Humoral and T Cell Response to SARS-CoV-2 Vaccination in Patients With Rheumatoid Arthritis.

OBJECTIVE: The objective of this study was to assess the SARS-CoV-2-specific humoral and T cell response after a two-dose regimen of SARS-CoV-2 vaccine in patients with rheumatoid arthritis (RA). METHODS: In this observational study, patients with RA who are ≥18 years of age and vaccinated for SARS-CoV-2 according to the Argentine National Health Ministry's vaccination strategy were included. Anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies (ELISA-COVIDAR test), neutralizing activity (cytotoxicity in VERO cells), and specific T cell response (IFN-γ ELISpot Assay) were assessed after the first and second dose. RESULTS: A total of 120 patients with RA were included. Mostly, homologous regimens were used, including Gam-COVID-Vac (27.5%), ChAdOx1 (24.2%), and BBIBP-CorV (22.5%). The most frequent combination was Gam-COVID-Vac/mRNA-1273 (21.7%). After the second dose, 81.7% presented with anti-SARS-CoV-2 antibodies, 70.0% presented with neutralizing activity, and 65.3% presented with specific T cell response. The use of BBIBP-CorV and treatment with abatacept (ABA) and rituximab (RTX) were associated with undetectable antibodies and no neutralizing activity after two doses. BBIBP-CorV was also associated with the absence of T cell response. The total incidence of adverse events was 357.1 events per 1,000 doses, significantly lower with BBIBP-CorV (166.7 events per 1,000 doses, P < 0.02). CONCLUSION: In this RA cohort vaccinated with homologous and heterologous regimens against COVID-19, 2 out of 10 patients did not develop anti-SARS-CoV-2 IgG, 70% presented with neutralizing activity, and 65% presented with specific T cell response. The use of BBIBP-CorV was associated with deficient humoral and cellular response, whereas treatment with ABA and RTX resulted in an impaired anti-SARS-CoV-2 IgG formation and neutralizing activity.

Springing forward: Migrating songbirds catch up with the start of spring in North America.

In temperate regions, the annual pattern of spring onset can be envisioned as a 'green wave' of emerging vegetation that moves across continents from low to high latitudes, signifying increasing food availability for consumers. Many herbivorous migrants 'surf' such resource waves, timing their movements to exploit peak vegetation resources in early spring. Although less well studied at the individual level, secondary consumers such as insectivorous songbirds can track vegetation phenology during migration as well. We hypothesized that four species of ground-foraging songbirds in eastern North America-two warblers and two thrushes-time their spring migrations to coincide with later phases of vegetation phenology, corresponding to increased arthropod prey, and predicted they would match their migration rate to the green wave but trail behind it rather than surfing its leading edge. We further hypothesized that the rate at which spring onset progresses across the continent influences bird migration rates, such that individuals adjust migration timing within North America to phenological conditions they experience en route. To test our hypotheses, we used a continent-wide automated radio telemetry network to track individual songbirds on spring migration between the U.S. Gulf Coast region and northern locations closer to their breeding grounds. We measured vegetation phenology using two metrics of spring onset, the spring index first leaf date and the normalized difference vegetation index (NDVI), then calculated the rate and timing of spring onset relative to bird detections. All individuals arrived in the southeastern United States well after local spring onset. Counter to our expectations, we found that songbirds exhibited a 'catching up' pattern: Individuals migrated faster than the green wave of spring onset, effectively closing in on the start of spring as they approached breeding areas. While surfing of resource waves is a well-documented migration strategy for herbivorous waterfowl and ungulates, individual songbirds in our study migrated faster than the green wave and increasingly caught up to its leading edge en route. Consequently, songbirds experience a range of vegetation phenophases while migrating through North America, suggesting flexibility in their capacity to exploit variable resources in spring.

En las regiones templadas, el patrón anual de inicio de la primavera puede concebirse como una "ola verde" de vegetación emergente que se desplaza por los continentes desde las latitudes bajas a las altas, lo que significa una mayor disponibilidad de alimento para los consumidores. Muchos herbívoros migratorios "surfean" estas olas de recursos, programando sus movimientos para aprovechar los picos de vegetación a principios de primavera. Aunque menos estudiados a nivel de individuo, los consumidores secundarios, como las aves terrestres insectívoras, también pueden seguir la fenología de la vegetación durante la migración. Hipotetizamos es que cuatro especies de aves terrestres que se alimentan en el suelo en el este de Norteamérica - dos reinitas y dos zorzales - programan sus migraciones primaverales para que coincidan con las fases más tardías de la fenología de la vegetación, que se corresponden con un aumento de artrópodos, y predijimos que sincronizarian su ritmo de migración con la ola verde, pero que irían detrás de ella en lugar de surfear su borde delantero. También hipotetizamos que el ritmo al que avanza la primavera en el continente influye en las tasas de migración de las aves, de modo que los individuos ajustan la fecha de migración dentro de Norteamérica a las condiciones fenológicas que experimentan en ruta. Para comprobar nuestras hipótesis, utilizamos una red automatizada de radiotelemetría a escala continental para seguir individuos en su migración primaveral entre la región de la costa del Golfo de EEUU y las localidades septentrionales más cercanas a sus zonas de cría. Medimos la fenología de la vegetación utilizando dos métricas del inicio de la primavera, el índice de la fecha de la primera hoja primaveral y el índice de vegetación de diferencia normalizada (NDVI), luego calculamos la tasa y el tiempo de la aparaciòn de la primavera relativo a las detecciones de aves. Todos los individuos llegaron al sureste de EEUU bastante después del inicio de la primavera local. Contrario a nuestras expectativas, descubrimos que las aves terrestres mostraron un patrón de Carrera para "ponerse al día": los individuos migraron frente a la ola verde del inicio de la primavera, acercándose efectivamente al inicio de la primavera a medida que llegaban a las zonas de cría. Mientras que el surfing de las olas de recursos es una estrategia migratoria bien documentada para las aves acuáticas herbívoras y los ungulados, los individuos de aves terrestres de nuestro estudio migraron más rápido que la ola verde y alcanzaron cada vez más el borde delantero en ruta. En consecuencia, las aves terrestres experimentan una serie de fases fenológicas de la vegetación mientras migran a través de Norteamérica, lo que sugiere flexibilidad en su capacidad para explotar recursos variables en primavera.

Phenolic, Polysaccharides Composition, and Texture Properties during Ripening and Storage Time of New Table Grape Cultivars in Chile.

The aim of this study is to determine the phenolic and polysaccharidic composition, texture properties, and gene expression of new seedless table grape cultivars Timco™ and Krissy™ and compare them to the traditional table grape variety Crimson Seedless (Vitis vinifera L.), during ripening and in commercial postharvest conditions. According to the results, phenolic compounds were present in very different proportions. The total anthocyanins responsible for skin color increased during maturation and the majority anthocyanin in the three cultivars was peonidin-3-glucoside, followed by malvidin-3-glucoside. The phenolic compounds presented a different behavior (decreasing or increasing) during postharvest. The total skin soluble polysaccharides decreased during ripening and postharvest in Crimson Seedless and Krissy™ and remained constant from technological maturity to postharvest storage in Timco™. In all cultivars, the majority soluble polysaccharide fraction was that with a molecular mass between 500 and 35 KDa. The skin mechanical properties of table grapes were good parameters for differentiating varieties, with better results for the new cultivars, compared to the traditional Crimson Seedless, especially in postharvest. Genes involved in the flavonoid pathway and cell wall metabolism in skins exhibited an increase in expression from veraison to remaining constant at the end of the berry ripening.

A National Inpatient Sample Analysis of Racial Disparities After Segmental Colectomy for Inflammatory Colorectal Diseases.

BACKGROUND: Racial disparities and poor access to care are common among African Americans (AA), potentially adversely affecting surgical outcomes in inflammatory bowel conditions. We aimed to analyze the effect of race on outcomes in patients undergoing segmental colectomy for inflammatory bowel conditions. METHODS: Retrospective review of data from the National Inpatient Sample between 2010 and 2015 identified patients who underwent segmental colectomy without ostomy for Crohn's or diverticular disease. AA patients were compared with Caucasians using a multivariable analysis model. Primary outcomes of interest were overall complications, mortality, and extended hospital stay. RESULTS: 38,143 admissions were analyzed; AA patients constituted 8% of the overall cohort. Diagnoses included Crohn's (11%) and diverticular disease (89%). After multivariable analysis, AA patients had significantly higher overall risk of complications (OR = 1.27; 95% CI, 1.15-1.40) and extended hospital stay (OR = 1.59; 95% CI, 1.45-1.75) than Caucasians. On bivariate analysis, there was no significant difference in mortality between AA and Caucasian patients. AA patients had significantly higher rates of Medicaid insurance (14% vs 6%, P < .001), lower rates of private insurance (35% vs 47%, P < .001), and were less likely to undergo surgery at a private hospital (31% vs 41%, P < .001). CONCLUSIONS: AA patients requiring segmental colectomy for inflammatory colorectal conditions experience significantly higher rates of postoperative complications, longer hospital stays, and lower rates of private insurance. Direct correlation between insurance status and postoperative outcomes could not be established, but we speculate such great disparity in outcomes may stem from these socioeconomic differences.

Immune Response to SARS-CoV-2 Third Vaccine in Patients With Rheumatoid Arthritis Who Had No Seroconversion After Primary 2-Dose Regimen With Inactivated or Vector-Based Vaccines.

OBJECTIVE: The aim of this study was to assess the immune response after a third dose of SARS-CoV-2 vaccine in patients with rheumatoid arthritis (RA) with undetectable antibody titers after the primary regimen of 2 doses. METHODS: Patients with RA with no seroconversion after 2 doses of SARS-CoV-2 vaccine and who received a third dose of either an mRNA or vector-based vaccine were included. Anti-SARS-CoV-2 IgG antibodies, neutralizing activity, and T cell responses were assessed after the third dose. RESULTS: A total of 21 nonresponder patients were included. At the time of vaccination, 29% were receiving glucocorticoids and 85% biologic disease-modifying antirheumatic drugs (including 6 taking abatacept [ABA] and 4 taking rituximab [RTX]). The majority (95%) received the BNT162b2 vaccine and only one of them received the ChAdOx1 nCoV-19 vaccine. After the third dose, 91% of the patients presented detectable anti-SARS-CoV-2 IgG and 76% showed neutralizing activity. Compared to other treatments, ABA and RTX were associated with the absence of neutralizing activity in 4 out of 5 (80%) patients and lower titers of neutralizing antibodies (median 3, IQR 0-20 vs 8, IQR 4-128; P = 0.20). Specific T cell response was detected in 41% of all patients after the second dose, increasing to 71% after the third dose. The use of ABA was associated with a lower frequency of T cell response (33% vs 87%, P = 0.03). CONCLUSION: In this RA cohort, 91% of patients who failed to seroconvert after 2 doses of SARS-CoV-2 vaccine presented detectable anti-SARS-CoV-2 IgG after a third dose. The use of ABA was associated with a lower frequency of specific T cell response.

Opportunities for the conservation of migratory birds to benefit threatened resident vertebrates in the Neotropics.

Neotropical countries receive financing and effort from temperate nations to aid the conservation of migratory species that move between temperate and tropical regions. If allocated strategically, these resources could simultaneously contribute to other conservation initiatives. In this study, we use novel distribution maps to show how those resources could aid planning for the recovery of threatened resident vertebrates.Using eBird-based relative abundance estimates, we first identified areas with high richness of Neotropical migrant landbirds of conservation concern (23 species) during the stationary non-breeding period. Within these areas, we then identified threatened species richness, projected forest loss and conducted a prioritization for 1,261 red-listed vertebrates using Terrestrial Area-of-Habitat maps.Richness for migrants was greatest along a corridor from the Yucatan peninsula south to the northern Andes but also included south-west Mexico and Hispaniola. Protected areas account for 22% of this region while 21% is at risk of forest loss. Within this focal region for migrants, all four vertebrate groups showed hotspots of threatened species richness along the west and east Andean slopes. Taxa-specific hotspots included montane areas of southern Mexico and central Guatemala (amphibians/reptiles) and the entire east slope of the Colombian East Andes (mammals).Our prioritization highlighted several areas of importance for conservation due to high threatened species richness and projected forest loss including (a) the Pacific dry forests of south-west Mexico, (b) montane regions of northern Central America and (c) the west Andean slope of Colombia and Ecuador. At a landscape scale in southern Colombia, we show how conservation efforts for six Neotropical migrants could benefit 56 threatened residents that share a similar elevational range. Synthesis and applications. Funding and effort for migratory bird conservation also has potential to benefit threatened resident vertebrates in the Neotropics. Our study highlights how novel, high-resolution information on species distributions and risk of forest loss can be integrated to identify priority areas for the two groups at regional and landscape scales. The approach and data can be further modified for more specific goals, such as within-country initiatives.

Los países neotropicales reciben financiamiento y recursos esfuerzos de países templados para ayudar a la conservación de las aves migratorias que se mueven entre estas dos regiones. Si se asignan estratégicamente, estos recursos podrían beneficiar simultáneamente a otras iniciativas de conservación. En esta investigación, usamos novedosos mapas de distribución para mostrar cómo esos recursos podrían ayudar a planificar la conservación de especies residentes amenazadas.Utilizando estimaciones de abundancia de eBird, delineamos la Región Focal con la mayor riqueza de aves migratorias neotropicales de interés para la conservación durante el periodo invernal (23 especies). Dentro de esta región, determinamos la riqueza de especies residentes amenazadas, la proyección de pérdida de bosque, y realizamos una priorización para 1261 especies de vertebrados incluidos en la lista roja de la IUCN utilizando mapas del área de hábitat terrestre.En la Región Focal, la riqueza de aves migratorias fue mayor a lo largo de un corredor desde el sur de la península de Yucatán hasta el norte de los Andes, y en el suroeste de México y la isla La Española. Las áreas protegidas representan 22% de esta región mientras que el 21% está en riesgo de pérdida de bosque. Dentro de la Región Focal para las aves migratorias, todos los vertebrados residentes mostraron puntos de mayor riqueza de especies amenazadas en los Andes occidentales y orientales. Las regiones con mayor riqueza para taxones específicos incluyeron las montañas del sur de México y del centro de Guatemala (anfibios y reptiles) y la vertiente oriental de la cordillera oriental de Colombia (mamíferos).La priorización destacó varias áreas de importancia para la conservación debido a la alta riqueza de especies amenazadas y a la pérdida de bosque proyectada incluyendo 1) los bosques secos del Pacífico del suroeste de México, 2) las regiones montañosas del norte de Centroamérica y 3) la vertiente occidental de los Andes Occidental de Colombia y Ecuador. A escala del paisaje en el sur de Colombia, mostramos cómo los esfuerzos para la conservación de 6 aves migratorias podrían beneficiar a 56 especies residentes amenazadas que comparten un rango altitudinal similar. Síntesis y aplicaciones. La financiación y esfuerzos para la conservación de las aves migratorias tienen el potencial a beneficiar a los vertebrados residentes amenazados en el Neotrópico. Nuestro estudio resalta como se puede integrar información novedosa y de alta resolución acerca de la distribución de especies y el riesgo de pérdida de bosques para identificar áreas prioritarias para los dos grupos a escala regional y paisajística. El enfoque y los datos se pueden modificar para objetivos más específicos, como por ejemplo iniciativas dentro de cada país.

Bariatric Surgery Improves Heart Geometry and Plasticity.

BACKGROUND: Obesity is commonly associated with increased sympathetic tone, changes in heart geometry, and mortality. The aforementioned translates into a higher and potentially modifiable mortality risk for this specific population. OBJECTIVES: The aim of the study was to analyze the extent of changes in the heart ventricular structure following rapid weight loss after bariatric surgery. SETTING: Academic, university-affiliated hospital. METHODS: We retrospectively reviewed all the patients that underwent bariatric surgery at our institution between 2010 and 2015. Data analyzed included demographics, BMI, and associated medical problems. Preoperative and postoperative echography readings were compared looking at the heart geometry, cardiac volumes, and wall thickness. RESULTS: Fifty-one patients who had bariatric surgery and had echocardiography before and after the surgery were identified. There were 33 females (64.7%). The mean age was 63.4 ± 12.0 years with an average BMI of 40.3 ± 6.3. The mean follow-up was 1.2 years after the procedure. At 1 year follow-up 25 patients (49%, p = 0.01) showed normal left ventricular geometry. The left ventricular mass (229 ± 82.1 vs 193.2 ± 42.5, p<0.01) and the left ventricular end diastolic volume (129.4 ± 53 vs 96.4 ± 36.5, p = 0.01) showed a significant modification following the procedure. There was a significant improvement in the interventricular septal thickness (p = 0.01) and relative wall thickness (p < 0.01) following surgery. CONCLUSION: The patients with obesity present a significant cardiac remodeling from concentric remodeling to normal geometry after bariatric surgery. The decrease in BMI has a direct effect on improvement of the left ventricular structure. Further studies must be carried out to define the damage of obesity to diastolic function.

Psychotherapeutic change in children and adolescents who have been sexually abused: a model from participants' perspectives.

INTRODUCTION: Change in psychotherapy research in cases of child sexual abuse (CSA) has mainly emerged from a symptomatologic view, which needs to be complemented by a subjective perspective of change. Thus, this article aim is to describe different outcomes and stages of change during psychotherapy in children and adolescents who have been sexually abused, from the subjective perspectives of those involved in the process. METHODS: A longitudinal qualitative study was developed. Qualitative interviews were conducted at different moments of the psychotherapeutic process (at around 6 months of therapy, 12 months and at the end of therapy) with 28 children and adolescents aged 6 to 17, with their caregivers and therapists. All children and adolescents attended and then completed psychotherapy due to sexual abuse in natural settings, in public specialized centres in Santiago, Chile. Sexual abuse occurred mainly in an intrafamilial context or by acquaintances. Data analysis was conducted using narrative analysis. RESULTS: Three stages of therapy were identified: (1) settling into therapy, (2) approaching CSA and (3) healing from abuse. Three different outcomes of psychotherapeutic change were also identified: (1) protective and psychosocial changes, (2) changes related to diminishing the effects of abuse and (3) changes related to healing from abuse. Psychosocial characteristics of the cases and features of the therapeutic process are described in each group. DISCUSSION: The outcomes of change and the stages of therapy are interrelated in a dynamic and gradual process where change is linked with the case's psychosocial characteristics and the features of the therapeutic process. Results allowed the authors to situate the voices of the participants within a proposed model of psychotherapeutic change for CSA, with clinical practical implications.

Potential beneficial effects of bariatric surgery on the prevalence of kidney cancer: a national database study.

BACKGROUND: The incidence of obesity has been steadily increasing, especially in developed countries. Also, obesity is considered one of the modifiable risk factors of kidney cancer. OBJECTIVES: This study aims to determine the impact of bariatric surgery-induced weight loss on the prevention of kidney cancer. SETTING: Academic Hospital, United States. METHODS: The National (Nationwide) Inpatient Sample (NIS) was queried for the period 2010 to 2015 for first-time kidney cancer-related hospitalization, used as a proxy for cancer incidence, in patients with a history of bariatric surgery (cases) and patients with obesity but no history of bariatric surgery (controls). Patients with a previous diagnosis of cancer were excluded from the analysis. In order to identify comparable patients, all controls had to have a body mass index ≥35 kg/m2, as per the existing qualification criteria for bariatric surgery. The International Classification of Diseases-9 codes (ICD-9) was used to identify admissions for kidney cancer. A univariate analysis was conducted to compare demographics and co-morbidities between groups. A multivariate logistic regression model was performed to assess differences between surgical and control groups and adjust for independent variables such as smoking history and family history of malignancy. All percentages and means (with confidence intervals [CIs]) were weighted. RESULTS: A total of 2,300,845 were included in the analysis, of which 2,004,804 controls-subjects, with a mean age of 54.4 ± .05 years, and 296,041 treatment-subjects, with a mean age of 51.9 ± .05 years. Demographics and co-morbidities, such as tobacco use, diabetes, and hypertension, were also measured. Patients with a history of bariatric surgery were significantly less likely to experience renal cancer than patients without a history of bariatric surgery, with 5935 cases in the control group and 684 in the case group (P < .0001). After a multivariate logistic regression was performed, the OR was 1.10 (95% CI: 1.02-1.22, P < .0224). CONCLUSION: Our finding suggests that bariatric surgery-induced weight loss could significantly prevent first-time kidney cancer-related hospitalizations in patients with obesity. Prospective studies are needed to confirm our findings.

Investigación científica sobre malaria: un análisis bibliométrico en América Latina, 2011-2020 / Scientific Research on Malaria: A Bibliometric Analysis in Latin America, 2011- 2020

Introducción: La malaria es una enfermedad protozoaria que continúa siendo un grave problema de salud pública en América Latina. El objetivo fue describir la producción científica de malaria en América Latina en el período 2011-2020. Materiales y métodos: Estudio bibliométrico. Se realizó una búsqueda sistemática en Scopus, se incluyeron artículos en formato IMRD realizados en humanos con malaria como variable principal, durante el período 2011-2020. Resultados: Se encontraron 1731 artículos sobre malaria en Scopus, de los cuales se incluyeron 590 (34,08%) según los criterios de selección. La publicación científica aumentó de 2011 a 2020 en un 147,22%. Se encontró que 415 (70,33%) estudios se publicaron en revistas del primer trimestre y 141 (23,9%) se publicaron en Malaria Journal. Asimismo, 506 (85,76%) estudios fueron redactados en inglés y la entidad de financiación más influyente fue el Conselho Nacional de Desenvolvimento Científico e Tecnológico 117 (11,44%). En 271 (45,93%) estudios, el autor correspondiente tenía afiliación brasileña, y en 53 (8,98%) artículos predominó la Fundação Oswaldo Cruz. En cuanto al diseño, 274 (46,44%) estudios fueron descriptivos, 260 (44,07%) epidemiológicos y 286 (48,47%) se realizaron en personas de la comunidad. Se ha incrementado la producción científica latinoamericana sobre malaria; hay un predominio en las revistas del primer trimestre, siendo Malaria Journal la más importante. La mayoría de los estudios son descriptivos relacionados con la epidemiología. Se requieren esfuerzos para incrementar la producción científica en el resto de países latinoamericanos con alta prevalencia de malaria(AU)

Introduction: Malaria is a protozoan disease that continues to be a serious public health problem in Latin America. The goal was to describe the scientific production of malaria in Latin America during the period 2011-2020. Materials and methods: Bibliometric study. A systematic search was carried out in Scopus, articles in IMRD format carried out in humans with malaria as the main variable were included, during the period 2011-2020. Results: 1731 malaria articles were found in Scopus, of which 590 (34.08%) were included according to the selection criteria. Scientific publication increased from 2011 to 2020 by 147.22%. It was found that 415 (70.33%) studies were published in Q1 journals and 141 (23.9%) published in Malaria Journal. Likewise, 506 (85.76%) studies were written in English language and the most influential funding entity was the Conselho Nacional de Desenvolvimento Científico e Tecnológico 117 (11.44%). In 271 (45.93%) studies, the corresponding author had Brazilian affiliation, and in 53 (8.98%) articles the Fundação Oswaldo Cruz predominated. Regarding the design, 274 (46.44%) studies were descriptive, 260 (44.07%) were epidemiological and 286 (48.47%) were carried out with people from the community. Latin American scientific production on malaria has increased; there is predominance in Q1 journals, with Malaria Journal being the most important. Most of the studies are descriptive related to epidemiology. Efforts are required to increase scientific production in the rest of the Latin American countries with a high prevalence of malaria(AU)

Cambio Psicoterapéutico en niños, niñas y adolescentes que han sido víctimas de agresiones sexuales: Evaluación de la continuidad y caracterización del cambio posterior a la psicoterapia / Psychotherapeutic change in children and adolescents who have been victims of sexual abuse: Evaluation of the continuity and characterization of change after psychotherapy

Resumen Antecedentes: Son escasos los estudios sobre psicoterapia en agresión sexual infantil que incluyan un seguimiento tras su finalización. Objetivo: Explorar la continuidad del cambio psicoterapéutico en niños que han sido víctimas de agresiones sexuales luego de finalizada la psicoterapia, y caracterizarlo, integrando sus perspectivas y la de sus adultos responsables. Método: Se realiza un estudio con metodología mixta, incorporando 10 niños/as y adolescentes entre 7 y 17 años. Se evaluó sintomatología al inicio y final de la psicoterapia y luego de 1 a 2 años que ésta había finalizado. En el seguimiento, se entrevistaron a los niños/as y adolescentes y a sus adultos responsables. Los datos cuantitativos (instrumentos sintomatológicos) se analizaron con pruebas no paramétricas y los cualitativos (entrevistas) mediante análisis narrativo. Resultados: Se aprecian diferencias significativas entre la sintomatología pre, post-terapia y seguimiento evaluada cuantitativamente, mostrando que existen cambios al finalizar la terapia, los que se mantienen en el seguimiento. En las entrevistas se identifican diferentes esferas de cambios logrados durante la terapia que se mantienen posterior a su finalización, destacándose factores favorecedores. Conclusiones: Se discuten elementos relevantes para la mantención del cambio post-terapia, tales como el trabajo con el adulto responsable y el cese del contacto con el agresor.

Abstract Background: There are few studies in psychotherapy in child sexual abuse that includes follow-up after therapy. Objective: To explore the continuity of psychotherapeutic change in children that have been victims of sexual abuse after therapy ended and to characterize it, integrating their perspectives and the one of their responsible adults. Method: a study with mix methods was done, incorporating 10 children and adolescents between 7 and 17 years old. Symptomatology was assessed at the beginning and end of psychotherapy, and after 1 to 2 years after therapy ended. At follow up children and adolescents, and their responsible adults were interviewed. Quantitative data (symptomatology instruments) was analyzed with non-parametric tests and qualitative data (interviews) with narrative analysis. Results: Significant differences were found between symptomatology evaluated quantitatively at pre, post-therapy and follow up, showing changes after therapy that maintains at follow-up. With interviews different areas of change accomplished during therapy are identified, which maintains after therapy, highlighting factors that facilitate it. Conclusions: Relevant factors for the maintenance of change after therapy are discussed, such as working with the responsible adult and ending contact with the aggressor.

Sleeve gastrectomy versus Roux-en-Y gastric bypass in patients Aged ≥65 years: a comparison of short-term outcomes.

BACKGROUND: Bariatric surgery in the elderly population has been reported as feasible and safe. Sleeve gastrectomy (SG) seems to have fewer complications than Roux-en-Y gastric bypass (RYGB) even in the 65 years of age population. We analyzed the difference in weight loss between SG and RYGB in patients age 65 years. OBJECTIVES: To analyze and compare outcomes between SG and RYGB in patients 65 years of age and older. SETTING: Academic hospital, United States. METHODS: After internal review board approval, we retrospectively reviewed 2486 patients who underwent either SG or RYGB between 2005 and 2018 at our institution. Basic demographics, preoperative body mass index (BMI), and co-morbidities were described. We identified all patients age ≥65 years and subsequently divided them into 2 groups based on type of bariatric procedure performed. Analysis and comparison of outcomes between these groups were completed. Postoperative BMI was reviewed at 6, 12, and 24 months and percent excess BMI loss (%EBMIL, as defined by the ASMBS clinical committee) was calculated accordingly. The t test and χ2 analysis were performed for nominal and categorical variables, respectively. RESULTS: From 2486 patients reviewed, 22.7% (n = 565) were aged ≥65 years. From these, 43.1% (n = 244) underwent SG and 56.8% (n = 321) underwent RYGB. White and female patients were predominant in both groups. Mean age was similar for both populations (SG: 71.1 ± 4.0, RYGB: 71.7 ± 4.5; P = .12). Pre-procedure mean BMI for both groups was close in value, but the difference was statistically significant (40.5 ± 5.5 for SG versus 43.7 ± 7.2 for RYGB; P < .0001). Postoperative follow-up rates were similar in both groups at 12 and 24 months (SG: 51.2% and 31.6%; RYGB: 48.3% and 34.3%; P = .49 and P = .5). The %EBMIL at 6, 12, and 24 months was higher for the RYGB group than the SG group (59.3 ± 27.9, 72.1 ± 29.5, 77.4 ± 26.1 versus 50.2 ± 21.9, 55.2 ± 25.6, 43.9 ± 32.2; P < .01, P < .01, and P < .01, respectively). Complication rates were significantly higher in RYGB versus SG (27.7% versus 9.4%; P < .01). We observed significantly higher anastomotic ulcer and stricture rates for RYGB versus SG (7.2% and 5.9 versus 0% and 0%; P < .01 and P < .01, respectively). RYGB had a higher rate for gastrointestinal obstruction requiring intervention (2.2% versus .4%; P = .07). A similar de novo gastroesophageal reflux disease rate was noted in both procedures (3.7% versus 3.7%; P = .98). No leaks were reported in either group. CONCLUSIONS: Both SG and RYGB are effective weight loss procedures for patients aged ≥65 years. RYGB seems to have higher %EBMIL at 1 and 2 years; however, when compared with SG, complication rates appear to be almost 3 times higher.

Embryo Buoyancy and Cell Death Gene Expression During Embryogenesis of Yellow-Tail Kingfish Seriola lalandi.

In pelagic fish, embryo buoyancy is a noteworthy aspect of the reproductive strategy, and is associated with overall quality, survival, and further developmental success. In captivity, the loss of buoyancy of early embryos correlates with high mortality that might be related to massive cell death. Therefore, the aim of this study was to evaluate under captivity conditions the expression of genes related to the apoptosis process during the early embryonic development of the pelagic fish Seriola lalandi, and its relationship to the buoyancy of embryos. The relative expression of bcl2, bax-like, casp9, casp8, and casp3 was evaluated by RT-qPCR and FasL/Fas protein levels by western blot in five development stages of embryos sorted as floating or low-floating. All genes examined were expressed in both floating and low-floating embryos up to 24 h of development. Expression of the pro-apoptotic factors bax, casp9, casp8, and casp3 was higher in low-floating as compared with floating embryos in a developmental stage-specific manner. In contrast, there was no difference in expression of bcl2 between floating and low-floating embryos. Fas protein was detected as a single band in floating embryos without changes in expression throughout development; however, in low-floating embryos, three higher intensity reactive bands were detected in the 24-h embryos. Interestingly, FasL was only detected at 24-h in floating embryos, whereas in low-floating samples this ligand was present at all stages, with a sharp increase as development progressed. Cell death, as evaluated by the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay, was highly increased in low-floating embryos as compared to floating embryos throughout all developmental stages, with the highest levels observed during the gastrula stage and at 24 h. The results of this study suggest that an increase in cell death, probably associated with the intrinsic and extrinsic apoptosis pathways, is present in low-floating embryos that might explain their lower developmental potential under captivity conditions.

Migratory connectivity then and now: a northward shift in breeding origins of a long-distance migratory bird wintering in the tropics.

Temporal variation in the connectivity of populations of migratory animals has not been widely documented, despite having important repercussions for population ecology and conservation. Because the long-distance movements of migratory animals link ecologically distinct and geographically distant areas of the world, changes in the abundance and migratory patterns of species may reflect differential drivers of demographic trends acting over various spatial scales. Using stable hydrogen isotope analyses (δ2H) of feathers from historical museum specimens and contemporary samples obtained in the field, we provide evidence for an approximately 600 km northward shift over 45 years in the breeding origin of a species of songbird of major conservation concern (blackpoll warbler, Setophaga striata) wintering in the foothills of the eastern Andes of Colombia. Our finding mirrors predictions of range shifts for boreal-breeding species under warming climate scenarios and habitat loss in the temperate zone, and underscores likely drivers of widespread declines in populations of migratory birds. Our work also highlights the value of natural history collections to document the effects of global change on biodiversity.

Change in avian functional fingerprints of a Neotropical montane forest over 100 years as an indicator of ecosystem integrity.

Ecologically relevant traits of organisms in an assemblage determine an ecosystem's functional fingerprint (i.e., the shape, size, and position of multidimensional trait space). Quantifying changes in functional fingerprints can therefore provide information about the effects of diversity loss or gain through time on ecosystem condition and is a promising approach to monitoring ecological integrity. This, however, is seldom possible owing to limitations in historical surveys and a lack of data on organismal traits, particularly in diverse tropical regions. Using data from detailed bird surveys from 4 periods across more than a century, and morphological and ecological traits of 233 species, we quantified changes in the avian functional fingerprint of a tropical montane forest in the Andes of Colombia. We found that 78% of the variation in functional space, regardless of period, was described by 3 major axes summarizing body size, dispersal ability (indexed by wing shape), and habitat breadth. Changes in species composition significantly altered the functional fingerprint of the assemblage and functional richness and dispersion decreased 35-60%. Owing to species extirpations and to novel additions to the assemblage, functional space decreased over time, but at least 11% of its volume in the 2010s extended to areas of functional space that were unoccupied in the 1910s. The assemblage now includes fewer large-sized species, more species with greater dispersal ability, and fewer habitat specialists. Extirpated species had high functional uniqueness and distinctiveness, resulting in large reductions in functional richness and dispersion after their loss, which implies important consequences for ecosystem integrity. Conservation efforts aimed at maintaining ecosystem function must move beyond seeking to sustain species numbers to designing complementary strategies for the maintenance of ecological function by identifying and conserving species with traits conferring high vulnerability such as large body size, poor dispersal ability, and greater habitat specialization. Article impact statement: Changes in functional fingerprints provide a means to quantify the integrity of ecological assemblages affected by diversity loss or gain.

Cambios en las Huellas Funcionales Aviarias en un Bosque Neotropical de Montaña durante Cien Años como Indicadores de la Integridad del Ecosistema Resumen Las características ecológicamente relevantes de los organismos que pertenecen a un ensamblaje determinan la huella funcional de un ecosistema (es decir, la forma, el tamaño y la posición del espacio multidimensional de la característica en cuestión). Por lo tanto, la cuantificación de los cambios en las huellas funcionales puede proporcionar información sobre los efectos que tiene la pérdida o ganancia de diversidad a lo largo del tiempo sobre las condiciones del ecosistema; por esto se le considera una estrategia prometedora para el monitoreo de la integridad ecológica. Sin embargo, lo anterior es pocas veces posible debido a las limitaciones de los censos históricos y a la falta de datos sobre las características del organismo, particularmente en las diversas regiones tropicales. Con datos detallados de censos realizados durante cuatro periodos en más de un siglo, y utilizando las características morfológicas y ecológicas de 233 especies, cuantificamos los cambios en la huella funcional aviaria de un bosque tropical de montaña en los Andes de Colombia. Encontramos que el 78% de la variación en el espacio funcional, sin importar el periodo, estuvo descrito por tres ejes principales que resumen el tamaño corporal, la habilidad de dispersión (indicada por la forma de las alas) y la amplitud del hábitat. Los cambios en la composición de especies alteraron significativamente la huella funcional del ensamblaje y la riqueza y dispersión funcional disminuyeron en 35-60%. Debido a la pérdida de especies y a la adición de especies nuevas al ensamblaje, el espacio funcional disminuyó con el tiempo, pero, durante la década de 2010, al menos el 11% de su volumen se extendió a áreas de espacio funcional que no estaban ocupadas cien años antes. El ensamblaje ahora incluye menos especies de gran tamaño, más especies con buena habilidad de dispersión y menos especialistas de hábitat. Las especies que se perdieron eran funcionalmente únicas, lo que resultó en reducciones importantes en la riqueza y en la dispersión funcional después de su pérdida, e implicó consecuencias importantes para la integridad del ecosistema. Los esfuerzos de conservación enfocados en mantener la función del ecosistema deben ir más allá de la búsqueda de la preservación del número de especies y enfocarse también en el diseño de estrategias complementarias para el mantenimiento de la función ecológica por medio de la identificación y conservación de especies con características que otorgan una vulnerabilidad alta, como lo son el tamaño corporal grande, una habilidad de dispersión pobre y una mayor especialización de hábitat.

Understanding intraoperative fluorescent cholangiography: ten steps for an effective and successful procedure.

BACKGROUND: Common bile duct injuries (BDI) during laparoscopic cholecystectomy (LC) continue to be the source of morbidity and mortality. The reason for BDI is mostly related to the misidentification of the extrahepatic bile duct structures and the anatomic variability. Near-infrared fluorescent cholangiography (NIFC) has proven to enhance visualization of extrahepatic biliary structures during LCs. The purpose of this study was to describe the most important steps in the performance of NIFC. METHODS: In accordance to the most current surgical practice of LC at our institution, a consensus was achieved on the most relevant steps to be followed when utilizing NIFC. Dose of indocyanine green (ICG), time of administration, and identification of critical structures were previously determined based on prospective and randomized controlled studies performed at CCF. RESULTS: The ten steps identified as critical when performing NIFC during LC are preoperative administration of ICG, exposure of the hepatoduodenal ligament, initial anatomical evaluation, identification of the cystic duct and common bile duct junction, the cystic duct and its junction to the gallbladder, the CHD, the common bile duct, accessory ducts, cystic artery and, time-out and identification of Calot's triangle, and evaluation of the liver bed. CONCLUSIONS: Routine use of NIFC is a useful diagnostic tool to better visualize the extrahepatic biliary structures during LC. The implementation of specific standardized steps might provide the surgeon with a better algorithm to use this technology and consequently reduce the incidence of BDI.

Body mass data set for 1,317 bird and 270 mammal species from Colombia.

Body mass is one of the most important phenotypic attributes in animal ecology and life history. This trait is widely used in the fields of ecology and macroevolution, since it influences physiology, morphological functions, and a myriad of ecological and social interactions. In this data set, our aim was to gather a comprehensive bird and mammal body mass data set from northern South America. We report body mass, discriminated by sex, for 42,022 individual birds and 7,441 mammals representing 1,317 bird species (69% of Colombia's avifauna) and 270 mammal species (51% of Colombian mammals) from the Neotropics. The data were sourced from vouchers collected between 1942 and 2020 and from individuals captured and released at banding stations over the last two decades for birds (2000-2020) and the last decade for mammals (2010-2020), by 10 research groups and institutions in Colombia. This data set fills gaps identified in other similar databases, as it focuses on northern South America, a highly diverse Neotropical region often underrepresented in morphological data sets. We provide wide taxonomic coverage for studies interested in information both at regional and local scales. There are no copyright restrictions; the present data paper should be appropriately cited when data are used for publication. The authors would appreciate learning about research projects, teaching exercises, and other uses given to this data set and are open to contribute in further collaborations using these data.

Weight loss following bariatric surgery decreases pericardial fat thickness lowering the risk of developing coronary artery disease.

BACKGROUND: Pericardial fat has a local atherosclerotic effect and is associated with both metabolic syndrome (MetS) and coronary artery disease (CAD). OBJECTIVES: The aim of this study is to report changes in pericardial fat thickness (PFT) after bariatric surgery, and to investigate its significance on the risk of developing coronary artery disease (CAD). SETTING: Academic institution. METHODS: We retrospectively measured the linear pericardial thickness from patients' computed tomography (CT) scans within 5 years preoperatively and compared to any available CT scan within 5 years postoperatively. The PFT was measured at the right ventricular wall, perpendicular to the myocardium, at the level of the sternum. The risk of developing CAD was estimated by calculating the Framingham risk score (FRS). We divided the patients into 2 groups: laparoscopic sleeve gastrectomy (SG, Group 1), and laparoscopic gastric Roux-en-Y gastric bypass (LRYGB, Group 2). Common demographic characteristics and co-morbidities were collected along with the preoperative and postoperative lipid profiles. RESULTS: A total of 113 patients met the inclusion criteria, with 64 (56.6%) patients in group 1 and 49 (43.3%) patients in group 2. Group 1 consisted of 83.6% (n = 53) female patients versus 75.5% (n = 37) in group 2. The percent excess body mass index loss (%EBMIL) at 12 months was 74.4 ± 35.8% for group 1 versus 67 ± 30.1% for group 2 (P = .292). Pericardial thickness before surgery was 5.6 ± 1.9 mm and 4.6 ± 1.6 mm after surgery (P = .0001). The risk of CAD in females was 9.1% before and 6.6% after surgery. We found statistically significant linear association between pericardial thickness after surgery and a lower risk of CAD (P = .001). CONCLUSION: Bariatric surgery decreases the PFT lowering risk of developing CAD. Further studies may be needed to better assess these findings.

Short-term multiorgan metabolic benefits of rapid weight loss after sleeve gastrectomy in severely obese patients.

BACKGROUND: Sleeve gastrectomy (SG) has become the most prevalent bariatric-metabolic surgical approach in the United States. Its popularity among surgeons and patients is mainly due to a better safety profile and less overall morbidity, with broad benefits from a systemic and metabolic perspective. OBJECTIVE: Comprehensively describe the short-term multiorgan metabolic effects of rapid weight loss after SG. SETTING: Academic hospital, United States. METHODS: We retrospectively reviewed the charts of patients that underwent SG at our institution between 2012 and 2016. We analyzed the required variables to calculate multiple risk scores, such as cardiovascular, hypertension, and diabetes risk scores. Furthermore, the renal and hepatic functions and the metabolic and hematologic profiles were assessed at 12 months of follow-up. RESULTS: A total of 1002 patients were included in the analysis. The percentage of excess body mass index loss was, on average, 65% at 12 months of follow-up. We observed a positive cardio-renal-hepatic improvement, demonstrated by a substantial reduction of the 10-year cardiovascular risk. We noticed an improvement of renal function, which was more significant in chronic kidney disease (stage ≥2), and a significant improvement on liver function tests (measured by decreased aspartate aminotransferase and alanine transaminase) at 12 months of follow-up. Our data also show a positive impact on decreasing the risk of developing hypertension and type 2 diabetes. There was a positive impact on the lipid profile, with the exception of low-density lipoprotein. CONCLUSION: There are significant short-term benefits on multiorgan metabolic parameters after rapid weight loss in severely obese patients undergoing sleeve gastrectomy.

Ripening and Storage Time Effects on the Aromatic Profile of New Table Grape Cultivars in Chile.

The aim of this study was to determine the volatile profiles of new seedless table grape cultivars Timco™, Magenta™, Krissy™ and Arra15™ and compare them with the traditional table grape variety Crimson seedless. The volatile profiles were extracted employing solid-phase microextraction and analyzed with gas chromatography coupled with mass spectrometry. Terpenes were present in very different proportions, with the Magenta, Krissy, and Arra15 varieties showing much higher quantities than Crimson and Timco. ß-Ionone and octanal, important indicators in the aromatic flavor quality of table grapes, were present in higher levels in Crimson and Arra15, and this might be responsible for driving consumer preference. These compounds significantly increased during ripening, except in Crimson, and gradually decreased from harvest to the end of the storage in all the cultivars. Evolution during ripening was different depending on the variety but the general tendency terpenes was to increase from veraison to harvest. A postharvest study revealed that Crimson could have a better conservation of the volatile components during postharvest storage compared with Timco and Krissy. These results could help in plant breeding programs and to make decisions for new planting according to needs for storing fresh table grapes given distances to consumer markets.