"How Fluent Do I Need to Be to Say I'm Fluent?" Research Experiences of Communities that Speak Languages Other than English.

OBJECTIVE: The goal of this study was to partner with community organizations to understand the research experiences of communities who speak languages other than English (LOE). METHODS: We conducted semi-structured qualitative interviews in Spanish, Nepali, Mandarin, French, or Kizigua with LOE community members and community leaders who completed recruitment and data collection. Audio-recordings of the interviews were transcribed and translated. We conducted qualitative coding using a mixed deductive-inductive analysis approach and thematic analyses using three rounds of affinity clustering. This study occurred in partnership with an established community-academic collaboration. RESULTS: Thirty community members and six community leaders were interviewed. 83% of LOE participants were born outside of the US and most participants (63%) had never participated in a prior research study. Six themes emerged from this work. Many participants did not understand the concept of research, but those that did thought that inclusion of LOE communities is critical for equity. Even when research was understood as a concept, it was often inaccessible to LOE individuals, particularly because of the lack of language services. When LOE participants engaged in research, they did not always understand their participation. Participants thought that improving research trust was essential and recommended partnering with community organizations and disseminating research results to the community. CONCLUSION: This study's results can serve as an important foundation for researchers seeking to include LOE communities in future research to be more inclusive and scientifically rigorous.

ANKS1B encoded AIDA-1 regulates social behaviors by controlling oligodendrocyte function.

Heterozygous deletions in the ANKS1B gene cause ANKS1B neurodevelopmental syndrome (ANDS), a rare genetic disease characterized by autism spectrum disorder (ASD), attention deficit/hyperactivity disorder, and speech and motor deficits. The ANKS1B gene encodes for AIDA-1, a protein that is enriched at neuronal synapses and regulates synaptic plasticity. Here we report an unexpected role for oligodendroglial deficits in ANDS pathophysiology. We show that Anks1b-deficient mouse models display deficits in oligodendrocyte maturation, myelination, and Rac1 function, and recapitulate white matter abnormalities observed in ANDS patients. Selective loss of Anks1b from the oligodendrocyte lineage, but not from neuronal populations, leads to deficits in social preference and sensory reactivity previously observed in a brain-wide Anks1b haploinsufficiency model. Furthermore, we find that clemastine, an antihistamine shown to increase oligodendrocyte precursor cell maturation and central nervous system myelination, rescues deficits in social preference in 7-month-old Anks1b-deficient mice. Our work shows that deficits in social behaviors present in ANDS may originate from abnormal Rac1 activity within oligodendrocytes.

Assessment of Meal Anticipation for Improving Fully Automated Insulin Delivery in Adults With Type 1 Diabetes.

OBJECTIVE: Meals are a consistent challenge to glycemic control in type 1 diabetes (T1D). Our objective was to assess the glycemic impact of meal anticipation within a fully automated insulin delivery (AID) system among adults with T1D. RESEARCH DESIGN AND METHODS: We report the results of a randomized crossover clinical trial comparing three modalities of AID systems: hybrid closed loop (HCL), full closed loop (FCL), and full closed loop with meal anticipation (FCL+). Modalities were tested during three supervised 24-h admissions, where breakfast, lunch, and dinner were consumed per participant's home schedule, at a fixed time, and with a 1.5-h delay, respectively. Primary outcome was the percent time in range 70-180 mg/dL (TIR) during the breakfast postprandial period for FCL+ versus FCL. RESULTS: Thirty-five adults with T1D (age 44.5 ± 15.4 years; HbA1c 6.7 ± 0.9%; n = 23 women and n = 12 men) were randomly assigned. TIR for the 5-h period after breakfast was 75 ± 23%, 58 ± 21%, and 63 ± 19% for HCL, FCL, and FCL+, respectively, with no significant difference between FCL+ and FCL. For the 2 h before dinner, time below range (TBR) was similar for FCL and FCL+. For the 5-h period after dinner, TIR was similar for FCL+ and FCL (71 ± 34% vs. 72 ± 29%; P = 1.0), whereas TBR was reduced in FCL+ (median 0% [0-0%] vs. 0% [0-0.8%]; P = 0.03). Overall, 24-h control for HCL, FCL, and FCL+ was 86 ± 10%, 77 ± 11%, and 77 ± 12%, respectively. CONCLUSIONS: Although postprandial control remained optimal with hybrid AID, both fully AID solutions offered overall TIR >70% with similar or lower exposure to hypoglycemia. Anticipation did not significantly improve postprandial control in AID systems but also did not increase hypoglycemic risk when meals were delayed.

Business analytics approach to artificial intelligence.

Artificial Intelligence has become an essential element for strengthening the business fabric. The advances obtained in recent years as a result of the incorporation of technology for the improvement of productive activities and the positioning of companies in the markets are remarkable. Hence, the purpose of this paper is to analyze the origin, evolution and development of business analytics (BA) and its relationship with Artificial Intelligence (AI); from the conceptualization, evolution and identification of the main characteristics and research areas of AI and BA, as well as research conducted and published in journals indexed in Scopus between 2002 and 2022. The aim is to define the incidence of BA in business activities and analyze scientific activity and advances of BA to define new research horizons in this field. For this purpose, a bibliometric and documentary analysis is applied, allowing to highlight the findings that provide recognition and comparison of the results. This will facilitate the understanding of the current dynamics, its importance for organizations, and its impact in the face of the new challenges generated by the requirements of world trade.

Apolipoprotein E4 Effects a Distinct Transcriptomic Profile and Dendritic Arbor Characteristics in Hippocampal Neurons Cultured in vitro.

The APOE gene is diversified by three alleles ε2, ε3, and ε4 encoding corresponding apolipoprotein (apo) E isoforms. Possession of the ε4 allele is signified by increased risks of age-related cognitive decline, Alzheimer's disease (AD), and the rate of AD dementia progression. ApoE is secreted by astrocytes as high-density lipoprotein-like particles and these are internalized by neurons upon binding to neuron-expressed apoE receptors. ApoE isoforms differentially engage neuronal plasticity through poorly understood mechanisms. We examined here the effects of native apoE lipoproteins produced by immortalized astrocytes homozygous for ε2, ε3, and ε4 alleles on the maturation and the transcriptomic profile of primary hippocampal neurons. Control neurons were grown in the presence of conditioned media from Apoe -/- astrocytes. ApoE2 and apoE3 significantly increase the dendritic arbor branching, the combined neurite length, and the total arbor surface of the hippocampal neurons, while apoE4 fails to produce similar effects and even significantly reduces the combined neurite length compared to the control. ApoE lipoproteins show no systemic effect on dendritic spine density, yet apoE2 and apoE3 increase the mature spines fraction, while apoE4 increases the immature spine fraction. This is associated with opposing effects of apoE2 or apoE3 and apoE4 on the expression of NR1 NMDA receptor subunit and PSD95. There are 1,062 genes differentially expressed across neurons cultured in the presence of apoE lipoproteins compared to the control. KEGG enrichment and gene ontology analyses show apoE2 and apoE3 commonly activate expression of genes involved in neurite branching, and synaptic signaling. In contrast, apoE4 cultured neurons show upregulation of genes related to the glycolipid metabolism, which are involved in dendritic spine turnover, and those which are usually silent in neurons and are related to cell cycle and DNA repair. In conclusion, our work reveals that lipoprotein particles comprised of various apoE isoforms differentially regulate various neuronal arbor characteristics through interaction with neuronal transcriptome. ApoE4 produces a functionally distinct transcriptomic profile, which is associated with attenuated neuronal development. Differential regulation of neuronal transcriptome by apoE isoforms is a newly identified biological mechanism, which has both implication in the development and aging of the CNS.

Absence of Apolipoprotein E is associated with exacerbation of prion pathology and promotes microglial neurodegenerative phenotype.

Prion diseases or prionoses are a group of rapidly progressing and invariably fatal neurodegenerative diseases. The pathogenesis of prionoses is associated with self-replication and connectomal spread of PrPSc, a disease specific conformer of the prion protein. Microglia undergo activation early in the course of prion pathogenesis and exert opposing roles in PrPSc mediated neurodegeneration. While clearance of PrPSc and apoptotic neurons have disease-limiting effect, microglia-driven neuroinflammation bears deleterious consequences to neuronal networks. Apolipoprotein (apo) E is a lipid transporting protein with pleiotropic functions, which include controlling of the phagocytic and inflammatory characteristics of activated microglia in neurodegenerative diseases. Despite the significance of microglia in prion pathogenesis, the role of apoE in prionoses has not been established. We showed here that infection of wild type mice with 22L mouse adapted scrapie strain is associated with significant increase in the total brain apoE protein and mRNA levels and also with a conspicuous cell-type shift in the apoE expression. There is reduced expression of apoE in activated astrocytes and marked upregulation of apoE expression by activated microglia. We also showed apoE ablation exaggerates PrPSc mediated neurodegeneration. Apoe-/- mice have shorter disease incubation period, increased load of spongiform lesion, pronounced neuronal loss, and exaggerated astro and microgliosis. Astrocytes of Apoe-/- mice display salient upregulation of transcriptomic markers defining A1 neurotoxic astrocytes while microglia show upregulation of transcriptomic markers characteristic for microglial neurodegenerative phenotype. There is impaired clearance of PrPSc and dying neurons by microglia in Apoe-/- mice along with increased level of proinflammatory cytokines. Our work indicates that apoE absence renders clearance of PrPSc and dying neurons by microglia inefficient, while the excess of neuronal debris promotes microglial neurodegenerative phenotype aggravating the vicious cycle of neuronal death and neuroinflammation.

Advanced Closed-Loop Control System Improves Postprandial Glycemic Control Compared With a Hybrid Closed-Loop System Following Unannounced Meal.

OBJECTIVE: Meals are a major hurdle to glycemic control in type 1 diabetes (T1D). Our objective was to test a fully automated closed-loop control (CLC) system in the absence of announcement of carbohydrate ingestion among adolescents with T1D, who are known to commonly omit meal announcement. RESEARCH DESIGN AND METHODS: Eighteen adolescents with T1D (age 15.6 ± 1.7 years; HbA1c 7.4 ± 1.5%; 9 females/9 males) participated in a randomized crossover clinical trial comparing our legacy hybrid CLC system (Unified Safety System Virginia [USS]-Virginia) with a novel fully automated CLC system (RocketAP) during two 46-h supervised admissions (each with one announced and one unannounced dinner), following 2 weeks of data collection. Primary outcome was the percentage time-in-range 70-180 mg/dL (TIR) following the unannounced meal, with secondary outcomes related to additional continuous glucose monitoring-based metrics. RESULTS: Both TIR and time-in-tight-range 70-140 mg/dL (TTR) were significantly higher using RocketAP than using USS-Virginia during the 6 h following the unannounced meal (83% [interquartile range 64-93] vs. 53% [40-71]; P = 0.004 and 49% [41-59] vs. 27% [22-36]; P = 0.002, respectively), primarily driven by reduced time-above-range (TAR >180 mg/dL: 17% [1.3-34] vs. 47% [28-60]), with no increase in time-below-range (TBR <70 mg/dL: 0% median for both). RocketAP also improved control following the announced meal (mean difference TBR: -0.7%, TIR: +7%, TTR: +6%), overall (TIR: +5%, TAR: -5%, TTR: +8%), and overnight (TIR: +7%, TTR: +19%, TAR: -5%). RocketAP delivered less insulin overall (78 ± 23 units vs. 85 ± 20 units, P = 0.01). CONCLUSIONS: A new fully automated CLC system with automatic prandial dosing was proven to be safe and feasible and outperformed our legacy USS-Virginia in an adolescent population with and without meal announcement.

Peroxiredoxin 6 mediates protective function of astrocytes in Aß proteostasis.

BACKGROUND: Disruption of ß-amyloid (Aß) homeostasis is the initial culprit in Alzheimer's disease (AD) pathogenesis. Astrocytes respond to emerging Aß plaques by altering their phenotype and function, yet molecular mechanisms governing astrocytic response and their precise role in countering Aß deposition remain ill-defined. Peroxiredoxin (PRDX) 6 is an enzymatic protein with independent glutathione peroxidase (Gpx) and phospholipase A2 (PLA2) activities involved in repair of oxidatively damaged cell membrane lipids and cellular signaling. In the CNS, PRDX6 is uniquely expressed by astrocytes and its exact function remains unexplored. METHODS: APPswe/PS1dE9 AD transgenic mice were once crossed to mice overexpressing wild-type Prdx6 allele or to Prdx6 knock out mice. Aß pathology and associated neuritic degeneration were assessed in mice aged 10 months. Laser scanning confocal microscopy was used to characterize Aß plaque morphology and activation of plaque-associated astrocytes and microglia. Effect of Prdx6 gene dose on plaque seeding was assessed in mice aged six months. RESULTS: We show that hemizygous knock in of the overexpressing Prdx6 transgene in APPswe/PS1dE9 AD transgenic mice promotes selective enticement of astrocytes to Aß plaques and penetration of plaques by astrocytic processes along with increased number and phagocytic activation of periplaque microglia. This effects suppression of nascent plaque seeding and remodeling of mature plaques consequently curtailing brain Aß load and Aß-associated neuritic degeneration. Conversely, Prdx6 haplodeficiency attenuates astro- and microglia activation around Aß plaques promoting Aß deposition and neuritic degeneration. CONCLUSIONS: We identify here PRDX6 as an important factor regulating response of astrocytes toward Aß plaques. Demonstration that phagocytic activation of periplaque microglia vary directly with astrocytic PRDX6 expression level implies previously unappreciated astrocyte-guided microglia effect in Aß proteostasis. Our showing that upregulation of PRDX6 attenuates Aß pathology may be of therapeutic relevance for AD.

An optimization-based control strategy for energy efficiency of discrete manufacturing systems.

In order to reduce the global energy consumption and avoid highest power peaks during operation of manufacturing systems, an optimization-based controller for selective switching on/off of peripheral devices in a test bench that emulates the energy consumption of a periodic system is proposed. First, energy consumption models for the test-bench devices are obtained based on data and subspace identification methods. Next, a control strategy is designed based on both optimization and receding horizon approach, considering the energy consumption models, operating constraints, and the real processes performed by peripheral devices. Thus, a control policy based on dynamical models of peripheral devices is proposed to reduce the energy consumption of the manufacturing systems without sacrificing the productivity. Afterward, the proposed strategy is validated in the test bench and comparing to a typical rule-based control scheme commonly used for these manufacturing systems. Based on the obtained results, reductions near 7% could be achieved allowing improvements in energy efficiency via minimization of the energy costs related to nominal power purchased.

Comprensiones narrativas de los factores asociados al desempeño académico en estudiantes de Boyacá, Colombia / Narrative understanding of factors associated with academic performance in students of Boyacá, Colombia

Resumen El presente artículo es un estudio cualitativo de tipo narrativo cuyo objetivo principal fue comprender la relación entre los factores psicosocial, familiar e institucional, y el desempeño académico. Participaron de manera voluntaria 16 estudiantes en situación de prueba académica en dos escenarios conversacionales. Para el procesamiento de la información se diseñó una matriz de análisis que permitió categorizar las narrativas en función de los dóminos temáticos de la investigación. Los análisis de las narrativas presentadas por los estudiantes en los escenarios realizados permitieron comprender el significado de relevancia que los estudiantes le dan a la relación con el docente; la importancia del apoyo familiar como un elemento motivador; las dificultades familiares como un interferente; la influencia de los pares en la toma de decisiones, mayor interés por las actividades sociales que sobre aspectos académicos y finalmente características personales de afrontamiento evasivo con cierta regularidad frente a las dificultades académicas reportadas.

Abstract This article presents a qualitative study belonging to a narrative type, whose main objective was to understand the relationship between psychosocial, family and institutional factors and academic performance. 16 students undergoing academic trial participated voluntarily in two conversational scenarios. An analysis matrix was designed to carry out data processing through categorization of narratives according to the thematic domains of the research. The analysis of the students' narratives at the implemented scenarios allowed the comprehension of the meaning of relevance that students attribute to their relationship with teachers; the importance of family support as a motivational element and family difficulties as an interference; the influence of their peers in decision making and greater interest in social activities than academic aspects, and finally, frequent personal features of evasive coping, facing reported academic difficulties.

Dipeptidyl peptidase 3, a novel protease from Leishmania braziliensis.

The increase of leishmaniasis cases worldwide and the emergence of Leishmania strains resistant to current treatments make necessary to find new therapeutic targets. Proteases are appealing drug targets because they play pivotal roles in facilitating parasite survival and promoting pathogenesis. Enzymes belonging to the dipeptidyl peptidase 3 (DPP3) group have been described in different organisms such as mammals, insects and yeast, in which these enzymes have been involved in both protein turnover and protection against oxidative damage. The aim of this work was to characterize the structure and function of the Leishmania braziliensis DPP3 (LbDPP3) protein as the first step to elucidate its suitability as a potential drug target. Sequence alignment showed 43% of identity between LbDPP3 and its human orthologous (hDPP3) enzyme. Although the modeled protein adopted a globally conserved three-dimensional (3D) structure, structural differences were found in the vicinity of the active site and the substrate binding-cleft. In addition, the Leishmania protein was expressed as a soluble recombinant protein and its kinetics parameters were determined using the z-Arginine-Arginine-AMC substrate. The LbDPP3 activity was maximal at pH values between 8.0-8.5. Interestingly, classical enzyme inhibitors such as the tynorphin and its derivative peptide IVYPW were found to actively inhibit the LbDPP3 activity. Moreover, these DPP3 inhibitors showed a detrimental effect upon parasite survival, decreasing the viability of promastigotes by up to 29%. Finally, it was observed that LbDPP3 was equally expressed along the in vitro differentiation from promastigotes to axenic amastigotes. In conclusion, these findings suggest that the L. brazileinsis DPP3 could be a promising drug target.

Prevalencia de las enfermedades autoinmunes en pacientes mayores de 13 años en el Hospital Universitario de Santander de Bucaramanga / Prevalence of autoimmune diseases in patients over the age of 13 at the University Hospital of Santander Bucaramanga

Introducción y objetivo: Las enfermedades autoinmunes afectan alrededor del 3 ­ 5% de los seres humanos, especialmente a las mujeres. Por su poca prevalencia se desconocen dato clínicos locales sobre el comportamiento de estas entidades. El objetivo es encontrar la prevalencia de las enfermedades autoinmunes en el Hospital Universitario de Santander así como realizar su caracterización clínica y sociodemográfica. Métodos: Estudio observacional, descriptivo de corte transversal retrospectivo sobre la prevalencia de enfermedades autoinmunes en el Hospital Universitario de Santander entre el 2012 y el 2016 en pacientes mayores de 13 años que ingresaron a la institución.

Hallazgos clínicos en pacientes con esclerosis sistémica en un Hospital Universitario de Santander / Clinical findings in patients with systemic sclerosis in a University Hospital of Santander

Introducción y objetivo: La esclerosis sistémica (ES) es una enfermedad crónica autoin-mune del tejido conectivo caracterizada por presentar procesos de fibrosis e inflamación anormal en el paciente afectando a nivel de los diversos órganos y sistemas. Es poco fre-cuente, su prevalencia general es de 10 por 100.000 habitantes. El objetivo del presente es-tudio fue describir la población de pacientes con ES atendidos en un hospital universitario. Métodos: Estudio observacional, descriptivo de corte transversal retrospectivo. La pobla-ción de estudio fueron pacientes mayores de 13 años con SSc que ingresaron a un hospi-tal universitario de Colombia entre el período comprendido entre los años 2012-2016.

Identification of a type I nitroreductase gene in non-virulent Trypanosoma rangeli

ABSTRACT Trypanosomatid type I nitroreductases (NTRs), i.e., mitochondrial enzymes that metabolise nitroaromatic pro-drugs, are essential for parasite growth, infection, and survival. Here, a type I NTR of non-virulent protozoan Trypanosoma rangeli is described and compared to those of other trypanosomatids. The NTR gene was isolated from KP1(+) and KP1(-) strains, and its corresponding transcript and 5' untranslated region (5'UTR) were determined. Bioinformatics analyses and nitro-drug activation assays were also performed. The results indicated that the type I NTR gene is present in both KP1(-) and KP1(+) strains, with 98% identity. However, the predicted subcellular localisation of the protein differed among the strains (predicted as mitochondrial in the KP1(+) strain). Comparisons of the domains and 3D structures of the NTRs with those of orthologs demonstrated that the nitroreductase domain of T. rangeli NTR is conserved across all the strains, including the residues involved in the interaction with the FMN cofactor and in the tertiary structure characteristics of this oxidoreductase protein family. mRNA processing and expression were also observed. In addition, T. rangeli was shown to be sensitive to benznidazole and nifurtimox in a concentration-dependent manner. In summary, T. rangeli appears to have a newly discovered functional type I NTR.

Identification of a type I nitroreductase gene in non-virulent Trypanosoma rangeli.

Trypanosomatid type I nitroreductases (NTRs), i.e., mitochondrial enzymes that metabolise nitroaromatic pro-drugs, are essential for parasite growth, infection, and survival. Here, a type I NTR of non-virulent protozoan Trypanosoma rangeli is described and compared to those of other trypanosomatids. The NTR gene was isolated from KP1(+) and KP1(-) strains, and its corresponding transcript and 5' untranslated region (5'UTR) were determined. Bioinformatics analyses and nitro-drug activation assays were also performed. The results indicated that the type I NTR gene is present in both KP1(-) and KP1(+) strains, with 98% identity. However, the predicted subcellular localisation of the protein differed among the strains (predicted as mitochondrial in the KP1(+) strain). Comparisons of the domains and 3D structures of the NTRs with those of orthologs demonstrated that the nitroreductase domain of T. rangeli NTR is conserved across all the strains, including the residues involved in the interaction with the FMN cofactor and in the tertiary structure characteristics of this oxidoreductase protein family. mRNA processing and expression were also observed. In addition, T. rangeli was shown to be sensitive to benznidazole and nifurtimox in a concentration-dependent manner. In summary, T. rangeli appears to have a newly discovered functional type I NTR.

The sural nerve: Sonographic anatomy, variability and relation to the small saphenous vein in the setting of endovenous thermal ablation.

Background Neurological complications are well documented in association with both surgical stripping or disconnection and thermal ablation of the small saphenous vein. The sural nerve (medial sural cutaneous nerve) is most vulnerable due to its close relationship to the small saphenous vein. Objective This is a cross-sectional observational study of the sonographic anatomy of 115 Australian patients to determine the course of the sural nerve and its relationship to the small saphenous vein, and to identify its relevance in the thermal ablation of the small saphenous vein. Method Sonographic mapping of the right sural nerve was performed with a Philips L12.5 and Sonosite 10.5 MHz ultrasound machine on 115 patients. The sural nerve was traced proximally from the level of the lateral malleolus to the popliteal fossa in order to measure its distance from the small saphenous vein at four reference points in the lower leg. Results A total of 115 patients were studied (females 82, males 33). The sural nerve was identified in 100% of patients; 64 patients (55.7%) showed usual sural nerve anatomy, while 51 patients (44.3%) demonstrated a range of anatomical variations, including the sural nerve becoming epifascial at a higher point than usual. Conclusion The sural nerve was identifiable on duplex ultrasound in 100% of cases. Classic anatomical relations and the perceived protection of the sural nerve conferred by the deep fascia of the upper calf are unreliable. Preoperative strategies can help to approach and protect the sural nerve in the endovenous ablation setting.

Hydrodisplacement of sural nerve for safety and efficacy of endovenous thermal ablation for small saphenous vein incompetence.

Background Endovenous radio frequency ablation for small saphenous vein incompetence by and large appears to be superior and safer than conventional open surgery. Small saphenous vein ablation from approximately mid-calf to the point proximally where the small saphenous vein dives into the popliteal fossa is considered to be safe, as the sural nerve is in most cases separated from this segment of the small saphenous vein by the deep fascia. The outcome of the distal incompetent small saphenous vein remains unclear. Efficacy of the endovenous radio frequency ablation can be enhanced by increasing the length of the ablatable small saphenous vein segment. Methodology To optimise endovenous radio frequency ablation outcome, the distal small saphenous vein may be made amenable to ablation if safety of the sural nerve can be assured. The sural nerve was successfully located using duplex ultrasound in 100% of our cohort in this study. The standard entry point for venous access was just above the lateral malleolus. After introduction of the introducer sheath, the radio frequency catheter was advanced proximally; the sural nerve was displaced from the small saphenous vein by approximately 1 cm with the administration of tumescent anaesthesia ( hydrodisplacement). A total of 118 patients underwent extended endovenous radio frequency ablation of 124 incompetent small saphenous vein trunks using the method described. Results Successful extended ablation of the small saphenous vein was achieved in 100% of cases and it was confirmed by duplex scanning at one and six weeks. Two neurological events were recorded during the study: 1. One patient with temporary foot drop lasting for less than 6 h with complete recovery. 2. A second patient with a sural nerve sensory deficit reported by the patient at day 2-3, which remains current at six weeks. Conclusions Extended endovenous radio frequency ablation of the small saphenous vein to optimise length of the ablatable vein segment is feasible with careful identification and hydrodisplacement of the sural nerve. This method is shown to be associated with fewer neurological complications than other methods reported in the literature.

Espondilitis anquilosante: reporte de un caso / Ankylosing spondylitis: a case report

Las espóndilo artropatías (spa) son un grupo de condiciones inflamatorias crónicas, frecuentes y eventualmente discapacitantes. Son una familia de desórdenes interrelacionados, pero heterogéneos con diferentes manifestaciones clínicas. La espondilitis anquilosante (EA) es el prototipo de este grupo de patologías, caracterizadas por un compromiso articular axial y/o periférico, entesitis, ciertas manifestaciones extra-articulares características y una fuerte asociación genética con el HLA - B27. La afectación de otros miembros de la familia del paciente es otra característica importante. La espondilitis o espóndilo artritis anquilosante es un reumatismo inflamatorio crónico que afecta de forma predominante al esqueleto axial, pelvis, columna vertebral y tórax, en especial a las articulaciones sacroilíacas, su localización más constante y característica. También puede afectar a las articulaciones periféricas y algunos pacientes desarrollan manifestaciones extraarticulares. Los varones se afectan con mayor frecuencia que las mujeres en una proporción de 3-4:1. Su prevalencia varía en función de la frecuencia del antígeno HLA-B27 en la población analizada. La frecuencia más alta se ha encontrado en ciertas tribus de indios americanos, en especial los Haida, donde un 50% de la población general posee el HLA-B27. En la raza blanca se estima una prevalencia de 2 a 10 casos por 1.000 habitantes; esta cifra es inferior en las razas negra y oriental. A continuación se presenta el caso de una mujer de 50 años con lumbalgia crónica y diagnosticada como E.A.

The spondyloarthropathies (spa) are a group of frequent chronic inflammatory conditions eventually disabling. They are a family of interrelated disorders, but they are heterogeneous with different clinical manifestations. Ankylosing spondylitis (AS) is the prototype of this group of diseases characterized by an axial and / or peripheral joint involvement, enthesitis, certain extra-articular manifestations and a strong genetic association with HLA - B27. The involvement of other relatives of patients is another important feature. Spondylitis or spondylo arthritis ankylosing, is a chronic inflammatory rheumatism which affects mainly the axial skeleton, pelvis, spine and thorax, especially the sacroiliac joints, its most frequent and characteristic location. It can also affect the peripheral joints and some patients develop extra-articular manifestations. Males are affected more often than females by a ratio of 3-4:1. Its prevalence varies depending on the frequency of HLA-B27 antigen in the population tested. The highest frequency has been found in certain American Indian tribes, especially the Haida Indians, where 50% of the general population has the HLA-B27. In Caucasians prevalence of 2 to 10 cases per 1,000 inhabitants is estimated; this figure is lower in black and oriental races. Here is the case of a 50 year old woman with chronic low back pain and diagnosed as AS.

Desarrollo de un simulador de movimientos mandibulares para pruebas de resistencia abrasiva de biomateriales / Development of a mandibular movement simulator for wear testing of biomaterials

El objetivo de este estudio fue diseñar y elaborar un Simulador de Movimientos Mandibulares (SMM) que pudiera reproducir enforma precisa los movimientos y fuerzas mandibulares de la Articulación Temporo-Mandibular (ATM) y de la mandíbula. Uncráneo humano de características antropométricas normales se duplicó en fibra de vidrio, con arcos dentales metálicos colados(Aleación de Ni-Cr), con cavidades oclusales previamente preparadas en premolares y molares. La simulación del ligamentoperiodontal se hizo con polivinilsiloxano liviano y la del disco articular con silicona. Se replicaron los movimientos de la ATM yla mandíbula con servomotores de tecnología de robótica: Apertura (45mm), cierre, lateralidad (5mm) y protrusiva (5mm), confuerzas masticatorias promedio de 200 Newtons. Se desarrolló un programa computarizado que simula los movimientosmandibulares en 12 ciclos diferentes, cada ciclo se repitió aproximadamente 4,000 veces durante las pruebas.Este estudio desarrolló una herramienta de investigación de características más reales para realizar estudios de desgaste demateriales dentales en el laboratorio.

The purpose of this study was to design and fabricate a mandibular movement simulator (MMS) that can closely reproduce themovements of the human temporomandibular joint and (TMJ) and the mandible. A human skull was duplicated in fiberglass withcast metallic teeth (Ni-Cr alloy) with occlusal cavities in premolars and molars. Light polyvinyl siloxane was used to simulate theperiodontal ligament and Medigel-Z® to simulate the TMJ disc. The TMJ and mandibular movements were simulated withrobotic technology and servomotors: Opening (45mm), closure, lateral (5 mm) and protrusive (5 mm) with an average chewingforces of 200 Newtons. Computer software was developed to simulate mandibular movements in 12 different cycles; each cyclewas typically repeated more than 4,000 times during testing. This study developed a research tool with more realistic features toperform wear test in the laboratory.

Factores que influyen en el abandono del programa de control de tuberculosis en algunos centros de salud de Arequipa, enero 1994-julio 1995

El presente trabajo se realizó en algunos establecimientos periféricos de salud de la Provincia de Arequipa (14 Centros de Salud y 10 Puestos de Salud), en los cuales se lleva el Programa de Control de Tuberculosis. Se inicio el trabajo de investigación con 68 pacientes que abandonaron el P.C.T. a partir del 1 de enero de 1994 al 30 de julio de 1995, trabajándose finalmente con 61 pacientes (2 fallecidos, 3 direcciones falsas, 2 malos registros), dicho trabajo tuvo como propósito establecer si existe relación entre: edad, sexo, procedencia, estado marital, grado de instrucción, tratamiento autoadministrado, mejoría del paciente, accesibilidad a los servicios de salud, consumo de alcohol, percepción del paciente sobre la atención en el P.C.T. con el abandono de los pacientes del P.C.T. de Arequipa. Para tal efecto se utilizó el método descriptivo con un diseño de correlación. La determinación de la población se obtuvo partiendo del estudio del cohorte de tratamiento del P.C.T. Región Arequipa primer semestre 1994, tomando aquellos Centros de Salud que presentaron porcentajes más elevados de abandono al P.C.T. seguidamente se ubicó a los pacientes de los Centros de Salud en coordinación con la enfermera responsable del P.C.T. en cada Centro de Salud, haciendo revisión del Libro de Registro y Seguimiento de Pacientes del P.C.T., Tarjetas de Control de Tratamiento y a través de las visitas domiciliarias. Ubicados los pacientes se procedió a entrevistarlos aplicandoles un formulario a través de visitas domiciliarias realizada a los pacientes que abandonaron su tratamiento, obteniéndose la información requerida, la cual se sometió a la prueva estadística del Ji cuadrado, obteniendose significancia estadística en las siguientes variables: Procedencia, grado de instrucción , accesibilidad de vivienda, disponibilidad de tiempo, tipo de tratamiento recibido, percepción del paciente sobre la mejoría durante el tratamiento, percepción sobre el tipo de atención en el P.C.T. consumo de alcohol..