Environmental sympatry through time: spatio-temporal distribution and conservation status of two sympatric anuran species (Leptodactylidae) in South America / Simpatría ambiental a través del tiempo: distribución espacio-temporal y estado de conservación de dos especies de anuros simpátricos (Leptodactylidae) en América del Sur

Abstract Introduction: Leptodactylus latinasus and Physalaemus cuqui are sympatric anuran species with similar environmental requirements and contrasting reproductive modes. Climatic configuration determines distribution patterns and promotes sympatry of environmental niches, but specificity/selectivity determines the success of reproductive modes. Species distribution models (SDM) are a valuable tool to predict spatio-temporal distributions based on the extrapolation of environmental predictors. Objectives: To determine the spatio-temporal distribution of environmental niches and assess whether the protected areas of the World Database of Protected Areas (WDPA) allow the conservation of these species in the current scenario and future. Methods: We applied different algorithms to predict the distribution and spatio-temporal overlap of environmental niches of L. latinasus and P. cuqui within South America in the last glacial maximum (LGM), middle-Holocene, current and future scenarios. We assess the conservation status of both species with the WDPA conservation units. Results: All applied algorithms showed high performance for both species (TSS = 0.87, AUC = 0.95). The L. latinasus predictions showed wide environmental niches from LGM to the current scenario (49 % stable niches, 37 % gained niches, and 13 % lost niches), suggesting historical fidelity to stable climatic-environmental regions. In the current-future transition, L. latinasus would increase the number of stable (70 %) and lost (20 %) niches, suggesting fidelity to lowland regions and a possible trend toward microendemism. P. cuqui loses environmental niches from the LGM to the current scenario (25 %) and in the current-future transition (63 %), increasing the environmental sympathy between both species; 31 % spatial overlap in the current scenario and 70 % in the future. Conclusion: Extreme drought events and rainfall variations, derived from climate change, suggest the loss of environmental niches for these species that are not currently threatened but are not adequately protected by conservation units. The loss of environmental niches increases spatial sympatry which represents a new challenge for anurans and the conservation of their populations.

Resumen Introducción: Leptodactylus latinasus y Physalaemus cuqui son especies de anuros simpátricos con requerimientos ambientales similares y modos reproductivos contrastantes. La configuración climática determina los patrones de distribución y promueve la simpatría de los nichos ambientales, pero la especificidad/selectividad determina el éxito de los modos reproductivos. Los modelos de distribución de especies (MDE) son una herramienta valiosa para predecir distribuciones espacio-temporales basadas en la extrapolación de predictores ambientales. Objetivos: Determinar la distribución espacio-temporal de los nichos ambientales y evaluar si las áreas protegidas de la base de Datos Mundial de Áreas Protegidas (DMAP) permiten la conservación de estas especies en el escenario actual y futuro. Métodos: Aplicamos diferentes algoritmos para predecir la distribución y superposición espacio-temporal de nichos ambientales de L. latinasus y P. cuqui dentro de América del Sur en el último máximo glacial (UGM), Holoceno medio, actual y futuro. Evaluamos el estado de conservación de ambas especies con las unidades de conservación de la DMAP. Resultados: Todos los algoritmos aplicados mostraron un alto rendimiento para ambas especies (TSS = 0.87, AUC = 0.95). Las predicciones de L. latinasus mostraron amplios nichos ambientales desde LGM hasta el escenario actual (49 % de nichos estables, 37 % de nichos ganados y 13 % de nichos perdidos), sugiriendo fidelidad histórica por regiones climático-ambientales estables. En la transición actual-futura L. latinasus incrementaría la cantidad de nichos estables (70 %) y perdidos (20 %), sugiriendo fidelidad por regiones de tierras bajas y la posible tendencia hacia el microendemismo. P. cuqui pierde nichos ambientales desde el LGM al escenario actual (25 %) y en la transición actual-futura (63 %), incrementando la simpatría ambiental entre ambas especies; 31 % de superposición espacial en el escenario actual y 70 % en el futuro. Conclusión: Los eventos de sequía extrema y las variaciones de precipitaciones, derivados del cambio climático, sugieren la pérdida de nichos ambientales para estas especies, actualmente no se encuentran amenazadas, pero no están adecuadamente protegidas por las unidades de conservación. La pérdida de nichos ambientales aumenta la simpatría espacial que representa un nuevo desafío para estos anuros y la conservación de sus poblaciones.

Culturally adapted mobile application for optimizing metabolic control in type 1 diabetes: a pilot study / Aplicación móvil adaptada desde el punto de vista cultural para optimizar el control metabólico en la diabetes tipo 1: estudio piloto / Aplicativo móvel culturalmente adaptado para otimizar o controle metabólico do diabetes tipo 1: estudo-piloto

[ABSTRACT]. Objective. To evaluate whether use of a culturally adapted mobile application (app) for adolescents with type 1 diabetes is associated with improved metabolic control. Methods. The Dominican Republic’s National Institute of Diabetes, Endocrinology, and Nutrition and the Learning to Live clinic recruited 23 pediatric participants for the study. Blood tests were performed before and after use of the app for a period of 3 months. Based on the user profile, participants were encouraged to use the app’s bolus insulin calculator after each meal. The app included a list of regionally and culturally specific foods, color-coded to indicate a high glycemic index (GI) as red; medium GI as yellow; and low GI as green. The color-coding was designed to assist participants in making healthier eating choices. Results. There were statistically significant improvements in lipid profile. Mean high-density lipoprotein values rose to acceptable levels, while low-density lipoproteins and triglyceride levels fell to the recommended values. The overall quality of life increased, although glycated hemoglobin levels showed no statistically significant changes. Conclusion. The findings of this study suggest that using this culturally tailored app can help young patients with type 1 diabetes to improve metabolic health.

[RESUMEN]. Objetivo. Evaluar si el uso de una aplicación móvil (app) para adolescentes con diabetes tipo 1, adaptada desde el punto de vista cultural, se asocia a una mejora del control metabólico. Métodos. El Instituto Nacional de Diabetes, Endocrinología y Nutrición de República Dominicana y Learning to Live Clinic reclutaron a 23 participantes pediátricos para el estudio. Se realizaron análisis de sangre antes y después de utilizar la aplicación durante un período de 3 meses. En función del perfil de usuario, se alentó a los participantes a utilizar la calculadora del bolo de insulina de la aplicación después de cada comida. La aplicación incluía una lista de alimentos propios de la región y la cultura, codificados por colores para indicar un índice glucémico (IG) alto (rojo), medio (amarillo) o bajo (verde). El código de colores se diseñó para ayudar a los participantes a adoptar opciones de alimentación más saludables. Resultados. Se observaron mejoras estadísticamente significativas en el perfil lipídico. Los valores medios de las lipoproteínas de alta densidad aumentaron hasta niveles aceptables, mientras que los niveles de las lipoproteínas de baja densidad y los triglicéridos descendieron hasta los valores recomendados. Se observó una mejora en la calidad de vida general, si bien no se observaron cambios estadísticamente significativos en los niveles de hemoglobina glucosilada. Conclusiones. Los resultados de este estudio sugieren que el uso de esta aplicación adaptada desde el punto de vista cultural puede ayudar a los pacientes jóvenes con diabetes mellitus tipo 1 a mejorar su salud metabólica.

[RESUMO]. Objetivo. Avaliar se o uso de um aplicativo móvel culturalmente adaptado para adolescentes com diabetes tipo 1 está associado a um melhor controle metabólico. Métodos. O Instituto Nacional de Diabetes, Endocrinologia e Nutrição da República Dominicana e a clínica Learning to Live recrutaram 23 participantes pediátricos para o estudo. Foram realizados exames de sangue antes e depois do uso do aplicativo por um período de 3 meses. Com base no perfil de usuário, os participantes foram incentivados a usar a calculadora de bolus de insulina do aplicativo após cada refeição. O aplicativo incluía uma lista de alimentos específicos da região e da cultura, codificados por cores para indicar índices glicêmicos (IG) altos em vermelho; IG médios em amarelo; e IG baixos em verde. O código de cores foi criado para ajudar os participantes a fazer escolhas alimentares mais saudáveis. Resultados. Houve melhoras estatisticamente significantes no perfil lipídico. Os valores médios de lipoproteínas de alta densidade subiram para níveis aceitáveis, e os níveis de lipoproteínas de baixa densidade e de triglicerídeos caíram para os valores recomendados. A qualidade de vida geral aumentou, embora os níveis de hemoglobina glicada não tenham apresentado alterações estatisticamente significantes. Conclusão. Os resultados deste estudo sugerem que o uso desse aplicativo culturalmente adaptado pode ajudar pacientes jovens com diabetes tipo 1 a melhorar sua saúde metabólica.

The use of steroids associated with PD1/PDL-1 blockage in patients with brain metastasis: a systematic review and meta-analysis

BACKGROUND: Brain metastases (BMs) represent the most common intracranial neoplasms in adults, affecting up to 25% of patients with metastatic cancers. Primary cancers of the lung, melanoma and colorectal are responsible for the majority of diagnosed BMs. Current therapies for BMs include stereotactic radiosurgery, whole-brain radiotherapy, surgical resection, interstitial laser thermal therapy, systemic cytotoxic chemotherapy, targeted agents, and PD1/PDL-1 blockage, which play a crucial role in cancer immunotherapy. METHODS: A systematic search was conducted through PubMed, Embase and Cochrane databases for studies that assess the benefit of neoadjuvant treatment with PD-1/PD-L1 inhibitors plus steroids and the impact of this combination on treatment effectiveness. Hazard ratios (HRs) were computed for binary endpoints, with 95% confidence intervals (CIs). We performed the meta-analysis using RStudio v4.4.2 software. RESULTS: The systematic analysis, including 1,658 patients, assessed the impact of PD-1/PD-L1 inhibitors on overall survival (OS) and progression-free survival (PFS) in treating BMs from non-small cell lung cancer (NSCLC) and melanoma. For OS, eight studies with 848 patients indicated a significant improvement using steroids (HR: 1.978; 95% CI 1.308-2.992; I2 = 62%) compared to non-users. Regarding PFS, data from four studies involving 790 patients did not reach statistical significance (HR: 1.483; 95% CI: 0.843-2.608; I2 = 82%). The addition of steroids did not show a clear beneficial effect on the efficacy of PD-1/PD-L1 inhibitors in extending progression-free survival. CONCLUSIONS: The systematic analysis underscores the effectiveness of PD-1/PD-L1 blockage in improving overall survival in patients with BMs from NSCLC and melanoma, however, their impact on delaying disease progression, especially when combined with steroids, requires further investigation to clarify their role and optimize therapeutic strategies.

Tumores del sistema nervioso central. Clasificación de la Organización Mundial de la Salud 2021. Hacia un cambio de paradigma / Tumors of the central nervous system. Classification of the World Health Organization 2021. Towards a paradigm shift

El estudio de los tumores del sistema nervioso central (SNC) resulta ser un tema de gran consideración y su conocimiento reviste una alta importancia en la práctica médica. Las clasificaciones de las neoplasias del SNC comenzaron a mediados del siglo XIX hasta que en 1979 la Organización Mundial de la Salud (OMS) publicó la primera edición de una sistemática útil con el objetivo de establecer un lenguaje común para todas las especialidades médicas. Al día de hoy, 5 ediciones actualizaron la taxonomía neoplásica. La quinta edición del año 2021 consolida el cambio de paradigma dado por los avances moleculares, si bien todavía la transición se encuentra en proceso entre la caracterización morfológica y la biológica molecular. En este artículo, se analizan las nuevas modificaciones incorporadas en las diferentes familias tumorales más frecuentes en pediatría haciendo hincapié en aquella información de utilidad para el médico pediatra en su práctica diaria y la consulta multidisciplinaria.

The study of central nervous system (CNS) tumors is a subject of great interest and such knowledge is of great importance in medical practice. The classifications of CNS neoplasms began in the mid-19 th century, until the World Health Organization (WHO) published, in 1979, the first edition of a useful systematic review for the purpose of establishing a common language for all medical specialties. To date, 5 updated editions of neoplastic taxonomy have been published.The fifth edition, from 2021, consolidates the paradigm shift brought about by molecular advances, although the transition between morphological and molecular biological characterization is still in progress. In this article, the new modifications introduced in the different most frequent families of tumors in pediatrics are analyzed, emphasizing useful information for pediatricians in their daily practice and multidisciplinary consultations.

Bacteriemia asociada a catéteres venosos centrales no tunelizados en niños en hemodiálisis crónica / Bacteremia associated with non-tunneled central venous catheters in children undergoing chronic hemodialysis

Introducción. La infección asociada a catéter venoso central (CVC) es la principal complicación que presentan los pacientes en hemodiálisis en los que se usa este tipo de acceso. Objetivo. Estimar la incidencia de bacteriemia asociada a CVC no tunelizado, analizar la frecuencia de agentes causales y explorar factores de riesgo asociados en niños en hemodiálisis. Población y métodos. Estudio retrospectivo realizado en niños en hemodiálisis por CVC no tunelizado entre el 1 junio de 2015 y el 30 de junio de 2019. Para evaluar factores de riesgo predictores de bacteriemia asociada a CVC, se realizó regresión logística. Los factores de riesgo independiente se expresaron con odds ratio con sus respectivos intervalos de confianza del 95 %. Se consideró estadísticamente significativo un valor de p <0,05. Resultados. En este estudio se incluyeron 121 CVC no tunelizados. La incidencia de bacteriemia fue de 3,15 por 1000 días de catéter. El microorganismo aislado con mayor frecuencia fue Staphylococcus epidermidis (16 casos, 51,5 %). La infección previa del catéter fue el único factor de riesgo independiente encontrado para el desarrollo de bacteriemia asociada a CVC no tunelizado (OR: 2,84; IC95%: 1,017,96; p = 0,04). Conclusiones. El uso prolongado de los CVC no tunelizados para hemodiálisis crónica se asoció con una incidencia baja de bacteriemia. Los gérmenes grampositivos predominaron como agentes causales. La presencia de infección previa del CVC aumentó en casi 3 veces el riesgo de bacteriemia asociada a CVC en nuestra población pediátrica en hemodiálisis.

Introduction. Central venous catheter (CVC)-related infection is the main complication observed in patients undergoing hemodialysis with this type of venous access. Objective. To estimate the incidence of non-tunneled CVC-related bacteremia, analyze the frequency ofcausative agents, and explore associated risk factors in children undergoing hemodialysis. Population and methods. Retrospective study in children receiving hemodialysis via a non-tunneled CVC between June 1 st, 2015 and June 30 th, 2019. A logistic regression was carried out to assess risk factors that were predictors of CVC-related bacteremia. Independent risk factors were described as odds ratios with their corresponding 95% confidence interval (CI). A value of p < 0.05 was considered statistically significant. Results. A total of 121 non-tunneled CVCs were included in this study. The incidence of bacteremia was 3.15 per 1000 catheter-days. The most commonly isolated microorganism was Staphylococcus epidermidis(16 cases, 51.5%). Prior catheter infection was the only independent risk factor for the development of bacteremia associated with non-tunneled CVC (OR: 2.84, 95% CI: 1.01­7.96, p = 0.04). Conclusions. Prolonged use of non-tunneled CVCs for chronic hemodialysis was associated with a low incidence of bacteremia. Gram-positive microorganisms prevailed among causative agents. A prior CVC infection almost trebled the risk for CVC-related bacteremia in our pediatric population receiving hemodialysis.

Reforzando los lasos para un objetivo académico

En esta edición presentamos dos artículos originales que abordan variantes genéticas de relevancia asociadas a enfermedades del metabolismo de los carbohidratos y trastornos neuromusculares en una región específica de Colombia. Estos hallazgos subrayan la urgente necesidad de capacitar a los profesionales de la salud para el diagnóstico temprano de estas patologías y de involucrar al Estado en la promoción y generación de conocimiento sobre las enfermedades desatendidas. También incluimos un informe sobre un caso hemato-oncológico extraordinariamente raro, que documenta la acumulación masiva de variantes en el número de copias. Este informe ilustra de manera sorprendente la importancia clínica de los estudios de variantes de copia en hemato-oncología, destacando el primer caso registrado de Geroderma osteodisplástica en Panamá. Por último, presentamos una revisión bibliográfica exhaustiva que explora los genes asociados al cáncer de próstata, abarcando las investigaciones publicadas entre 2019 y 2023. Esta revisión destaca la influencia crítica de los genes BRCA1, BRCA2, AR y PTEN en la patogénesis del cáncer de próstata, especialmente en su forma metastásica resistente a la castración (mCRPC). La identificación de BRCA1 y BRCA2 como marcadores de agresividad, junto con la relevancia de PTEN en la progresión de la enfermedad, refuerza la necesidad de desarrollar terapias más específicas y explorar biomarcadores adicionales, dado el complejo panorama que presentan las células cancerosas. Estos artículos reflejan el compromiso inquebrantable de nuestros investigadores por generar conocimiento desde nuestra región latinoamericana, contribuyendo significativamente a la ciencia global. Esperamos que esta edición sea de gran ayuda y estímulo para su labor científica. Queremos aprovechar esta oportunidad para agradecer a los editores, revisores y lectores por sus valiosos aportes para la realización de esta publicación. El papel del editor es esencial en la construcción y mantenimiento de la calidad científica de nuestra revista. Su visión y dedicación garantizan que cada artículo publicado no sólo cumpla con los más altos estándares académicos, sino que también refleje relevancia e impacto en la comunidad científica. Sin su liderazgo y orientación, este riguroso proceso no sería posible. Este tipo de colaboración sólo puede perdurar con una visión clara y honesta del impacto a largo plazo de la educación. Los revisores, con su conocimiento experto y su análisis meticuloso, representan la columna vertebral del proceso de revisión por pares. Su compromiso de examinar minuciosamente cada manuscrito y aportar críticas constructivas es esencial para garantizar la exactitud, fiabilidad y novedad de la investigación que compartimos con nuestro público. A menudo trabajando entre bastidores, los revisores contribuyen significativamente a la ciencia, mejorando la calidad de los trabajos y guiando a los autores hacia la excelencia. Por último, nuestros lectores desempeñan un papel esencial en el ciclo de la comunicación científica. Su interés, curiosidad y aplicación práctica de los conocimientos adquiridos dan vida a la investigación publicada. Cada artículo se convierte en un puente entre la investigación y la práctica cuando es leído, discutido y aplicado por ustedes, nuestros lectores. Sus comentarios y su participación activa nos motivan a seguir mejorando y a seguir siendo una fuente fiable de información científica. Juntos, editores, revisores y lectores, formamos un triángulo esencial que apoya y fortalece la misión de nuestra revista: hacer avanzar el conocimiento científico y contribuir a la mejora de la salud y el bienestar de la sociedad. A todos ustedes, nuestra más profunda gratitud. Atentamente, Jorge D. Méndez-Ríos Editor JefeGenética y Genómica Clínica (provisto por Infomedic International)

In this edition, we present two original articles that address genetic variants of relevance associated with carbohydrate metabolism diseases and neuromuscular disorders in a specific region of Colombia. These findings underline the urgent need to train healthcare professionals for the early diagnosis of these pathologies and to involve the state in promoting and generating knowledge about neglected diseases. We also include a report on an extraordinarily rare hemato-oncological case, documenting the massive accumulation of copy number variants. This report strikingly illustrates the clinical importance of copy variant studies in hemato-oncology, highlighting the first recorded case of Geroderma osteodysplastica in Panama. Finally, we present a comprehensive literature review that explores the genes associated with prostate cancer, covering research published between 2019 and 2023. This review highlights the critical influence of the genes BRCA1, BRCA2, AR, and PTEN in the pathogenesis of prostate cancer, especially in its castration-resistant metastatic form (mCRPC). The identification of BRCA1 and BRCA2 as markers of aggressiveness, along with the relevance of PTEN in disease progression, reinforces the need to develop more specific therapies and explore additional biomarkers, given the complex landscape presented by cancer cells. These articles reflect the unwavering commitment of our researchers to generating knowledge from our Latin American region, significantly contributing to global science. We hope that this edition will be of great help and encouragement to your scientific work. We want to take this opportunity to thank the editors, reviewers, and readers for their valuable contributions to the realization of this publication. The role of the editor is essential in the construction and maintenance of the scientific quality of our journal. Their vision and dedication ensure that each published article not only meets the highest academic standards but also reflects relevance and impact in the scientific community. Without their leadership and guidance, this rigorous process would not be possible. This type of partnership can only endure with a clear and honest vision of the long-term impact of education.Reviewers, with their expert knowledge and meticulous analysis, represent the backbone of the peer review process. Their commitment to thoroughly examining each manuscript and providing constructive criticism is essential to ensuring the accuracy, reliability, and novelty of the research we share with our audience. Often working behind the scenes, reviewers significantly contribute to science, enhancing the quality of works and guiding authors towards excellence. Finally, our readers play an essential role in the cycle of scientific communication. Their interest, curiosity, and practical application of the knowledge acquired bring the published research to life. Each article becomes a bridge between research and practice when it is read, discussed, and applied by you, our readers. Your feedback and active participation motivate us to continue improving and to remain a reliable source of scientific information. Together, editors, reviewers, and readers form an essential triangle that supports and strengthens the mission of our journal: to advance scientific knowledge and contribute to the improvement of health and well-being in society. To all of you, our deepest gratitude. Sincerely, Jorge D. Méndez-Ríos Editor-in-Chief Genetics and Clinical Genomics   (provided by Infomedic International)

Cumplimiento de las recomendaciones de la OMS para la notificación de COVID-19 en Argentina

Introducción : La Organización Mundial de la Salud (OMS) efectuó recomendaciones en relación con la recopilación y notificación de datos agregados semanales de COVID-19. Objetivo : Investigar el grado de cumplimiento de las recomendaciones elaboradas por la OMS para la notificación de casos y muertes de COVID-19 en la Argentina durante el año 2020 a 2022, y comparar la notificación de muertes con el número de defunciones por COVID-19 consolidadas en el registro de estadísticas vitales del país. Materiales y métodos : Estudio cuantitativo descriptivo, basado en revisión documental y en fuentes de datos secundarias. Se utilizó los reportes diarios de información epidemiológica y la base de datos Dataset, COVID-19 casos registrados en la República Argentina. Adicionalmente, para estimar la omisión en los registros epidemiológicos de fallecimientos por COVID-19 en los años 2020 y 2021, se cotejaron los resultados de las bases de datos Dataset COVID-19 con la base de las Estadísticas vitales de mortalidad por causa de defunción, proporcionadas por la Dirección de Estadísticas e Información en Salud (DEIS). Se analizaron las variables recomendadas por la OMS para la notificación de casos y muertes por COVID-19. En cuanto a las consideraciones éticas relacionadas con el uso de la información utilizada en este trabajo, las bases de datos cumplen con lo estipulado por la Ley Nacional N° 17.622 de Resguardo del Secreto Estadístico, garantizando que la información mantiene el carácter confidencial y reservado del informante. Resultados: Del análisis de los reportes diarios, durante 2020 se observó que, de los 13 indicadores recomendados, 9 presentan datos algunos meses y los 4 restantes no se relevaron; en 2021 solo 7 indicadores presentaron datos algunos meses, y en 2022 solo 3 indicadores se continuaron informando. Respecto al análisis de la base de datos Dataset COVID-19, la mayoría fueron captadas. Respecto a la comparación de los valores de las defunciones registradas por el sistema de vigilancia epidemiológica y por la DEIS para los años 2020 y 2021, las muertes registradas fueron superiores en el registro de la DEIS (9,6% y 14,2%). Conclusiones : El Estado argentino cumplió con gran parte de las recomendaciones que establece la OMS para la notificación de los casos de COVID-19. Estudios posteriores deberían analizar otros componentes de la calidad de los datos, así como la oportunidad de los registros de defunciones, característica necesaria para la toma de decisiones en salud pública.

Introduction : The World Health Organization (WHO) establishes recommendations regarding the collection and reporting of weekly aggregated data on COVID-19. Objective : To investigate the degree of compliance with the recommendations made by the WHO for the reporting of COVID-19 cases and deaths in Argentina during the years 2020 to 2022, and to compare death notifications with the number of COVID-19 deaths recorded in the country's vital statistics registry. Materials and methods : Descriptive quantitative study, based on a documentary review and secondary data sources. Daily reports of epidemiological information and the Dataset database containing registered COVID-19 cases in the Argentine Republic were used. Additionally, to estimate the omission in the epidemiological records of COVID-19 deaths in the years 2020 and 2021, the results of the Dataset COVID-19 databases were compared with the vital statistics death registry on cause of death, provided by the Directorate of Statistics and Health Information (DEIS, by its acronym in Spanish). The variables recommended by the WHO for the reporting of COVID-19 cases and deaths were analyzed. As for the ethical considerations related to the use of the information in this study, the databases comply with the provisions of National Law 17,622 on the Protection of Statistical Secrecy, ensuring that the information remains confidential and reserved for the informant. Results : From the analysis of daily reports, it was observed that in 2020, out of the 13 recommended indicators, 9 had data for some months, and the remaining 4 were not reported. In 2021 only 7 indicators had data for some months, and in 2022 only 3 indicators continued to be reported. Regarding the analysis of the Dataset COVID-19 database, most data were captured. In comparing the values of deaths recorded by the epidemiological surveillance system and by the DEIS for the years 2020 and 2021, the deaths recorded were higher in the DEIS registry (9.6% and 14.2%). Conclusions : The Argentine state largely complied with the recommendations established by the WHO for the reporting of COVID-19 cases. Subsequent studies should analyze other components of data quality, as well as the timeliness of death records, a necessary characteristic for public health decision-making.

Tratamento integrado para correção do sorriso gengival: relato de caso / Integrated treatment for correction of gingival smile: case report

O sorriso gengival possui inúmeras causas, podendo acontecer por motivos esqueléticos, musculares ou por alteração no desenvolvimento dos tecidos de suporte. No entanto, na atualidade, a estética vermelha e a branca têm se apresentado completamente passíveis de transformações e com uma gama de procedimentos cirúrgicos ou não cirúrgicos para sanar as queixas dos pacientes. O objetivo geral deste trabalho é mostrar o poder que a odontologia tem frente às questões estéticas, como, por exemplo, a vergonha de sorrir por não se sentir confortável com os dentes curtos e com uma grande faixa de gengiva sendo exposta. O método utilizado foi um relato de caso. Que descreve todos os passos clínicos do tratamento de um paciente de 40 anos, que estava insatisfeita com o seu sorriso por apresentar erupção passiva alterada juntamente com hiperatividade do lábio superior. O plano de tratamento escolhido foi de realizar a cirurgia de aumento de coroa clínica estético, seguido de clareamento dentário e posteriormente um reposicionamento labial, com ajuda da toxina botulínica. Finalizando, para ajudar na cicatrização, o uso de laserterapia. O resultado de todo o processo cirúrgico envolvido neste trabalho, é satisfação do paciente, materializando o sonho deste, devolvendo segurança e espontaneidade ao sorrir. Pôde-se observar que através da combinação de técnicas cirúrgicas periodontais para tratar o sorriso gengival, obtém-se êxito tanto no sentido científico quanto no biológico, alcançando um sorriso esteticamente mais atrativo(AU)

Gummy smile has numerous causes, which can occur for skeletal or muscular reasons or due to changes in the development of supporting tissues. However, nowadays, the red and white aesthetics have been completely capable of transformation and with a range of surgical or non-surgical procedures to resolve patients' complaints. The general objective of this work is to show the power that dentistry has in the face of aesthetic issues, such as, for example, the shame of smiling due to not feeling comfortable with short teeth and a large strip of gum being exposed. The method used was a case report. Which describes all the clinical steps of the treatment of a 40-year-old patient, who was dissatisfied with her smile due to an altered passive eruption together with hyperactivity of the upper lip. The chosen treatment plan was to perform aesthetic clinical crown augmentation surgery, followed by tooth whitening and later lip repositioning, with the help of botulinum toxin. Finally, to help with healing, the use of laser therapy. The result of the entire surgical process involved in this work is patient satisfaction, materializing the patient's dream, restoring security and spontaneity when smiling. It was observed that through the combination of periodontal surgical techniques to treat gummy smile, success is achieved both in the scientific and biological sense, achieving a more aesthetically attractive smile(AU)

Determinación de la microdureza del esmalte en lesiones de manchas blancas tratadas con resinas infiltrantes / Determination of enamel microhardness in white spot lesions treated with infiltrating resins

Objetivo: Determinar in vitro si la microdureza superficial Knoop de las manchas blancas mejora con la infiltración de resinas de baja viscosidad en comparación con la microdureza del esmalte sano. Materiales y métodos: Se desmineralizaron 93 muestras de esmalte bovino simulando lesiones de manchas blancas, para luego ser tratadas mediante la infiltración de resinas. Se midió la microdureza Knoop de las muestras antes de desmineralizarlas, luego de este proceso y a continuación de la infiltración. Resultados: Las muestras desmineralizadas mostraron una disminución del 50% en la microdureza. La infiltración con resinas mejoró esta propiedad, aunque los valores obtenidos se encontraron muy por debajo de la microdureza del esmalte sano. El análisis estadístico, mediante análisis de varianza (ANOVA) y prueba post-hoc de Tukey, mostraron diferencias estadísticamente significativas entre los tres grupos (p<0.001). Conclusiones: El tratamiento de las lesiones de manchas blancas artificiales con resinas infiltrantes aumentó la dureza Knoop, pero sin recuperar totalmente los valores próximos a la dureza del esmalte sano. (AU)

Aim: Determine in vitro if the Knoop surface microhardness of white spots lesions improve with the infiltration of low viscosity resins and compare it with the microhardness of healthy enamel. Materials and methods: 93 samples of bovine enamel were demineralized simulating white spot lesions, and then treated by infiltration of resins. The Knoop microhardness of the samples was measured before demineralization, after this process and after infiltration. Results: Demineralized samples showed a decrease in microhardness of 50%. The infiltration with resins improved this property, although the obtained values were far below the microhardness of healthy enamel. The statistical analysis, through analysis of variance (ANOVA) and Tukey's posthoc test, showed statistically significant differences between groups (p<0.001). Conclusions: Treatment of artificial white spot enamel lesions with infiltrating resins increased Knoop hardness but failed to reach values close to the hardness of healthy enamel. (AU)

Life-course influences of poverty on violence and homicide: 30-year Brazilian birth cohort study.

BACKGROUND: Homicide is the leading cause of death among young people in Latin America, one of the world's most violent regions. Poverty is widely considered a key cause of violence, but theories suggest different effects of poverty, depending on when it is experienced in the life-course. Longitudinal studies of violence are scarce in Latin America, and very few prospective data are available worldwide to test different life-course influences on homicide. METHODS: In a prospective birth cohort study following 5914 children born in southern Brazil, we examined the role of poverty at birth, in early childhood, and in early adulthood on violence and homicide perpetration, in criminal records up to age 30 years. A novel Structured Life Course Modelling Approach was used to test competing life-course hypotheses about 'sensitive periods', 'accumulation of risk', and 'downward mobility' regarding the influence of poverty on violence and homicide. RESULTS: Cumulative poverty and poverty in early adulthood were the most important influences on violence and homicide perpetration. This supports the hypothesis that early adulthood is a sensitive period for the influence of poverty on lethal and non-lethal violence. Results were replicable using different definitions of poverty and an alternative outcome of self-reported fights. CONCLUSION: Cumulative poverty from childhood to adulthood was an important driver of violence and homicide in this population. However, poverty experienced in early adulthood was especially influential, suggesting the importance of proximal mechanisms for violence in this context, such as unemployment, organized crime, drug trafficking, and ineffective policing and justice systems.

Liver response to the consumption of fried sunflower oil.

Sunflower oil is one of the most commonly used fat sources in Argentina, and deep-fat frying is the popular food preparation process. The liver response of feeding a diet containing fried sunflower oil (SFOx) on growing rats was studied. Thirty-nine male weanling Wistar rats were randomly assigned to one of three diets for 8 wks: control (C), sunflower oil (SFO), and a diet containing SFOx, both of the sunflower diets were mixed with a commercial rat chow at weight ratio of 13% (w/w). Body weight and food consumption were recorded weekly. At t=8 wk, lipid profile and glycemia were measured. Visceral adiposity was registered. Liver was weighed and preserved for histological analysis, relative fatty acid profile, fibrosis markers and oxidative status. The three diets did not alter body weights; however, the SFOx fed rats showed increased energy intake and visceral fat; therefore, in liver saturated fat content, trans fatty acids, plus other unidentified minor components, such as hydroperoxides, hydroxides, epidioxides, hydroperoxy epidioxides, hydroxylepidioxides, and epoxides, were detected. The hepatosomatic index of SFOx rats was altered and showed hepatic steatosis. SFOx rats exhibited increased liver dichlorodihydrofluorescein-diacetate and thiobarbituric acid substance levels and oxidized-proteins content. Their livers had lower relative levels of monounsaturated, polyunsaturated fatty acids and catalase activity, but matrix metalloproteinase-9 activity was unchanged. Consumption of a diet rich in fried oil during growth could induce liver damage due to steatosis, excessive lipid toxicity and the accumulation of reactive oxygen species. Further progression could lead to hepatic fibrosis.

Unlocking pilot-scale green diesel production from microalgae.

Microalgae have emerged as a promising source of biomass to produce renewable biofuels due to their ability to synthesize high-energy density compounds of commercial interest. This study proposes an approach for pilot-scale oil extraction, purification by fractional distillation, hydrocarbon characterization by gas chromatography coupled to mass spectrometry (GC-MS), evaluation of physicochemical parameters of the produced hydrocarbons, preliminary cost analysis, and challenges and future opportunities for green diesel on a commercial scale. Here, the microalgae Tetradesmus obliquus was cultivated in 12 m³ photobioreactors using biodigested swine waste as a culture medium. The resulting biomass was subjected to drying and harvesting, followed by oil extraction using a hot solvent extraction method, followed by distillation to purify the compounds. Three different extraction and distillation experiments were conducted, each using different solvent combinations. The results obtained revealed that extraction with a solvent blend, composed of hexane and ethanol, provided more significant yields compared to extraction with pure hexane. GC-MS analysis showed the presence of alkanes and alkenes in the oil samples, and the proportion of solvent used in the extraction directly influenced the production of alkanes. Additionally, specific hydrocarbons such as 4-methyl-1-decene, 8-heptadecene, 1-pentadecene, 9-heneicosene, and 2-dodecene were identified. The evaluation of the physicochemical parameters demonstrated that the calorific value of the distilled oil samples is within the range of typical values for petroleum diesel. However, it was observed that the distilled oil samples had higher sulfur content compared to conventional diesel. Regarding the cost analysis, it was found that it varies depending on the experimental conditions. In particular, the process using a solvent mixture of 70% hexane and 30% ethanol proved to be more economical than the others, since it extracted a greater quantity of oil with a lower initial biomass requirement. In summary, this microalgae-derived hydrocarbon production process is promising and offers insights for compound purification and future biofuel applications.

Isolated bladder training or in combination with other therapies to improve overactive bladder symptoms: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Bladder training (BT), the maintenance of a scheduled voiding regime at gradually adjusted intervals, is a common treatment for overactive bladder (OAB). OBJECTIVES: To assess the effects of isolated BT and/or in combination with other therapies on OAB symptoms. METHODS: A systematic review of eight databases was conducted. After screening titles and abstracts, full texts were retrieved. Cochrane RoB 2 and the GRADE approach were used. RESULTS: Fourteen RCTs were included: they studied isolated BT (n = 11), BT plus drug treatment (DT; n = 5), BT plus intravaginal electrical stimulation (IVES; n = 2), BT plus biofeedback and IVES (n = 1), BT plus pelvic floor muscle training and behavioral therapy (n = 2), BT plus percutaneous tibial nerve stimulation, and BT plus transcutaneous tibial nerve stimulation (n = 1). In a meta-analysis of short-term follow-up data, BT plus IVES resulted in greater improvement in nocturia (mean difference [MD]: 0.89, 95% CI: 0.5, 1.20), urinary incontinence (UI; MD: 1.93, 95% CI: 1.32, 2.55), and quality of life (QoL; MD: 4.87, 95% CI: 2.24, 7.50) than isolated BT, while DT and BT improved UI (MD: 0.58, 95% CI: 0.23, 0.92) more than isolated BT. CONCLUSION: In the short term, BT plus IVES improves the OAB symptoms of nocturia and UI while improving QoL. The limited number of RCTs and heterogeneity among them provide a low level of evidence, making the effect of BT on OAB inconclusive, which suggests that new RCTs should be performed.

Microfluid biosensor for detection of hpv in patient scraping samples: Determining E6 and E7 oncogenes.

E6 and E7 oncogenes are pivotal in the carcinogenic transformation in HPV infections and efficient diagnostic methods can ensure the detection and differentiation of HPV genotype. This study describes the development and validation of an electrochemical, label-free genosensor coupled with a microfluidic system for detecting the E6 and E7 oncogenes in cervical scraping samples. The nanostructuring employed was based on a cysteine and graphene quantum dots layer that provides functional groups, surface area, and interesting electrochemical properties. Biorecognition tests with cervical scraping samples showed differentiation in the voltammetric response. Low-risk HPV exhibited a lower biorecognition response, reflected in ΔI% values of 82.33 % ± 0.29 for HPV06 and 80.65 % ± 0.68 for HPV11 at a dilution of 1:100. Meanwhile, high-risk, HPV16 and HPV18, demonstrated ΔI% values of 96.65 % ± 1.27 and 93 % ± 0.026, respectively, at the same dilution. Therefore, the biorecognition intensity followed the order: HPV16 >HPV18 >HPV06 >HPV11. The limit of detection and the limit of quantification of E6E7 microfluidic LOC-Genosensor was 26 fM, and 79.6 fM. Consequently, the E6E7 biosensor is a valuable alternative for clinical HPV diagnosis, capable of detecting the potential for oncogenic progression even in the early stages of infection.

Tributyltin-induced visceral adiposity is associated with impaired redox balance in white adipose tissue of male rats.

Tributyltin (TBT) is an organotin compound that has several adverse health effects, including the development of obesity. Although obesity is strongly associated with adipose redox imbalance, there is a lack of information on whether TBT promotes a pro-oxidative environment in WAT. Thus, adult male Wistar rats were randomly exposed to either vehicle (ethanol 0.4%) or TBT (1000 ng/kg) for 30 days. Body and fat pad masses, visceral fat morphology, lipid peroxidation, protein carbonylation, redox status markers, and catalase activity were evaluated. TBT promoted increased adiposity and visceral fat, with hypertrophic adipocytes, but did not alter body mass and subcutaneous fat. ROS production and lipid peroxidation were elevated in TBT group, as well as catalase protein expression and activity, although protein oxidation and glutathione peroxidase protein expression remained unchanged. In conclusion, this is the first study to demonstrate that subacute TBT administration leads to visceral adipose redox imbalance, with increased oxidative stress. This enlights the understanding of the metabolic toxic outcomes of continuous exposure to TBT in mammals.

The activation of D2-like dopamine receptors increases NMDA currents in the dorsal raphe serotonergic neurons.

The dorsal raphe nucleus (DRN) receives dopaminergic inputs from the ventral tegmental area (VTA). Also, the DRN contains a small population of cells that express dopamine (DRNDA neurons). However, the physiological role of dopamine (DA) in the DRN and its interaction with serotonergic (5-HT) neurons is poorly understood. Several works have reported moderate levels of D1, D2, and D3 DA receptors in the DRN. Furthermore, it was found that the activation of D2 receptors increased the firing of putative 5-HT neurons. Other studies have reported that D1 and D2 dopamine receptors can interact with glutamate NMDA receptors, modulating the excitability of different cell types. In the present work, we used immunocytochemical techniques to determine the kind of DA receptors in the DRN. Additionally, we performed electrophysiological experiments in brainstem slices to study the effect of DA agonists on NMDA-elicited currents recorded from identified 5-HT DRN neurons. We found that D2 and D3 but not D1 receptors are present in this nucleus. Also, we demonstrated that the activation of D2-like receptors increases NMDA-elicited currents in 5-HT neurons through a mechanism involving phospholipase C (PLC) and protein kinase C (PKC) enzymes. Possible physiological implications related to the sleep-wake cycle are discussed.

Evaluation of adhesive properties and enzymatic activity at the hybrid layer of a simplified adhesive loaded with 0.2 % Cu and 5 % ZnO nanoparticles: A Randomized Clinical Trial and ex vivo analysis.

OBJECTIVE: The aim of this study was to evaluate the effect of an adhesive loaded with 0.2 % copper (Cu) and 5 % zinc oxide (ZnO) nanoparticles (Nps) on its adhesive properties and enzymatic activity at the hybrid layer ex vivo in a randomized clinical model. METHODS: Fifteen patients participated in this study, and a total of 30 third molars were used. Occlusal cavities (4 × 4 × 2 mm) were made in each tooth, and randomly divided into 2 groups: (i) Experimental group: commercial adhesive loaded with 0.2wt % CuNps and 5wt % ZnONps; and (ii) Control Group: non-loaded commercial adhesive. Teeth were restored with resin composite. Thirty days later, extractions were performed. Extracted teeth were longitudinally sectioned. Nps in powder were characterized by field emission scanning electron microscope (FE-SEM) and energy dispersive X-ray (EDX) analysis. Microtensile bond strength (µTBS), degree of conversion (DC), and nanoleakeage (NL) tests were executed. In situ zymography (Zym) was performed to evaluate the gelatinolytic activity at the hybrid layer. Student's t-test (α = 0.05) was applied for all tests. RESULTS: µTBS and DC did not show significant differences (p > 0.05) between both groups. However, NL and gelatinolytic activity at the hybrid layer showed significant values (p < 0.05) for experimental group in comparison with control group. CONCLUSION: The addition of 0.2 % CuNps and 5 % ZnONps to a universal adhesive decreases NL and gelatinolytic activity at the hybrid layer, without jeopardizing its adhesive properties. SIGNIFICANCE: This randomized clinical trial with ex vivo analysis demonstrate that a commercial adhesive modified with 0.2wt % Cu and 5wt % ZnO Nps that does not affect its adhesive properties, reducing gelatinolytic activity and nanoleakage at the hybrid layer, which should contribute to an improvement of long term bonding-dentine clinical performance.

Synthesis and characterization of different nano-hydroxyapatites and their impact on dental enamel following topical application for dental bleaching.

OBJECTIVE: This study aims to synthesize, characterize, and assess the penetration of hydrogen peroxide (HP), color change (CC), and surface morphology changes after the application of two distinct nano-hydroxyapatite (nano-HAp). METHODS: Two nano-HAp were previously synthesized by co-precipitation: one with rod-shaped particles (RS) and the other with spherical-shaped particles (SS). The surface charge of the nano-HAp particles was determined at varying pH levels and characterized by X-ray diffraction patterns and Fourier transform infrared spectroscopy. The morphology of the samples was assessed using scanning electron microscopy (SEM). The nano-HAp particles were applied before the dental bleaching procedure. Forty teeth were divided into four groups (n = 10) according to the bleaching treatment: no treatment, bleaching with 35 % HP only, RS application and bleaching with 35 % HP, and SS application and bleaching with 35 % HP. HP concentration (µg mL-1) was measured using UV-Vis, while CC was evaluated with a digital spectrophotometer (ΔEab, ΔE00 and WID). Additionally, four teeth from each group were selected for SEM analysis. Statistical analysis encompassed one-way ANOVA, Tukey's, and Dunnet's tests. RESULTS: RS and SS were successfully synthesized by coprecipitation, primarily differing in pH during synthesis. Both variations of nano-HAp morphology significantly reduced HP diffusion into the pulp chamber (p < 0.001). Regarding enamel morphology, groups analyzed post dental bleaching exhibited greater HAp deposition on the enamel surface. Notably, this deposition did not impede CC. SIGNIFICANCE: The utilization of different nano-HAp morphologies prior to dental bleaching appears to be a promising strategy for mitigating adverse effects associated with dental bleaching procedures.

Effect of NiAl alloy microparticles deposited in flexible SERS substrates on the limit of detection of rhodamine B molecules.

Flexible-SERS (FSERS) substrates were fabricated by depositing Ni64Al36(NiAl)-alloy-microparticles and/or spherical Ag-NPs (sizes of 10-40 nm) on recycled plastics, which had an aluminum layer on their surface. First, FSERS substrates made of Al + Ag-NPs and an area of 1 cm2 were used to detect rhodamine B (RhB) molecules. The limit-of-detection (LOD) for RhB was 8.35 × 10-22 moles (∼503 molecules), and the enhancement factor (EF) was 3.11 × 1015. After adding NiAl-microparticles to the substrate, the LOD decreased to 8.35 × 10-24 moles (∼5 molecules) and the EF was increased to 2.05 × 1017. Such EF values were calculated with respect to substrates made only with Al + NiAl-alloy (without Ag-NPs), which did not show any Raman signal. Other FSERS substrates were made with graphene-layer + Ag-NPs or graphene-layer + NiAl-alloy + Ag-Nps, and the best LOD and EF values were 8.35 × 10-22 moles and 6.89 × 1015, respectively. Overall, combining the Ag-NPs and NiAl-alloy microparticles allowed for the zeptomole detection of RhB. This was possible due to the formation of Ag aggregates around the alloy microparticles, which enhanced the number of hotspots. If no alloy is present in the FSERS substrates, the detection of RhB is lowered. Overall, we presented a low-cost FSERS substrate that does not require expensive Au films or Au-NPs (as previously reported) to detect RhB at the zeptomole level.