Hyperosmolar therapies for neurological deterioration in mild and moderate traumatic brain injury: A scoping review.

OBJECTIVE: To explore the available evidence on hyperosmolar therapies(HT) in mild and moderate traumatic brain injury(TBI) and to evaluate the effects on outcomes.A scoping review was conducted according to the Joanna Briggs Institute methodology. Inclusion criteria: (a)randomized controlled trials(RCTs), prospective and retrospective cohort studies and case-control studies; (b)all-ages mild and moderate TBIs; (c)HT administration; (d)functional outcomes recorded; (e)comparator group. RESULTS: From 4424 records, only 3 respected the inclusion criteria. In a retrospective cohort study of adult moderate TBIs, the Glasgow Coma Scale(GCS) remained the same at 48 hours in those treated with hypertonic saline(HTS) while it worsened in the non-treated. A trend toward increased pulmonary infections and length of stay was found. In an RCT of adult severe and moderate TBIs, moderate TBIs treated with HTS showed a trend toward better secondary outcomes than standard care alone, with similar odds of adverse effects. An RCT enrolling children with mild TBI found a significant improvement in concussive pain immediately after HTS administration and after 2-3 days. No adverse events occurred. CONCLUSIONS: A gap in the literature about HTs' role in mild and moderate TBI was found. Some benefits may exist with limited side effects and further studies are desirable.

Body norms, body image, and media in a market-integrating indigenous population in Argentina: A mixed-methods investigation.

OBJECTIVE: The aim of this study was to investigate the relationship between media, body norms, and body image among the Qom, a market-integrating indigenous population in Argentina that has historically idealized larger body sizes. METHODS: With men and women (n = 87), we measured frequency of media/technology use through a Likert-type questionnaire. Using the Stunkard Figure Rating Scale, we asked participants to select the most healthy and ideal body size for their gender, as well as their own body size. We calculated body dissatisfaction as the difference between ideal and own body size. We conducted semi-structured interviews to describe the role of media in body norms and body image. RESULTS: Media exposure was not significantly associated with perceptions of the "healthiest" or most "ideal" body sizes, nor body dissatisfaction. Men and women perceived categorically "middle-range" body sizes as both healthy and ideal, differing from a similar study in 2010, where larger bodies were favored. Interviews revealed that: media is not recognized as affecting body norms and body image, but is conceptually associated with cultural loss (Theme 1); a "dual stigma" of fatness and thinness is perpetuated by peers, family, and healthcare providers (Theme 2); and body acceptance is highly valued (Theme 3). CONCLUSION: In this context, while some body norms have changed over time, the impact of media on body norms and image may be secondary to influences from individuals' social networks, and may be occluded by norms favoring body acceptance.

Early Stages Management of Traumatic Spinal Cord Injury in Latin America: A Scoping Review.

OBJECTIVE: To understand the extent and type of evidence on diagnosis, clinical presentation, management, outcomes, and costs of traumatic spinal cord injury (TSCI) in the early stages in Latin America. METHODS: The Joanna Briggs Institute methodology for scoping reviews was followed. Extracted data included study aim, country, methodology, population characteristics, and outcome measures. RESULTS: Thirteen studies met the inclusion criteria. Studies were grouped into 5 categories: associated lesions and intensive care unit (ICU); treatment; complications; neurologic outcomes; length of hospital stay (LOS), costs, and mortality. Studies were from Brazil, Mexico, Argentina, Colombia, Chile, and one included several countries. A significant number of patients had associated injuries, little information was found about ICU management. A high variability existed in the surgical and conservative management rate. Some medical therapies were found to be used that could partially alleviate the neurologic symptoms. Most complications were preventable, not always directly related to the event, and could be associated with increased mortality. LOS could be related to complications and to the type of interventions required, which, in turn, could increase the in-hospital costs. CONCLUSIONS: Information about the management of traumatic spinal cord injury in the early stages in Latin America is not exhaustive and high variability exists among the studies in all the examined sections. Nevertheless, many patients are polytraumatized, and little is known about ICU requirement. Treatment is heterogeneous and the complications are in many cases preventable conditions that can increase LOS, costs, and mortality.

Epidemiological Review of Spinal Cord Injury due to Road Traffic Accidents in Latin America.

Spinal cord injury (SCI) is a disease that affects the normal function of the spinal cord. Road traffic accidents (RTAs) represent the main cause of SCI worldwide. SCI may generate physical disability and economic dependency, which is especially significant in low- and middle-income countries such as most of the Latin American countries. The main objective of this study was to present an epidemiological review of SCI secondary to RTAs. Stronger evidence on this condition in Latin America is important for future-specific data collection and prevention strategies. A literature review was carried out using specific search strategies in databases of indexed journals from the period 2000 to 2019. Data on SCI secondary to RTAs in the Latin American region were collected and analyzed. After initial screening and removal of duplicates, 16 articles met the inclusion criteria and were chosen for analysis. Data from 7 Latin American countries were retrievable. On average, RTAs were responsible for 40.81% of SCI. Data from different studies are heterogeneous. Car accidents and moto accidents were equally responsible for SCIs (50.61% vs. 49.06%). The thoracic segments were the most commonly affected (57.87%). Males in their 30s were the most affected category (76.6%). SCI due to RTAs may represent a severe but preventable condition that affects mostly men in their productive age, generating important social and economic issues. Data about this condition in Latin America are scarce, and could limit prevention and treatment strategies. Prospective data collection about this condition is recommended.

From Learning to Relearning: A Framework for Diminishing Bias in Social Robot Navigation.

The exponentially increasing advances in robotics and machine learning are facilitating the transition of robots from being confined to controlled industrial spaces to performing novel everyday tasks in domestic and urban environments. In order to make the presence of robots safe as well as comfortable for humans, and to facilitate their acceptance in public environments, they are often equipped with social abilities for navigation and interaction. Socially compliant robot navigation is increasingly being learned from human observations or demonstrations. We argue that these techniques that typically aim to mimic human behavior do not guarantee fair behavior. As a consequence, social navigation models can replicate, promote, and amplify societal unfairness, such as discrimination and segregation. In this work, we investigate a framework for diminishing bias in social robot navigation models so that robots are equipped with the capability to plan as well as adapt their paths based on both physical and social demands. Our proposed framework consists of two components: learning which incorporates social context into the learning process to account for safety and comfort, and relearning to detect and correct potentially harmful outcomes before the onset. We provide both technological and societal analysis using three diverse case studies in different social scenarios of interaction. Moreover, we present ethical implications of deploying robots in social environments and propose potential solutions. Through this study, we highlight the importance and advocate for fairness in human-robot interactions in order to promote more equitable social relationships, roles, and dynamics and consequently positively influence our society.

Utilizing minimally purified secreted rAAV for rapid and cost-effective manipulation of gene expression in the CNS.

BACKGROUND: Recombinant adeno-associated virus (rAAV) is widely used in the neuroscience field to manipulate gene expression in the nervous system. However, a limitation to the use of rAAV vectors is the time and expense needed to produce them. To overcome this limitation, we evaluated whether unpurified rAAV vectors secreted into the media following scalable PEI transfection of HEK293T cells can be used in lieu of purified rAAV. METHODS: We packaged rAAV2-EGFP vectors in 30 different wild-type and mutant capsids and subsequently collected the media containing secreted rAAV. Genomic titers of each rAAV vector were assessed and the ability of each unpurified virus to transduce primary mixed neuroglial cultures (PNGCs), organotypic brain slice cultures (BSCs) and the mouse brain was evaluated. RESULTS: There was ~ 40-fold wide variance in the average genomic titers of the rAAV2-EGFP vector packaged in the 30 different capsids, ranging from a low ~ 4.7 × 1010 vector genomes (vg)/mL for rAAV2/5-EGFP to a high of ~ 2.0 × 1012 vg/mL for a capsid mutant of rAAV2/8-EGFP. In PNGC studies, we observed a wide range of transduction efficiency among the 30 capsids evaluated, with the rAAV2/6-EGFP vector demonstrating the highest overall transduction efficiency. In BSC studies, we observed robust transduction by wild-type capsid vectors rAAV2/6, 2/8 and 2/9, and by capsid mutants of rAAV2/1, 2/6, and 2/8. In the in vivo somatic brain transgenesis (SBT) studies, we found that intra-cerebroventricular injection of media containing unpurified rAAV2-EGFP vectors packaged with select mutant capsids resulted in abundant EGFP positive neurons and astrocytes in the hippocampus and forebrain of non-transgenic mice. We demonstrate that unpurified rAAV can express transgenes at equivalent levels to lysate-purified rAAV both in vitro and in vivo. We also show that unpurified rAAV is sufficient to drive tau pathology in BSC and neuroinflammation in vivo, recapitulating previous studies using purified rAAV. CONCLUSIONS: Unpurified rAAV vectors secreted into the media can efficiently transduce brain cells in vitro and in vivo, providing a cost-effective way to manipulate gene expression. The use of unpurified virus will greatly reduce costs of exploratory studies and further increase the utility of rAAV vectors for standard laboratory use.

Expresiones infantiles de agresividad en contextos educativos: una interpretación desde la psicología dinámica y las relaciones familiares / Infant expressions of aggressiveness in educational Context. Interpretation from dynamic psychology and family relationships

Este artículo es uno de los productos de la investigación Perspectivas interdisciplinarias de intervención con familias. Caso de la ciudad de Medellín y el Municipio de Rionegro. Una comprensión desde la Psicología, la Educación y la Familia. Describe los discursos de los niños sobre el fenómeno de la agresividad que experimentan en el Colegio Bello Oriente de Medellín. Su objetivo es detallar roles y límites en familias en las que hay niños que se comportan de manera agresiva en ambientes educativos. El enfoque metodológico de la investigación fue cualitativo. Los resultados de la investigación de los que se da cuenta en este artículo muestran una interpretación de la agresividad infantil a partir de la Psicología Dinámica; y un análisis de los roles y límites como dimensiones de la dinámica familiar. Como conclusión, es posible afirmar que los niños y las niñas pueden hacerse responsables de sus comportamientos agresivos y tramitar tal agresividad de manera simbólica cuando hallan mecanismos adecuados en sus familias e instituciones educativas; las relaciones familiares influyen en la formación de la personalidad de los infantes.

This article is a product of the research interdisciplinary perspectives of intervention with families. Case of Medellin and the Municipality of Rionegro. An understanding from Psychology, Education and Families. It Describes children's speeches on the phenomenon of aggression, experienced in the school Colegio Bello Oriente in Medellin. Its aim is to detail roles and limits in families where there are children who behave aggressively in educational settings. The methodological approach was qualitative research. The results show an understanding of children's aggression from the theoretical perspective of dynamic psychology, and an analysis of the roles and limits as dimensions of family dynamics in which children. In conclusion, it can be said that the children can take responsibility for their aggressive behavior and process symbolically this aggressiveness when they find appropriate mechanisms in their families and educational institutions.