Impact of congenital uterine anomalies on obstetric and perinatal outcomes: systematic review and meta-analysis.

Background: Congenital uterine anomalies (CUA) can be associated with impairments of early and late pregnancy events. Objective: To assess the impact of CUA on reproductive outcomes in pregnancies conceived spontaneously or after assisted reproduction. Materials and Methods: Systematic review and meta-analysis of cohort studies comparing patients with CUA versus women with normal uterus. A structured literature search was performed in leading scientific databases to identify prospective and retrospective studies. The Newcastle-Ottawa scale, adapted to AHRQ standards, was used to assess the risk of bias. Pooled odds ratios (OR) were calculated. Publication bias and statistical heterogeneity were assessed, and meta-regression was used to analyse the heterogeneity. Main outcome measures: Miscarriage, ectopic pregnancy, placental abruption, term, and premature rupture of membranes (PROM), malpresentation at delivery, preterm delivery prior to 37, 34 and 32 weeks, caesarean delivery, intrauterine growth restriction/small for gestational age, foetal mortality and perinatal mortality. Results: 32 studies were included. CUAs increased significantly the risk of first/second trimester miscarriage (OR:1.54;95%CI:1.14-2.07), placental abruption (OR:5.04;3.60-7.04), PROM (OR:1.71;1.34-2.18), foetal malpresentation at delivery (OR:21.04;10.95-40.44), preterm birth (adjusted OR:4.34;3.59-5.21), a caesarean delivery (adjusted OR:7.69;4.17-14.29), intrauterine growth restriction/small for gestational age (adjusted OR:50;6.11-424), foetal mortality (OR:2.07;1.56-2.73) and perinatal mortality (OR:3.28;2.01-5.36). Conclusions: CUA increases the risk of complications during pregnancy, delivery, and postpartum. Complications most frequent in CUA patients were preterm delivery, foetal malpresentation, and caesarean delivery. What is new?: Bicornuate uterus was associated with the highest number of adverse outcomes, followed by didelphys, subseptate and septate uterus.

Considerations for the development of guidance on dose level selection for developmental and reproductive toxicity studies.

In 2022, the European Chemicals Agency issued advice on the selection of high dose levels for developmental and reproductive toxicity (DART) studies indicating that the highest dose tested should aim to induce clear evidence of reproductive toxicity without excessive toxicity and severe suffering in parental animals. In addition, a recent publication advocated that a 10% decrease in body weight gain should be replaced with a 10% decrease in bodyweight as a criterion for dose adequacy. Experts from the European Centre for Ecotoxicology and Toxicology of Chemicals evaluated these recent developments and their potential impact on study outcomes and interpretation and identified that the advice was not aligned with OECD test guidelines or with humane endpoints guidance. Furthermore, data analysis from DART studies indicated that a 10% decrease in maternal body weight during gestation equates to a 25% decrease in body weight gain, which differs from the consensus of experts at a 2010 ILSI/HESI workshop. Dose selection should be based on a biological approach that considers a range of other factors. Excessive dose levels that cause frank toxicity and overwhelm homeostasis should be avoided as they can give rise to effects that are not relevant to human health assessments.

Incidencia de úlceras por presión secundarias al decúbito prono en pacientes ingresados en unidades de cuidados intensivos por SARS-CoV-2 / Incidence of pressure ulcers due to prone position in patients admitted to the ICU for Covid-19

La aparición de úlceras por presión (UPP) es una de las complicaciones frecuentes del decúbito prono (DP), debido a la presión prolongada y las fuerzas de cizallamiento. Objetivos: Comparar la incidencia de UPP secundarias a la posición del decúbito prono y describir su localización entre 4 unidades de cuidados intensivos (UCI) de hospitales públicos. Metodología: Estudio observacional descriptivo retrospectivo multicéntrico. La población estuvo formada por pacientes ingresados en la UCI entre febrero de 2020 y mayo 2021, diagnosticados de COVID-19 que precisaron decúbito prono. Las variables estudiadas fueron sociodemográficas, días de ingreso en la UCI, horas totales en DP, prevención de UPP, localización, estadio, frecuencia de cambios posturales, nutrición y aporte de proteínas. La recogida de datos se realizó a través de la historia clínica de las diferentes bases de datos informatizadas de cada hospital. Se realizó análisis descriptivo y asociación entre las variables, utilizando el programa SPSS vs.20.0.Resultados: Ingresaron 574 pacientes por COVID-19, el 43,03% fueron pronados. El 69,6% fueron hombres, la mediana de edad fue 66 (RIC: 55-74) y el IMC de 30,7 (RIC: 27-34,2). La mediana de estancia en la UCI fue de 28 días (RIC: 17-44,2) y la mediana de horas en DP por paciente 48h (RIC: 24-96). La incidencia de aparición de UPP fue del 56,3% y el 76,2% de los pacientes la presentaron; la localización más frecuente fue la frente (74,9%). Existen diferencias significativas entre hospitales en cuanto a la incidencia de UPP (p<0,001), su localización (p=0,000) y la duración media de horas por cada episodio de DP (p=0,001). Conclusiones: La incidencia de UPP secundarias al DP fue muy elevada. Existe gran variabilidad en cuanto a incidencia de UPP entre hospitales, la localización y la duración media de horas por cada episodio de DP.(AU)

The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. Objectives: To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. Methods: Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. Results: A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (p=0.002), location (p<0.001) and median duration of hours per PD episode (p=0.001). Conclusions: The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.(AU)

[Incidence of pressure ulcers due to prone position in patients admitted to the ICU for Covid-19]. / Incidencia de úlceras por presión secundarias al decúbito prono en pacientes ingresados en unidades de cuidados intensivos por SARS-CoV-2.

The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. Objectives: To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. Methods: Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. Results: A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48 h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (p = 0.002), location (p < 0.001) and median duration of hours per PD episode (p = 0.001). Conclusions: The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.

Muscle architectural properties indicate a primary role in support for the pelvic limb of three-toed sloths (Bradypus variegatus).

Tree sloths evolved below-branch locomotion making them one of few mammalian taxa beyond primates for which suspension is nearly obligatory. Suspension requires strong limb flexor muscles that provide both propulsion and braking/support, and available locomotor kinetics data indicate that these roles differ between fore- and hindlimb pairs. Muscle structure in the pelvic limb is hypothesized to be a key anatomical correlate of function in braking/support during suspensory walking and propulsion and/or support during vertical climbing. This expectation was tested by quantifying architecture properties in the hindlimb limb musculature of brown-throated three-toed sloths (Bradypus variegatus: N = 7) to distinguish the roles of the flexor/extensor functional muscle groups at each joint. Measurements of muscle moment arm (rm ), mass, belly length, fascicle length, pennation angle, and physiological cross-sectional area (PCSA) were taken from n = 45 muscles. Overall, most muscles studied show properties for contractile excursion and fast joint rotational velocity. However, the flexor musculature is more massive (p = 0.048) and has larger PCSA (p = 0.003) than the extensors, especially at the knee joint and digits where well-developed and strong flexors are capable of applying large joint torque. Moreover, selected hip flexors/extensors and knee flexors have modified long rm that can amplify applied joint torque in muscles with otherwise long, parallel fascicles, and one muscle (m. iliopsoas) was capable of moderately high power in B. variegatus. The architectural properties observed in the hip flexors and extensors match well with roles in suspensory braking and vertical propulsion, respectively, whereas strong knee flexors and digital flexors appear to be the main muscles providing suspensory support in the pelvic limb. With aid in support by the forelimbs and the use of adaptive slow locomotion and slow muscle fiber recruitment patterns, structure-function in the tensile limb systems of sloths appears to collectively represent an additional mechanism for energy conservation.

Incidence of pressure ulcers due to prone position in patients admitted to the ICU for Covid-19.

The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces. OBJECTIVES: To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals. METHODS: Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0. RESULTS: A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48 h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (P = .002), location (P = .000) and median duration of hours per PD episode (P = .001). CONCLUSIONS: The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.

Análisis de la presión plantar durante la carrera en el sitio en diferentes superficies / Analysis of Plantar Pressure during the Running in Place over Different Surfaces

El objetivo de este trabajo es evaluar en 36 corredores aficionados, la fuerza y las presiones del pie sobre tres superficies comúnmente empleadas para el entrenamiento de la carrera en el sitio (césped artificial, suelo técnico de caucho y trampolín plano). Los valores de fuerza y presión se registraron mediante plantillas instrumentadas (Gebiomized® Munster, Germany). Se obtuvieron los siguientes parámetros: Fuerza máxima (N) y picos de presión (N/cm2) en 6 zonas específicas del pie. Según los resultados, la fuerza máxima ejercida por el pie dominante en césped artificial (657 N) y en suelo técnico de caucho (692,5 N) fue significativamente superior al registrado sobre el trampolín (262 N). Respecto a la presión, la mayor parte de la presión ejercida por el pie en superficies duras (césped artificial y suelo técnico de caucho), se observó en las cabezas de los metatarsianos, mientras que en el trampolín la presión se repartió entre estas y el calcáneo. (AU)

The objective of this study is to evaluate the Maximum Force and Peak Pressure of the foot on three surfaces commonly used for running in place training (artificial turf, rubber floor and flat trampoline). Force and pressure were recorded in 36 amateur runners using instrumented insoles (Gebiomized® Munster, Germany). The following parameters were obtained: Maximum Force (N) and Peak Pressure (N/cm2) in 6 specific areas of the foot. According to the results, the maximum force exerted by the dominant foot on artificial turf (657 N) and rubber floor (692.5 N) was significantly higher than the recorded on the trampoline (262 N). Regarding the pressure, most of the pressure exerted by the foot on hard surfaces (artificial turf and technical floor), was observed in the heads of the metatarsals, while in the trampoline the pressure was distributed in the heads of the metatarsals and the calcaneus. (AU)

Weber number and the outcome of binary collisions between quantum droplets.

A theoretical analysis of binary collisions of quantum droplets under feasible experimental conditions is reported. Droplets formed from degenerate dilute Bose gases made up from binary mixtures of ultracold atoms are considered. Reliable expressions for the surface tension of the droplets are introduced based on a study of low energy excitations of their ground state within the random phase approximation. Their relevance is evaluated considering an estimation of the expected excitation energy having in mind the Thouless variational theorem. The surface tension expressions allow calculating the Weber number of the droplets involved in the collisions. Several regimes on the outcomes of the binary frontal collisions that range from the coalescence of the quantum droplets to their disintegration into smaller droplets are identified. Atoms losses of the droplets derived from self-evaporation and three-body scattering are quantified for both homo- and hetero-nuclear mixtures. Their control is mandatory for the observation of some interesting effects arising from droplets collisions.

Cuidados de enfermería en la elefantisis verrucosa nostra. A propósito de un caso / Nursing care in the treatment of elephantiasis nostras verrucosa and myiasis with 20% trichloroacetic acid: A case report

Introducción: La elefantiasis verrucosa nostra es una afección dermatológica deformante poco frecuente asociada al linfedema crónico. Se caracteriza por presentar edema de la parte afectada con fibrosis progresiva de aspecto leñoso de la dermis y el tejido subcutáneo, hiperqueratosis de la epidermis y lesiones papilomatosas y verrucosas que dan una apariencia de empedrado a la piel.Presentación del caso:La paciente, además de sufrir elefantisis verrucosa nostra en ambas extremidades, también sufría colonización por larvas de díptero, úlceras por presión en ambos talones y un estado general de salud muy deteriorado. Se realizó un plan de atención de enfermería (PAE), valorando a la paciente según las 14 Necesidades Básicas Humanas de Virginia Henderson, seguida de una fase diagnóstica según la North American Nursing Diagnosis Association (NANDA) realizando una planificación de objetivos basándonos en la Nursing Outcomes Classification (NOC) y llevando a cabo una serie de intervenciones con actividades específicas apoyándonos en la Nursing Interventions Classification (NIC), realizando una evaluación constante de la evolución de la paciente.Para apreciar la evolución del PAE focalizando en un mismo diagnóstico NANDA, “Deterioro de la integridad cutánea”, a lo largo de todo el proceso hospitalario de la paciente y como el tratamiento de la afección con ácido tricloracético al 20% (TCA 20%) mejoró el estado de la piel.Conclusiones:El tratamiento con ácido tricloroacético al 20% ha resultado efectivo frente a la elefantisis verrucosa nostra, reduciendo la hiperqueratosis hasta obtener una piel aceptablemente sana. El seguimiento del plan de atención a enfermería a lo largo del todo el proceso garantiza los cuidados necesarios para una correcta recuperación del paciente. (AU)

Introduction: Elephantiasis Verrucosa Nostra is a rare deforming dermatologic condition associated with chronic lymphedema. It is characterized by edema of the affected area with progressive woody fibrosis of the dermis and the subcutaneous tissue, hyperkeratosis of the epidermis, and papillomatous and verrucous lesions that give the skin a cobblestone appearance.Case presentation:The patient, in addition to suffering from elephantitisis verrucosa nostra on both limbs, also suffered from dipteran larvae colonisation, pressure ulcers on both heels and aexceptionally deteriorated health condition.A Nursing Care Plan (PAE) was carried out, Assessing the patient according to Virginia Henderson's 14 Basic Human Needs, followed by a diagnostic phase according to the North American Nursing Diagnosis Association (NANDA), carrying out a planning of objectives based on the Nursing Outcomes Classification (NOC) and accomplishing a series of interventions with specific activities based on the Nursing Interventions Classification (NIC), getting a constant evaluation of thepatient's evolution. In order to appreciate the PAE's evolution focusing on the same NANDA diagnosis, “Deterioration of Skin Integrity”, throughout the entire hospital process and how thedisease's treatment with 20% trichloroacetic acid (TCA 20%) improved the condition of the skin.Conclusions:Treatment with 20% trichloroacetic acid has been effective against elephantiasis verrucosa nostra, reducing hyperkeratosis to an acceptably healthy skin. The monitoring of the nursing care plan throughout the entire process guarantees the necessary care for the correct recovery of the patient. (AU)

Baseline brain function in the preadolescents of the ABCD Study.

The Adolescent Brain Cognitive Development (ABCD) Study® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development.

Long-range optofluidic control with plasmon heating.

Using light to manipulate fluids has been a long-sought-after goal for lab-on-a-chip applications to address the size mismatch between bulky external fluid controllers and microfluidic devices. Yet, this goal has remained elusive due to the complexity of thermally driven fluid dynamic phenomena, and the lack of approaches that allow comprehensive multiscale and multiparameter studies. Here, we report an innovative optofluidic platform that fulfills this need by combining digital holographic microscopy with state-of-the-art thermoplasmonics, allowing us to identify the different contributions from thermophoresis, thermo-osmosis, convection, and radiation pressure. In our experiments, we demonstrate that a local thermal perturbation at the microscale can lead to mm-scale changes in both the particle and fluid dynamics, thus achieving long-range transport. Furthermore, thanks to a comprehensive parameter study involving sample geometry, temperature increase, light fluence, and size of the heat source, we showcase an integrated and reconfigurable all-optical control strategy for microfluidic devices, thereby opening new frontiers in fluid actuation technology.

Engraftment after autologous hematopoietic stem cell transplantation in patients mobilized with Plerixafor: A retrospective, multicenter study of a large series of patients.

Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored. Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT. The median number of PLX days to reach the stem cell collection goal (≥2 × 106 CD34+ cells/kg) was 1 (range 1-4) and the median PLX administration time before apheresis was 11 h (range 1-18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1-5) and the mean number of CD34+ cells collected was 2.95 × 106/kg (range 0-30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported. The median time to achieve an absolute neutrophil count (ANC) >500/µL was 11 days (range 3-31) and the median time to platelet recovery >20 × 103/µL was 13 days (range 5-69). At 100 days after auto-HCT, the platelet count was 137 × 109/L (range 7-340), the ANC was 2.3 × 109/L (range 0.1-13.0), and the hemoglobin concentration was 123 g/L (range 79-165). PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34+ cell concentration on day +4 or low CD34+ cell yield on apheresis.

Ultra-dry air plasma treatment for enhancing the dielectric properties of Al2O3-GPTMS-PMMA hybrid dielectric gate layers in a-IGZO TFT applications.

We assessed the effects of ultra dry-air plasma surface treatments on the properties of Al2O3-GPTMS-PMMA hybrid dielectric layers for applications to high-performance amorphous Indium Gallium Zinc Oxide (a-IGZO) thin film transistors (TFTs). The hybrid layers were deposited by an easy dip coating sol-gel process at low temperature and then treated with dry-air plasma at 1, 2 and 3 consecutive cycles. Their properties were analyzed as a function of the number of plasma cycles and contrasted with those of the untreated ones. The dielectric characteristics of the hybrid layers were determined from I-V and C-f measurements performed on metal-insulator-metal and metal-insulator-semiconductor devices. The results show that the plasma treatments increase the surface energy and wettability of the hybrid films. There is also a reduction of the OH groups and oxygen vacancies in the hybrid network improving the dielectric properties. The incorporation of nitrogen into the hybrid films surface is also observed. The plasma-treated hybrid dielectric layers were applied as dielectric gate in the fabrication of a-IGZO TFTs. The best electrical performance of the fabricated TFTs was achieved with the 3 cycles plasma-treated hybrid dielectric gate, showing high mobility, 29.3 cm2 V-1 s-1, low threshold voltage, 2.9 V, high I ON/OFF current ratio, 106, and low subthreshold swing of 0.42 V dec-1.

Rabdomiolisis secundaria a intoxicación por lamotrigina / Rhabdomyolysis secondary to lamotrigine overdose

La lamotrigina es un fármaco empleado fundamentalmente en el tratamiento de las crisis epilépticas y en la profilaxis del trastorno bipolar tipo I, gracias a su acción como estabilizador del estado de ánimo. Presentamos el caso de un intento autolítico por ingesta de lamotrigina que destaca tanto por la elevada dosis ingerida, como por la aparición de una intensa rabdomiolisis, en ausencia de convulsiones, que presentó valores de creatina kinasa mucho más elevados que los descritos hasta la fecha por sobredosis de este fármaco. (AU)

Lamotrigine is a drug used to treat epilepsy and bipolar disorder type I owing to its action as a mood stabilizer. We report a case of an autolytic attempt due to lamotrigine overdose which stands out both for the high dose administrated and the presence of severe rhabdomyolysis, in absence of seizures, which included creatine kinase levels much more elevated than those published to date due to overdose of this drug. (AU)

Neumonía vírica bilateral por COVID-19 como hallazgo casual en 18F-FDG-PET-TC de estadificación de paciente con melanoma gemelar derecho / Bilateral viral pneumonia by COVID-19 as a chance finding in staging with 18F-FGD-PET/CT of patient with right calf melanoma

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