The ants of the genus Rhopalothrix Mayr, 1870 (Hymenoptera, Formicidae, Myrmicinae) in Colombia.

The ants of the genus Rhopalothrix are diverse in the Neotropical region, with 14 of the 16 described species. Based on museum material and recent fieldwork, Rhopalothrix ants in Colombia were reviewed. Morphological analysis of the workers allowed delimitation of six species, including two new species, Rhopalothrixmandibularis Guerrero & Grajales, sp. nov. and Rhopalothrixmariaemirae Tocora, Fiorentino & Fernández, sp. nov. A new combination Rhopalothrixamaticomb. nov. is proposed for Eurhopalothrixamati. A worker-based taxonomic key, high-definition images of the workers, and a distribution map of all Rhopalothrix species present in Colombia are provided.

First Ecuadorian statement consensus for the evaluation and treatment of osteoporosis.

Osteoporosis management has become more relevant as the life expectancy increases. In Ecuador, approximately 19% of adults over 65 years of age have been diagnosed with osteoporosis. There is no national consensus for the management and prevention of the disease being this proposal the first Ecuadorian consensus. INTRODUCTION: In Ecuador, it is estimated that around 19% of adults over 65 years of age have osteoporosis. Due to the increase in life expectancy in the world population, the evaluation and management of osteoporosis has become more relevant. Currently, there is no national consensus for the management and prevention of the disease. The Ecuadorian Society of Rheumatology presented the project for the elaboration of the first Ecuadorian consensus for the management and prevention of osteoporosis. METHODS: A panel of experts in multiple areas and extensive experience was invited to participate. The consensus was carried out using the Delphi method. Six working dimensions were created: definition and epidemiology of osteoporosis, fracture risk prediction tools, non-pharmacological treatment, pharmacological treatment, calcium and vitamin D, and glucocorticoid-induced osteoporosis. RESULTS: The first round was held in December 2021, followed by the second round in February 2022 and the third round in March 2022. The data was shared with the specialists at the end of each round. After three rounds of work, a consensus was reached for the management and prevention of osteoporosis. CONCLUSION: This is the first Ecuadorian consensus for the management and treatment of postmenopausal osteoporosis.

D-Dimer trend in a long-term rheumatoid arthritis patient with tofacitinib treatment and recent COVID-19 infection

The SARS-CoV-2 virus was first identified in December 2019, the infection was named COVID-19. The initial symptoms and evolution of the disease have been described over the past year. The virus has been shown to increase the risk of thromboembolic events due to the hypercoagulable state triggered by systemic endothelial inflammation. We present the case of a patient with a history of rheumatoid arthritis under prolonged treatment with tofacitinib, who presented COVID-19 and subsequently developed a hypercoagulable state of approximately 6 months' duration. The possible association between viral infection and the use of tofacitinib is debated.

El virus SARS-CoV-2 se identificó por primera vez en diciembre de 2019; la infección se denominó COVID-19. Los síntomas iniciales y la evolución de la enfermedad se han descrito durante el último anno. Se ha demostrado que el virus aumenta el riesgo de eventos trom-boembólicos debido al estado de hipercoagulabilidad desencadenado por la inflamación endotelial sistêmica. Se presenta el caso de un paciente con antecedente de artritis reuma-toide en tratamiento prolongado con tofacitinib, que presentó COVID-19 y posteriormente desarrolló un estado de hipercoagulabilidad de aproximadamente seis meses de duración. Se debate la posible asociación entre la infección viral y el uso de tofacitinib.

The Pheidole Westwood, 1839 ants (Formicidae: Myrmicinae) in Colombia: new records including two species with remarkable morphology.

Pheidole is one of the most diverse groups of ants in the World, with more than 630 species known from the Neotropical Region. As part of studies on the ant fauna of Colombia, a contribution to the taxonomy of these ants is presented here. The worker subcastes of Pheidole praeusta Roger are redescribed, this being the first record of a trimorphic species outside the Nearctic region. Pheidole amata Forel is proposed as a junior synonym of Pheidole praeusta. Pheidole rogeripolita Longino is identified as the first species in the New World with a 5-segmented antennal club, and the third species with such antennal club in the world. Pheidole distorta Forel, a species described 120 years ago, is redescribed, and notes on its reproductive caste are offered. The description and diagnosis of the Pheidole iceni Fernndez soldier is amended. New species records for the country and South America are listed. Multifocus photographs of P. praeusta, and P. rogeripolita are offered.

Autoinflammatory/Autoimmunity Syndrome Induced By Adjuvants (ASIA) Due to Silicone Incompatibility Syndrome.

The adjuvant-induced autoimmune syndrome (ASIA) is associated with a dysregulation of the innate and adaptive immune system after exposure to chemical compounds, including liquid paraffin, silicone gel, acrylamides, and hyaluronic acid. Due the increase of the use of these compounds in cosmetic procedures, the prevalence of this syndrome is increasing. We present the first report in Ecuador associated to ASIA after an elective silicone breast prosthesis procedure, manifested as polyarthralgia, positive antinuclear antibody, anticentromere antibody, and a moderate positive Sclero-70.

Resultados clínicos del tratamiento de pacientes con hernia inguinal unilateral mediante cirugía ambulatoria

Objetivo: Describir los resultados clínicos del tratamiento de pacientes con hernia inguinal unilateral (HIU) realizados en una unidad de cirugía mayor ambulatoria de un hospital de nivel III. Material y métodos: Se revisaron las historias clínicas de los pacientes operados de HIU en la Unidad de Cirugía Mayor ambulatoria (UCMA) del Hospital Cayetano Heredia (HCH) entre julio del 2013 y junio del 2016. Resultados: El número final de pacientes incluidos fue 154. La edad promedio fue 43 años; 101 (65,6%) fueron varones; 104 (67,5%) tenían riesgo quirúrgico ASA I; 12 (7,8%) tenían enfermedades asociadas; 94 (61,0%) se operaron con la técnica abierta, y 60 (39,0%) por la vía laparoscópica. La cirugía laparoscópica fue usada con más frecuencia en las mujeres (p=0.037). El tiempo operatorio fue mayor en la cirugía laparoscópica (p=0.033). No hubo diferencia significativa con respecto a la edad, riesgo quirúrgico, complicaciones anestésicas y complicaciones quirúrgicas entre pacientes operados con cirugía abierta y con cirugía laparoscópica. En total 34 (22%) pacientes no salieron de alta el mismo día de la cirugía: Ocho (5,2%) pacientes por presentar complicaciones y 26 (16,8%) pacientes por razones administrativas/ sociales. Conclusión: La cirugía ambulatoria de HIU en adultos realizada por la técnica abierta o laparoscópica, es un procedimiento seguro que permite el alta del paciente el mismo día de la cirugía.

SUMMARY Objective: To describe the clinical outcomes of patients with unilateral inguinal hernia (UIH) treated in an ambulatory surgical unit (ASU) of a level III hospital. Methods: The clinical charts of patients treated at the ASU of Cayetano Heredia Hospital from July 2013 to June 2016 were reviewed. Results: 154 patients were included, mean age was 43 years; 101 (65.6%) were males; 104 (67.5%) had ASA I risk; 12 (7.8%) had underlying diseases; 94 (61.0%) undergone the open technique and 60 (39.0%) undergone laparoscopy. Laparoscopy was most frequently applied in women (p=0.037). Surgical time was higher in laparoscopic procedures (p=0.033). No significant differences were observed in variables such as age, surgical risk, anesthetic and surgical complications between open and laparoscopic procedures. Thirty-four (22%) patients were not discharged the day of the procedure: 8 (5.2%) presented complications and 26 (16.8%) had administrative or social reasons. Conclusion : Ambulatory surgery of UIH in adults either by open or laparoscopic procedures is safe and allows discharging patients the day of the procedure.

Morphological and genetic evidence supports the separation of two Tapinoma ants (Formicidae, Dolichoderinae) from the Atlantic Forest biome.

The taxonomic boundaries of many Neotropical ant species of the genus Tapinoma are still unclear. Tapinoma atriceps and T. atriceps breviscapum are two morphologically similar taxa which occur sympatrically in the southern Atlantic Forest of Brazil. Some characters such as the scape length and head shape suggest that these taxa may be different species. We used DNA analysis and morphological evidence, including scanning electron microscopy, to evaluate the taxonomic validity of these taxa. We found distinct morphological characteristics that allow separating them as two different species, Tapinoma atriceps and Tapinoma breviscapum status novo, and this decision is supported by the DNA results, where Tapinoma atriceps was recovered as a lineage independent of T. breviscapum.

Beyond Rheumatoid Arthritis Evaluation: What are We Missing?

Rheumatoid Arthritis (RA) is a chronic inflammatory autoimmune systemic disease that preferentially affects small and large joints with a progressive course and can become deforming and disabling. In recent years, much progress has been made in the evaluation of inflammation and disease activity, however, there are other factors that have a high impact on the quality of life of these patients, such as depression, anxiety, fatigue, sleep disorders, suicidal behavior, fibromyalgia, sexual activity, sarcopenia, frailty, cachexia and obesity that are not always evaluated by rheumatologists. This review shows that the evaluation and timely detection of these aspects in patients with RA could interfere with the prognosis and improve their quality of life.

Transfer of two South American ant species from Tapinoma Foerster 1850 to Forelius Emery 1888 (Hymenoptera: Formicidae: Dolichoderinae).

Some species of the ant genus Forelius can be misclassified as the genus Tapinoma due to the convergent reduction of the petiolar scale. I review the taxonomic status of Tapinoma antarcticum Forel 1904 and Tapinoma heyeri Forel 1902. Morphological evidence supports the transfer of these names to the ant genus Forelius. Proposed taxonomic changes are as follows: Forelius antarcticus (Forel) comb. nov. (=Forelius fazi (Santschi 1923) comb. nov., =Forelius eidmanni Goetsch 1933 comb. rev.); Forelius heyeri (Forel) comb. nov. (=Forelius heyeri risii (Forel 1912) comb. and syn. nov., =Forelius pusillus (Santschi 1922) syn. nov., =Forelius tucumanus (Kusnezov 1953) syn. nov.). Lectotypes for Forelius antarcticus and Forelius heyeri are designated. The worker of Forelius heyeri, as well as the worker and queen of Forelius antarcticus are diagnosed and redescribed. Multifocus images for lectotype workers are provided. Morphological variation within and between species of Forelius with rounded spiracles is discussed.

LARS study: Latin American rheumatologist survey.

BACKGROUND/OBJECTIVE: Latin America has scarce information related to rheumatologist's education, working conditions, productivity, and job satisfaction. The purpose of this survey was to describe the training and clinical practice characteristics of the rheumatology community in Latin America. METHODS: This is a cross-sectional study. A digital survey was created, approved, and endorsed by the scientific committee of the Pan-American League of Associations for Rheumatology (PANLAR) and later sent to the rheumatology associations of the region. The data was analyzed in the statistical program SPSS v.22. RESULTS: We included 600 surveys of rheumatologists from 19 Latin American countries. The majority were females (53%) and mestizos (58%). The mean age was 46.8 ± 11.7 years. The most frequent workplace was public/government hospitals 33.5% followed by private practice 28.8%, private hospital 20.8%, and university hospital 15.5%. The average number of weekly working hours was 37.8 ± 17.7. 87.5% worked in adult rheumatology, 12.7% pediatric rheumatology, and 23.5% internal medicine. Average satisfaction with practice as a rheumatologist was 5.3/7, career options 4.3/7, location 4.7/7, income 3.5/7, job security 3.7/7, and colleagues and co-workers 4.5/7. Finally, 69.7% had an annual compensation of < 50,000 US dollars. CONCLUSIONS: The majority of the rheumatologists in the region who responded were women, worked in public hospitals, and were satisfied with their clinical practice. There was a low level of income for the region. Key Points • This is the first study that showed the demographic and clinical practice characteristics of rheumatologists in Latin America. • The challenges faced by Latin rheumatologists are like those faced by the region: ethnic diversity, gender differences, migration, difficult access to education, limited research, and low income. • Due to the high prevalence of rheumatic diseases and the shortage of professionals in this area, it is essential to analyze the current workforce and the projections of supply and demand in rheumatology that are expected in the future.

La cirugía bariátrica modifica la diversidad bacteriana y los metabolitos de la microbiota intestinal mejorando el perfil metabólico del huésped y contribuyendo a la reducción del peso

La obesidad es una enfermedad crónica multifactorial de características inflamatorias que afecta a ambos sexos y a todas las edades a nivel mundial, aumentando la morbilidad y mortalidad por diversas enfermedades. La obesidad se asocia a disbiosis de la microbiota intestinal, alterando con ello la absorción de nutrientes y el metabolismo energético. La cirugía bariátrica ha demostrado ser el mejor tratamiento para la obesidad mórbida y las enfermedades asociadas al sobrepeso. Los estudios de los efectos de la cirugía bariátrica sobre la microbiota intestinal, realizados en los últimos cinco años, se caracterizaron por tener poca cantidad de sujetos en las muestras, con seguimientos entre seis meses y un año, teniendo resultados heterogéneos. En general, la cirugía bariátrica produce cambios importantes en la microbiota intestinal, con aumento de los filos Proteobacteria, Fusobacteria y Verrucomicrobia; y disminución del filo Firmicutes. Akkermansia muciniphila puede ser una bacteria-clave asociada a los beneficios obtenidos por la cirugía. La diversidad bacteriana aumenta a partir de los seis meses de la cirugía, y la conformación final de la microbiota, luego de un periodo de adaptación, está asociado a un perfil metabólico bacteriano detox-redox con poca liberación de energía. No se ha demostrado ninguna relación de causalidad entre los cambios de la microbiota intestinal producidos por la cirugía y los efectos beneficiosos de la misma, aunque los estudios de trasplante de material fecal sugieren una verdadera transferencia fenotípica asociada al peso y al perfil metabólico. Conocer los mecanismos de esta relación microbiota-hospedero ayudaría a encontrar intervenciones terapéuticas con los mismos resultados que se obtienen con la cirugía. En conclusión, la cirugía bariátrica induce cambios importantes en la microbiota intestinal, donde los metabolitos bacterianos interactúan con el huésped mejorando el perfil metabólico y contribuyendo a la pérdida del peso.

Rol de la homocisteína y vitamina B en el metabolismo óseo / Role of homocysteine and vitamin B in bone metabolism

RESUMEN Se han propuesto varios estudios que sugieren que el grupo de vitaminas B posee un rol en la fisiología ósea. Se realizó una revisión bibliográfica sobre la interacción de este con la homocisteína y la relación de ambos con el metabolismo óseo y la osteoporosis. Algunos estudios han sugerido que los niveles de vitamina B, sobre todo las vitaminas B12 y B9, se han asociado a una baja densitometría ósea y a un aumentado riesgo a fractura, y que estos, a su vez, intervienen en el metabolismo de la homocisteína, por lo que su déficit puede ocasionar un estado de hiperhomocisteinemia. Publicaciones recientes proponen que la hiperhomocisteinemia se encuentra asociada a desmineralización ósea, baja calidad de masa ósea y aumento de biomarcadores de recambio óseo, dado que influye en la actividad osteoclástica y en los enlaces cruzados de colágeno. Por lo tanto, la hiperhomocisteinemia puede ser un factor que reduce la densidad y la calidad ósea. Se necesita más información para determinar el papel que tiene cada vitamina directamente en la salud ósea, o si estas solo influyen a través de las concentraciones séricas de homocisteína.

ABSTRACT Several studies have suggested a role for B-vitamins in bone physiology. A systematic review is presented on the interaction of B-vitamins with homocysteine and the relationship of both in bone metabolism and osteoporosis. The levels of vitamin-B, particularly B12 and B9, have been associated with a low bone mineral density and an increased risk of fracture. At the same time, its deficit affects the metabolism of homocysteine, which can then result in a high serum homocysteine. Recent findings have proposed that high serum homocysteine is linked to bone demineralisation, low quality of bone mass, and an increase in bone turnover biomarkers, given the influence over the osteoclastic activity and the cross-linking of collagen molecules. Therefore, high serum homocysteine could be a factor that reduces bone density and quality. More information is needed to determine whether there is a direct role of each vitamin in bone health, or if they are just influenced by homocysteine serum concentrations.

FRAX-based assessment and intervention threshold curves for osteoporosis evaluation in Ecuador / Curvas de intervención y evaluación basadas en FRAX Ecuador

RESUMEN Introducción: La herramienta FRAX ha sido validada y adaptada a diferentes países, cubriendo a casi el 80% de la población mundial, incluido Ecuador, donde fue adaptada en 2009. El objetivo de este estudio fue elaborar curvas de evaluación e intervención basadas en FRAX Ecuador. Métodos: Utilizando el modelo FRAX Ecuador, calculamos la probabilidad de fractura osteoporótica mayor y fractura de cadera femenina sin ningún factor de riesgo y sin la inclusión de DMO. Las probabilidades se calcularon en intervalos de 5 años de 40 a 90 años. Las probabilidades de fractura mayor y de cadera se calcularon en 3 escenarios diferentes: 1. Historia de fractura previa sin la inclusión de DMO, 2. T-Score de -2,5 SD sin otros factores de riesgo clínico, 3. T-Score -1,5 SD sin otros factores de riesgo clínico. Resultados: En mujeres sin factores de riesgo, la probabilidad de fractura osteoporótica mayor aumentó con la edad del 0,4% a los 40 años al 7,3% a los 90 años. La probabilidad de fractura de cadera aumentó con la edad de 0% a los 40 años a 3,6% a los 90 anos. La probabilidad de fractura osteoporótica mayor aumentó en mujeres con un puntaje T de -2,5 SD de 0,9% a los 40 años a 5,5% a los 90 años; con puntaje T de -1,5 DE, de 0,6% a los 40 años a 3,9% a los 90 anos. Conclusión: Los datos muestran la importancia de aplicar herramientas como FRAX, específicas para cada país y también la creación de curvas de evaluación e intervención que permitan discernir según cada paciente la necesidad de utilizar recursos como DXA y tratamientos específicos.

ABSTRACT Introduction: FRAX has been validated and adapted to different countries, covering almost 80% of the world's population, including Ecuador where it was adapted in 2009. The purpose of this study is to elaborate evaluation and intervention curves based on FRAX Ecuador. Methods: Using the FRAX Ecuador model, we calculated the probability of a major osteoporotic fracture and a female hip fracture without any risk factor and without the inclusion of BMD. The probabilities were calculated in 5-year intervals from 40 to 90 years. The probabilities of major fractures and hip fractures were calculated in 3 different scenarios: 1. History of previous fracture without the inclusion of BMD, 2. T score -2.5 SD without other clinical risk factors, 3. T score -1.5 SD without other clinical risk factors. Results: In women without risk factors, the probability of a major osteoporotic fracture increased with age from 0.4% at 40 years to 7.3% at 90 years. The probability of hip fracture increased with age from 0% at 40 years to 3.6% at 90 years. The probability of a major osteoporotic fracture increased in women with a T score of -2.5 SD from 0.9% at 40 years to 5.5% at 90 years; with a T-score of -1.5 SD, from 0.6% at 40 years to 3.9% at 90 years. Conclusion: Data shows the importance of applying tools such as FRAX, specific for each country and also the creation of evaluation and intervention curves that allow discerning according to each patient the need for the use of resources such as DXA and specific treatments.

Functional Disability and Its Determinants in Ecuadorian Patients with Rheumatoid Arthritis.

INTRODUCTION: Disability in RA is associated with loss of workdays, greater use of health resources and a higher prevalence of depression. The purpose of this study was to determine the prevalence of functional disability and the factors associated with it. METHODS: A cross-sectional study was carried out during January-June 2019 at a rheumatology clinic in the city of Guayaquil. Patients with pre-established RA were included. Functional disability was measured using the HAQ-DI. Data were analyzed using the statistical program SPSS v22. We compared characteristics between patients with and without disability using Student's t-test and chi-square. A multiple logistic regression model for functional disability was made. RESULTS: We included 395 patients, 87.8% female and 12.2% male with a mean age of 51.4±12 years and mean duration of disease 13.8±7 years. Most patients had extra-articular manifestations (80.8%) and comorbidities (81.3%). The mean HAQ-DI was 0.8±0.9, with a prevalence of disability of 26.6%. We found a statistically significant relationship between disability and female sex (p=0.018), age (p=0.020), presence of extra-articular manifestations (p=0.008), myalgia (p<0.001) and fatigue (p<0.001). In addition, patients with disabilities had a lower employment rate (26.7%) compared to those without disability (45.5%, p=0.001). In the multivariate logistic analysis, only depression (p=0.029), diabetes (p=0.003), SJC (p=0.001) and VAS of pain (p=0.004) were significantly related to functional disability. CONCLUSION: Disability affects a quarter of patients with RA. Among the determinants of disability, we found female sex, older age, grade of pain, inflammatory markers and the level of disease activity.

Vitamin D Megadose: Definition, Efficacy in Bone Metabolism, Risk of Falls and Fractures.

INTRODUCTION: Currently, approximately more than one billion people around the world are considered to have deficient levels of vitamin D. International consensus recommends vitamin D supplementation to high-risk patients (advanced age, osteoporosis, liver failure, malabsorption syndromes, etc.) and those with levels below 30 ng/mL. There are several vitamin D formulations and dosages available, including megadoses. At the moment, there is no consensus on the definition of megadoses. The purpose of this review is to define what is a megadose and analyze its effectiveness in bone metabolism, risk of fractures and falls. CONCLUSION: The administration of doses higher than 100,000 IU of vitamin D is considered a megadose. It is evident that the use of megadoses increases serum concentrations of vitamin D; however, there has been no evidence of a decrease in the risk of falls, vertebral fractures or changes in bone mineral density.

Rheumatologists in Ecuador: Results of a Survey.

INTRODUCTION: Currently, there are no records of the current status of rheumatologists in Ecuador. OBJECTIVE: The purpose of this study is to get to know the current status of rheumatologists in Ecuador, focusing on education, working conditions, productivity, distribution of time between work activities, and job satisfaction. MATERIALS AND METHODS: A digital survey was created using the Google Forms platform. It was distributed to all rheumatologist members of the Ecuadorian Society of Rheumatology. The data analysis was carried out using the statistical program SPSS v.23®. RESULTS: A total of 64 surveys were received. The response rate was 86.48%. 62.5% were men and 37.5% women, with an average age of 40.76 ± 9.18. The main workplace was state/public hospital (56.3%). The average working hours per week were 40.35 ± 25.72. Most rheumatologists in Ecuador (62.5%) received their training abroad. 79.7% of rheumatologists earn less than $ 49,000 annually. The mean retirement age was 66.51 ± 6.7, and 54.7% have a retirement plan. The average satisfaction of Ecuadorian rheumatologists was 5.4 ± 1.33 [0-7]; 17.2% are very dissatisfied with their annual income. CONCLUSIONS: This is the first recorded data on the characteristics of rheumatologists in Ecuador. Most rheumatologists obtained their specialist degree abroad. In general, rheumatologists in Ecuador are satisfied with their clinical practice and dissatisfied with their annual income and job security.

Schismatothelinae spiders (Araneae, Mygalomorphae, Theraphosidae) from Colombia: four new species and an approach to their diversity.

The spider subfamily Schismatothelinae from Colombia is revised. One new species of Euthycaelus Simon 1889 and three new species of Schismatothele Karsch 1879 are named, as well as new geographical records provided. E. guane sp. nov. from Santander, S. hacaritama sp. nov. from Norte de Santander, S. olsoni sp. nov. from Norte de Santander and Táchira (Venezuela), and S. weinmanni sp. nov. from Cundinamarca are herein described, diagnosed and illustrated. Schismatothele is newly recorded from Colombia. Morphological aspects and diversity of the Ischnocolinae and Schismatothelinae from Colombia are discussed. An identification key to species of these subfamilies from Colombia is provided.

Design and implementation of modified-texture diet in older adults with oropharyngeal dysphagia: a randomized controlled trial.

BACKGROUND/OBJECTIVES: Oropharyngeal dysphagia (OD) is a common problem in elderly population that negatively affects the oral intake and body composition resulting in clinical complications as malnutrition and dehydration. The aim of this study was to design, implement, and evaluate the effect of texture-modified foods and thickened drinks diet, with nectar or pudding viscosity and controlled bolus volume in older adults with OD on body composition and oral intake. SUBJECTS/METHODS: Randomized clinical trial, simple blind. Patients ≥ 65 years, admitted at a national institute, who had a confirmed diagnosis of OD were included. A texture-modified foods and thickened drinks diet, with nectar or pudding viscosity and controlled bolus volume, was compared to isocaloric standard treatment for 12 weeks. Body composition was evaluated by bioelectrical impedance, muscular functionality was evaluated by handgrip strength, and daily energy and protein intake by 24-h recall and evaluated by Food Processor Nutrition Analysis® software. RESULTS: Twenty participants were included per group, with mean age 76 years. After 12 weeks, the consumption of energy (29 ± 10 to 40 ± 15 kcal/kg, p = 0.009) and protein (1.3 ± 0.6 to 1.8 ± 0.7 g/kg, p = 0.03), as well as phase angle (4.4 ± 1.8 to 5.5 ± 2.5°, p = 0.05), body weight (56 ± 10 to 60 ± 10 kg, p < 0.001), and handgrip strength (18 ± 11 to 21 ± 13 kg, p = 0.004) increased in the intervention group. In control group there were no changes. CONCLUSIONS: The dietary intervention improved oral intake, weight, handgrip strength, and phase angle, which can prevent or limit the nutritional complications associated with the OD.

Development of a Laparoscopic Box Trainer Based on Open Source Hardware and Artificial Intelligence for Objective Assessment of Surgical Psychomotor Skills.

BACKGROUND: A trainer for online laparoscopic surgical skills assessment based on the performance of experts and nonexperts is presented. The system uses computer vision, augmented reality, and artificial intelligence algorithms, implemented into a Raspberry Pi board with Python programming language. METHODS: Two training tasks were evaluated by the laparoscopic system: transferring and pattern cutting. Computer vision libraries were used to obtain the number of transferred points and simulated pattern cutting trace by means of tracking of the laparoscopic instrument. An artificial neural network (ANN) was trained to learn from experts and nonexperts' behavior for pattern cutting task, whereas the assessment of transferring task was performed using a preestablished threshold. Four expert surgeons in laparoscopic surgery, from hospital "Raymundo Abarca Alarcón," constituted the experienced class for the ANN. Sixteen trainees (10 medical students and 6 residents) without laparoscopic surgical skills and limited experience in minimal invasive techniques from School of Medicine at Universidad Autónoma de Guerrero constituted the nonexperienced class. Data from participants performing 5 daily repetitions for each task during 5 days were used to build the ANN. RESULTS: The participants tend to improve their learning curve and dexterity with this laparoscopic training system. The classifier shows mean accuracy and receiver operating characteristic curve of 90.98% and 0.93, respectively. Moreover, the ANN was able to evaluate the psychomotor skills of users into 2 classes: experienced or nonexperienced. CONCLUSION: We constructed and evaluated an affordable laparoscopic trainer system using computer vision, augmented reality, and an artificial intelligence algorithm. The proposed trainer has the potential to increase the self-confidence of trainees and to be applied to programs with limited resources.

Taxonomic identity of the ghost ant, Tapinoma melanocephalum (Fabricius, 1793) (Formicidae: Dolichoderinae).

This paper revises the taxonomy of Tapinoma melanocephalum (Fabricius, 1793) as follows: T. melanocephalum = Tapinoma luffae (Kuriam, 1955) syn. nov., = Tapinoma melanocephalum coronatum Forel, 1908 syn. nov., = Tapinoma melanocephalum malesianum Forel, 1913 syn. nov. A neotype of Tapinoma melanocephalum (Fabricius, 1793) is designed here. Lectotypes of Tapinoma melanocephalum coronatum Forel, 1908 and T. melanocephalum malesianum Forel, 1913 are designated. Formica wallacei is proposed as a replacement name for Formica familiaris (= T. melanocephalum senior synonym). The worker, queen and male are redescribed and diagnosed. The morphological variability of populations is discussed. All castes are included in full color images.