External urology consultation quality at a third-level public hospital in Mexico.

INTRODUCTION: Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. OBJECTIVE: To identify the quality of care in the Urology outpatient department of a third-level hospital. MATERIALS AND METHODS: The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. RESULTS: According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11-20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. CONCLUSIONS: The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.

Formant-Based Recognition of Words and Other Naturalistic Sounds in Rhesus Monkeys.

In social animals, identifying sounds is critical for communication. In humans, the acoustic parameters involved in speech recognition, such as the formant frequencies derived from the resonance of the supralaryngeal vocal tract, have been well documented. However, how formants contribute to recognizing learned sounds in non-human primates remains unclear. To determine this, we trained two rhesus monkeys to discriminate target and non-target sounds presented in sequences of 1-3 sounds. After training, we performed three experiments: (1) We tested the monkeys' accuracy and reaction times during the discrimination of various acoustic categories; (2) their ability to discriminate morphing sounds; and (3) their ability to identify sounds consisting of formant 1 (F1), formant 2 (F2), or F1 and F2 (F1F2) pass filters. Our results indicate that macaques can learn diverse sounds and discriminate from morphs and formants F1 and F2, suggesting that information from few acoustic parameters suffice for recognizing complex sounds. We anticipate that future neurophysiological experiments in this paradigm may help elucidate how formants contribute to the recognition of sounds.

Systemic inflammation, innate immunity and pathogenesis after Zika virus infection in cynomolgus macaques are modulated by strain-specificity within the Asian lineage.

Zika virus (ZIKV) is an emerging arbovirus with recent global expansion. Historically, ZIKV infections with Asian lineages have been associated with mild disease such as rash and fever. However, recent Asian sub-lineages have caused outbreaks in the South Pacific and Latin America with increased prevalence of neurological disorders in infants and adults. Asian sub-lineage differences may partially explain the range of disease severity observed. However, the effect of Asian sub-lineage differences on pathogenesis remains poorly characterized. Current study conducts a head-to-head comparison of three Asian sub-lineages that are representative of the circulating ancestral mild Asian strain (ZIKV-SG), the 2007 epidemic French Polynesian strain (ZIKV-FP), and the 2013 epidemic Brazil strain (ZIKV-Brazil) in adult Cynomolgus macaques. Animals infected intervenously or subcutaneously with either of the three clinical isolates showed sub-lineage-specific differences in viral pathogenesis, early innate immune responses and systemic inflammation. Despite the lack of neurological symptoms in infected animals, the epidemiologically neurotropic ZIKV sub-lineages (ZIKV-Brazil and/or ZIKV-FP) were associated with more sustained viral replication, higher systemic inflammation (i.e. higher levels of TNFα, MCP-1, IL15 and G-CSF) and greater percentage of CD14+ monocytes and dendritic cells in blood. Multidimensional analysis showed clustering of ZIKV-SG away from ZIKV-Brazil and ZIKV-FP, further confirming sub-lineage differences in the measured parameters. These findings highlight greater systemic inflammation and monocyte recruitment as possible risk factors of adult ZIKV disease observed during the 2007 FP and 2013 Brazil epidemics. Future studies should explore the use of anti-inflammatory therapeutics as early treatment to prevent ZIKV-associated disease in adults.

Obtention and characterization of the recombinant simian Interleukin-15 in Escherichia coli for the preclinical assessment of an IL-15-based therapeutic vaccine.

Recombinant simian IL-15 (siIL-15) was obtained for the preclinical assessment of an anti-human IL-15 vaccine. For this purpose, the cDNA from peripheral blood mononuclear cells of a Macaca fascicularis monkey was cloned into a pIL-2 vector. The siIL-15 was expressed in Escherichia coli strain W3110 as an insoluble protein which accounted for 13% of the total cellular proteins. Inclusion bodies were solubilized in an 8 M urea solution, which was purified by ion exchange and reverse phase chromatography up to 92% purity. The protein identity was validated by electrospray ionization-mass spectrometry, confirming the presence of the amino acids which distinguish the siIL-15 from human IL-15. The purified siIL-15 stimulates the proliferation of cytotoxic T-lymphocytes line (CTLL)-2 and Kit 225 cells with EC50 values of 3.1 and 32.5 ng/mL, respectively. Antisera from modified human IL-15-immunized macaques were reactive to human and simian IL-15 in enzyme-linked immunosorbent assays. Moreover, the anti-human IL-15 antibodies from immune sera inhibited siIL-15 activity in CTLL-2 and Kit 225 cells, supporting the activity and purity of recombinant siIL-15. These results indicate that the recombinant siIL-15 is biologically active in two IL-15-dependent cell lines, and it is also suitable for the preclinical evaluation of an IL-15-based therapeutic vaccine.

Role of Nhp6 and Hmo1 in SWI/SNF occupancy and nucleosome landscape at gene regulatory regions.

Diverse chromatin modifiers are involved in regulation of gene expression at the level of transcriptional regulation. Among these modifiers are ATP-dependent chromatin remodelers, where the SWI/SNF complex is the founding member. It has been observed that High Mobility Group (HMG) proteins can influence the activity of a number of these chromatin remodelers. In this context, we have previously demonstrated that the yeast HMG proteins Nhp6 and Hmo1 can stimulate SWI/SNF activity. Here, we studied the genome-wide binding patterns of Nhp6, Hmo1 and the SWI/SNF complex, finding that most of gene promoters presenting high occupancy of this complex also display high enrichment of these HMG proteins. Using deletion mutant strains we demonstrate that binding of SWI/SNF is significantly reduced at numerous genomic locations by deletion of NHP6 and/or deletion of HMO1. Moreover, alterations in the nucleosome landscape take place at gene promoters undergoing reduced SWI/SNF binding. Additional analyses show that these effects also correlate with alterations in transcriptional activity. Our results suggest that, besides the ability to stimulate SWI/SNF activity, these HMG proteins are able to assist the loading of this complex onto gene regulatory regions.

Nucleosome remodeling by the SWI/SNF complex is enhanced by yeast high mobility group box (HMGB) proteins.

The regulation of gene expression at the level of transcription involves the concerted action of several proteins and protein complexes committed to dynamically alter the surrounding chromatin environment of a gene being activated or repressed. ATP-dependent chromatin remodeling complexes are key factors in chromatin remodeling, and the SWI/SNF complex is the founding member. While many studies have linked the action of these complexes to specific transcriptional regulation of a large number of genes and much is known about their catalytic activity, less is known about the nuclear elements that can enhance or modulate their activity. A number of studies have found that certain High Mobility Group (HMG) proteins are able to stimulate ATP-dependent chromatin remodeling activity, but their influence on the different biochemical outcomes of this activity is still unknown. In this work we studied the influence of the yeast Nhp6A, Nhp6B and Hmo1 proteins (HMGB family members) on different biochemical outcomes of yeast SWI/SNF remodeling activity. We found that all these HMG proteins stimulate the sliding activity of ySWI/SNF, while transient exposure of nucleosomal DNA and octamer transfer catalyzed by this complex are only stimulated by Hmo1. Consistently, only Hmo1 stimulates SWI/SNF binding to the nucleosome. Additionally, the sliding activity of another chromatin remodeling complex, ISW1a, is only stimulated by Hmo1. Further analyses show that these differential stimulatory effects of Hmo1 are dependent on the presence of its C-terminal tail, which contains a stretch of acidic and basic residues.

Introducing of the Novel Midsagittal Line for Diagnosis of Craniofacial Asymmetry With P. A Cephalometry Radiography / Introdução de uma Nova Linha Média Sagital para Diagnóstico de AssimetriaCraniofacial com Radiografia Cefalométrica P.A.

Objetivo: Determinação da linha de referência sagital mediana (LRSM), para avaliação de assimetrias craniofaciais, traçando uma linha paralela da crista galli à linha vertical verdadeira, em cefalometria PA, utilizando a técnica da posição natural da cabeça (PNC).Metodologia: 60 indivíduos (30 homens e 30 mulheres, com idade variando de 9 a 13 anos, de uma população iraniana), com oclusão normal Classe I sem história de tratamento ortodôntico ou cirurgia mandibular, foram selecionados no Departamento de Ortodontia, Universidade de Shahid Beheshti, MC Faculdade de Odontologia, Teerã, Irã, 2009-2010. Os pacientes não portavam supranumerários ou ausência dentária, nem anormalidade esquelética. Radiografias cefelométricas PA foram obtidas para todas as amostras pela técnica da posição natural da cabeça (PNC). A linha sagital mediana também foitraçada paralelamente da corrente pendurada à referência intracraniana selecionada (crista galli). Esta linha é a linha vertical verdadeira. A linha horizontal verdadeira foi traçada perpendicularmente à corrente pendurada da crista galli (Cg). Mensurou-se a assimetria craniofacial com medições linear, angular e trigonométrica por meio de radiografias cefalométricas PA pela técnica da posição natural da cabeça (PNC), usando as verdadeiras linhas vertical e horizontal. As diferenças médias entre as medidas acima nos lados direito e esquerdo foram analisadas pelo teste t.Resultados: Cada variável foi avaliada independentemente; os valores da média e desvio padrão foram calculados separadamente. Ademais, relações transversais foram preparadas na nossa amostra (faixa etária de 9 a 13 anos). Todos os pacientes eram descendentes iranianos.

Para a validação da linha media sagital (LMS), foi medida a distância entre a espinha nasal anterior (ENA) e o Mento (Me).Conclusão: Os achados deste estudo evidenciam que a cefalometria PA com a técnica da posição natural da cabeça (PNC) pode medir a assimetria facial com o nível de 96% de intervalo de confiança. Contudo, a introdução da linha média sagital pelo uso da técnica da posição natural da cabeça (PNC) poderia fornecer a capacidade de diagnosticar assimetrias faciais

Objective: Determination of midsagittal reference line (MSL) for craniofacial asymmetries assessment by drawing a line from crista gali parallel to true vertical line in PA cephalometry , using NHP technique. Method: 60 samples (30 males and 30 females, within the age range of 9-13 years old Iranian population) were selected with normal Class I occlusion without any history of orthodontic or jaw surgery treatments in Department of Orthodontics, Shahid Beheshti University, Tehran. Iran, 2009-2010. Patients had no supernumerary or missing teeth and any skeletal anomaly. PA cephalometry radiographs were taken from all samples with NHP technique. The midsagittal line was also traced parallel to the hanging chain from our selected intracranial reference point (Crista gali). This line is a true vertical line. True horizontal line traced perpendicular to the hanging chain from Crista gali (Cg). We assessed craniofacial symmetry with linear, angular and trigonometrical measurements in PA cephalometric radiographs by NHP technique, using true vertical and horizontal lines. The mean differences of above measurements in left and right sides were analyzed by T- test.Results: Each variable was measured independently; then the mean values and S.D was calculated separately. Also, transverse ratios were prepared in our samples (age range of 9-13 years). All patients were from Iranian decent. For midsagittal line (MSL) validity, the ANS (Anterior Nasal Spine) distance in the middle third and Me (Menton) distance in lower third from MSL was measured.Conclusion: Findings of this study showed that P.A.cephalometry with NHP technique could assess the facial symmetry with the rate 96% confidence interval. Therefore, the introduced midsagittal line by using NHP Technique, could prove the ability for diagnosis of facial asymmetries