial resistance. The microbiome of fecal samples from Mexican adolescents were analyzed and correlated with eating habits, and the presence of AMR genes on bacteria in the microbiome was evaluated. Fecal samples from adolescents were collected and processed to extract genomic DNA. An Illumina HiSeq 1500 system was used to determine resistance genes and the microbiome of adolescents through the amplification of gene resistance and the V3-V4 regions of RNA, respectively. Analysis of the microbiome from fecal samples taken from 18 obese, overweight, and normal-weight adolescents revealed that the Firmicutes was the most frequent phylum, followed by Bacteroidetes, Actinobacteria, Proteobacteria and Verrucomicrobia. The following species were detected as the most frequent in the samples: F. prausnitzii, P. cori, B. adolescentis, E. coli and A. muciniphila. The presence of Bacteroides, Prevotella and Ruminococcus was used to establish the enterotype; enterotype 1 was more common in women and enterotype 2 was more common in men. Twenty-nine AMR genes were found for ß-lactamases, fluoroquinolones, aminoglycosides, macrolide, lincosamides, streptogramin (MLS), tetracyclines and sulfonamides. The presence of microorganisms in fecal samples that harbor AMR genes that work against antimicrobials frequently used for the treatment of microbial infections such as b-lactams, macrolides, aminoglycosides, MLS, and tetracyclines is of great concern, as these organisms may be an important reservoir for horizontal AMR gene transfer.

Towards an ethical framework about Big Data era: metaethical, normative ethical and hermeneutical approaches.

The main ethical challenges that arise for Information Sciences (with the daily use in different areas of Big Data applications) are not about the reliability of its professionals to carry out tasks in the organization area in an impartial way or about the obligation to train themselves technologically in the area of Data Science. The most important problems are related to the concept of moral responsibility, especially from a metaethical perspective, in line with the reflection of the implementation of technology with respect to human autonomy. In this paper it is stated that the challenges of Big Data go beyond the individual spectrum of responsibility of a professional in Information Sciences (specifically, due to the negative social consequences), so that the changes brought about by massive data sets are essentially problems of a group ethics, so they require approaches from the theoretical postulates of these disciplines. In addition to this, the moral challenges in dealing with Big Data are usually approached from applied ethics (such as information ethics), but in this article it will be approached as a problem of metaethics and normative ethics (as a foundation for its application in professional codes), and also from some ideas of digital hermeneutics and the philosophy of technology.

Smile Arc Esthetics in Middle-Aged Man from the Layperson's Perspective Via Eye-Tracking

Abstract Objective: To evaluate the perceptions of smile esthetics associated with variations in the vertical plane of the maxillary incisors in the smile arc using eye-tracking software. Material and Methods: An image of a 59-year-old Caucasian male model was adapted and edited to make three changes in the vertical plane, simulating a convex, straight, and reverse smile arc. Four areas of interest were inserted at the right and left eyes, nose, and mouth. Forty laypeople raters between 18 and 45 years of age participated of the study. Eye-tribe hardware and Ogama software were used to perform eye-tracking. Attractiveness and age-perception questions were also incorporated into the study. ANOVA test and Pearson's correlation coefficient, at p < 0.05. Results: The most observed AOI in images with convex, straight, and reverse smiles, as assessed using heatmaps and point maps, was the mouth, followed by the right eye. A significant difference for the eye (p=0.02) was found when comparing convex and reverse smiles, whereas a significant difference for the mouth was observed between the straight and reverse smiles (p=0.03). Conclusion: Convex and straight smile arcs were associated with equal levels of attractiveness; the reverse smile was less attractive. No significant difference was noticed regarding age perception and the smile arcs. However, the reverse smile recorded a more complete fixation time.

Zebrafish (Danio rerio) as an animal model for bath infection by Flavobacterium psychrophilum.

Flavobacterium psychrophilum is the causative agent of bacterial cold-water disease and rainbow trout syndrome in freshwater salmonid fish worldwide, generating injuries and high mortality rates. Despite several studies on this bacterium, the infection mechanism remains unknown due to limitations in the employed animal models. In this work, we propose using zebrafish (Danio rerio) as a model for studying bacterial pathogenicity. To substantiate this proposal, zebrafish infection by F. psychrophilum strain JIP 02/86 was characterized. Zebrafish larvae were infected using the bath method, and morphological changes and innate immune system activation were monitored using transgenic fish. Salmonid-like infection phenotypes were observed in 4.74% of treated larvae, as manifested by fin, muscle and caudal peduncle damage. Symptomatic and dead larvae accounted for 1.35% of all challenged larvae. Interestingly, infected larvae with no infection phenotypes showed stronger innate immune system activation than specimens with phenotypes. A failure of function assay for myeloid factor pu.1 resulted in more infected larvae (up to 43.5%), suggesting that low infection rates by F. psychrophilum would be due to the protective actions of the innate immune system against this bacterium in zebrafish larvae. Our results support the use of zebrafish as an infection model for studying F. psychrophilum. Furthermore, the percentage of infected fish can be modulated by disturbing, to varying extents, the differentiation of myeloid cells. Using this evidence as a starting point, different aspects of the infection mechanism of F. psychrophilum could be studied in vivo.

Lesiones oculares y radiación ionizante / Eye injuries and ionising radiation

El número y la complejidad de los procedimientos de diagnóstico e intervencionismo cardiovascular han incrementado de manera significativa, hecho que genera mayor exposición a dosis bajas de radiación ionizante debido a la radiación dispersa por el paciente. El cristalino es una de las estructuras más sensibles a la radiación y las cataratas son la enfermedad ocular más estudiada y frecuente en el personal de la salud ocupacionalmente expuesto a dosis bajas de radiación. La formación de cataratas es un proceso multifactorial y la exposición a la radiación ionizante se ha asociado a opacidades subcapsulares posteriores, que es la forma más común de lesión, seguida por las cataratas corticales. Existen varios estudios que han evaluado los efectos de la exposición ocupacional por radiación ionizante en el cristalino en cardiólogos intervencionistas, comparándolos con controles no expuestos. Concluyen que hay mayor prevalencia de opacidades subcapsulares posteriores en el personal expuesto a radiación ionizante, especialmente en los cardiólogos intervencionistas (por trabajar muy cerca del generador de rayos X), las cuales están relacionadas con la duración de la práctica del intervencionismo cardíaco y disminuyen con el uso regular de los lentes plomados. Lo llamativo de muchos estudios es el bajo uso por parte de los cardiólogos intervencionistas de los elementos de protección radiológica, especialmente gafas y mampara plomada, las cuales han demostrado efectividad en la reducción de la radiación ionizante recibida por el personal de la sala de cateterismo cardiaco.

As the number and complexity of diagnostic and cardiovascular intervention procedures has increased significantly, this has led to a greater exposure to low doses of ionising radiation due to the radiation dispersal by the patient. The crystalline lens is one of the structures most sensitive to radiation, and cataracts are the most studied eye disease, and are common in health staff occupationally exposed to low radiation doses. The formation of cataracts is a process involving many factors, and exposure to ionising radiation has been associated with posterior sub-capsular opacities, the most common form of the injury, followed by cortical cataracts. There are several studies that have evaluated the effects of occupational exposure due to ionising radiation in the crystalline lens in interventionist cardiologists, and comparing them with non-exposed controls. They conclude that there is a higher prevalence of posterior sub-capsular opacities in personnel exposed to ionising radiation, especially in interventionist cardiologists (due to working very near the X-ray generator). These are associated with the duration of the practice of cardiac interventions, and decrease with the regular use of leaded glasses. The low use of radiation protection wear by interventionist cardiologists is highlighted in many studies, especially glasses and a leaded screen, which have shown to be effective in the reduction in the ionising radiation by the staff in the cardiac catheterisation room.

Las tecnologías convergentes (nanotecnología, biotecnología y las ciencias cognitivas) y su relación con la bibliotecología / Converging technologies (nanotechnology, biotechnol- ogy and cognitive sciences) and their relationship with Library and Information Science

RESUMEN La designación tecnologías convergentes hace referencia a la confluencia de la iencia computacional con campos tecnocientíficos como la Nanotecnología, la Biotecnología y las Ciencias Cognitivas. El objetivo de este trabajo es señalar y analizar los vínculos que guardan estas tecnologías convergentes con la Bibliotecología -que también recurre al uso de las tecnologías de la información y la comunicación-, ya sea en términos metodológicos, conceptuales o de aplicación. Como principal conclusión se deduce que la Nanotecnología, la Biotecnología y las Ciencias Cognitivas han reconfigurado, en los últimos años, sus propios conceptos de información. Esto ha hecho que profesionales de otras disciplinas, que tienen por objeto de estudio a la información, se detengan a re-pensar su naturaleza, dinámica y utilización.

ABSTRACT The denomination convergent technologies refers to the confluence of computational science with techno-scientific fields such as nanotechnology, biotechnology and cognitive sciences. The objective of this work is to point out and analyze the links that these convergent technologies keep with Library Science (which also uses the information and communication technologies), either in methodological, conceptual or application terms. The main conclusion is that both nanotechnology, biotechnology and cognitive sciences have reconfigured their own conceptuation of information in recent years. This has caused professionals from other disciplines, who study information, to stop to rethink its nature, dynamics and use.

Wnt/ß-catenin signaling stimulates the expression and synaptic clustering of the autism-associated Neuroligin 3 gene.

Synaptic abnormalities have been described in individuals with autism spectrum disorders (ASD). The cell-adhesion molecule Neuroligin-3 (Nlgn3) has an essential role in the function and maturation of synapses and NLGN3 ASD-associated mutations disrupt hippocampal and cortical function. Here we show that Wnt/ß-catenin signaling increases Nlgn3 mRNA and protein levels in HT22 mouse hippocampal cells and primary cultures of rat hippocampal neurons. We characterized the activity of mouse and rat Nlgn3 promoter constructs containing conserved putative T-cell factor/lymphoid enhancing factor (TCF/LEF)-binding elements (TBE) and found that their activity is significantly augmented in Wnt/ß-catenin cell reporter assays. Chromatin immunoprecipitation (ChIP) assays and site-directed mutagenesis experiments revealed that endogenous ß-catenin binds to novel TBE consensus sequences in the Nlgn3 promoter. Moreover, activation of the signaling cascade increased Nlgn3 clustering and co- localization with the scaffold PSD-95 protein in dendritic processes of primary neurons. Our results directly link Wnt/ß-catenin signaling to the transcription of the Nlgn3 gene and support a functional role for the signaling pathway in the dysregulation of excitatory/inhibitory neuronal activity, as is observed in animal models of ASD.

Cytotoxic activity of Flavobacterium psychrophilum in skeletal muscle cells of rainbow trout (Oncorhynchus mykiss).

Flavobacterium psychrophilum is the etiologic agent of bacterial coldwater disease (BCWD) and rainbow trout fry syndrome (RTFS), which cause significant worldwide losses in aquaculture. Juvenile rainbow trout are particularly susceptible to F. psychrophilum infection, the main external clinical signs of which are extensive necrotic myositis and ulcerative lesions. Despite the economic relevance of this pathogen in aquaculture, little is known about the molecular mechanisms underlying F. psychrophilum infection and pathogenesis. In this study, cultured skeletal muscle cells from rainbow trout (Oncorhynchus mykiss) were co-incubated with the virulent strain of F. psychrophilum JIP02/86 (ATCC 49511). Trypan blue exclusion analysis at 48h post-incubation revealed decreased cellular viability. Direct bacteria-myoblast contact was found a key factor in inducing F. psychrophilum cytotoxicity. Apoptosis was characterized by nuclear DNA fragmentation, decreased plasma membrane integrity, increased caspase activity, and the proteolytic cleavage of poly(ADP-ribose)polymerase-1 (PARP-1). Moreover, bacterial infection induced an early inhibition of NF-κB signaling, as well as a differential expression of the pro- and anti-apoptotic genes, bax and bcl-2. These findings suggest that F. psychrophilum induces rainbow trout muscle apoptosis through the modulation of the NF-κB signaling as a mechanism for nutrient acquisition and survival.

RNA-seq analysis of the head-kidney transcriptome response to handling-stress in the red cusk-eel (Genypterus chilensis).

Stress is a primary contributing factor of fish disease and mortality in aquaculture. We have previously reported that the red cusk-eel (Genypterus chilensis), an important farmed marine fish, demonstrates a handling-stress response that results in increased juvenile mortality, which is mainly associated with skeletal muscle atrophy and liver steatosis. To better understand the systemic effects of stress on red cusk-eel immune-related gene expression, the present study assessed the transcriptomic head-kidney response to handling-stress. The RNA sequencing generated a total of 61,655,525 paired-end reads from control and stressed conditions. De novo assembly using the CLC Genomic Workbench produced 86,840 transcripts and created a reference transcriptome with a N50 of 1426bp. Reads mapped onto the assembled reference transcriptome resulted in the identification of 569 up-regulated and 513 down-regulated transcripts. Gene ontology enrichment analysis revealed a significant up-regulation of the biological processes, like response to stress, response to biotic stimulus, and immune response. Conversely, a significant down-regulation of biological processes is associated with metabolic processes. These results were validated by RT-qPCR analysis for nine candidate genes involved in the immune response. The present data demonstrated that short term stress promotes the immune innate response in the marine teleost G. chilensis. This study is an important step towards understanding the immune adaptive response to stress in non-model teleost species.

Cxcl8b and Cxcr2 Regulate Neutrophil Migration through Bloodstream in Zebrafish.

Neutrophils play an essential role during an inflammatory response, which is dependent on their rapid recruitment from the bone marrow to the vasculature. However, there is no information about the molecular signals that regulate neutrophil entry to circulation during an inflammatory process in humans. This is mainly due to the lack of a suitable model of study that contains similar set of molecules and that allows in vivo analyses. In this study, we used the zebrafish to assess the role of Cxcl8a, Cxcl8b, and Cxcr2 in neutrophil migration to blood circulation after injury. Using Tg(BACmpx:GFP)i114 transgenic embryos and two damage models (severe and mild), we developed in vivo lack of function assays. We found that the transcription levels of cxcl8a, cxcl8b, and cxcr2 were upregulated in the severe damage model. In contrast, only cxcr2 and cxcl8a mRNA levels were increased during mild damage. After knocking down Cxcl8a, neutrophil quantity decreased at the injury site, while Cxcl8b decreased neutrophils in circulation. When inhibiting Cxcr2, we observed a decrease in neutrophil entry to the bloodstream. In conclusion, we identified different functions for both Cxcl8 paralogues, being the Cxcl8b/Cxcr2 axis that regulates neutrophil entry to the bloodstream, while Cxcl8a/Cxcr2 regulates the migration to the affected area.

Neutrophil migration in the activation of the innate immune response to different Flavobacterium psychrophilum vaccines in zebrafish (Danio rerio).

Flavobacterium psychrophilum is a Gram-negative bacterium, responsible for the bacterial cold-water disease and the rainbow trout fry syndrome in freshwater salmonid fish. At present, there is only one commercial vaccine in Chile, made with two Chilean F. psychrophilum isolates and another licensed in Europe. The present study analyzed neutrophil migration, as a marker of innate immune activation, in zebrafish (Danio rerio) in response to different F. psychrophilum bath vaccines, which is the first step in evaluating vaccine effectiveness and efficiency in fish. Results indicated that bacterins of the LM-02-Fp isolate were more immunogenic than those from the LM-13-Fp isolate. However, no differences were observed between the same bacteria inactivated by either formaldehyde or heat. Importantly, the same vaccine formulation without an adjuvant only triggered a mild neutrophil migration compared to the complete vaccine. Observations also found that, after a year of storage at 4°C, the activation of the innate immune system by the different vaccines was considerably decreased. Finally, new vaccine formulations prepared with heat and formaldehyde inactivated LM-02-Fp were significantly more efficient than the available commercial vaccine in regard to stimulating the innate immune system.

Diagnosis and Treatment of Pseudo-Class III Malocclusion.

Pseudo-Class III malocclusion is characterized by the presence of an anterior crossbite due to a forward functional displacement of the mandible; in most cases, the maxillary incisors present some degree of retroclination, and the mandibular incisors are proclined. Various types of appliances have been described in the literature for the early treatment of pseudo-Class III malocclusion. The objectives of this paper are to demonstrate the importance of making the differential diagnosis between a skeletal and a pseudo-Class III malocclusion and to describe the correction of an anterior crossbite. The association of maxillary expansion and a 2 × 4 appliance can successfully be used to correct anterior crossbites.

Overrepresentation of glutamate signaling in Alzheimer's disease: network-based pathway enrichment using meta-analysis of genome-wide association studies.

Genome-wide association studies (GWAS) have successfully identified several risk loci for Alzheimer's disease (AD). Nonetheless, these loci do not explain the entire susceptibility of the disease, suggesting that other genetic contributions remain to be identified. Here, we performed a meta-analysis combining data of 4,569 individuals (2,540 cases and 2,029 healthy controls) derived from three publicly available GWAS in AD and replicated a broad genomic region (>248,000 bp) associated with the disease near the APOE/TOMM40 locus in chromosome 19. To detect minor effect size contributions that could help to explain the remaining genetic risk, we conducted network-based pathway analyses either by extracting gene-wise p-values (GW), defined as the single strongest association signal within a gene, or calculated a more stringent gene-based association p-value using the extended Simes (GATES) procedure. Comparison of these strategies revealed that ontological sub-networks (SNs) involved in glutamate signaling were significantly overrepresented in AD (p<2.7×10(-11), p<1.9×10(-11); GW and GATES, respectively). Notably, glutamate signaling SNs were also found to be significantly overrepresented (p<5.1×10(-8)) in the Alzheimer's disease Neuroimaging Initiative (ADNI) study, which was used as a targeted replication sample. Interestingly, components of the glutamate signaling SNs are coordinately expressed in disease-related tissues, which are tightly related to known pathological hallmarks of AD. Our findings suggest that genetic variation within glutamate signaling contributes to the remaining genetic risk of AD and support the notion that functional biological networks should be targeted in future therapies aimed to prevent or treat this devastating neurological disorder.

Propulsores mandibulares para la corrección de maloclusiones de Clase II-1 subdivisión de Angle / Mandibular protraction appliance for the correction Angle Malocclusions Class II - 1 subdivision A

El tratamiento de maloclusiones de Clase II es un procedimiento de rutina en la práctica ortodóncica, y son de especial interés las que presentan subdivisiones, por su complejidad y factores de asimetrías que presentan. Hoy en día los aparatos de propulsion mandibular (APM) han ganado mayor aceptación por los clínicos debido a sus ventajas de acortar el tiempo de tratamiento general, lo que disminuye la necesidad de cooperación por parte de los pacientes. El aparato de protracción mandibular (APM IV) posee como ventaja que puede ser facilmente elaborado por el ortodoncista en su oficina. Sin embargo se hace importante entender cuáles son los efectos, beneficios y contraindicaciones de los propulsores antes de usarlos. El objetivo del presente artículo es describir cada uno de estos factores mediante un caso clínico.(AU)

The treatment of Class II malocclusions is a routine procedure in orthodontic practice, of special interest are the ones with subdivisions, because of their complexity and asymetric factors that they show. Nowadays the mandibular protraction appliances are gaining the acceptance of the clinicians because of their advantages in reducing the general treatment time and decreasing the need of patients´cooperation. The mandibular protraction appliance (MPA IV) has the advantage that it can be easily constructed by the orthodontist in his office. However it is important to understand which are the effects, benefits and contraindications of these appliances before using them. The aim of this article is to describe each of these factors through a case report(AU)