Multitemporal modeling and simulation of the complex dynamics in urban wetlands: the case of Bogota, Colombia.

Urban wetlands are essential to the longstanding health and well-being of cities. Acknowledged as rich in biodiversity and highly productive ecosystems, they provide ecosystem services represented in aspects such as air purification, urban climate regulation, physical and mental health, recreation, and contemplation, among a wide variety of other goods and services on which the quality of life of the inhabitants of large cities such as Bogota depends largely. We used cellular automata to model and simulate urban wetland changes in Bogota, Colombia. The study applied the coupled Markov-Future Land Use Simulation (FLUS) model to simulate and analyze land use/land cover (LULC) change over 20 years. First, we used an orthomosaic (1998) and two WorldView-2 satellite images (2004 and 2010), to detect land cover changes. Then, using the artificial neural network FLUS module, we calculated the relationships between land classes and associated drivers and estimated the probability of occurrence of each land class. Finally, we applied Intensity Analysis to examine the observed and projected LULC change (1998-2034). Results indicate that gains in areas of crops and pastures are at the expense of wetlands. In addition, simulation outputs show that wetlands will likely represent less than 2% of the total study area in 2034, representing a 14% decrease in 24 years. The importance of this project lies in its potential contribution to the decision-making process within the city and as an instrument of natural resource management. Additionally, the results of this study could contribute to the United Nations Sustainable Development Goal 6, "Clean water and sanitation," and climate change mitigation.

[Abdominal pain with neuropsychiatric symptoms and ventilatory failure as a presentation of acute porphyria]. / Abdomen agudo con compromiso neuropsiquiátrico y ventilatoria como presentación de porfiria agudac.

Background: Acute intermittent porphyria (AIP) is an uncommon metabolic disease, being the most common of the acute porphyrias. The most frequent symptom is acute abdominal pain, although can be accompanied by seizures, neuro-psychiatric alterations or symmetrical motor neuropathies, which in some patients can progress to respiratory musculature paralysis. Objective: To describe an atypical presentation of acute porphyria to be considered as differential diagnoses in abdominal pain. Clinical case: We present a case of a patient with AIP, presenting acute abdomen, seizures, later developed neuropsychiatric compromise and symmetrical motor neuropathy, and was admitted to mechanical ventilation. Due to the severity of the neurological involvement, he received hemin arginate, presenting with transient hypertransaminemia, an adverse event not previously reported. The evolution was favorable, with mechanical ventilation and hospital discharge withdrawn. Conclusions: The diagnosis of AIP should be considered in cases of acute abdominal pain associated with neurological and/or psychiatric symptoms, particularly young women. The administration of hemin is considered the standard of treatment, and even late could have beneficial effects.

Introducción: la porfiria aguda intermitente (PAI) es una enfermedad metabólica infrecuente, siendo la más común de las porfirias agudas. El síntoma más frecuente es el dolor abdominal agudo, aunque también pueden acompañarse de convulsiones, alteraciones neuro-psiquiátricas o neuropatías motoras simétricas, y que en algunos pacientes puede progresar a la parálisis de la musculatura respiratoria. El objetivo de este trabajo es describir una forma atípica de presentación de una porfiria aguda, a fin de considerar como diagnósticos diferenciales en dolor abdominal. Caso clínico: paciente con PAI, que presenta abdomen agudo, convulsiones, posteriormente compromiso neuro-psiquiátrico y neuropatía motora simétrica, ingresando a ventilación mecánica. Por la gravedad del compromiso neurológico recibió arginato de hemina, cursando con hipertransaminemia transitoria, evento adverso no reportado previamente. La evolución fue favorable, retirándosele la ventilación mecánica y el alta hospitalaria. Conclusiones: se debe considerar el diagnóstico de PAI en casos de dolor abdominal agudo asociado a síntomas neurológicos y/o psiquiátricos, particularmente en mujeres jóvenes. La administración de hemina es considerada el estándar de tratamiento, y aun en forma tardía podría tener efectos beneficiosos.

HIV silencing and cell survival signatures in infected T cell reservoirs.

Rare CD4 T cells that contain HIV under antiretroviral therapy represent an important barrier to HIV cure1-3, but the infeasibility of isolating and characterizing these cells in their natural state has led to uncertainty about whether they possess distinctive attributes that HIV cure-directed therapies might exploit. Here we address this challenge using a microfluidic technology that isolates the transcriptomes of HIV-infected cells based solely on the detection of HIV DNA. HIV-DNA+ memory CD4 T cells in the blood from people receiving antiretroviral therapy showed inhibition of six transcriptomic pathways, including death receptor signalling, necroptosis signalling and antiproliferative Gα12/13 signalling. Moreover, two groups of genes identified by network co-expression analysis were significantly associated with HIV-DNA+ cells. These genes (n = 145) accounted for just 0.81% of the measured transcriptome and included negative regulators of HIV transcription that were higher in HIV-DNA+ cells, positive regulators of HIV transcription that were lower in HIV-DNA+ cells, and other genes involved in RNA processing, negative regulation of mRNA translation, and regulation of cell state and fate. These findings reveal that HIV-infected memory CD4 T cells under antiretroviral therapy are a distinctive population with host gene expression patterns that favour HIV silencing, cell survival and cell proliferation, with important implications for the development of HIV cure strategies.

Point-of-care ultrasound needs assessment in a paediatric acute care setting in Malawi.

OBJECTIVE: To describe the use of point-of-care ultrasound (POCUS) in an acute-care paediatric setting in Malawi, including clinical indications, types of examinations and frequency of positive findings. METHODS: Retrospective, cross-sectional study of a convenience sample of POCUS examinations performed in one tertiary referral hospital in Lilongwe, Malawi over 1 year. POCUS examinations were performed by Paediatric Emergency Medicine physician consultants as part of routine clinical practice and at the request of local clinicians. Images were saved along with the clinical indication and physician interpretation for quality review. Ultrasounds performed by the radiology department and those examinations that were technically faulty, missing clinical application or interpretation were excluded. RESULTS: In total, 225 ultrasounds of 142 patients were analysed. The most common clinical indications for which examinations were completed were respiratory distress (23%), oedema (11.7%) and shock/arrest (6.2%). The most common examinations performed were cardiac (41.8%) and lung (15.1%), focused assessment with sonography in trauma (FAST; 12.9%) and ultrasound-guided procedural examinations (9.8%). Pathology was identified in 68% of non-procedural examinations. Cardiac examinations demonstrated significant pathology, including reduced cardiac function (12.8%), gross cardiac structural abnormality (11.8%) and pericardial effusion (10.3%). CONCLUSIONS: POCUS was used for both clinical decision-making and procedural guidance, and a significant number of POCUS examinations yielded positive findings. Thus, we propose that cardiopulmonary, FAST and procedural examinations should be considered in future for the POCUS curriculum in this setting.

Spatial Prediction of Current and Future Flood Susceptibility: Examining the Implications of Changing Climates on Flood Susceptibility Using Machine Learning Models.

The main aim of this study was to predict current and future flood susceptibility under three climate change scenarios of RCP2.6 (i.e., optimistic), RCP4.5 (i.e., business as usual), and RCP8.5 (i.e., pessimistic) employing four machine learning models, including Gradient Boosting Machine (GBM), Random Forest (RF), Multilayer Perceptron Neural Network (MLP-NN), and Naïve Bayes (NB). The study was conducted for two watersheds in Canada, namely Lower Nicola River, BC and Loup, QC. Three statistical metrics were used to validate the models: Receiver Operating Characteristic Curve, Figure of Merit, and F1-score. Findings indicated that the RF model had the highest accuracy in providing the flood susceptibility maps (FSMs). Moreover, the provided FSMs indicated that flooding is more likely to occur in the Lower Nicola River watershed than the Loup watershed. Following the RCP4.5 scenario, the area percentages of the flood susceptibility classes in the Loup watershed in 2050 and 2080 have changed by the following percentages from the year 2020 and 2050, respectively: Very Low = -1.68%, Low = -5.82%, Moderate = +6.19%, High = +0.71%, and Very High = +0.6% and Very Low = -1.61%, Low = +2.98%, Moderate = -3.49%, High = +1.29%, and Very High = +0.83%. Likewise, in the Lower Nicola River watershed, the changes between the years 2020 and 2050 and between the years 2050 and 2080 were: Very Low = -0.38%, Low = -0.81%, Moderate = -0.95%, High = +1.72%, and Very High = +0.42% and Very Low = -1.31%, Low = -1.35%, Moderate = -1.81%, High = +2.37%, and Very High = +2.1%, respectively. The impact of climate changes on future flood-prone places revealed that the regions designated as highly and very highly susceptible to flooding, grow in the forecasts for both watersheds. The main contribution of this study lies in the novel insights it provides concerning the flood susceptibility of watersheds in British Columbia and Quebec over time and under various climate change scenarios.

Droplet-microfluidics-assisted sequencing of HIV proviruses and their integration sites in cells from people on antiretroviral therapy.

The human immunodeficiency virus (HIV) integrates its genome into that of infected cells and may enter an inactive state of reversible latency that cannot be targeted using antiretroviral therapy. Sequencing such a provirus and the adjacent host junctions in individual cells may elucidate the mechanisms of the persistence of infected cells, but this is difficult owing to the 150-million-fold higher amount of background human DNA. Here we show that full-length proviruses connected to their contiguous HIV-host DNA junctions can be assembled via a high-throughput microfluidic assay where droplet-based whole-genome amplification of HIV DNA in its native context is followed by a polymerase chain reaction (PCR) to tag droplets containing proviruses for sequencing. We assayed infected cells from people with HIV receiving suppressive antiretroviral therapy, resulting in the detection and sequencing of paired proviral genomes and integration sites, 90% of which were not recovered by commonly used nested-PCR methods. The sequencing of individual proviral genomes with their integration sites could improve the genetic analysis of persistent HIV-infected cell reservoirs.

Measurement of total and free prostate specific antigen (PSA) in human serum samples using an ultra-microanalytical system.

Prostate specific antigen (PSA) is a serine protease used for the screening of prostate cancer. The total portion of PSA (tPSA) can be found in its free form (fPSA), or bound to other proteins forming a stable complex. A heterogeneous sandwich-type UltraMicro Enzyme-Linked ImmunoSorbent Assay (UMELISA) has been developed for the measurement of tPSA and fPSA in human serum samples. Strips coated with a high affinity monoclonal antibody (MAb) directed against PSA are used as solid phase, to ensure the specificity of the assay. Biotinylated MAbs specific for tPSA and fPSA ensured sensitivity, given the high affinity binding to streptavidin. The assay was completed in 1.5 h, with a measuring range 0.019-20 µg/L (tPSA), and 0.009-20 µg/L (fPSA). The intra- and inter-assay CV were lower than 9%. Recovery percentages were 96-105%. High correlations were found between the values of the UMELISA PSA standards and the International Reference Standards 96/670 (R2 = 0.9996) and 96/688 (R2 = 0.9989). The assay did not recognize any of the interfering molecules tested. Regression analysis of serum samples showed a good correlation with Roche Elecsys total PSA (n = 631, R2 = 0.986, ρc = 0.992), BioMérieux VIDAS TPSA (n = 631, R2 = 0.989, ρc = 0.993) and Roche Elecsys free PSA (n = 164, R2 = 0.973, ρc = 0.979), all with a relative difference below 15%, and a p < 0.001. A retrospective study of the use of UMELISA PSA in Cuba was carried out. The analytical performance characteristics of UMELISA PSA support its use for the quantification of tPSA and fPSA in human serum samples in a single kit, making it an affordable diagnostic assay available to Cuban Public Health System and developing countries. Between the years 2014-2020, more than 3 million Cuban patients have benefited from the test for free.

An enzyme immunoassay to determine human chorionic gonadotropin (HCG) in serum and urine samples using an ultra-microanalytical system.

The determination of Human Chorionic Gonadotropin (HCG) in biological fluids is of great interest in the early pregnancy diagnostics, the evaluation of pregnancy disorders, as a tumor marker, as a screening procedure for anti-doping control, and many other purposes. A simple sandwich-type UltraMicro Enzyme-Linked ImmunoSorbent Assay (UMELISA) has been developed for the measurement of HCG in serum and urine samples. Strips coated with a high affinity MAb directed against HCG are used as solid phase, to ensure the specificity of the assay. The HCG assay was completed in 1.5 h, with a measuring range of 0.76-400 mIU/mL. The intra- and inter-assay coefficients of variation were lower than 10 %, depending on the HCG concentrations evaluated. Recovery percentages were 96.43-97.16 % (serum) and 98.10-99.04 % (urine). The assay detected intact HCG, nicked HCG, HCG ß, and nicked HCG ß, and did not recognize any of the interfering molecules tested. Regression analysis showed a good correlation with Elecsys in serum (n = 1459, r = 0.952, ρc = 0.948) and urine (n = 869, r = 0.988, ρc = 0.978). A good correlation was also found with 84 RIQAS samples analyzed with the kits Elecsys (r = 0.969, ρc = 0.957), Architect (r = 0.982, ρc = 0.970), Dimension (r = 0.989, ρc = 0.977), and Bioscience (r = 0.992, ρc = 0.980), all with a p < 0.01. Comparison with transvaginal ultrasonography in early pregnancy detection showed a specificity and a sensitivity of 100 % (n = 2385, κ = 1). The analytical performance characteristics of UMELISA HCG endorse its use for the quantification of HCG in serum and urine samples. This assay will make a cost-effective diagnostic kit accessible to low-income countries and is now available in the Cuban Public Health System.

Evaluation of Quality, Antioxidant Capacity, and Digestibility of Chickpea (Cicer arietinum L. cv Blanoro) Stored under N2 and CO2 Atmospheres.

The aim of this work was to monitor the quality, antioxidant capacity and digestibility of chickpea exposed to different modified atmospheres. Chickpea quality (proximal analysis, color, texture, and water absorption) and the antioxidant capacity of free, conjugated, and bound phenol fractions obtained from raw and cooked chickpea, were determined. Cooked chickpea was exposed to N2 and CO2 atmospheres for 0, 25, and 50 days, and the antioxidant capacity was analyzed by DPPH (2,2'-diphenyl-1-picrylhydrazyl), ABTS (2,2'-azino-bis-[3ethylbenzothiazoline-6-sulfonic acid]), and total phenols. After in vitro digestion, the antioxidant capacity was measured by DPPH, ABTS, FRAP (ferric reducing antioxidant power), and AAPH (2,2'-Azobis [2-methylpropionamidine]). Additionally, quantification of total phenols, and UPLC-MS profile were determined. The results indicated that this grain contain high quality and high protein (18.38%). Bound phenolic compounds showed the highest amount (105.6 mg GAE/100 g) and the highest antioxidant capacity in all techniques. Cooked chickpeas maintained their quality and antioxidant capacity during 50 days of storage at 4 and -20 °C under a nitrogen atmosphere. Free and conjugated phenolic compounds could be hydrolyzed by digestive enzymes, increasing their bioaccessibility and their antioxidant capacity during each step of digestion. The majority compound in all samples was enterodiol, prevailing the flavonoid type in the rest of the identified compounds. Chickpea contains biological interest compounds with antioxidant potential suggesting that this legume can be exploited for various technologies.

Diagnosing Acute Heart Failure in the Pediatric Emergency Department Using Point-of-Care Ultrasound.

BACKGROUND: Acute heart failure (AHF) in children is associated with significant disease burden with high rates of morbidity, mortality, and resource utilization. These children often present to the emergency department with clinical features that mimic common childhood illnesses. Cardiac point-of-care ultrasound (POCUS) can be an effective tool for rapidly identifying abnormal cardiac function. CASE REPORTS: This case series documents 10 children presenting with AHF between 2016 and 2019 and demonstrates how pediatric emergency physicians used cardiac POCUS to expedite their diagnosis, management, and disposition. All cardiac POCUS was performed before comprehensive echocardiograms were completed. One case is described in detail; the other cases are summarized in a Table. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Early recognition of AHF is critical to reduce pediatric morbidity and mortality. With proper training, cardiac POCUS can be an effective adjunct and should be considered for the early diagnosis and treatment of infants and children with AHF.

Influence of multiple reflections on the transmission coefficients of uniaxial plane-parallel plates.

A study on the influence of multiple reflections on the transmission coefficients of uniaxial plane-parallel plates is presented. Two representative models are analyzed: one that considers only the first transmission, and a rigorous one, taking into account the multiple reflections within the plate. Modules, phases, and the interference between $p$ and $s$ transmitted fields are evaluated in a wide range of angles of incidence by means of three emblematic examples that illustrate the effects of thickness, birefringence, and optical axis orientation. For simplicity, whereas the optical axis can form an arbitrary angle with the interface, it is restricted to the plane of incidence. A complete theoretical framework is provided along with general reference guidelines derived from numerical examples.

Consenso Colombiano para la prevención, diagnóstico y manejo de condiciones trombóticas en pacientes adultos con COVID-19: aplicando el Marco de la Evidencia a la Decisión (EtD) GRADE / Colombian consensus for the prevention, diagnosis and treatment of thrombotic conditions in adult patients with COVID-19: applying GRADE Evidence to Decision (EtD) Frameworks

resumen está disponible en el texto completo

Abstract Recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. In this context, the aim was to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: A rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: Recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.

El posgrado en el movimiento iSchools en América del Norte, Asia Pacífico y Europa / The postgraduate in the iSchool movement in North America, Asia Pacific and Europe

El presente estudio se propuso caracterizar los cursos de posgrado del Movimiento iSchools en América del Norte, Asia Pacífico y Europa. Se enuncian los aspectos teóricos conceptuales referentes al posgrado, además de la génesis y desarrollo del movimiento iSchools. Se utiliza el enfoque cuantitativo, apoyado del método análisis de contenido y la técnica análisis documental para analizar el tipo, la modalidad, duración, evaluación y contenidos de los posgrados en el movimiento iSchools. Se consultan los campos semánticos del Docutes para la identificación de los principales contenidos presentes en los programas de posgrado. Dentro de los principales resultados se identificaron las maestrías como tipología de posgrado más frecuentes. La modalidad a tiempo completo fue la más utilizada por las tres regiones geográficas. Los tipos de evaluación de mayor cuantía fueron las tesis. Los contenidos más relevantes en los tres capítulos continentales se encuentran asociados a los campos semánticos Sistemas de Información y Representación y recuperación de información(AU)

The present study aimed to characterize the graduate courses of the iSchools Movement in North America, Asia Pacific and Europe. The theoretical and conceptual aspects of postgraduate studies are enunciated, as well as the genesis and development of the iSchools movement. The quantitative approach is used, supported by the content analysis method and the documentary analysis technique to analyze the type, modality, duration, evaluation and content of postgraduate courses in the iSchools movement. The semantic fields of the Docutes were consulted for the identification of the main contents present in the postgraduate programs. Among the main results, master's degrees were identified as the most frequent postgraduate typology. The full-time modality was the most used by the three geographical regions. The types of evaluation with the highest amount were theses. The most relevant contents in the three continental chapters are associated with the semantic fields Information Systems and Information representation and retrieval(AU)

Optimization of growing conditions for pigments production from microalga Navicula incerta using response surface methodology and its antioxidant capacity.

Navicula incerta is a marine microalga distributed in Baja California, México, commonly used in aquaculture nutrition, and has been extended to human food, biomedical, and pharmaceutical industries due to its high biological activity. Therefore, the study aimed to optimize culture conditions to produce antioxidant pigments. A central composite experimental design and response surface methodology (RSM) was employed to analyze the best culture conditions. The medium (nitrogen-deficient concentrations), salinity (PSU = Practical Salinity Unity [g/kg]), age of culture (days), and solvent extraction (ethanol, methanol, and acetone) were the factors used for the experiment. Chlorophyll a (Chl a) and total carotenoids (T-Car), determined spectroscopically, were used as the response variables. The antioxidant capacity was evaluated by DPPH• and ABTS•+ radical inhibition, FRAP, and anti-hemolytic activity. According to the overlay plots, the optimum growth conditions for Chl a and T-Car production were the following conditions: medium = 0.44 mol·L-1 of NaNO3, salinity = 40 PSU, age of culture: 3.5 days, and solvent = methanol. The pigment extracts obtained in these optimized conditions had high antioxidant activity in ABTS•+ (86.2-92.1% of inhibition) and anti-hemolytic activity (81.8-96.7% of hemolysis inhibition). Low inhibition (33-35%) was observed in DPPH•. The highest value of FRAP (766.03 ± 16.62 µmol TE/g) was observed in the acetonic extract. The results demonstrated that RSM could obtain an extract with high antioxidant capacity with potential applications in the biomedical and pharmaceutical industry, which encourages the use of natural resources for chemoprevention of chronic-degenerative pathologies.

Consenso colombiano para la prevención, el diagnóstico y el tratamiento de condiciones trombóticas en adultos con COVID-19: aplicando el Marco de la Evidencia a la Decisión (EtD) GRADE / Colombian consensus for the prevention, diagnosis and treatment of thrombotic conditions in adults with COVID-19: applying GRADE Evidence to Decision (EtD) Frameworks

Introducción estudios recientes han reportado fenómenos trombóticos o coagulopatía en pacientes con COVID-19. Hay posiciones divergentes en cuanto a la prevención, el diagnóstico y el tratamiento de estos fenómenos, y la práctica clínica actual está basada únicamente en deducciones por extensión a partir de estudios retrospectivos, series de casos, estudios observacionales y guías internacionales desarrolladas previas a la pandemia. Objetivo establecer una serie de recomendaciones sobre prevención, diagnóstico y manejo de las complicaciones trombóticas asociadas a COVID-19. Métodos se desarrolló una guía rápida en la que se aplicó el marco de la evidencia a la decisión (EtD) de GRADE y un sistema de participación iterativo, con análisis estadísticos y cualitativos de sus resultados. Resultados se generaron 31 recomendaciones clínicas enfocadas a: a) Pruebas de coagulación en adultos sintomáticos con sospecha de infección o infección confirmada por SARS-CoV-2; b) Tromboprofilaxis en personas adultas con diagnóstico de COVID-19 (escalas de riesgo, tromboprofilaxis de manejo ambulatorio, intrahospitalario y duración de tromboprofilaxis después del egreso de hospitalización), c) Diagnóstico y tratamiento de las complicaciones trombóticas y d) Manejo de personas con indicación previa a usar agentes anticoagulantes. Conclusiones las recomendaciones clínicas de este consenso orientan la toma de decisiones clínicas respecto a prevención, diagnóstico y tratamiento de fenómenos trombóticos en pacientes con COVID-19, y representan un acuerdo que ayudará a disminuir la dispersión en las prácticas clínicas acorde con el desafío que impone la pandemia.

Abstract Introduction: recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. Objective: to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: a rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.

An enzyme immunoassay for determining albumin in human urine samples using an ultra-microanalytical system.

Microalbuminuria is a term to describe a moderate increase in the level of albumin in urine. It is an important prognostic marker for kidney damage in diseases such as diabetes mellitus and hypertension. A simple sandwich-type ultramicroELISA assay (UMELISA) has been developed for the measurement of albumin in human urine samples. Strips coated with a high affinity monoclonal antibody directed against albumin are used as solid phase, to ensure the specificity of the assay. The albumin assay was completed in 1 hr and 30 min, with a measuring range of 1.44-200 ng/mL. The intra- and inter-assay coefficients of variation were 3.98-4.35% and 7.59-8.92%, respectively, depending on the albumin concentrations evaluated. Percentage recovery ranged from 94.26 to 98.50%. Regression analysis showed a good correlation with the commercial quantitative turbidimetric test Microalbumin-turbilatex (n = 240, r = 0.994, p < .01). The analytical performance characteristics of our UMELISA MICROALBUMINA endorse its use for the quantification of albumin in human urine samples. This test will make a cost-effective diagnostic kit accessible to low-income countries such as Latin American countries and is now available in the Cuban Public Health System.

Dynamic Shifts in the HIV Proviral Landscape During Long Term Combination Antiretroviral Therapy: Implications for Persistence and Control of HIV Infections.

Combination antiretroviral therapy (cART) controls but does not eradicate HIV infection; HIV persistence is the principal obstacle to curing infections. The proportion of defective proviruses increases during cART, but the dynamics of this process are not well understood, and a quantitative analysis of how the proviral landscape is reshaped after cART is initiated is critical to understanding how HIV persists. Here, we studied longitudinal samples from HIV infected individuals undergoing long term cART using multiplexed Droplet Digital PCR (ddPCR) approaches to quantify the proportion of deleted proviruses in lymphocytes. In most individuals undergoing cART, HIV proviruses that contain gag are lost more quickly than those that lack gag. Increases in the fraction of gag-deleted proviruses occurred only after 1-2 years of therapy, suggesting that the immune system, and/or toxicity of viral re-activation helps to gradually shape the proviral landscape. After 10-15 years on therapy, there were as many as 3.5-5 times more proviruses in which gag was deleted or highly defective than those containing intact gag. We developed a provirus-specific ddPCR approach to quantify individual clones. Investigation of a clone of cells containing a deleted HIV provirus integrated in the HORMAD2 gene revealed that the cells underwent a massive expansion shortly after cART was initiated until the clone, which was primarily in effector memory cells, dominated the population of proviruses for over 6 years. The expansion of this HIV-infected clone had substantial effects on the overall proviral population.

Generation and characterization of murine monoclonal antibodies against immunoreactive trypsinogen for newborn screening of cystic fibrosis.

Cystic fibrosis (CF) is a multisystem disorder that reduces quality of life and survival in affected individuals. In newborns, the release of pancreatic enzymes into the blood raises the levels of immunoreactive trypsinogen (IRT), the main marker for CF screening, which is detected in dried blood samples on filter paper by immunoenzymatic assays. In Cuba, CF has an estimated incidence of 1/9862 live births and should be included in the national basic newborn screening (NBS) panel given its benefits in terms of nutrition, lung function and survival. The Immunoassay Center develops and produces diagnostic kits allowing the establishment of large-scale NBS programs for inherited metabolic disorders in Cuba and other Latin American countries. IRT-specific monoclonal antibodies (MAbs) obtained at the Immunoassay Center are essential for developing an affordable immunoassay for IRT to support CF NBS in our low-income country. An immunization scheme with trypsinogen-1 originated two IgG1-producing murine hybridomas. 4C9C9 and 4C9E11 MAbs recognized different determinants on both trypsin-1 and trypsin-2 molecules. Both antibodies identified conformational epitopes on the molecule of trypsin-1 and of its zymogen. As 4C9E11 MAb cross-reacted with proteins structurally and functionally related to trypsinogen, it was used as revealing antibody in a sandwich-type UMELISA® assay for IRT determination with 4C9C9 MAb for capture. This combination, aside from detecting several commercially available trypsins, adequately quantified IRT from dried blood samples on filter paper of newborns. The evaluation of the assay's accuracy yielded percentage recoveries ranging 93.3-109.2% for commercial controls. The properties of the studied MAbs demonstrate their suitability for being used in a sandwich-type UMELISA® assay for the CF NBS in Cuba.

Patrón de consumo alimentario y su relación con el estado de nutrición en lactantes de la región del Istmo de Tehuantepec / Pattern of food consumption and its relation to the nutritional status of infants in the Isthmus of Tehuantepec region

FUNDAMENTOS: En la etapa lactante los patrones de consumo alimentario (PCA) adecuados pueden mantener el correcto estado nutricional. La presente investigación buscó asociar el PCA durante la alimentación complementaria con el estado nutricional en lactantes. MÉTODOS:Se realizó un estudio transversal analítico (mayo-julio de 2017) con población lactante (n=35, femeninos 60% y masculinos 40%) de 4 a 12 meses de edad del municipio de Santo Domingo, Oaxaca. Se evaluó el estado nutricional con indicadores (Peso/Edad, Peso/Longitud y Longitud/Edad), así como se realizó valoración dietética aplicada a las madres o cuidadoras. RESULTADOS: El 68,57% de los lactantes presentaron un estado de nutrición normal. Se encontró una asociación significativa entre el adecuado estado de nutrición y el consumo de verduras, cereales sin grasa, alimentos de origen animal, leche, aceites sin proteína y con proteína. La asociación del estado de nutrición con el PCA no fue significativa (p=0,501). CONCLUSIONES: Se encontró una asociación significativa entre el adecuado estado de nutrición y el consumo de ciertos alimentos. El balance energético positivo de los lactantes es un factor que conduce a un sesgo de información, ya que el PCA inadecuado en esta etapa y la ingesta elevada de calorías incrementa el peso corporal

BACKGROUND: In the lactating stage, adequate dietary consumption patterns (PCA) can maintain the correct nutritional status. The present investigation seeks to associate the PCA during complementary feeding with the nutritional status in infants. METHODS: An analytical cross-sectional study was included (May-July 2017) with a lactating population (n=35, 60% female and 40% male) from 4 to 12 months of age born from the Santo Domingo, Oaxaca. The nutritional status was evaluated with indicators (Weight/Age, Weight/Length and Length/Age), as well as dietary assessment applied to mothers or caregivers. RESULTS: 68.57% of infants had a normal nutritional status. A significant association was found between the proper state of nutrition and the consumptionof vegetables, non-fat cereals, foods of animal origin, milk, oils without protein and with protein. The association of the nutritional status with the PCA was not significant (p = 0.501). CONCLUSIONS: A significant association was found between the proper state of nutrition and the consumption of certain foods. The positive energy balance of infants is a factor that leads to information bias, since inadequate PCA at this stage and high calorie intake increases body weight