Strong thickness dependence in thin film photocatalytic heterojunctions: the ZnO-Bi2O3 case study.

Semiconductor heterojunctions are an effective way to achieve efficient photocatalysts, as they can provide an adequate redox potential with visible light excitation. Several works have reported synergistic effects with nanoparticle semiconductor materials. The question is still open for thin film heterojunctions formed by stacked layers, as photocatalysis is considered a surface phenomenon. To investigate if the internal layer really affects or modifies the photocatalytic properties of the external material, we analyze the thin film heterojunction with ZnO and Bi2O3 semiconductors deposited by spray pyrolysis in two configurations: substrate/ZnO/Bi2O3 and substrate/Bi2O3/ZnO. Microstructural analysis was performed to verify the formation of the physical junction of the materials and discard new ternary phases. The photocatalytic activity was analyzed as a function of the thickness of the layers under blue light irradiation. We determined the conduction and valence bands positions, the carrier concentrations, mobilities, Fermi levels, etc. that allowed us to distinguish two reaction mechanisms depending on the configuration. There is a strong compromise between the order and thickness of the layers with the photocatalytic activity. The internal electric field produced in the interface defines the route of the photogenerated charges, and therefore the photocatalytic response. Thus, well-designed thin film heterojunctions can indeed improve the photocatalytic activity of the surface layer.

Ocular Trauma Characterization in a Reference Emergency Eye Centre in Colombia (FOSCAL).

BACKGROUND: Ocular trauma is one of the most important causes of ocular morbidity and inadequate visual acuity in developed and developing countries. In some countries, eye trauma is the leading cause of monocular blindness. Studies conducted in developing countries like Colombia suggest that there is a lack of awareness of preventive measures. In Colombia, there is no countrywide ocular trauma registry. The purpose of the present study is to describe and analyse characteristics of ocular trauma at a tertiary ophthalmology emergency department in Colombia. PATIENTS/METHODS AND MATERIAL: Patients who consulted or were referred to the ophthalmologic emergency department of FOSCAL due to eye injuries between March 1, 2022, and January 10, 2023, were included in this cross-sectional study. RESULTS: Of 1 957 patients, 2 088 eyes were included. Men comprised 78.5% of the patients, the median age was 36 years, and 75.0% lived in urban areas. The median latency between trauma and ophthalmology consultation was 21.8 hours. Of the eyes, 1 805 (88.4%) had suffered mechanical or mixed (mechanical plus burn) trauma. Of the injuries, 87.5% were unilateral. In terms of the circumstances, 45.9% of injuries occurred during working or educational activities (in 85.6% of these cases, without eye protection), 28.2% in home accidents, and 14.0% in transportation situations. According to the Birmingham Eye Trauma Terminology System (BETT), 1 735 eyes (91.1%) were closed globe injuries, and 49 eyes (2.7%) were open globe injuries. Fifty eyes (2.8%) could not be categorised according to BETT at the initial consultation and were classified as "still to be determined". In the Ocular Trauma Score (OTS), 85.8% were category 5. Of the ocular burn cases, 93.0% were categorised as grade I according to the Roper Hall classification. CONCLUSIONS: In line with global literature, a much higher proportion of men than women sought consultation for ocular trauma. The findings suggest a need for improvement in the referral process from institutions with the lowest level of care. Lack of awareness about eye protection is an issue. Surgical exploration or additional tests may be necessary for precise injury classification. We therefore propose adding a "still to be determined" category to the BETT initial classification. These cases may be reclassified later, thus improving the accuracy of OTS calculation.

Early-Phase Perceptions of COVID-19's Impact on Ophthalmology Practice Patterns: A Survey from the Pan-American Association of Ophthalmology.

Purpose: The COVID-19 pandemic affected medical practice worldwide due to interventions to prevent spreading. Its effect on ophthalmology practices in Latin America has not yet been explored. We aimed to assess the perceptions about the pandemic from countries' ophthalmological national and subspecialty retina societies affiliated to the Pan-American Association of Ophthalmology (PAAO). Patients and Methods: A survey-based study of leaders of national ophthalmological and retinal societies was conducted. The survey was sent by email to 30 societies, from which 20 responded (12 countries, 66.6% response rate). It included closed- and open-ended questions about (1) operational capacity and precautions, (2) telemedicine and virtual care, (3) procedures, and (4) post-pandemic considerations. Results: There was a marked decline in ophthalmology patient visits (80-95%) and elective surgeries (90%) during 2020 compared to before the pandemic. Precautions like temperature checks, mask usage, and social distancing were widely implemented while personal protective equipment (PPE) availability varied. Telemedicine use was limited due to lack of experience with it. Reopening plans focused on maintaining precautions and gradually resuming activities. Economic and security concerns were raised, and adherence to guidelines was emphasized. Respondents acknowledged the need to adapt to a "new normal". Long duration drugs, fewer imaging studies, and shorter wait times were preferred; however, availability of long duration drugs was limited. Conclusion: The pandemic impacted ophthalmology in Latin America, with reduced patient visits, procedures, and surgeries. Delayed treatment and complications were likely the result of the pandemic.

TOR Complex 1: Orchestrating Nutrient Signaling and Cell Cycle Progression.

The highly conserved TOR signaling pathway is crucial for coordinating cellular growth with the cell cycle machinery in eukaryotes. One of the two TOR complexes in budding yeast, TORC1, integrates environmental cues and promotes cell growth. While cells grow, they need to copy their chromosomes, segregate them in mitosis, divide all their components during cytokinesis, and finally physically separate mother and daughter cells to start a new cell cycle apart from each other. To maintain cell size homeostasis and chromosome stability, it is crucial that mechanisms that control growth are connected and coordinated with the cell cycle. Successive periods of high and low TORC1 activity would participate in the adequate cell cycle progression. Here, we review the known molecular mechanisms through which TORC1 regulates the cell cycle in the budding yeast Saccharomyces cerevisiae that have been extensively used as a model organism to understand the role of its mammalian ortholog, mTORC1.

TOR complex 1 negatively regulates NDR kinase Cbk1 to control cell separation in budding yeast.

The target of rapamycin (TOR) signalling pathway plays a key role in the coordination between cellular growth and the cell cycle machinery in eukaryotes. The underlying molecular mechanisms by which TOR might regulate events after anaphase remain unknown. We show for the first time that one of the 2 TOR complexes in budding yeast, TORC1, blocks the separation of cells following cytokinesis by phosphorylation of a member of the NDR (nuclear Dbf2-related) protein-kinase family, the protein Cbk1. We observe that TORC1 alters the phosphorylation pattern of Cbk1 and we identify a residue within Cbk1 activation loop, T574, for which a phosphomimetic substitution makes Cbk1 catalytically inactive and, indeed, reproduces TORC1 control over cell separation. In addition, we identify the exocyst component Sec3 as a key substrate of Cbk1, since Sec3 activates the SNARE complex to promote membrane fusion. TORC1 activity ultimately compromises the interaction between Sec3 and a t-SNARE component. Our data indicate that TORC1 negatively regulates cell separation in budding yeast by participating in Cbk1 phosphorylation, which in turn controls the fusion of secretory vesicles transporting hydrolase at the site of division.

Repercussions of COVID-19 on psychiatric inpatient care in Latin America and the Caribbean.

OBJETIVE: To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region. METHODS: Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalisations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries. The interviews were done between 8 May and 30 June 2020. The data were analysed quantitatively and qualitatively. RESULTS: An initial decrease in the demand for hospitalisation is reported, attributed to the population's fear of approaching health services as well as restrictions on mobility. Stricter criteria for hospitalisation were reported with a double focus on the acute within the acute. The length of hospitalisations were mixed, with both increases and decreases in GHs and SHs. The therapeutic offer was drastically reduced, and interaction between hospitalised people and their support networks was restricted. CONCLUSIONS: In the COVID-19 context, hospitalisation seems to be not the last but the only alternative for psychiatric treatment. The decrease in the number of beds in SHs could be a positive aspect for the reform of psychiatric care, but it is questioned since this reduction also occurs in GHs.

Automatic extraction of ranked SNP-phenotype associations from text using a BERT-LSTM-based method.

Extraction of associations of singular nucleotide polymorphism (SNP) and phenotypes from biomedical literature is a vital task in BioNLP. Recently, some methods have been developed to extract mutation-diseases affiliations. However, no accessible method of extracting associations of SNP-phenotype from content considers their degree of certainty. In this paper, several machine learning methods were developed to extract ranked SNP-phenotype associations from biomedical abstracts and then were compared to each other. In addition, shallow machine learning methods, including random forest, logistic regression, and decision tree and two kernel-based methods like subtree and local context, a rule-based and a deep CNN-LSTM-based and two BERT-based methods were developed in this study to extract associations. Furthermore, the experiments indicated that although the used linguist features could be employed to implement a superior association extraction method outperforming the kernel-based counterparts, the used deep learning and BERT-based methods exhibited the best performance. However, the used PubMedBERT-LSTM outperformed the other developed methods among the used methods. Moreover, similar experiments were conducted to estimate the degree of certainty of the extracted association, which can be used to assess the strength of the reported association. The experiments revealed that our proposed PubMedBERT-CNN-LSTM method outperformed the sophisticated methods on the task.

Repercusiones de la COVID-19 en la Internación Psiquiátrica en América Latina y el Caribe

Objetivo: Caracterizar el impacto de la pandemia por COVID-19 en las internaciones psiquiátricas en la región de América Latina y el Caribe. Métodos: Estudio descriptivo. Se realizaron 85 entrevistas semiestructuradas con trabajadores de hospitales generales (HG) y hospitales especializados (HE) en salud mental en 18 países de la región de América Latina y el Caribe entre el 8 de mayo y el 30 de junio de 2020. Los datos se analizaron cuantitativa y cualitativamente. Resultados: Se reporta una disminución inicial en la demanda de internación, atribuida al temor de la población a acercarse a los servicios, así como a restricciones en la movilidad. Se indican criterios más estrictos para internar con una doble focalización de lo agudo dentro de lo agudo. Los tiempos de internación presentaron un comportamiento mixto, tanto de aumento como de disminución en HG y en HE. La oferta terapéutica durante la internación se vio drásticamente reducida, y se restringió la interacción de las personas internadas con sus redes de apoyo. Conclusiones: La internación pareciera estar siendo no la última, sino la única alternativa de tratamiento psiquiátrico en el contexto de la pandemia. La reducción de camas en los HE podría ser un aspecto positivo para la reforma de la atención, pero es puesto en duda, ya que dicha reducción también se produce en los HG.

Objetive: To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region. Methods: Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalizations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries. The interviews were done between 8 May and 30 June 2020. The data were analysed quantitatively and qualitatively. Results: An initial decrease in the demand for hospitalization is reported, attributed to the population's fear of approaching health services as well as restrictions on mobility. Stricter criteria for hospitalization were reported with a double focus on the acute within the acute. The length of hospitalizations were mixed, with both increases and decreases in GHs and SHs. The therapeutic offer was drastically reduced, and interaction between hospitalised people and their support networks was restricted. Conclusions: In the COVID-19 context, hospitalization seems to be not the last but the only alternative for psychiatric treatment. The decrease in the number of beds in SHs could be a positive aspect for the reform of psychiatric care, but it is questioned since this reduction also occurs in GHs.

Xanthogranuloma of the sellar region: a systematic review.

Knowledge of xanthogranuloma (XG) of the sellar region comes from short series or single cases. We performed a systematic review, using the PubMed, Web of Science, Embase, Scopus, eLibrary, and BIOSIS Preview databases, of all cases reported from 2000 to the present. We also describe one unreported patient treated in our institution. A search of the literature revealed that of 71 patients 50.7% were male and that mean age at diagnosis was 34.7 ± 19.2 years old. Median time from clinical onset until diagnosis was 7 (3-21) months. Hypopituitarism (70.4%), visual disorders (64.7%), headache (53.5%), and polyuria-polydipsia (28.2%) were the most common symptoms. On MRI, median tumor size was 20 (16-29) mm, while 71.8% were sellar/suprasellar and less frequently exclusively suprasellar (15.5%) or sellar (12.7%). On T1-weighted imaging, XG was hyperintense in 76.3% of patients, while it showed variable appearance on T2-weighted imaging. The tumor showed cystic features in 50.7%, gadolinium enhancement in 45.1%, and calcification in 22.5% of patients. All patients underwent surgery (77.4% transphenoidal approach and 18.3% craniotomy), with hypopituitarism (56.4%), diabetes insipidus (34.5%), and visual defects (7.3%) being the most common complications. Total/subtotal resection was achieved in 93.5%, while the tumor was partially removed in 6.6%. Median follow-up was 24 (6-55) months and no tumor recurrence or remnant growth was reported in 97.5% of cases. In conclusion, XG affects the younger population, manifested by hormonal deficit and mass effect symptoms. Surgery is safe and offers excellent outcomes, though hypopituitarism is frequent post-surgery. Tumor recurrence or remnant growth is rare and radiological surveillance is a good option for patients with remnant lesions.

[Repercussions of COVID-19 on psychiatric inpatient care in Latin America and the Caribbean]. / Repercusiones de la COVID-19 en la Internación Psiquiátrica en América Latina y el Caribe.

Objetive: To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region. Methods: Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalisations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries. The interviews were done between 8 May and 30 June 2020. The data were analysed quantitatively and qualitatively. Results: An initial decrease in the demand for hospitalisation is reported, attributed to the population's fear of approaching health services as well as restrictions on mobility. Stricter criteria for hospitalisation were reported with a double focus on the acute within the acute. The length of hospitalisations were mixed, with both increases and decreases in GHs and SHs. The therapeutic offer was drastically reduced, and interaction between hospitalised people and their support networks was restricted. Conclusions: In the COVID-19 context, hospitalisation seems to be not the last but the only alternative for psychiatric treatment. The decrease in the number of beds in SHs could be a positive aspect for the reform of psychiatric care, but it is questioned since this reduction also occurs in GHs.

"About Navigating Chaos": Latin American and Caribbean Mental Health Workers' Personal Impact Due to SARS-CoV-2 in the First Hundred Days.

Objectives: The personal impact of COVID-19 on mental health care workers (MHWs) has received scarce attention despite their work addressing the emotional wellbeing of those affected by the pandemic. This study aims to analyze Latin American and Caribbean's MHWs' subjective impact in connection to working during the initial times of the pandemic. Methods: One hundred and fifty-five persons (n = 155) from seventeen countries were contacted in May-June 2020 through a snowball approach. Complementary methodological strategies of analysis used for data triangulation included content analysis, thematic analysis, and interpretative phenomenological analysis. Results: Participants reported feelings of fear, anxiety, anguish, and fatigue. Milder negative impacts (e.g., uncertainty, concern), and complex feelings (e.g., ambivalence) were also frequent. One third of participants acknowledged their capacity to learn from this situation and/or experience satisfaction. Conclusion: Mental health of MHWs in Latin America and the Caribbean were under severe strain and the ongoing mental health reforms at risk during the pandemic's beginning. More research and additional care may be needed to offer support to those involved in caring for the wellbeing of others.

Evaluation of virtual surgical planning and three-dimensional configurations for reconstruction of maxillary defects using the fibula free flap.

BACKGROUND: Maxillary reconstructive surgery with fibula free flaps (FFFs) is a challenging procedure for head and neck surgeons. However, virtual surgical planning (VSP) and three-dimensional (3D) printing technologies have contributed to improved functional and aesthetic outcomes. The objective of this report is to demonstrate VSP/3D application in reconstruction of maxillary defects using the FFF by describing the different configurations available. We reviewed a series of consecutive cases operated at our institution and considered the management strategy of in-house planning in VSP/3D application. METHODS: In total, 11 cases were included from November 2016 to December 2021. Eight male and three female were included, with a mean age of 55.4 years old (range: 34-74 years old). Maxillary defects were classified according to Brown's Classification: two cases with IIB, one case with IIC, four cases with IID, three cases with III, and one case with IV. Preoperatively, facial computed tomography (CT) and lower extremity computed tomography angiogram (CTA) were performed in all patients. Osteocutaneous FFFs were planned, harvested, and customized according to the VSP/3D guide configuration. VSP and 3D printed cutting guides were performed by an external company in nine cases and were self-planned in three of them. Titanium 3D-printed fixation plates were used in four cases. RESULTS: All flaps survived, and the main reconstructive goals were achieved in 9 cases out of 11. Mean FFF length before osteotomy was 20.0 cm (17.5-22.5 cm). None of the cases experienced flap ischemia or venous congestion. At least one complication occurred in four cases: Prefabricated titanium plate exposure (two cases), loss of donor site skin grafts (one case), and ectropion (one case). One patient underwent a second FFF reconstruction. Two titanium printed plates became exposed after radiotherapy and needed to be removed. Mean follow-up time was 23.5 months (range 6-63 months). Dental rehabilitation was completed in eight of the 11 cases. Regarding functional recovery, five cases underwent delayed osseo-integrated dental implants (ODI), and two cases had immediate ODI procedures. One case was treated with removal dentition. CONCLUSION: VSP/3D printing technology is a new and helpful tool to successful restoration of craniofacial function and aesthetics. It can be used in the broad range of configurations offered by FFFs considering our suggested management strategy.

PP2A-Cdc55 phosphatase regulates actomyosin ring contraction and septum formation during cytokinesis.

Eukaryotic cells divide and separate all their components after chromosome segregation by a process called cytokinesis to complete cell division. Cytokinesis is highly regulated by the recruitment of the components to the division site and through post-translational modifications such as phosphorylations. The budding yeast mitotic kinases Cdc28-Clb2, Cdc5, and Dbf2-Mob1 phosphorylate several cytokinetic proteins contributing to the regulation of cytokinesis. The PP2A-Cdc55 phosphatase regulates mitosis counteracting Cdk1- and Cdc5-dependent phosphorylation. This prompted us to propose that PP2A-Cdc55 could also be counteracting the mitotic kinases during cytokinesis. Here we show that in the absence of Cdc55, AMR contraction and the primary septum formation occur asymmetrically to one side of the bud neck supporting a role for PP2A-Cdc55 in cytokinesis regulation. In addition, by in vivo and in vitro assays, we show that PP2A-Cdc55 dephosphorylates the chitin synthase II (Chs2 in budding yeast) a component of the Ingression Progression Complexes (IPCs) involved in cytokinesis. Interestingly, the non-phosphorylable version of Chs2 rescues the asymmetric AMR contraction and the defective septa formation observed in cdc55∆ mutant cells. Therefore, timely dephosphorylation of the Chs2 by PP2A-Cdc55 is crucial for proper actomyosin ring contraction. These findings reveal a new mechanism of cytokinesis regulation by the PP2A-Cdc55 phosphatase and extend our knowledge of the involvement of multiple phosphatases during cytokinesis.

Efectos de la pandemia por COVID-19 en la atención de personas con discapacidad psicosocial: perspectiva de trabajadores / COVID-19 pandemic effects on the care of people with psychosocial disabilities: workers' perspective

INTRODUCCIÓN: La pandemia de COVID-19 alteró el funcionamiento de los sistemas de salud y, particularmente, la provisión de servicios destinados a personas con discapacidad psicosocial de un modo pendiente de análisis en Argentina. El objetivo fue caracterizar los efectos de la pandemia de COVID-19 en los servicios de atención dirigidos a personas con discapacidad psicosocial en Rosario (Santa Fe), Resistencia (Chaco) y el Área Metropolitana de Buenos Aires desde la perspectiva de sus trabajadores durante 2020-2021. MÉTODOS: Se realizó un estudio exploratorio y descriptivo a partir de entrevistas a 53 trabajadores de tres tipos de servicios de rehabilitación (orientados a dar apoyo para la socialización, el trabajo o la vivienda), en dos momentos (fin de 2020 y mediados de 2021). Se calcularon frecuencias y se realizó un análisis temático. RESULTADOS: Hubo una afectación amplia y duradera de los servicios, que se tornaron menos accesibles y eficaces para contribuir a la rehabilitación. Se observaron aspectos comunes, como la adaptación para seguir funcionando, la centralidad de la tecnología y el impacto subjetivo en los trabajadores, marcado por el cansancio. Al año de la pandemia, dos tercios de los servicios orientados a la socialización estaban muy afectados o cerrados. DISCUSIÓN: A partir de la descripción y análisis de cómo se vieron afectados los servicios de rehabilitación, se abre el interrogante respecto de su futuro y el rumbo que tomará la reforma en salud mental.

COVID-19 pandemic effects on the care of people with psychosocial disabilities: workers' perspective / Efectos de la pandemia por covid-19 en la atención de personas con discapacidad psicosocial: perspectiva de trabajadores

RESUMEN INTRODUCCIÓN La pandemia de COVID-19 alteró el funcionamiento de los sistemas de salud y, particularmente, la provisión de servicios destinados a personas con discapacidad psicosocial de un modo pendiente de análisis en Argentina. El objetivo fue caracterizar los efectos de la pandemia de COVID-19 en los servicios de atención dirigidos a personas con discapacidad psicosocial en Rosario (Santa Fe), Resistencia (Chaco) y el Área Metropolitana de Buenos Aires desde la perspectiva de sus trabajadores durante 2020-2021 MÉTODOS Se realizó un estudio exploratorio y descriptivo a partir de entrevistas a 53 trabajadores de tres tipos de servicios de rehabilitación (orientados a dar apoyo para la socialización, el trabajo o la vivienda), en dos momentos (fin de 2020 y mediados de 2021). Se calcularon frecuencias y se realizó un análisis temático RESULTADOS Hubo una afectación amplia y duradera de los servicios, que se tornaron menos accesibles y eficaces para contribuir a la rehabilitación. Se observaron aspectos comunes, como la adaptación para seguir funcionando, la centralidad de la tecnología y el impacto subjetivo en los trabajadores, marcado por el cansancio. Al año de la pandemia, dos tercios de los servicios orientados a la socialización estaban muy afectados o cerrados DISCUSIÓN A partir de la descripción y análisis de cómo se vieron afectados los servicios de rehabilitación, se abre el interrogante respecto de su futuro y el rumbo que tomará la reforma en salud mental. ^s+

ABSTRACT INTRODUCTION The COVID-19 pandemic produced a reorganization of health systems and, in particular, affected the provision of services for people with psychosocial disabilities in a way that was pending an analysis in Argentina. The objective was to characterize the effects of the COVID-19 pandemic on services aimed at people with psychosocial disabilities in the cities of Rosario (Santa Fe), Resistencia (Chaco) and the Metropolitan Area of Buenos Aires from the perspective of their workers during 2020-2021 METHODS An exploratory and descriptive study was carried out by interviewing 53 workers from three types of rehabilitation services (aimed at providing support for socialization, for work or for housing) in two moments (November-December 2020 and April-June 2021). Frequencies were calculated and a thematic analysis was performed RESULTS The impact on services was broad and long-lasting, they became less accessible and effective in contributing to rehabilitation. Common aspects such as the new centrality of technology, massive adaptations and deep subjective impact on workers marked by fatigue were observed. Within a year of the pandemic, two-thirds of socialization-oriented services were still severely affected or closed DISCUSSION From the description and analysis of how the rehabilitation services were affected, the question remains regarding their future and how the mental health reform will unfold.

Analgesic efficacy of naproxen sodium versus hydrocodone/acetaminophen in acute postsurgical dental pain: a randomized, double-blind, placebo-controlled trial.

OBJECTIVES: Opioid/acetaminophen combinations may be overly prescribed in many post-surgical situations where a non-steroidal anti-inflammatory drug with equal or greater efficacy, fewer central nervous system side effects, and no risk for opioid abuse could be substituted. We compared a single, non-prescription dose of naproxen sodium 440 mg (NapS) against hydrocodone plus acetaminophen 10/650 mg (HYD+APAP) in post-impaction surgery pain. METHODS: Single-center, randomized, double-blind, placebo-controlled study in moderate-severe pain after surgical removal of impacted third molars (ClinicalTrials.gov: NCT04307940). Patients (n = 212) received NapS, HYD+APAP, or placebo and were assessed over 12 hours. Primary endpoint: summed pain intensity difference from 0 to 12 hours (SPID0-12). Secondary endpoints: pain intensity, pain relief, time to rescue medication, duration of pain at least half gone. Others: onset of pain relief, global assessment of treatment, adverse events. RESULTS: All 221 randomized patients formed the safety population and were included in the intention-to-treat sensitivity analysis. Nine patients discontinued treatment or had protocol violations, and 212 patients were included in the per-protocol, primary efficacy population. Both active treatments were significantly more effective than placebo. NapS was significantly more effective than HYD+APAP regarding SPID0-12 (p = 0.01; primary endpoint), total pain relief (0-6 and 0-12 hours; p < 0.05), time to rescue medication (p < 0.001), and duration of pain at least half gone (p < 0.001). HYD+APAP was not statistically superior to NapS for any endpoint. More adverse events were reported with HYD+APAP (n = 63) than NapS (n = 2) and placebo (n = 20), including nausea, vomiting, and dizziness. CONCLUSION: In moderate-to-severe postsurgical dental pain, a single dose of NapS was at least as effective as HYD+APAP in the early hours, significantly more effective at reducing pain intensity and providing greater pain relief over 12 hours, and was better tolerated. When not contraindicated, NapS should be considered a preferred alternative to opioid combinations for acute pain. (ClinicalTrials.gov, Identifier: NCT04307940; https://clinicaltrials.gov/ct2/show/NCT04307940).

[Subjective impact of COVID-19 pandemic among mental health service workers in Argentina]. / Impacto subjetivo de la pandemia de COVID-19 en los trabajadores de salud mental de la Argentina.

INTRODUCTION: The impact of the COVID-19 pandemic on health workers has been studied on an international level. However, mental health workers, who are also called upon to address such ailments both in the general population as well as in the health personnel, have not been asked about their experiences. METHODS: Seventy mental health workers in five regions of Argentina were interviewed between May and June 2020 regarding the subjective impact of changes in their work due to the pandemic. The responses were analyzed quantitatively and qualitatively. RESULTS: The results indicate emotions and experiences associated with a negative impact, in connection to feelings of tiresome, uncertainty, fear, anguish and anxiety and, to a lesser extent, some positive impacts are also described. More than a third of participants mentioned mixed feelings (i.e., being surprised, ambivalent, alert and sensitive). CONCLUSIONS: The personnel who are supposed to support the rest of the health workers are affected and experience having been relegated one more time to other aspects within the health care system. Focusing on learnings, having management roles, counting on colleagues, and agreeing with macro policies could be protective factors against the difficulties associated with the changes in work that the pandemic has imposed.

Utilisation of remote capillary blood testing in an outpatient clinic setting to improve shared decision making and patient and clinician experience: a validation and pilot study.

BACKGROUND: In a tertiary respiratory centre, large cohorts of patients are managed in an outpatient setting and require blood tests to monitor disease activity and organ toxicity. This requires either visits to tertiary centres for phlebotomy and physician review or utilisation of primary care services. OBJECTIVES: This study aims to validate remote capillary blood testing in an outpatient setting and analyse impact on clinical pathways. METHODS: A single-centre prospective cross-sectional validation and parallel observational study was performed. Remote finger prick capillary blood testing was validated compared with local standard venesection using comparative statistical analysis: paired t-test, correlation and Bland-Altman. Capillary was considered interchangeable with venous samples if all three criteria were met: non-significant paired t-test (ie, p>0.05), Pearson's correlation coefficient (r)>0.8% and 95% of tests within 10% difference through Bland-Altman (limits of agreement). In parallel, current clinical pathways including phlebotomy practice were analysed over 4 weeks to review test predictability. A subsequent pilot cohort study analysed potential impact of remote capillary blood sampling on shared decision making. A final implementation phase ensued to embed the service into clinical pathways within the institution. RESULTS: 117 paired capillary and venous blood samples were prospectively analysed. Interchangeability with venous blood was seen with glycated haemoglobin (%), total protein and C reactive protein. Further tests, although not interchangeable, are likely useful to enable longitudinal remote monitoring (eg, liver function and total IgE). 65% of outpatient clinic blood tests were predictable with 16% of patients requiring further follow-up. Patient and clinician-reported improvement in shared decision making given contemporaneous blood test results was observed. CONCLUSIONS: Remote capillary blood sampling can be used accurately for specific tests to monitor chronic disease, and when incorporated into an outpatient clinical pathway can improve shared decision making and patient experience. Further research is required to determine health economic impact and applicability within telemedicine-based outpatient care.

Neoplasia benigna de origen mesodérmico, forma clínica y tratamiento. Informe de caso / Benign neoplasia of mesodermal origin. A case presentation

RESUMEN Se presenta un caso clínico de lipoma en lengua de un paciente masculino de 60 años de edad, masculino raza blanca, hipertenso y obeso. La lesión medía aproximadamente 2 centímetros de diámetro, comprometiendo cara dorsal de lengua a nivel de tercio anterior; es diagnosticado clínicamente y operado en el Hospital General Dr. Gustavo Aldereguía Lima de Cienfuegos. Se eliminó con buenos resultados la lesión; la cual aportó la novedad de su ubicación y forma. Se concluye que el diagnóstico oportuno y la eliminación por cirugía de este tipo de lesión es sumamente importante.

ABSTRACT Mesodermal origin tumors of the oral cavity and adjacent structures are an important part of stomatology due to the role that the oral cavity professional plays in the diagnosis and treatment of these lesions. Lipomas are benign neoplasms of adipose cells, extremely rare in the oral cavity. The buccal mucosa, tongue and floor of the mouth are some of the most common sites. The typical clinical presentation is that of an asymptomatic, yellow submucosal tumor lesion. Surgical removal is the treatment of choice, recurrence is rarely seen. A clinical case of lipoma on the tongue in a 60-years-old male patient is presented, which involves the dorsal aspect of the tongue at the level of the anterior third, diagnosed and treated at the Dr. Gustavo Aldereguia Lima General Hospital.