Influence of face masks on recalibration of phonetic categories.

Previous research demonstrates listeners dynamically adjust phonetic categories in line with lexical context. While listeners show flexibility in adapting speech categories, recalibration may be constrained when variability can be attributed externally. It has been hypothesized that when listeners attribute atypical speech input to a causal factor, phonetic recalibration is attenuated. The current study investigated this theory directly by examining the influence of face masks, an external factor that affects both visual and articulatory cues, on the magnitude of phonetic recalibration. Across four experiments, listeners completed a lexical decision exposure phase in which they heard an ambiguous sound in either /s/-biasing or /ʃ/-biasing lexical contexts, while simultaneously viewing a speaker with a mask off, mask on the chin, or mask over the mouth. Following exposure, all listeners completed an auditory phonetic categorization test along an /ʃ/-/s/ continuum. In Experiment 1 (when no face mask was present during exposure trials), Experiment 2 (when the face mask was on the chin), Experiment 3 (when the face mask was on the mouth during ambiguous items), and Experiment 4 (when the face mask was on the mouth during the entire exposure phase), listeners showed a robust and equivalent phonetic recalibration effect. Recalibration manifested as greater proportion /s/ responses for listeners in the /s/-biased exposure group, relative to listeners in the /ʃ/-biased exposure group. Results support the notion that listeners do not causally attribute face masks with speech idiosyncrasies, which may reflect a general speech learning adjustment during the COVID-19 pandemic.

Elaboration and Biocompatibility of an Eggshell-Derived Hydroxyapatite Material Modified with Si/PLGA for Bone Regeneration in Dentistry.

Hydroxyapatite (HAp) is the most commonly used biomaterial in modern bone regeneration studies because of its chemical similarity to bone, biocompatibility with different polymers, osteoconductivity, low cost, and lack of immune response. However, to overcome the disadvantages of HAp, which include fragility and low mechanical strength, current studies typically focus on property modification through the addition of other materials. Objective. To develop and evaluate the biocompatibility of a HAp material extracted from eggshells and modified with silicon (Si) and poly(lactic-co-glycolic) acid (PLGA). Materials and Methods. An in vitro experimental study in which a HAp material prepared from eggshells was synthesized by wet chemical and conventional chemical precipitation. Subsequently, this material was reinforced with Si/PLGA using the freezing/lyophilization method, and then osteoblast cells were seeded on the experimental material (HAp/Si/PLGA). To analyse the biocompatibility of this composite material, scanning electron microscopy (SEM) and fluorescence confocal microscopy (FCM) techniques were used. PLGA, bovine bone/PLGA (BB/PLGA), and HAp/PLGA were used as controls. Results. A cellular viability of 96% was observed for the experimental HAp/Si/PLGA material as well as for the PLGA. The viability for the BB/PLGA material was 90%, and the viability for the HAp/PLGA was 86%. Cell adhesion was observed on the exterior surface of all materials. However, a continuous monolayer and the presence of filopodia were observed over both external and internal surface of the experimental materials. Conclusions. The HAp/Si/PLGA material is highly biocompatible with osteoblastic cells and can be considered promising for the construction of three-dimensional scaffolds for bone regeneration in dentistry.

Thromboelastographyguided transfusion therapy in a pregnant patient with hemorrhagic dengue fever hospitalized in icu. case report / Tromboelastografía para dirigir la terapia transfusional en dengue hemorrágico en una paciente embarazada hospitalizada en uci: reporte de caso

ABSTRACT Dengue fever is the biggest public health issue in tropical countries. A significant percentage of patients who suffer from this disease require admission to the intensive care unit (ICU) due to the severity of the clinical picture. This case reports the clinical evolution of an eight-week pregnant woman with dengue fever associated with thrombocytopenia and leukopenia. The patient comes from an endemic area for tropical diseases, fact that led to diagnose dengue fever with hemorrhagic characteristics. During her stay in the ICU, the patient presented with first trimester bleeding and placental hematoma. Therefore, and considering the pregnancy and the risk of loss, the hematological function was monitored through thromboelastography. The transfusion of blood products was decided according to the specific findings. Controlling and reversing the obstetric bleeding process was possible, the patient condition evolved favorably, and she was subsequently discharged from the ICU. This article reports on the usefulness of dynamic monitoring the hematological function using thromboelastography in patients with hemorrhagic dengue fever and special conditions such as pregnancy.

RESUMEN El dengue es una enfermedad considerada como el mayor problema de salud pública en países tropicales. Un importante porcentaje de pacientes que lo padecen requieren ingreso a la unidad de cuidados intensivos (UCI) debido a la severidad del cuadro clínico. El presente caso reporta la evolución clínica de una gestante de ocho semanas con cuadro febril asociado a trombocitopenia y leucopenia. La paciente procede de un área endémica para enfermedades tropicales, lo que lleva a realizar un diagnóstico de dengue con características hemorrágicas. En la UCI, la paciente presenta hemorragia del primer trimestre y hematoma placentario, por lo que, ante el estado de embarazo y el riesgo de pérdida del mismo, se decide monitorizar la función hematológica con tromboelastrografía y transfundir hemoderivados según los hallazgos específicos. Se logra controlar y revertir el proceso de sangrado obstétrico con evolución favorable de la paciente y egreso de UCI. En el presente artículo se reporta la utilidad de la monitorización dinámica de la función hematológica con tromboelastografia en pacientes con dengue hemorrágico y condiciones especiales, tales como el embarazo.

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug

Compression of the esophagus by a retroesophageal aberrant right subclavian artery (ARSA) is a rare cause of dysphagia. We present the case of a 47-year-old female with symptoms of progressive dysphagia diagnosed with dysphagia lusoria using barium swallow and contrast computed tomography and successfully treated with a hybrid procedure: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug through the right superficial femoral artery. We consider this approach safer, less invasive and more complete to avoid recurrent dysphagia (AU)

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Loss of Breathing Modulation of Heart Rate Variability in Patients with Recent and Long Standing Diabetes Mellitus Type II.

Healthy subjects under rhythmic breathing have heart interbeat intervals with a respiratory band in the frequency domain that can be an index of vagal activity. Diabetes Mellitus Type II (DM) affects the autonomic nervous system of patients, thus it can be expected changes on the vagal activity. Here, the influence of DM on the breathing modulation of the heart rate is evaluated by analyzing in the frequency domain heart interbeat interval (IBI) records obtained from 30 recently diagnosed, 15 long standing DM patients, and 30 control subjects during standardized clinical tests of controlled breathing at 0.1 Hz, supine rest and standing upright. Fourier spectral analysis of IBI records quantifies heart rate variability in different regions: low-frequencies (LF, 0.04-0.15 Hz), high-frequencies (HF, 0.15-0.4 Hz), and a controlled breathing peak (RP, centered around 0.1 Hz). Two new parameters are introduced: the frequency radius rf (square root of the sum of LF and HF squared) and ß (power of RP divided by the sum of LF and HF). As diabetes evolves, the controlled breathing peak loses power and shifts to smaller frequencies, indicating that heart rate modulation is slower in diabetic patients than in controls. In contrast to the traditional parameters LF, HF and LF/HF, which do not show significant differences between the three populations in neither of the clinical tests, the new parameters rf and ß, distinguish between control and diabetic subjects in the case of controlled breathing. Sympathetic activity that is driven by the baroreceptor reflex associated with the 0.1 Hz breathing modulations is affected in DM patients. Diabetes produces not only a rigid heartbeat with less autonomic induced variability (rf diminishes), but also alters the coupling between breathing and heart rate (reduced ß), due to a progressive decline of vagal and sympathetic activity.

Personal and professional use of menopausal hormone therapy among gynecologists: A multinational study (REDLINC VII).

BACKGROUND: Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormone therapy (MHT) was its low rate of prescription by doctors. OBJECTIVE: To determine the use of MHT and perceived related risks among gynecologists. METHODS: A self-administered and anonymous questionnaire was delivered to certified gynecologists in 11 Latin American countries. RESULTS: A total of 2154 gynecologists were contacted, of whom 85.3% responded to the survey (n = 1837). Mean age was 48.1 ± 11.4 years; 55.5% were male, 20.3% were faculty members and 85% had a partner. Overall, 85.4% of gynecologists responded that they would use MHT if they had menopausal symptoms (81.8% in the case of female gynecologists) or prescribe it to their partner (88.2% in the case of male gynecologists; p < 0.001). Perceived risk related to MHT use (on a scale from 0 to 10) was higher among female than among male gynecologists (4.06 ± 2.09 vs. 3.83 ± 2.11, p < 0.02). The top two perceived reported risks were thromboembolism (women 33.6% vs. men 41.4%, p < 0.009) and breast cancer (women 38.5% vs. men 33.9%, p < 0.03). Overall, gynecologists reported prescribing MHT to 48.9% of their symptomatic patients (women 47.3% vs. men 50.2%, p < 0.03) and 86.8% currently prescribed non-hormonal remedies and 83.8% alternative therapies for the management of the menopause. Gynecologists who were older and academic professionals prescribed MHT more often. CONCLUSION: Although this Latin American survey showed that gynecologists are mostly supporters of MHT use (for themselves or their partners), this is not necessarily reflected in their clinical practice.

Hybrid treatment of dysphagia lusoria: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug.

Compression of the esophagus by a retroesophageal aberrant right subclavian artery (ARSA) is a rare cause of dysphagia. We present the case of a 47-year-old female with symptoms of progressive dysphagia diagnosed with dysphagia lusoria using barium swallow and contrast computed tomography and successfully treated with a hybrid procedure: right carotid to subclavian bypass and endovascular insertion of an Amplatzer II Vascular Plug through the right superficial femoral artery. We consider this approach safer, less invasive and more complete to avoid recurrent dysphagia.

Thermal diffusivity measurement for urchin-like gold nanofluids with different solvents, sizes and concentrations/shapes.

The thermal properties of nanofluids are an especially interesting research topic because of the variety of potential applications, which range from bio-utilities to next-generation heat-transfer fluids. In this study, photopyroelectric calorimetry for measuring the thermal diffusivity of urchin-like colloidal gold nanofluids as a function of particle size, concentration and shape in water, ethanol and ethylene glycol is reported. Urchin-like gold nanoparticles were synthesised in the presence of hydroquinone through seed-mediated growth with homogeneous shape and size ranging from 55 to 115 nm. The optical response, size and morphology of these nanoparticles were characterised using UV-visible spectroscopy and transmission electron microscopy. The thermal diffusivity of these nanofluids decreased as the size of the nanoparticles increased, and the enhancement depended on the thermal diffusivity of the solvent. The opposite effect (increase in thermal diffusivity) was observed when the nanoparticle concentration was increased. These effects were more evident for urchin-like gold nanofluids than for the corresponding spherical gold nanofluids.

Thermal diffusivity measurement of spherical gold nanofluids of different sizes/concentrations.

In recent times, nanofluids have been studied by their thermal properties due to their variety of applications that range from photothermal therapy and radiofrequency hyperthermia (which have proven their potential use as coadjutants in these medical treatments for cancer diseases) to next-generation thermo-fluids. In this work, photoacoustic spectroscopy for a specific study of thermal diffusivity, as a function of particle size and concentration, on colloidal water-based gold nanofluids is reported. Gold nanoparticles were synthetized in the presence of hydroquinone through a seed-mediated growth with homogenous sizes and shapes in a range of 16 to 125 nm. The optical response, size and morphology of these nanoparticles were characterized using ultraviolet-visible spectroscopy and transmission electron microscopy, respectively. Thermal characterizations show a decrease in the thermal diffusivity ratio as the nanoparticle size is increased and an enhancement in thermal diffusivity ratio as nanoparticle concentration is added into the nanofluids. Compared with other techniques in the literature such as thermal lens and hot wire method, this photoacoustic technique shows an advantage in terms of precision, and with a small amount of sample required (500 µl), this technique might be suitable for the thermal diffusivity measurement of nanofluids. It is also a promising alternative to classical techniques.

Morbilidad materna extrema en cuidados intensivos obstétricos: Cartagena (Colombia) 2006 - 2008 / Maternal near miss in obstetric critical care: Cartagena, Colombia, 2006 - 2008

Objetivo: el presente estudio tiene como objetivo establecer la incidencia de la morbilidad materna extrema (MME), sus características clínicas y hacer una primera aproximación a los indicadores de calidad de la atención obstétrica en la unidad de cuidados intensivos (UCI). Materiales y métodos: estudio de cohorte, retrospectivo de pacientes obstétricas con MME que ingresaron a la UCI de la Clínica de Maternidad Rafael Calvo de Cartagena entre el período del 1 de enero de 2006 al 31 de diciembre de 2008. Se registraron las características sociodemográficas, ginecoobstétricas, criterios de MME y los indicadores de calidad de la atención obstétrica. Para el análisis de resultados se utilizaron medidas de tendencia central y dispersión, porcentajes, tablas de frecuencia y razones estandarizadas de morbilidad con intervalos de confianza (IC) al 95%. Resultados: la incidencia de MME fue de 12,1 por 1000 nacimientos. El 27,2% (88 pacientes) eran adolescentes y el 61,6% multigestantes (199 pacientes). El principal diagnóstico asociado a la MME fue el trastorno hipertensivo del embarazo, 49,5% (160 pacientes), seguido por las hemorragias del embarazo, 22,6% (73 pacientes). Las principales disfunciones orgánicas fueron respiratorias, 38,1% (123 casos), hepáticas, 15,2% (49 casos) e inmunológicas, 14,6% (47 casos). La transfusión fue la intervención más común, 22,6% (73 pacientes). Durante los años de estudio la incidencia de MME y la razón de casos de MME: muerte materna (MM) aumentaron, mientras que el índice de mortalidad disminuyó. Conclusiones: se encontró una incidencia de MME del 12,1 por 1000 nacimientos. Se presentaron los indicadores de calidad como medición basal, lo que servirá de comparación para futuras mediciones...

Objective: the present study aim to establish the incidence of severe maternal morbidity (SMM), the clinical characteristics and a first approximation to the quality indicators of the obstetric attention, of patients with SMM in the intensive care unit (ICU). Materials and methods: a retrospective cohort study of all consecutive obstetric admissions to the intensive care unit (ICU) in the Rafael Calvo maternity clinic in Cartagena, Colombia from January 1, 2006 to December 31, 2008. Sociodemographic and obstetric data, severe maternal morbidity (SMM) criteria and indicators to monitor quality of obstetric care were registered. The statistical analysis utilized measures of central tendency and spread, percentages, frequency tables and Standardized Morbidity Ratio (SMR) with an interval confidence of 95% (CI 95%). Results: the severe maternal morbidity incidence was 12.1 per 1000 deliveries. 27.2% of the population studied (88 patients) were teenagers and 61.6% were multiparous (199 patients). The most common diagnosis was hypertensive disorders of pregnancy (49.5%; 160 patients) followed by obstetric hemorrhages 22.6% (73 patients). The main dysfunctions were respiratory: 38.1% (123 patients), hepatic: 15.2% (49 patients) and immunological: 14.6% (47 patients). The most common intervention was transfusion, 22.6% (73 patients). During the study period the severe maternal morbidity incidence and the Maternal Near Miss mortality ratio increased, while the mortality index decreased...

Alteraciones electrocardiográficas inducidas por paclitaxel (taxol) / Electrocardiographic alterations induced by paclitaxel (taxol)

Objetivo. Identificar repercusiones clínicas y alteraciones electrocardiográficas inducidas por la infusión de placlitaxel durante 24 horas. Pacientes y métodos. De enero de 1993 a enero de 1996, en los Departamentos de Medicina Interna del Hospital ABC y de Oncología del Hospital General de México, se estudiaron a 35 pacientes entre 18 y 75 años de edad, con diversas neoplasias karnofsky > 60 por ciento, que previamente habrían recibido uno o más esquemas de quimioterapia. Todos recibieron paclitaxel en infusión continua de 24 horas, cada 21 días, con dosis de 125-225 mg/m², y profilaxis para tratamiento de hipersensibilidad con dexametasona, ranitidina y clorfeniramina. Se practicó electrocardiograma antes y después de cada infusión del taxano. El grado de cardiotoxicidad se calificó de acuerdo con los criterios del national Cancer Institute. Resultados. Treinta y cinco pacientes con edad promedio de 50 ñ 8.8 años, 28 mujeres (80 por ciento) y siete hombres (20 por ciento), recibieron 110 ciclos. Diecinueve pacientes (54.2 por ciento) habían recibido doxorrubicina previamente y 10 habían sido sometidos a radioterapia mediastinal. Un paciente presentó infarto agudo al miocardio un año antes del tratamiento. Se encontró disminución de la frecuencia cardiaca en 37.1 por ciento de los pacientes y 26.3 por ciento de los ciclos con dosis de 125 y 150 mg/m². En 25.7 por ciento de los pacientes y 19 ciclos se detectó prolongación del intervalo QTc con dosis mayores de 150 mg/m². Hubo extrasístoles supraventriculares en cuatro pacientes durante ocho ciclos de tratamiento y extrasístoles ventriculares, en un paciente, durante un ciclo. Se detectó disminusión del voltaje del complejo QRS en 3.6 por ciento de los ciclos y en 5.7 por ciento de los pacientes con dosis de 135 y 175 mg/m². La inversión de la onda T se presentó en tres casos durante cuatro ciclos, sin repercusión hemodinámica ni traducción enzímatica. Se registró aumento de la frecuencia cardiaca en 28.5 por ciento de los pacientes y 18.1 por ciento de los ciclos con dosis superiores a 175 mg/m². Hubo un caso de taquicardia supraventricular con dosis de 225 mg/m². Todas las alteraciones se calificaron como grado I, sin repercusión hemodinámica ni significancia estadística...

Comportamiento de los indicadores de utilización de la cama hospitalaria por especialidades y etapas de atención / Behaviour of indicators of hospital beds utilization by specialities and care stages

Se presenta un análisis del comportamiento de los indicadores que miden la utilización de la cama en los servicios hospitalarios, clasificados por especialidad y etapas de atención en el período 1976-1981. Se estudian los promedios de estadía, número promedio de días de ocupación de la cama al año, el intervalo de sustitución y el índice de rotación en las especialidades de Medicina, Cirugía, Obstetricia y Ginecología, Pediatría y Cirugía Pediátrica, de acuerdo con una clasificación de los hospitales, según tipo y categoría por la nomenclatura del MINSAP; se evidencia que el comportamiento de los indicadores difieren para las etapas de atención en una misma especialidad, utilizándose mejor las camas en las etapas de mayor complejidad, excepto en Obstetricia y Ginecología. En todas las especialidades estudiadas, es susceptible de mejorar el aprovechamiento de este recurso, sobre todo en la Etapa 1: la especialidad que peor utiliza las camas es Pediatría (AU)

Comportamiento de los indicadores de utilización de la cama hospitalaria por especialidades y etapas de atención / Behaviour of indicators of hospital beds utilization by specialities and care stages

Se presenta un análisis del comportamiento de los indicadores que miden la utilización de la cama en los servicios hospitalarios, clasificados por especialidad y etapas de atención en el período 1976-1981. Se estudian los promedios de estadía, número promedio de días de ocupación de la cama al año, el intervalo de sustitución y el índice de rotación en las especialidades de Medicina, Cirugía, Obstetricia y Ginecología, Pediatría y Cirugía Pediátrica, de acuerdo con una clasificación de los hospitales, según tipo y categoría por la nomenclatura del MINSAP; se evidencia que el comportamiento de los indicadores difieren para las etapas de atención en una misma especialidad, utilizándose mejor las camas en las etapas de mayor complejidad, excepto en Obstetricia y Ginecología. En todas las especialidades estudiadas, es susceptible de mejorar el aprovechamiento de este recurso, sobre todo en la Etapa 1: la especialidad que peor utiliza las camas es Pediatría

Coledocoduodenostomía laterolateral: Indicaciones y técnicas / A side to choledochoduodenostomy: Indications and technique

Se revisan las indicaciones y técnica de la coledocoduodenostomía laterolateral y se señala la experiencia acumulada en el hospital docente "Enrique Cabrera", adquirida mediante la práctica de esa derivación biliodigestiva en 41 pacientes. La indicación para efectuarla en 18 enfermos fue la litiasis coledociana asociada a un colédoco muy dilatado. Comprobaron que la edad avanzada no aumentó la estadía posoperatoria de los pacientes; que la mortalidad fue de 4,8 porciento por causas ajenas al tipo de operación efectuada, y que la morbilidad no aumentó en los pacientes portadores de íctero obstructivo o en los edad avanzada. La variante de la técnica quirúrgica descrita por Juraz, con la modificación propuesta por el profesor Emilio Camayd fue la más utilizada, y tiene probada calidad para obtener posoperatorio óptimo (AU)