Evaluation of electrode separators and the external resistance in electrochemically assisted constructed wetlands.

A proton exchange membrane increases the electrical performance of a microbial fuel cell (MFC). New inexpensive materials should be sought, especially in a constructed wetland microbial fuel cell (CW-MFC). Here, in a laboratory-scale system of five CW-MFCs, wet clay, wet earth or mud, and non-woven cloth were used as inexpensive separators with long-term stability. The five CW-MFCs were planted with Typha latifolia, fed with synthetic wastewater, and packed with natural porous material. Graphite felt was used as electrodes and the experimental system had a hydraulic residence time of 3 days, operating under shade and natural conditions of temperature and light. Electrodes were connected to current collectors (copper wire) and to an external resistance, with a change every 20 days, starting in open-circuit and following with 20000, 18000, 15000, 10000, 5600, 1000, 560, and 10 Ω. These laboratory-scale CW-MFCs reduced concentrations of nitrates, ammonium ion, and sulfates without inhibiting electricity production. Microbiological analyses indicated that anaerobic, facultative, aerobic, and denitrifying bacteria may have caused these reductions. The reactor with the live plant and with the wet earth or mud separator achieved the highest production of electricity (22.6 mW/m2), and may be worth further attention.

The International Association for the Study of Lung Cancer Staging Project for Lung Cancer: Proposals for the Revision of the N Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer.

INTRODUCTION: The accurate assessment of nodal (N) status is crucial to the management and prognostication of nonmetastatic NSCLC. We sought to determine whether the current N descriptors should be maintained or revised for the upcoming ninth edition of the international TNM lung cancer staging system. METHODS: Data were assembled by the International Association for the Study of Lung Cancer on patients with NSCLC, detailing both clinical and pathologic N status, with information about anatomical location and individual station-level identification. Survival was calculated by the Kaplan-Meier method and prognostic groups were assessed by a Cox regression analysis. RESULTS: Data for clinical N and pathologic N status were available in 45,032 and 35,009 patients, respectively. The current N0 to N3 descriptors for both clinical N and pathologic N categories reflect prognostically distinct groups. Furthermore, single-station N2 involvement (N2a) exhibited a better prognosis than multistation N2 involvement (N2b) in both clinical and pathologic classifications, and the differences between all neighboring nodal subcategories were highly significant. The prognostic differences between N2a and N2b were robust and consistent across resection status, histologic type, T category, and geographic region. CONCLUSIONS: The current N descriptors should be maintained, with the addition of new subdescriptors to N2 for single-station involvement (N2a) and multiple-station involvement (N2b).

The International Association for the Study of Lung Cancer Lung Cancer Staging Project: Overview of Challenges and Opportunities in Revising the Nodal Classification of Lung Cancer.

The status of lymph node involvement is a major component of the TNM staging system. The N categories for lung cancer have remained unchanged since the fourth edition of the TNM staging system, partly because of differences in nodal mapping nomenclature, partly because of insufficient details to verify possible alternative approaches for staging. In preparation for the rigorous analysis of the International Association for the Study of Lung Cancer database necessary for the ninth edition TNM staging system, members of the N-Descriptors Subcommittee of the International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee reviewed the evidence for alternative approaches to categorizing the extent of lymph node involvement with lung cancer, which is currently based solely on the anatomical location of lymph node metastasis. We reviewed the literature focusing on NSCLC to stimulate dialogue and mutual understanding among subcommittee members engaged in developing the ninth edition TNM staging system for lung cancer, which has been proposed for adoption by the American Joint Committee on Cancer and Union for International Cancer Control in 2024. The discussion of the range of possible revision options for the N categories, including the pros and cons of counting lymph nodes, lymph node stations, or lymph node zones, also provides transparency to the process, explaining why certain options may be discarded, others deferred for future consideration. Finally, we provide a preliminary discussion of the future directions that the N-Descriptors Subcommittee might consider for the 10th edition and beyond.

Vertical Dimension of Occlusion: A comparative study between Anthropometric and Knebelman's craniometric methods.

The masticatory system changes as time passes. The vertical dimension of occlusion (VDO) undergoes alterations due to temporomandibular joint disorders which in turn may be caused by related muscle modifications or pathological tooth wear. There are many methods to measure VDO. Among these, the anthropometric method and Knebelman's craniometric method have been shown to be the most closely related to facial biotype. The aim of this study was to compare data recorded with those two methods. A descriptive cross-sectional study was performed with a total 200 patients. A vernier caliper was used to measure facial landmarks. Results were analyzed using paired t-test, setting the level of significance at p<0.05. There was no significant difference between the two methods but Knebelman's method had less variability. Results suggest that Knebelman's method should provide more reliability for determining VDO in all the facial biotypes studied.

El sistema masticatorio cambia con el paso del tiempo. La dimensión vertical oclusal sufre alteraciones que se atribuyen a trastornos temporomandibulares a su vez causados por modificaciones en la musculatura relacionada o al desgaste patológico de las piezas dentarias. Existen muchos métodos para medir la dimensión vertical, entre los cuales el método antropométrico y el método craneométrico de Knebelman mostraron ser los más vinculados con el biotipo facial. El objetivo de este estudio fue comparar datos registrados con ambos métodos. La comparación fue realizada mediante un estudio de diseño transversal descriptivo con un total de 200 pacientes, usando un calibrador vernier para realizar mediciones entre puntos faciales establecidos. Los resultados fueron analizados por medio de la prueba de t de Student para datos emparejados estableciendo el nivel de significación en P<0,05. No se encontró diferencia significativa entre los métodos, pero el método de Knebelman mostró generar menos variabilidad en sus medidas. Este último método parece proporcionar más confiabilidad para su aplicación en la determinación de la dimensión vertical oclusal en todos los biotipos faciales estudiados.

Vertical Dimension of Occlusion: A comparative study between Anthropometric and Knebelman's craniometric methods / Dimensión vertical oclusal: un estudio comparativo entre el método antropométrico y el método craneométrico de Knebelman

ABSTRACT The masticatory system changes as time passes. The vertical dimension of occlusion (VDO) undergoes alterations due to temporomandibular joint disorders which in turn may be caused by related muscle modifications or pathological tooth wear. There are many methods to measure VDO. Among these, the anthropometric method and Knebelman's craniometric method have been shown to be the most closely related to facial biotype. The aim of this study was to compare data recorded with those two methods. A descriptive cross-sectional study was performed with a total 200 patients. A vernier caliper was used to measure facial landmarks. Results were analyzed using paired t-test, setting the level of significance at p<0.05. There was no significant difference between the two methods but Knebelman's method had less variability. Results suggest that Knebelman's method should provide more reliability for determining VDO in all the facial biotypes studied.

RESUMEN El sistema masticatorio cambia con el paso del tiempo. La dimensión vertical oclusal sufre alteraciones que se atribuyen a trastornos temporomandibulares a su vez causados por modificaciones en la musculatura relacionada o al desgaste patológico de las piezas dentarias. Existen muchos métodos para medir la dimensión vertical, entre los cuales el método antropométrico y el método craneométrico de Knebelman mostraron ser los más vinculados con el biotipo facial. El objetivo de este estudio fue comparar datos registrados con ambos métodos. La comparación fue realizada mediante un estudio de diseño transversal descriptivo con un total de 200 pacientes, usando un calibrador vernier para realizar mediciones entre puntos faciales establecidos. Los resultados fueron analizados por medio de la prueba de t de Student para datos emparejados estableciendo el nivel de significación en P<0,05. No se encontró diferencia significativa entre los métodos, pero el método de Knebelman mostró generar menos variabilidad en sus medidas. Este último método parece proporcionar más confiabilidad para su aplicación en la determinación de la dimensión vertical oclusal en todos los biotipos faciales estudiados.

Description and characterization of the artisanal elasmobranch fishery on Guatemala's Caribbean coast.

Small-scale shark and ray fisheries are conducted throughout Central America's Caribbean coast. Yet, there is limited information regarding catch composition and diversity of these fisheries, especially in Guatemala. Surveys of catch landings were conducted in two of Guatemala's primary Caribbean coastal shark and ray fishing communities, El Quetzalito and Livingston, between January 2015 and July 2017. Biological data from 688 landed chondrichthyans were collected, with 31 species (24 sharks, six rays and one chimaera) identified. The four most frequently captured species included Carcharhinus falciformis (30.2%), Sphyrna lewini (12.7%), Hypanus guttatus (12%) and Rhizoprionodon spp. (6.7%). Landed sharks contained most size classes with a high proportion of juveniles of species with low productivity. The large-bodied species C. falciformis and S. lewini were often recorded at sizes below known maturity; 96.6% and 85.1%, of the captured individuals were immature, respectively. This study can serve as a baseline to determine future trends in the elasmobranch fisheries conducted by Guatemala's Caribbean coastal communities and support assessments on the persistence of the fisheries.

Techno-economic analysis of aniline production via amination of phenol.

The purpose of this research is to demonstrate through a techno-economic assessment that aniline can be industrially produced using a profitable and inherently safer process than the ones currently employed. The aniline production process was designed using process simulation software. From this, the mass and energy balances were determined, the equipment sizing was performed and the net present value (NPV) was calculated to be USD 93.5 million. Additionally, a heat integration analysis was carried out in order to improve process profitability, obtaining a new NPV of USD 97.5 million. The economic sensitivity analysis showed that the process could withstand fixed capital investment changes of up to +89%, weighted average cost of capital changes between 16-24% and a decrease in cyclohexylamine demand of up to 44%. The conceptual design is still profitable when aniline price is varied in a range of 1224-1840 $/t and phenol cost in a range of 815-1178 $/t.

Estado poblacional del pepino de mar (Clase Holothuroidea) en el Caribe de Guatemala / Population status of Sea Cucumber (Class Holothuroidea) in the Caribbean of Guatemala

Los holoturoideos o pepinos de mar pertenecen al filo Echinodermata, e incluyen animales con cuerpo vermiforme alargado y blando que viven en los fondos de los mares de todo el mundo. Ecológicamente estos organismos son recicladores eficientes de sedimentos en el ambiente. En los últimos años han cobrado alto valor comercial en el mercado asiático, por lo que su pesquería se ha expandido hacia muchos países. En Guatemala se decretó una veda precautoria en el 2010 por cinco años, al terminar esta se extendió por dos años más, pero con el compromise de obtener información científica durante dicho período. Con este fin, se realizó una evaluación poblacional del pepino de mar a través de transectos lineales de 60 m2, en siete puntos de la bahía de Amatique y la zona expuesta del mar Caribe de Guatemala, durante abril, junio y septiembre del 2016. Se evaluaron 6,300 m2, encontrando un total de 64 individuos de pepinos de mar. La riqueza de holotúridos está representada por siete especies, siendo las más abundantes Isostichopus badionotus (Selenka, 1867) y Holothuria mexicana (Ludwig, 1875). Los sitios con mayor abundancia fueron Faro Rojo y King Fish (p = .004). En base a los resultados de esta evaluación se puede determinar que la explotación comercial de los pepinos de mar en el Caribe guatemalteco no es viable, y que para aprovechar el valor comercial de estas especies se podría impulsar la acuicultura y comercializarlo a través de un sistema eficiente de trazabilidad.

Holothurians or sea cucumbers belong to the filum Equinodermata, which includes animals with long soft vermiform bodies that live on the ocean bottom of the entire world. Ecologically these organisms are efficient recyclers of sediments in the environment. In recent years, they have gained high commercial value in the Asian market, so their fishery has expanded to many countries. In Guatemala, a precautionary ban was decreed in 2010 for five years, when it ended it was extended for two more years, but with the commitment to obtain scientific information during that period. For this purpose, a population assessment of sea cucumber was carried out through linear transects of 60 m2, in seven points of Amatique Bay and the exposed zone of the Caribbean Sea of Guatemala, during April, June and September of 2016. 6300 m2 were evaluated, founding 64 organisms. The holothurians richness is represented by seven species, being the most abundant Isostichopus badionotus (Selenka, 1867) and Holothuria mexicana (Ludwig, 1875). The most abundant sites were Faro Rojo and King Fish (p = .004). Based on the results of this evaluation, it can be determined that the commercial exploitation of sea cucumbers in the guatemalan Caribbean is not viable, and that to take advantage of the commercial value of these species, aquaculture could be promoted and marketed through an efficient traceability system.

Riqueza y abundancia de peces arrecifales en el Caribe de Guatemala utilizando Estaciones Remotas de Video Subacuático con Carnada / Richness and abundance of reef fish in the Caribbean of Guatemala using Baited Remote Underwater Video Stations

El mar Caribe de Guatemala forma parte del Sistema Arrecifal Mesoamericano (SAM), el cual alberga una alta diversidad de especies marinas. Dichas poblaciones son importantes para el bienestar de las comunidades humanas que habitan en la zona marino-costera de los países que conforman el SAM, y que dependen de manera directa o indirecta de estos recursos. El objetivo de este estudio fue determinar la riqueza y abundancia tanto de las especies de peces herbívoros presentes en el área, como de aquellas que son atraídas por carnada de sábalo y atún, utilizando la metodología de Estaciones Remotas de Video Subacuático con Carnada BRUVS en sitios con presencia de arrecifes. El muestreo se realizó en siete sitios ubicados fuera de la Bahía de Amatique, Izabal, en abril, junio y septiembre de 2016. Se grabaron 26.06 h, en 21 sets de BRUVS. Se contabilizaron 778 organismos, correspondientes a dos clases, 20 familias, 31 géneros y 59 especies. Las especies más abundantes en el estudio fueron Scarus spp. (19.67 %), Clepticus parrae (9.64 %), Aluterus scriptus (6.04 %), Scarus iserti (5.14 %) y Caranx ruber (5.01 %). Los sitios Quetzalito 1 y 2 presentaron una riqueza de especies significativamente mayor (p < 0.006) al resto de sitios de muestreo. Quetzalito 1, 2 y King Fish presentaron una abundancia significativamente mayor (p < .038) al resto de sitios. El dendrograma derivado de la abundancia por especie para los sitios de muestreo, mostró cinco agrupaciones (similaridad de Bray-Curtis del 43 %). Finalmente se observó una baja presencia de peces de importancia comercial en los siete puntos evaluados.

The Guatemalan Caribbean Sea forms part of the Mesoamerican Reef System (MAR), which harbors a great marine biodiversity. These populations are important for the wellness of humans who live in communities at coastal areas located in the MAR region, and who directly or indirectly depend on these resources to survive and thrive. The main objective of this study was to determine not only species richness and abundance of herbivorous fish, but also those who are attracted by shad and tuna bait when used in the Baited Remote Underwater Video Stations (BRUVS) in sites with coral reef presence. Monitoring was held at seven spots located outside Bahía de Amatique, Izabal, in April, June and September 2016. In 21 sets of BRUVS, 26.06 h of video were recorded, counting a total of 778 organisms which belongs to two classes, 20 families, 31 genera and 59 species. The most abundant species were Scarus spp. (19.67 %), Clepticus parrae (9.64 %), Aluterus scriptus (6.04 %), Scarus iserti (5.14 %) and Caranx ruber (5.01 %). The sites that presented higher richness of species were Quetzalito 1 y 2 (p < 0.006 compared to the rest of the sampled sites). Quetzalito 1, 2 and King Fish showed higher abundance (p < .038) compared to the rest of the sites. Abundance per specie dendrogram showed five groups (Bray-Curtis similarity of 43 %). Finally, low presence of commercial fish species was seen at the seven monitored sites.

Ability of ICU Health-Care Professionals to Identify Patient-Ventilator Asynchrony Using Waveform Analysis.

BACKGROUND: Waveform analysis by visual inspection can be a reliable, noninvasive, and useful tool for detecting patient-ventilator asynchrony. However, it is a skill that requires a properly trained professional. METHODS: This observational study was conducted in 17 urban ICUs. Health-care professionals (HCPs) working in these ICUs were asked to recognize different types of asynchrony shown in 3 evaluation videos. The health-care professionals were categorized according to years of experience, prior training in mechanical ventilation, profession, and number of asynchronies identified correctly. RESULTS: A total of 366 HCPs were evaluated. Statistically significant differences were found when HCPs with and without prior training in mechanical ventilation (trained vs non-trained HCPs) were compared according to the number of asynchronies detected correctly (of the HCPs who identified 3 asynchronies, 63 [81%] trained vs 15 [19%] non-trained, P < .001; 2 asynchronies, 72 [65%] trained vs 39 [35%] non-trained, P = .034; 1 asynchrony, 55 [47%] trained vs 61 [53%] non-trained, P = .02; 0 asynchronies, 17 [28%] trained vs 44 [72%] non-trained, P < .001). HCPs who had prior training in mechanical ventilation also increased, nearly 4-fold, their odds of identifying ≥2 asynchronies correctly (odds ratio 3.67, 95% CI 1.93-6.96, P < .001). However, neither years of experience nor profession were associated with the ability of HCPs to identify asynchrony. CONCLUSIONS: HCPs who have specific training in mechanical ventilation increase their ability to identify asynchrony using waveform analysis. Neither experience nor profession proved to be a relevant factor to identify asynchrony correctly using waveform analysis.

Anemia de Diamond Blackfan: un diagnóstico de exclusión / Anemia of Diamond Blackfan: an exclusión diagnosis

La anemia de Diamond Blackfan es un trastorno genético y clínico raro, caracterizado por aplasia eritrocitaria, que clásicamente se manifiesta durante el primer año de vida, típicamente a los 2-3 meses de edad. El 25% de los afectados presentan anemia severa en la infancia, normo o macrocitosis, reticulocitopenia y disminución selectiva de células precursoras eritroides en medula ósea. Es causada por mutaciones que afectan genes que codifican para proteínas ribosomales, inicialmente fue identificado RPS19, que codifica la proteína S19 y las mutaciones a otros genes que codifican proteínas ribosomales. Se presenta el caso de una paciente de cuatro meses de edad quien debutó con anemia severa, quien no mejoró con la suplencia de hierro, vitamina B12, y ácido fólico y además fueron descartadas sistemáticamente causas frecuentes de anemia. El diagnóstico de anemia de Diamond Blackfan en nuestro medio es un diagnóstico de exclusión, dada la dificultad para acceso a pruebas de confirmación genética. Se establece el diagnóstico y se da manejo con glucocorticoides con buena respuesta clínica y paraclínica

The Diamond Blackfan anemia is a rare genetic and clinical disorder. It is characterized by red cell aplasia, which typically occurs during the first year of life, typically during the second to the third month of age. 25% of the patients had severe anemia during their childhood, normo or macrocytosis, reticulocyte and selective decrease in the number of erythroid precursor cells in bone marrow. It is caused by mutations affect genes encoding ribosomal proteins, RPS19 initially was identified, which encodes S19 protein and mutations in other genes encoding ribosomal proteins. We present a case of a four-month-old who debuted with severe anemia in whom the substitution were iron supplements, vitamin B12 and folic acid, showed no improvement and who also were systematically discarded as common causes of anemia. The diagnosis of Diamond Blackfan anemia in our country is a diagnosis of exclusion, given the difficulty of access to genetic confirmation tests. In this article the diagnosis is established and gives management with glucocorticoid with good clinical and paraclinical response

20 Years Spatial-Temporal Analysis of Dengue Fever and Hemorrhagic Fever in Mexico.

BACKGROUND AND AIM: Dengue Fever (DF) is a human vector-borne disease and a major public health problem worldwide. In Mexico, DF and Dengue Hemorrhagic Fever (DHF) cases have increased in recent years. The aim of this study was to identify variations in the spatial distribution of DF and DHF cases over time using space-time statistical analysis and geographic information systems. METHODS: Official data of DF and DHF cases were obtained in 32 states from 1995-2015. Space-time scan statistics were used to determine the space-time clusters of DF and DHF cases nationwide, and a geographic information system was used to display the location of clusters. RESULTS: A total of 885,748 DF cases was registered of which 13.4% (n = 119,174) correspond to DHF in the 32 states from 1995-2015. The most likely cluster of DF (relative risk = 25.5) contained the states of Jalisco, Colima, and Nayarit, on the Pacific coast in 2009, and the most likely cluster of DHF (relative risk = 8.5) was in the states of Chiapas, Tabasco, Campeche, Oaxaca, Veracruz, Quintana Roo, Yucatán, Puebla, Morelos, and Guerrero principally on the Gulf coast over 2006-2015. CONCLUSION: The geographic distribution of DF and DHF cases has increased in recent years and cases are significantly clustered in two coastal areas (Pacific and Gulf of Mexico). This provides the basis for further investigation of risk factors as well as interventions in specific areas.

Physical activity in a rural community in Colombia / Actividad física en una comunidad rural de Colombia

ABSTRACT Objective To characterize physical activity profiles in a rural community in the southwest of Colombia and to identify knowledge gaps on this issue in the country. Methods Cross-sectional study conducted in a rural area in Puerto Caldas, Pereira, Risaralda. The population of the study was obtained by convenience sampling from people participating in the activities of the Second Multidisciplinary Camp for Research and Services (CUMIS, for its acronym in Spanish), which was organized by the Colombian Association of Medical Students' Scientific Societies (ASCEMCOL, for its acronym in Spanish). The International Physical Activity Questionnaire (IPAQ) was used in order to measure and classify the physical activity behaviors of this population. Results Data from 100 subjects with a mean age of 43±18 years were collected. 6 % of the population did not perform any kind of physical activity, while 61 % performed vigorous physical activity. Men spent more time in doing vigorous and moderate physical activity than women did (p<0.05). The World Health Organization (WHO) recommendations on physical activity were followed by 72.29 % (n=60) and 82.35 % (n=14) of the people with an age of 18 to64 and ≥65 years, respectively. Conclusion It is necessary to build up evidence regarding physical activity in rural areas in order to implement public policies that promote its practice in communities where socioeconomic and health inequities exist. Part of the population living in the community where the study was carried out does not follow the WHO recommendations on physical activity; therefore, the lack of public health interventions is highlighted. A better coherence between international resolutions, national public policies and their implementation could lead to an increase in practice levels of physical activity.(AU)

RESUMEN Objetivo Caracterizar la actividad física en una comunidad rural del suroeste de Colombia e identificar los vacíos de conocimiento alrededor del tema en el país. Métodos Estudio de corte transversal en una zona rural de Puerto Caldas, Pereira, Risaralda. La población fue seleccionada, mediante muestreo por conveniencia, entre las personas que participaron en las actividades del II Campamento Multidisciplinar de Investigación y Servicios (CUMIS), dirigido por la Asociación Colombiana de Sociedades Científicas de Estudiantes de Medicina (ASCEMCOL). Se utilizó el International Physical Activity Questionnaire (IPAQ) para medir y clasificar los comportamientos de esta población en términos de actividad física. Resultados Se recogieron datos de 100 sujetos con edad promedio de 43±18 años. El 6 % de la población no realizó ningún tipo de actividad física, mientras que el 61 % realizó actividad física vigorosa. Los hombres dedicaron más tiempo a la práctica de actividad física vigorosa y moderada que las mujeres (p<0,05). Las recomendaciones sobre actividad física de la Organización Mundial de la Salud (OMS) fueron seguidas por el 72,3 % (n=60) y el 82,4 % (n=14) de las personas en los grupos de edad de 18 a 64 y ≥65 años, respectivamente Conclusión Es necesario construir evidencia en torno a la actividad física en el área rural, a fin de implementar políticas públicas que promuevan su práctica en comunidades que presenten desigualdades socioeconómicas y en salud. Parte de la población de la comunidad donde se llevó a cabo el estudio no sigue las recomendaciones de la OMS para actividad física, en consecuencia, la falta de intervenciones en salud pública se pone en evidencia. Una mayor coherencia entre las resoluciones internacionales, las políticas públicas nacionales y su aplicación podría conducir a un aumento en los niveles de actividad física.(AU)

Physical activity in a rural community in Colombia.

OBJECTIVE: To characterize physical activity profiles in a rural community in the southwest of Colombia and to identify knowledge gaps on this issue in the country. METHODS: Cross-sectional study conducted in a rural area in Puerto Caldas, Pereira, Risaralda. The population of the study was obtained by convenience sampling from people participating in the activities of the Second Multidisciplinary Camp for Research and Services (CUMIS, for its acronym in Spanish), which was organized by the Colombian Association of Medical Students' Scientific Societies (ASCEMCOL, for its acronym in Spanish). The International Physical Activity Questionnaire (IPAQ) was used in order to measure and classify the physical activity behaviors of this population. RESULTS: Data from 100 subjects with a mean age of 43±18 years were collected. 6 % of the population did not perform any kind of physical activity, while 61 % performed vigorous physical activity. Men spent more time in doing vigorous and moderate physical activity than women did (p<0.05). The World Health Organization (WHO) recommendations on physical activity were followed by 72.29 % (n=60) and 82.35 % (n=14) of the people with an age of 18 to64 and ≥65 years, respectively. CONCLUSION: It is necessary to build up evidence regarding physical activity in rural areas in order to implement public policies that promote its practice in communities where socioeconomic and health inequities exist. Part of the population living in the community where the study was carried out does not follow the WHO recommendations on physical activity; therefore, the lack of public health interventions is highlighted. A better coherence between international resolutions, national public policies and their implementation could lead to an increase in practice levels of physical activity.

Pentostatin, cyclophosphamide and rituximab for previously untreated advanced stage, low-grade B-cell lymphomas.

We conducted a prospective phase II trial of pentostatin, cyclophosphamide and rituximab as initial therapy for patients with previously untreated advanced stage low-grade or indolent B-cell lymphomas (iNHLs). Of 83 evaluable patients, 91·6% attained an overall response and 86·8% a complete or unconfirmed complete response. The 3-year progression-free survival (PFS) and overall survival rates were 73% and 93%, respectively. The 3-year PFS rate was significantly different for different diagnoses (P = 0·01): 83% [95% confidence interval (CI): 0·72, 0·96] for follicular lymphomas, 73% (95% CI: 0·54, 1·0) for marginal zone lymphomas and 61% (95% CI: 0·46, 0·81) for small lymphocytic lymphomas. The most common adverse events were haematological. Of 509 cycles of chemotherapy administered, grade 3 or 4 neutropenia was reported in 68 cycles (13% of cycles administered) and most frequently occurred during cycles 4-6. This is the first report demonstrating the effectiveness of pentostatin, cyclophosphamide and rituximab in patients with previously untreated iNHLs, including those over 60 years of age.

Job strain and heart rate variability in resident physicians within a general hospital.

OBJECTIVE: To evaluate the association of heart rate variability with job strain in first year resident physicians. METHODS: We performed the study at the "Manuel Gea González" General Hospital in Mexico City. 54 resident doctors were studied over a period of 24 hr in their first year of specialization. Two questionnaires were administered: the first on general demographics, and the second, the Job Content Questionnaire. Heart rate variability was evaluated through the frequency domain (low-frequency power, high-frequency power, and low-frequency power/high-frequency power ratio) and time domain (SDNN). The doctors wore a Holter monitor over a 24-hr period, which included a workday plus their on-call time. They recorded their activities in a log. RESULTS: Compared to physicians in the "low strain" category, physicians working in the "passive" category had lower overall peak-to-peak cardiac variability (standard deviation of N-N intervals, SDNN), -9.08% (95% CI -17.97, 0.74), a -25% (95% CI -45.00, 0.22) lower high-frequency power, and -26.95% (95% CI -39.00, -12.53) lower low-frequency power. Physicians working in the "high strain" category had lower low-frequency power, -17.85% (95%CI -32.34, -0.25), and lower low-frequency/high-frequency ratio -24.29% (95% CI 38.08, 7.42) compared to those in the "low strain" category. CONCLUSIONS: High job strain and low job control among medical residents were associated with several indicators of lowered heart rate variability. Thus, analysis of heart rate variability may be an informative marker for evaluating the physiological impacts of workplace stressors.

An indoor navigation system for the visually impaired.

Navigation in indoor environments is highly challenging for the severely visually impaired, particularly in spaces visited for the first time. Several solutions have been proposed to deal with this challenge. Although some of them have shown to be useful in real scenarios, they involve an important deployment effort or use artifacts that are not natural for blind users. This paper presents an indoor navigation system that was designed taking into consideration usability as the quality requirement to be maximized. This solution enables one to identify the position of a person and calculates the velocity and direction of his movements. Using this information, the system determines the user's trajectory, locates possible obstacles in that route, and offers navigation information to the user. The solution has been evaluated using two experimental scenarios. Although the results are still not enough to provide strong conclusions, they indicate that the system is suitable to guide visually impaired people through an unknown built environment.

Determinación de etilglucoronido por LC-MS/MS, posible indicador en análisis forense / Determination of ethylglucuronide by LC-MS/MS, possible indicator in forensic analysis

D-etilglucuronido (EtG) metabolíto estable del etanol, puede ser identificado en orina hasta 3,5 días después de la ingesta y podría ser útil para el diagnóstico de ingesta en estudios forenses, para su determinación se emplearon los sistemas LC-MS/MS. Los ensayos realizados en orina blanco y aquella tratada con EtG así como muestras y siguiendo la metodología analítica descrita para el estudio, se pudo observar la presencia de iones, siendo los más abundantes aquellos derivados de EtG y D5-EtG (m/z 75, 85, y 113) son resultado del ácido glucurónico no incluyendo el aglicon etanol. Por lo que se puede señalar que estos iones con baja abundancia son resultado de la lactonizatión o pérdida de agua (m/z 203), decarboxilación adicional (m/z 159), pérdida de etanol (m/z 113), y agua o CO. Por todo lo demostrado, el poder identificar a EtG, y utilizarlo como un indicador de la presencia de etanol en el organismo, para poder extrapolar datos de consumo de etanol, en estudios forenses proponemos que esta metodología podría ser empleada para esclarecer los conflictos relacionados con esta sustancia.

D-etilglucuronido (EtG) stable metabolite of ethanol, can be identified in urine up to 3.5 days after ingestion and may be useful for the diagnosis of intake in forensic studies, were used for determination LC-MS/MS systems. The target urine tests and those treated with EtG and samples and following the analytical methodology described in the study, we observed the presence of ions, the most abundant being those derived from D5-EtG and EtG (m/z 75, 85, and 113) are the result of glucuronic acid aglycone not including ethanol. As can be noted that these ions with low abundance are the result of lactonizatión or water loss (m/z 203), additional decarboxylation (m/z 159), loss of ethanol (m/z 113), and water or CO. For all the proven, EtG able to identify and use it as an indicator of the presence of ethanol in the body, to extrapolate data from consumption of ethanol in forensic studies suggest that this methodology could be used to clarify the conflicts this substance.

[The banishment of the marvellous. Hermaphrodites and sexual mutants in Enlightenment Spain]. / El destierro de lo maravilloso. Hermafroditas y mutantes sexuales en la España de la Ilustración.

This article presents a historical synthesis in order to trace how the collective belief in the existence of hermaphrodites and sex-changes was slowly eroded in the changing medical and cultural context of Enlightenment Spain. In order to explain this change, three interlinked processes are outlined. First, the naturalization of the monster and the disappearance of the "marvellous" in Enlightenment science. Second, the consolidation of modern legal or forensic science and the rise of the medical specialist as the relevant authority in the determination of sexual identity. Third, the emergence of the notion of fundamental biological differences between the sexes. The article concludes by discussing the consequences of these shifts for early nineteenth-century Spanish medicine.

Hyperglycemia alters the schwann cell mitochondrial proteome and decreases coupled respiration in the absence of superoxide production.

Hyperglycemia-induced mitochondrial dysfunction contributes to sensory neuron pathology in diabetic neuropathy. Although Schwann cells (SCs) also undergo substantial degeneration in diabetic neuropathy, the effect of hyperglycemia on the SC mitochondrial proteome and mitochondrial function has not been examined. Stable isotope labeling with amino acids in cell culture (SILAC) was used to quantify the temporal effect of hyperglycemia on the mitochondrial proteome of primary SCs isolated from neonatal rats. Of 317 mitochondrial proteins identified, about 78% were quantified and detected at multiple time points. Pathway analysis indicated that proteins associated with mitochondrial dysfunction, oxidative phosphorylation, the TCA cycle, and detoxification were significantly increased in expression and over-represented. Assessing mitochondrial respiration in intact SCs indicated that hyperglycemia increased the overall rate of oxygen consumption but decreased the efficiency of coupled respiration. Although a glucose-dependent increase in superoxide production occurs in embryonic sensory neurons, hyperglycemia did not induce a substantial change in superoxide levels in SCs. This correlated with a 1.9-fold increase in Mn superoxide dismutase expression, which was confirmed by immunoblot and enzymatic activity assays. These data support that hyperglycemia alters mitochondrial respiration and can cause remodeling of the SC mitochondrial proteome independent of significant contributions from glucose-induced superoxide production.