National sex- and age-specific burden of blindness and vision impairment by cause in Mexico in 2019: a secondary analysis of the Global Burden of Disease Study 2019.

Background: Reliable national estimations for blindness and vision impairment are fundamental to assessing their burden and developing public health policies. However, no comprehensive analysis is available for Mexico. Therefore, in this observational study we describe the national burden of blindness and vision loss by cause and severity during 2019. Methods: Using public data from the Global Burden of Disease (GBD) study 2019, we present national prevalence and years lived with disability (YLDs) counts and crude and age-standardized rates (per 100,000 people) of total, severity- and cause-specific blindness and vision impairment with 95% uncertainty intervals (UIs) by sex and age group. Findings: In Mexico, the burden of blindness and vision impairment was estimated at 11.01 million (95% UI, 9.25-13.11) prevalent cases and 384.96 thousand (259.57-544.24) YLDs during 2019. Uncorrected presbyopia caused the highest burden (6.06 million cases, 4.36-8.08), whereas severe vision loss and blindness affected 619.40 thousand (539.40-717.73) and 513.84 thousand (450.59-570.98) people, respectively. Near vision loss and refraction disorders caused 78.7% of the cases, whereas neonatal disorders and age-related macular degeneration were among the least frequent. Refraction disorders were the main cause of moderate and severe vision loss (61.44 and 35.43%), and cataracts were the second most frequent cause of blindness (26.73%). Females suffered an overall higher burden of blindness and vision impairment (54.99% and 52.85% of the total cases and YLDs), and people >50 years of age suffered the highest burden, with people between 70 and 74 years being the most affected. Interpretation: Vision loss represents a public health problem in Mexico, with women and older people being the most affected. Although the causes of vision loss contribute differentially to the severity of visual impairment, most of the impairment is avoidable. Consequently, a concerted effort at different levels is needed to alleviate this burden. Funding: This study received no funding.

The global leadership initiative on malnutrition criteria for the diagnosis of malnutrition in patients admitted to the intensive care unit: A systematic review and meta-analysis.

BACKGROUND: Malnutrition is associated with a high risk of morbidity and mortality in patients with critical illness. The nutrition status of patients in the intensive care unit (ICU) is challenging to assess. The Global Leadership Initiative on Malnutrition (GLIM) is a novel framework used for the diagnosis of malnutrition. However, its efficacy in patients with critical illness in the ICU has not been validated. AIM: To investigate the use and validity of the GLIM criteria in adult patients admitted to the ICU. METHODS: A systematic review and meta-analysis were performed, and seven databases were searched for relevant studies. The selection criteria included studies that used the GLIM in adult patients admitted to the ICU. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. RESULTS: Five studies were included in the analysis. Approximately 15%-68% of patients were diagnosed with malnutrition using the GLIM criteria. Meanwhile, 48%-75% of patients with malnutrition were identified with the Subjective Global Assessment (SGA). The inflammation criterion was easily adjudicated due to critical status, and three studies compared the GLIM and the SGA. According to the QUADAS-2 tool, the nutritional assessment process was not explicit in the studies. The meta-analysis had an overall sensitivity of 65.3% (95% CI: 34.9%-86.9%) and an overall specificity of 88.8% (95% CI: 58.1%-97.8%). In the prospective validation, malnutrition assessed by the GLIM criteria, and the SGA was associated with mortality. However, the association between length of hospital stay and mechanical ventilation was unclear. CONCLUSIONS: The use and validity of the GLIM criteria among patients admitted to the ICU is still limited. Moreover, some concurrent and predictive validation studies have methodological limitations. Further studies must be performed to validate the use of the GLIM criteria in the ICU.

Predicting mortality in penetrating cardiac trauma in developing countries through a new classification: Validation of the Bogotá classification.

Introduction: Penetrating chest trauma (PCT) represents 10% of worldwide mortality, with developing countries counting as some of the most affected by high mortality rates due to cardiac trauma. Colombia is considered one of the most violent countries due to the high mortality rate associated with war and crime, hence the validation of an own classification for penetrating cardiac injuries (PCI) is mandatory. Methods: Retrospective cross-sectional study which included adult patients with PCIs at a level 4 trauma center in Colombia, between January 2018 and April 2020. We used our own system (Bogotá Classification) and compared it with traditional systems (e.g., Ivatury's, OIS-AAST), by analyzing the mechanism of injury (MOI), the hemodynamic status of the patient at admission, the inpatient management, the individual outcomes, and some demographic variables. Bivariate statistical analysis, spearman correlation, and logistic regression were performed. Results: Four hundred and ninety-nine patients were included. Bivariate analysis demonstrated a significant relationship between mortality and hemodynamic state, MOI, its location and degree of lesion, cardiac/vessel injury, cardiac tamponade, time between injury and medical care, fluid reanimation, as well as the Ivatury's classification and the new classification (p < 0.005). The adequate correlation between Ivatury's and Bogotá classification supports the latter's clinical utility for patients presenting with PCI. Likewise, logistic regression showed a statistically significant association among mortality rates (p < 0.005). Conclusions: The Bogotá classification showed similar performance to the Ivatury's classification, correlating most strongly with mortality. This scale could be replicated in countries with similar social and economic contexts.

Laparoscopy has better performance than laparotomy in the treatment of stable penetrating abdominal trauma: A retrospective cross-sectional study in a trauma referral hospital in Colombia.

Background: Abdominal trauma is one of the leading causes of death. In Colombia, few studies have evaluated the results on related factors and outcomes when comparing laparotomy versus laparoscopy in the management of penetrating abdominal trauma. Therefore, the aim of this study was to investigate the feasibility and safety of laparoscopy in the treatment of stable penetrating abdominal trauma in a limited resources environment in a middle-income country. Methods: Retrospective cross-sectional study was conducted in Bogota, Colombia from January 2018 to October 2020. Patients over 18 years old, hemodynamically stable with penetrating abdominal trauma without other body parts injuries, that underwent laparoscopy and/or laparotomy surgical exploration and treatment were included. Frequencies, percentages, correlations, and odds ratio were calculated. Results: A total of 52 patients were analyzed (26 laparoscopy vs. 26 laparotomy). Stabbing injuries were more frequent in both groups (76.9%), as well as involvement of the anterior abdomen. None missed enterotomies were reported in the laparoscopy group. Surgical time and bleeding were significantly lower in the laparoscopic approach group (63 vs. 115 min and 65 vs. 992 cc, respectively). The time to oral intake and length of stay in the intensive care unit was significantly shorter in the laparoscopic management group (2 vs. 3 days and 1 vs. 4 days, respectively). Conclusions: Surgical results found a safe scenario in a limited resources environment for the application of the laparoscopic technique to approach penetrating abdominal trauma in stable patients without missed injuries, low threshold of conversion to open approach, and additionally not presenting a higher percentage of complications compared with the laparotomy group in Colombia. Operative time, oral intake, and length of hospital stay were lower in the fully therapeutic laparoscopy group.

Participation of Latin American surgeons in Twitter using the hashtag #SoMe4Surgery and #SoMe4IQLatAm.

Background: In medicine, social networks contribute to the professional training because it is a way to improve the knowledge and skills of students, residents and specialists; additionally, these networks allow the dissemination of evidence. However, Latin American surgeons' influence within this social network is not highlighted. In this study, using the hashtags #SoMe4Surgery and #SoMe4IQLatAm, the participation of Latin American surgeons in Twitter is established. Study Design: This is a prospective cross-sectional study of the academic tweets published in the period between October 13 and October 19, 2020, on Twitter by the academic accounts @Cirbosque and @MISIRG1 who are users of the social network Twitter in Latin America who participate in the network with the hashtags #SoMe4Surgery and #SoMe4IQLatAm with academic use. Results: A total of 56 tweets and 665 retweets were analyzed. Male sex presents greater interaction, as well as Mondays and Tuesdays week days. Geolocation was recorded as 37.1% in Latin America and 17.6% in Europe. #SoMe4Surgery was mentioned in 31 tweets and generated 211,700 impressions and 25,557 interactions, and #SoMe4IQLatam was mentioned in 25 tweets and achieved 57,585 impressions and 21,901 interactions. A growth of the participation rate of 6.5% in @Cirbosque and 10.5% in @ MISIRG1 was estimated for 2021. Conclusion: The use of social networks, particularly Twitter, in the surgeon community has proven to be a valuable tool during the last decade. The tweet that needs to be shared among more surgeons should be linked to the hashtag #SoMe4IQLatAm and #SoMe4Surgery and Twitter surgeon leaders mentions.

Reusability in visible light of titanate nanotubes for the removal of organic pollutants: role of calcination temperature.

Titanate nanotubes (NTs) were synthesised by the hydrothermal method and later calcined at temperatures between 100-500°C. The calcined NTs were characterised and evaluated in the physicochemical adsorption of the safranin dye and photocatalytic degradation of caffeine. The materials calcined at low temperatures displayed a tubular structure and the H2Ti3O7 crystalline phase, which was transformed into anatase nanoparticles at 400°C. The NTs treated at 100°C showed the highest adsorption capacity (94%). Safranin was adsorbed through an ion-exchange mechanism, following the Langmuir isotherm and a pseudo-second-order kinetic model. While NTs calcined at lower temperatures were better for adsorption, the photocatalytic degradation of caffeine increased in samples calcined at higher temperatures with a maximum removal of 72%. The photocatalytic behaviour of the NT samples confirmed that the crystalline anatase structure in conjunction with structural OH groups enhanced the photocatalytic activity. The addition of isopropanol as a scavenger confirmed the important role played by the •OH radicals in the photocatalytic process. NTs calcined at 300°C were efficient for both adsorption and photocatalytic processes. Due to its efficiency, this sample was reused after dye adsorption for the photocatalytic degradation of caffeine under visible light due to its enhanced absorbance in the visible region. This research work shows the potential of NTs for wastewater purification.

Synthesis and characterization of highly dispersed bimetallic Au-Rh nanoparticles supported on titanate nanotubes for CO oxidation reaction at low temperature.

Low-temperature CO oxidation was carried out by using rhodium incorporated into titanate nanotubes (Rh/NTs) prepared by the sol-gel and hydrothermal methods; otherwise, gold nanoparticles were deposited homogeneously onto the Rh/NT surface through the deposition-precipitation with urea (DPU) method. The Au-Rh/NT sample exhibited high metal dispersion (55%), outstanding CO oxidation at low temperature, and better resistance to deactivation than the monometallic Rh/NT and Au/NT samples. The characterization of bimetallic samples, with particle sizes from 1 to 3 nm, revealed the remarkable presence of interacting Au and Rh species in metallic state. In this way, Au0 and Rh0 were answerable for the higher catalytic activity observed in the bimetallic samples. The interaction between Au and Rh in the nanoparticles of Au-Rh/NT promoted a synergistic effect on the CO oxidation reaction, explained by the creation of new CO adsorption sites.

Autofluorescence in female carriers with choroideremia: A familial case with a novel mutation in the CHM gene.

BACKGROUND: Choroideremia is an X-linked chorioretinal dystrophy caused by mutations in the CHM gene. The main differential diagnosis is X-linked retinitis pigmentosa. Clinically, male patients that are affected by these two diseases have similar symptoms. This work aims to report a familial case of choroideremia initially diagnosed as X-linked retinitis pigmentosa with a novel mutation in the CHM gene, and the relevance of fundus autofluorescence (FAF) in female carriers. MATERIALS AND METHODS: A complete ophthalmological evaluation was done in a 37-year-old woman and her 53-year-old maternal uncle; the uncle had been diagnosed previously with X-linked retinitis pigmentosa. A visual field test, FAF imaging, full-field electroretinography, and a genetic test were performed. RESULTS: In the proband, the fundoscopy revealed diffuse changes in the retinal pigment epithelium in both eyes, and the FAF showed a speckled pattern of low- and high-density. The maternal uncle's ophthalmological evaluation showed choroidal and retinal atrophy consistent with choroideremia. The molecular analysis revealed a pathogenic variant in the CHM gene, c.190-1 G > T. CONCLUSIONS: In female carriers of choroideremia and X-linked retinitis pigmentosa, differential diagnosis may be challenging. A speckled pattern of low- and high-density in autofluorescence is commonly found in female carriers of choroideremia. FAF is a powerful tool for making a correct clinical diagnosis because the pattern in FAF is much more apparent than the visible retinal changes obtained by fundoscopy. Although it is crucial to perform molecular analysis to confirm the diagnosis, FAF is useful when genetic testing may not be readily available.

Extension of the mutational and clinical spectrum of SOX2 related disorders: Description of six new cases and a novel association with suprasellar teratoma.

SOX2 is a transcription factor that is essential for maintenance of pluripotency and has several conserved roles in early embryonic development. Heterozygous loss-of-function variants in SOX2 are identified in approximately 40% of all cases of bilateral anophthalmia/micropthalmia (A/M). Increasingly SOX2 mutation-positive patients without major eye findings, but with a range of other developmental disorders including autism, mild to moderate intellectual disability with or without structural brain changes, esophageal atresia, urogenital anomalies, and endocrinopathy are being reported, suggesting that the clinical phenotype associated with SOX2 loss is much broader than previously appreciated. In this report we describe six new cases, four of which carry novel pathogenic SOX2 variants. Four cases presented with bilateral anophthalmia in addition to extraocular involvement. Another individual presented with only unilateral anophthalmia. One individual did not have any eye findings but presented with a suprasellar teratoma in infancy and was found to have the recurrent c.70del20 mutation in SOX2 (c.70_89del, p.Asn24Argfs*65). This is this first time this tumor type has been reported in the context of a de novo SOX2 mutation. Notably, individuals with hypothalamic hamartomas and slow-growing hypothalamo-pituitary tumors have been reported previously, but it is still unclear how SOX2 loss contributes to their formation.

Hydrogen production by tailoring the brookite and Cu2O ratio of sol-gel Cu-TiO2 photocatalysts.

Cu-TiO2 photocatalysts were prepared by the sol-gel method. Copper loadings from, 1.0 to 5.0 wt % were used. The materials were annealed at different temperatures (from 400 to 600 °C) to study the formation of brookite and copper ionic species. The photocatalysts were characterized by X-ray diffraction, UV-vis, Raman and XPS spectroscopies, H2-temperature programmed reduction (TPR), N2 physisorption, and SEM-EDS to quantify the actual copper loadings and characterize morphology. The photocatalysts were evaluated during the hydrogen photocatalytic production using an ethanolic solution (50% v/v) under UV and visible radiation. The best hydrogen production was performed by Ti-Cu 1.0 with an overall hydrogen production that was five times higher than that obtained with photolysis. This sample had an optimal thermal treatment at 500 °C, and at this temperature, the Cu2O and brookite/anatase ratio boosted the photocatalytic production of hydrogen. In addition, a deactivation test was carried out for the most active sample (TiO2-Cu 1.0), showing unchanged H2 production for three cycles with negligible Cu lixiviation. The activity of hydrogen-through-copper production reported in this research work is comparable with the one featured by noble metals and that reported in the literature for doped TiO2 materials.

Mutagenicity and safety evaluation of water extract of Coriander sativum leaves.

Coriander has been used as a spice and medicinal plant for centuries. Several studies have described its biological properties and some reports have indicated its pharmacological actions in some human pathology. However, data on its toxicity and metabolism are limited or null, and no research has been conducted with mammalian cells. The purpose of this study was to evaluate the mutagenicity and safety of Coriandrum sativum extract. The mutagenic effects of C. sativum extract were evaluated by Ames test. Mutagenicity was present when the C. sativum extract was used in high concentrations in both tested strains (Salmonella typhimurium TA97 and TA102). Our research showed that C. sativum extract reduced the cell survival of human cell lines (WRL-68 and 293Q cells) by inducing apoptosis and necrosis in the cases where extract concentration was the highest. The C. sativum extract altered the cell cycle; it increased the G1 phase of hepatic cells and reduced the G2+M phase in both cell lines in a dose-response manner. These results showed correlation with a reduction in the mitotic index. The extract also induced severe malformations during embryonic development. Exposure of chicken embryos to the C. sativum extract resulted in a dose-dependent increase of anomalies. Present results show that C. sativum extract reduced the axial skeleton and affected the neural tube, the somites, the cardiovascular structures, and the eye. According to the present results, the C. sativum aqueous extract cannot be considered safe. These results indicate that some significant adverse effects of C. sativum extract could be observed in vivo.