Clinical and prognostic associations of autoantibodies recognizing adrenergic/muscarinic receptors in patients with heart failure.

AIMS: The importance of autoantibodies (AABs) against adrenergic/muscarinic receptors in heart failure (HF) is not well-understood. We investigated the prevalence and clinical/prognostic associations of four AABs recognizing the M2-muscarinic receptor or the ß1-, ß2-, or ß3-adrenergic receptor in a large and well-characterized cohort of patients with HF. METHODS AND RESULTS: Serum samples from 2256 patients with HF from the BIOSTAT-CHF cohort and 299 healthy controls were analysed using newly established chemiluminescence immunoassays. The primary outcome was a composite of all-cause mortality and HF rehospitalization at 2-year follow-up, and each outcome was also separately investigated. Collectively, 382 (16.9%) patients and 37 (12.4%) controls were seropositive for ≥1 AAB (P = 0.045). Seropositivity occurred more frequently only for anti-M2 AABs (P = 0.025). Amongst patients with HF, seropositivity was associated with the presence of comorbidities (renal disease, chronic obstructive pulmonary disease, stroke, and atrial fibrillation) and with medication use. Only anti-ß1 AAB seropositivity was associated with the primary outcome [hazard ratio (95% confidence interval): 1.37 (1.04-1.81), P = 0.024] and HF rehospitalization [1.57 (1.13-2.19), P = 0.010] in univariable analyses but remained associated only with HF rehospitalization after multivariable adjustment for the BIOSTAT-CHF risk model [1.47 (1.05-2.07), P = 0.030]. Principal component analyses showed considerable overlap in B-lymphocyte activity between seropositive and seronegative patients, based on 31 circulating biomarkers related to B-lymphocyte function. CONCLUSIONS: AAB seropositivity was not strongly associated with adverse outcomes in HF and was mostly related to the presence of comorbidities and medication use. Only anti-ß1 AABs were independently associated with HF rehospitalization. The exact clinical value of AABs remains to be elucidated.

Real-Time Human Activity Recognition with IMU and Encoder Sensors in Wearable Exoskeleton Robot via Deep Learning Networks.

Wearable exoskeleton robots have become a promising technology for supporting human motions in multiple tasks. Activity recognition in real-time provides useful information to enhance the robot's control assistance for daily tasks. This work implements a real-time activity recognition system based on the activity signals of an inertial measurement unit (IMU) and a pair of rotary encoders integrated into the exoskeleton robot. Five deep learning models have been trained and evaluated for activity recognition. As a result, a subset of optimized deep learning models was transferred to an edge device for real-time evaluation in a continuous action environment using eight common human tasks: stand, bend, crouch, walk, sit-down, sit-up, and ascend and descend stairs. These eight robot wearer's activities are recognized with an average accuracy of 97.35% in real-time tests, with an inference time under 10 ms and an overall latency of 0.506 s per recognition using the selected edge device.

Escorpionismo en la población amazónica del cantón Taisha en Ecuador / Scorpion stings in the Amazonian population from Taisha Canton in Ecuador

Introducción: En el Ecuador se desconoce la frecuencia, los factores de riesgo, el efecto preciso de las picaduras de escorpión, sus toxinas, la fisiopatología e interacción con la población. Objetivo: Registrar la incidencia de las picaduras de escorpión, el cuadro clínico, su manejo y las limitaciones para la obtención del antídoto en Ecuador. Métodos: Se realizó un estudio de cohorte retrospectivo, en el cual se recolectaron datos como edad, sexo, residencia, sitio corporal de picadura, cuadro clínico, tratamiento, estancia médica, referencia a unidad de mayor complejidad, morbilidad y mortalidad, durante el periodo entre enero de 2016 y noviembre de 2018 en la población amazónica del cantón Taisha, provincia de Morona Santiago, Ecuador. Resultados: Se evaluaron 134 picaduras de escorpión, las cuales predominaron en personas adultas (70,9 %). La región corporal más frecuente de picadura fue en las extremidades superiores e inferiores (92,5 %) y el nivel de intoxicación grave correspondió al 12,7 %. La estacionalidad de las picaduras de escorpión predominó en los meses de octubre, abril, diciembre y marzo. La presentación de la morbilidad anual fue mayor en el año 2017 (52,9 %). Conclusiones: Existe una alta incidencia de picaduras de escorpión en la zona de estudio. En el Ecuador la accesibilidad al antídoto es limitada, por lo que es necesario realizar más investigaciones en el tema, incluyendo intervenciones preventivas y curativas.

Introduction: In Ecuador, the frequency, risk factors, precise effects, toxins, pathophysiology and interaction with the population of scorpion stings are unknown. Objective: To report on the incidence of scorpion stings, its clinical picture and management, and the limitations for obtaining an antidote in Ecuador. Methods: A retrospective cohort study was conducted and data was collected on the age, gender, place of residence, site of sting, clinical picture, treatment, hospital stay, referral to higher complexity unit, morbidity, and mortality from January 2016 to November 2018 in the Amazonian population from Taisha canton, Morona-Santiago province in Ecuador. Results: 134 scorpion stings were evaluated. Most cases were adults (70.9%). The most frequent region stung by scorpions were the upper and lower extremities (92.5%) and severe intoxication level accounted for 12.7% of cases. The highest incidence of scorpion stings occurred in October, April, December and March. Annual morbidity was higher in 2017 (52.9%). Conclusions: There is a high incidence of scorpion Sting in the area under study. Accessibility to an antidote is limited in Ecuador; therefore, further research on this topic and on preventive and curative interventions are necessary.

Effect of convalescent plasma as complementary treatment in patients with moderate COVID-19 infection.

INTRODUCTION: South America is one of the regions most affected by the COVID-19 pandemic. Specific and affordable treatments are needed to treat SARS-CoV-2 infection. Evidence regarding the use of convalescent plasma in COVID-19 patients is still limited. We compared the safety and efficacy of COVID-19-convalescent plasma administration as a complement to standard treatment in the early management of patients with moderate SARS-CoV-2 infection. METHODS: We carried out a random double blinded, placebo-controlled trial that compared standard treatment plus convalescent plasma (CP) or plus non-convalescent plasma in the management of COVID-19 patients. The main outcome was survival and secondary endpoints included: length of hospitalisation (LOH), days from treatment to discharge, time to clinical improvement or death within a 28-day period, and adverse reactions to treatment. RESULTS: Administration of CP with antibodies against SARS-CoV-2 did not affect patient survival, RR = 1.003, 95% CI (0.3938, 2.555). These results led to terminate the RCT prematurely. However, early treatment of COVID-19 patients with CP tended to decrease the LOH while the delay in CP treatment was associated with longer hospitalisation. In addition, delay in CP treatment negatively affected the recovery of the respiratory rate. CONCLUSION: Use of CP for the treatment of COVID-19 patients is safe and its early use can decrease the LOH and improve respiratory function. Early administration of antibody-rich CP could contribute to decrease the negative impact of COVID-19 pandemic in patients with impaired immune response.

Hand Gesture Recognition Using Single Patchable Six-Axis Inertial Measurement Unit via Recurrent Neural Networks.

Recording human gestures from a wearable sensor produces valuable information to implement control gestures or in healthcare services. The wearable sensor is required to be small and easily worn. Advances in miniaturized sensor and materials research produces patchable inertial measurement units (IMUs). In this paper, a hand gesture recognition system using a single patchable six-axis IMU attached at the wrist via recurrent neural networks (RNN) is presented. The IMU comprises IC-based electronic components on a stretchable, adhesive substrate with serpentine-structured interconnections. The proposed patchable IMU with soft form-factors can be worn in close contact with the human body, comfortably adapting to skin deformations. Thus, signal distortion (i.e., motion artifacts) produced for vibration during the motion is minimized. Also, our patchable IMU has a wireless communication (i.e., Bluetooth) module to continuously send the sensed signals to any processing device. Our hand gesture recognition system was evaluated, attaching the proposed patchable six-axis IMU on the right wrist of five people to recognize three hand gestures using two models based on recurrent neural nets. The RNN-based models are trained and validated using a public database. The preliminary results show that our proposed patchable IMU have potential to continuously monitor people's motions in remote settings for applications in mobile health, human-computer interaction, and control gestures recognition.

Risk of cardiovascular disease according to the Framingham score in patients with high blood pressure from Píllaro, Ecuador. 2017-2018 / Riesgo cardiovascular según la escala de Framingham en pacientes hipertensos de Píllaro, Ecuador. 2017-2018

Abstract Introduction: Cardiovascular disease (CVD) is the main cause of morbidity and mortality worldwide. The use of the Framingham Risk Score is of great importance for predicting CVD risk. Objective: To estimate the 10-year CVD risk in adult patients diagnosed high blood pressure (HBP) who visited the outpatient service of the San Miguelito de Píllaro Health Center, in Tungura-hua, Ecuador, using the Framingham Risk Score (2008). Materials and methods: Cross-sectional, observational, prospective and descriptive study conducted in 120 HBP patients aged 30 to 74 years who visited the outpatient service between January and October 2017. Data were obtained from the review of medical records, which were in turn updated during the execution of the study. The Framingham risk score was used to calculate the 10-year CVD risk. A descriptive analysis of the data was performed in Epi Info 7, using absolute frequencies and percentages. Results: Of the 120 patients, 59.17% were women. Furthermore, 15% of the participants had been diagnosed with type 2 diabetes mellitus, 13.33% had a history of smoking, 47.50% had elevated systolic blood pressure, and 39.17% had hypercholesterolemia. CVD risk was low (≤ 1% Framingham score), intermediate (10-19%), and high (≥ 20%) in 15%, 29.16%, and 59.16% of participants, respectively. None of them had a very low CVD risk (≤1%). Conclusion: The Framingham risk score was useful to estimate CVD risk in the study population treated in the primary health care setting. Consequently, more extensive use of this instrument in different health units is recommended to obtain better estimates of CVD risk and, as a result, achieve the implementation of health prevention and health care actions that improve the prognosis in the medium and long term, and thus the quality of life of these patients.

Resumen Introducción. Las enfermedades cardiovasculares (ECV) son la principal casusa de morbimortalidades a nivel mundial; el uso de la escala de Framingham es de gran importancia para predecir el riesgo de ECV. Objetivo. Determinar el riesgo de ECV a 10 años en pacientes adultos con diagnóstico de hipertensión arterial (HTA) que asistieron al servicio de consulta externa del Centro de Salud de San Miguelito de Píllaro, Tungurahua, Ecuador, utilizando la escala de riesgo de Framingham (2008). Materiales y métodos. Estudio transversal, observacional, prospectivo y descriptivo realizado en 120 pacientes con edades entre 30 y 74 años y con diagnóstico de HTA que asistieron al servicio de consulta externa entre enero y octubre de 2017. Los datos se obtuvieron a partir de la revisión de las historias clínicas, las cuales, a su vez, fueron actualizadas durante la ejecución del estudio. El riesgo de ECV a 10 años se determinó según el puntaje obtenido en la escala Framingham. Se realizó un análisis descriptivo de los datos en el programa Epi Info 7 utilizando frecuencias absolutas y porcentajes. Resultados. De los 120 pacientes, 59.17% eran mujeres. Además, 15% de los participantes había sido diagnosticado con diabetes mellitus tipo 2, 13.33% tenía antecedentes de tabaquismo, 47.50% tenía presión arterial sistólica elevada y 39.17% tenía hipercolesterolemia. El riesgo cardiovascular fue bajo (≤1% puntaje Framingham), intermedio (10-19%) y alto (≥20%) en 15%, 29.16% y 59.16% de los participantes, respectivamente. Ninguno tuvo riesgo muy bajo (≤1%). Conclusión. La escala Framingham fue útil para estimar el riesgo cardiovascular de los participantes en el contexto de la atención primaria de salud, por lo que se recomienda un uso más amplio de este instrumento en las diferentes unidades de salud con el fin de obtener una mejor estimación del riesgo de ECV y así lograr la implementación de acciones de prevención y atención en salud que mejoren su pronóstico en el mediano y largo plazo, y, por tanto, la calidad de vida de estos pacientes.

Estudio experimental de intervención educativa en conocimientos, actitudes y prácticas para ictus / Experimental study of educational intervention in knowledge, attitudes and practices for ictus

El ictus es una de las patologías neurológicas de mayor prevalencia en el país.Objetivo: determinar la eficacia de la intervención educativa en el cambio de conocimientos, actitudes y prácticas frente a los factores de riesgo del ictus.Método: estudio experimental con muestra al azar de intervención en 68 sujetos, quienes recibieron programa educativo y al mismo tiempo actua-ron como control. Se aplicó un cuestionario sobre conocimientos, actitudes y prácticas validado pre y post intervención. Además, se realizó toma de su presión arterial, determinación del índice de masa corporal, perfil lipídico, hemoglobina glicosilada. La efectividad de la intervención educativa se representa como cambio en porcentaje pre y post intervención en un lapso de tres meses.Resultados: la media de edad fue de 61.07 años, 64.7% fueron mujeres, el porcentaje de conocimientos, actitudes y prácticas adecuadas mejoró de 61.36% a 73.7%; de 64.94% a 83.94%; 87.92% y 76.52% respectivamente. La efectividad total fue un incremento del 22%. Las variables cuantitativas como índice de masa corporal, tensión arterial, niveles de perfil lipídico, así como hemoglobina glicosilada no alcanzaron diferencia significativa.Conclusiones: existe una relación directa y eficacia mayor del 20% cuan-do los pacientes son intervenidos educativamente para modificar positiva-mente los conocimientos, actitudes y prácticas sobre los factores de riesgo de ictus.(AU).

Objective: to determine the effectiveness of the educational intervention in the change of knowledge, attitudes and practices regarding ictus.Method: It is a quasi-experimental study with a random sample of intervention in 68 subjects, who received an educational program and at the same time acted as control. A questionnaire on knowledge, attitudes and practices validated before and after intervention was applied.In addition, blood pressure, determination of body mass index, lipid profile and glycosylated hemoglobin were taken. The effectiveness of the educational intervention is represented as a change in pre and post intervention percentage in a period of three months.Results: the average age was 61.07 years, 64.7% were women, the percentage of knowledge, attitudes and appropriate practices improved from 61.36% to 73.7%; from 64.94% to 83.94%; 87.92% and 76.52% respectively. The total effectiveness was an increase of 22%. The quantitative variables such as body mass index, blood pressure, lipid profile levels, as well as glycosylated hemoglobin did not reach a significant difference.Conclusions: there is a direct and efficacy relationship greater than 20% when patients are educated to positively modify knowledge, attitudes and practices on risk factors regarding ictus. (AU).

Agenesia De La Arteria Carótida Interna: Presentación De Dos Casos Y Revisión De La Literatura / Agenesis Of The Internal Carotid Artery: Presentation Of Two Cases And Review Of The Literature

Resumen Introducción: Se presentan dos casos de pacientes con agenesia de arteria carótida interna izquierda, el primer caso con síntomas de glaucoma de ángulo abierto y catarata ipsilateral y el segundo caso de una paciente con cefalea tensional, así como una revisión de la literatura debido a la baja frecuencia de esta anomalía del desarrollo. Casos clínicos: caso 1: Se trata de mujer de 66 años con trastornos visuales asociados a catarata y glaucoma en quien por sospecha de fístula carotídea cavernosa se documentó una agenesia de carótida interna izquierda, con colateralidad a través del sistema posterior; caso 2: paciente de 58 años de edad con cefalea tensional la cual se realizó una IRM donde se documenta la agenesia de la arteria carótida izquierda, segmentos del C3 al C7. Conclusión: Las anormalidades en el desarrollo del sistema carotídeo ocurren tempranamente en la embriogénesis. En relación al momento en que ocurre la alteración se han descrito diferentes patrones circulatorios. Es posible que la presencia de circulación colateral sea la razón de que la mayoría de los casos sean reportados asintomáticos desde el punto de vista neurológico vascular. A pesar de ser una entidad rara, se debe conocer para poder diferenciarla de otras afecciones y vigilar la aparición de complicaciones asociadas.

Abstract Introduction: Two cases of patients with left internal carotid artery agenesis are presented, the first case with symptoms of open angle glaucoma and ipsilateral cataract and the second case of a patient with tension headache, as well as a review of the literature due to the Low frequency of this development anomaly. Clinical cases: case 1, A 66-year-old woman with visual disorders associated with cataract and glaucoma in whom, due to suspicion of a carotid fistula, a left internal carotid agenesis was documented, with collaterality through the posterior system, case 2, patient A 58-year-old man with tension headache underwent an MRI where the agenesis of the left carotid artery, segments from C3 to C7, was documented. Conclusion: Abnormalities in the development of the carotid system occur early in embryogenesis. In relation to the moment in which the alteration occurs, different circulatory patterns have been described. It is possible that the presence of collateral circulation is the reason that the majority of cases are reported asymptomatic from the vascular neurological point of view. Despite being a rare entity, it must be known in order to differentiate it from other conditions and monitor the appearance of associated complications.

Long-term Effects of Statins, Blood Pressure-Lowering, and Both on Erectile Function in Persons at Intermediate Risk for Cardiovascular Disease: A Substudy of the Heart Outcomes Prevention Evaluation-3 (HOPE-3) Randomized Controlled Trial.

BACKGROUND: It is unclear whether modifying cholesterol, blood pressure, or both affect erectile dysfunction. Also, there are concerns that erectile dysfunction is worsened by common medications used to treat these risk factors. In this study, we evaluated the effect of: (1) cholesterol-lowering with a statin; (2) pharmacologic blood pressure reduction; and (3) their combination, on erectile function. METHODS: A priori, this was a secondary analysis of the Heart Outcomes Prevention Evaluation-3 (HOPE-3) randomized controlled trial. Men were 55 years of age or older with at least 1 cardiovascular risk factor. Erectile function was measured using the erectile function domain of the International Index of Erectile Function (IIEF-EF) score. Men with incomplete scores, or who did not engage in sexual activity, were excluded. Using a 2 × 2 factorial design, participants were randomized to rosuvastatin (10 mg/d) or placebo, and to candesartan with hydrochlorothiazide (HCTZ; 16 mg/12.5 mg/d; Cand+HCTZ) or placebo. Primary outcome was change in IIEF-EF from baseline to end of study follow-up. RESULTS: Two thousand one hundred fifty-three men were included; mean age was 61.5 years, and mean follow-up was 5.8 years. Mean IIEF-EF score at baseline was 23.0 (SD 5.6). Least square mean change in the IIEF-EF score did not differ with rosuvastatin compared with placebo (-1.4; standard error [SE], 0.3 vs -1.5; SE, 0.3; P = 0.74), Cand+HCTZ compared with placebo (-1.6; SE, 0.3 vs -1.3; SE, 0.3; P = 0.10), or combination therapy compared with double placebo (P = 0.35). CONCLUSIONS: Cholesterol-lowering using a statin, and blood pressure-lowering using Cand+HCTZ, either alone or in combination, do not improve or adversely affect erectile function.

O aparelho utilitário ­ descrição de um novo dispositivo para reposicionamento mandibular / The utilytari appliance ­ description of a new device for mandibular repositioning

O presente artigo visa mostrar o desempenho clínico de um aparelho ortopédico fixo desenvolvido pelos autores para o tratamento da maloclusão de Classe II esquelética por deficiência mandibular e para o tratamento da Classe III não cirúrgica. O dispositivo em questão é associado ao aparelho ortodôntico fixo e, uma vez instalado, promove um reposicionamento da mandíbula na direção mesial ou distal, de acordo com o caso. A ativação deve ser incrementada progressivamente até se chegar à completa correção da maloclusão. Neste artigo são apresentados o caso de uma paciente adolescente portadora de maloclusão de Classe II por deficiência mandibular e um segundo caso de um adulto jovem com maloclusão de Classe III, ambos tratados com o dispositivo em questão. O aparelho ortopédico fixo aqui apresentado recebe o nome de Aparelho Utilitário (AU), já que com o mesmo dispositivo é possível tratar vários tipos de más oclusões. As evidências fotográficas e cefalométricas apresentadas permitem avaliar a simplicidade e efetividade do mecanismo ortopédico, assim como a total normalização das oclusões dos pacientes tratados após 20 e 16 meses de tratamento, respectivamente.(AU)

This article aims to show the clinical performance of a fixed orthopedic device, created by the authors of this article, for the treatment of both Class II skeletal malocclusion, due to mandibular deficiency, and non-surgical Class III. This device when associated to fixed orthodontic appliances promotes mandible repositioning in the mesial or distal direction according to the case. Activation should be gradually adjusted until the malocclusion is corrected. This article presents the case of a female adolescent patient with Class II malocclusion due to mandibular deficiency and a second case of a young adult with Class III malocclusion both treated with the orthopedic device. The fixed orthopedic device presented here is called "Utility Device", as it is possible to treat several types of malocclusions. Photographic and cephalometric evidence show the simplicity and effectiveness of this orthopedic mechanism, and the total normalization of patients occlusions after 20 and 16 months of treatment respectively.(AU)

Pros and cons of methylation-based enrichment methods for ancient DNA.

The recent discovery that DNA methylation survives in fossil material provides an opportunity for novel molecular approaches in palaeogenomics. Here, we apply to ancient DNA extracts the probe-independent Methylated Binding Domains (MBD)-based enrichment method, which targets DNA molecules containing methylated CpGs. Using remains of a Palaeo-Eskimo Saqqaq individual, woolly mammoths, polar bears and two equine species, we confirm that DNA methylation survives in a variety of tissues, environmental contexts and over a large temporal range (4,000 to over 45,000 years before present). MBD enrichment, however, appears principally biased towards the recovery of CpG-rich and long DNA templates and is limited by the fast post-mortem cytosine deamination rates of methylated epialleles. This method, thus, appears only appropriate for the analysis of ancient methylomes from very well preserved samples, where both DNA fragmentation and deamination have been limited. This work represents an essential step toward the characterization of ancient methylation signatures, which will help understanding the role of epigenetic changes in past environmental and cultural transitions.

Mitochondrial genomes reveal the extinct Hippidion as an outgroup to all living equids.

Hippidions were equids with very distinctive anatomical features. They lived in South America 2.5 million years ago (Ma) until their extinction approximately 10 000 years ago. The evolutionary origin of the three known Hippidion morphospecies is still disputed. Based on palaeontological data, Hippidion could have diverged from the lineage leading to modern equids before 10 Ma. In contrast, a much later divergence date, with Hippidion nesting within modern equids, was indicated by partial ancient mitochondrial DNA sequences. Here, we characterized eight Hippidion complete mitochondrial genomes at 3.4-386.3-fold coverage using target-enrichment capture and next-generation sequencing. Our dataset reveals that the two morphospecies sequenced (H. saldiasi and H. principale) formed a monophyletic clade, basal to extant and extinct Equus lineages. This contrasts with previous genetic analyses and supports Hippidion as a distinct genus, in agreement with palaeontological models. We date the Hippidion split from Equus at 5.6-6.5 Ma, suggesting an early divergence in North America prior to the colonization of South America, after the formation of the Panamanian Isthmus 3.5 Ma and the Great American Biotic Interchange.

Neuropatía autonómica diabética cardiovascular / Diabetic autonomic cardiovascular neuropathy

La neuropatía autonómica diabética cardiovascular es un trastorno en el cual una alteración en la regulación del sistema nervioso cardiovascular, por parte del sistema nervioso autónomo, desemboca en una constelación de síntomas, que pueden ir desde intolerancia al ejercicio hasta muerte súbita. Si bien no se conoce su prevalencia exacta, se estima que es alta en pacientes diabéticos, particularmente en aquellos con diabetes de larga data y con presencia de otras comorbilidades. Su reconocimiento temprano puede facilitar el manejo de estos pacientes y a su vez disminuir los costos asociados a pruebas e intervenciones innecesarias con el objetivo de evitar complicaciones asociadas con la enfermedad.

Cardiac autonomic diabetic neuropathy is a condition in which impairment of the autonomic control of the cardiovascular system leads to a myriad of symptoms, ranging from mild exercise intolerance to sudden cardiac death. Even though its exact prevalence is unknown, it is believed that it is highly prevalent in patients with long-standing diabetes, particularly those who have other pathologic conditions. Early detection is expected to have a positive impact in patient treatment, lowering costs associated with unnecessary tests and treatments, while at the same time avoiding disease-related complications.

Progenitor-derivative speciation in Pozoa (Apiaceae, Azorelloideae) of the southern Andes.

BACKGROUND AND AIMS: Studies examining patterns and processes of speciation in South America are fewer than in North America and Europe. One of the least well documented processes has been progenitor-derivative speciation. A particularly instructive example occurs in the southern Andes in the genus Pozoa (Apiaceae, Azorelloideae), which consists of only two diploid outcrossing species, the widespread P. coriacea and the geographically and ecologically restricted P. volcanica. This paper tests the hypothesis that the latter species originated from the former through local geographical and ecological isolation by progenitor-derivative speciation. METHODS: DNA sequences were analysed from Pozoa and the related South American genera Asteriscium, Eremocharis and Gymnophyton from non-coding regions of the plastid genome, ndhF-rpl32 and rpl32-trnL, plus incorporation of previously reported rpl16 intron and trnD-trnT intergenic spacer sequences. Amplified fragment length polymorphism (AFLP) data from 105 individuals in 21 populations throughout the entire range of distribution of the genus were used for estimation of genetic diversity, divergence and SplitsTree network analysis. Ecological factors, including habitat and associated species, were also examined. KEY RESULTS: Pozoa coriacea is more similar genetically to the outgroup genera, Asteriscium and Eremocharis, than is P. volcanica. At the population level, only P. volcanica is monophyletic, whereas P. coriacea is paraphyletic. Analyses of genetic differentiation among populations and genetic divergence and diversity of the species show highest values in P. coriacea and clear reductions in P. volcanica. Pozoa coriacea occurs in several types of high elevation habitats, whereas P. volcanica is found only in newly formed open volcanic ash zones. CONCLUSIONS: All facts support that Pozoa represents a good example of progenitor-derivative speciation in the Andes of southern South America.

Mercury contamination from artisanal gold mining in Antioquia, Colombia: The world's highest per capita mercury pollution.

The artisanal gold mining sector in Colombia has 200,000 miners officially producing 30tonnes Au/a. In the Northeast of the Department of Antioquia, there are 17 mining towns and between 15,000 and 30,000 artisanal gold miners. Guerrillas and paramilitary activities in the rural areas of Antioquia pushed miners to bring their gold ores to the towns to be processed in Processing Centers or entables. These Centers operate in the urban areas amalgamating the whole ore, i.e. without previous concentration, and later burn gold amalgam without any filtering/condensing system. Based on mercury mass balance in 15 entables, 50% of the mercury added to small ball mills (cocos) is lost: 46% with tailings and 4% when amalgam is burned. In just 5 cities of Antioquia, with a total of 150,000 inhabitants: Segovia, Remedios, Zaragoza, El Bagre, and Nechí, there are 323 entables producing 10-20tonnes Au/a. Considering the average levels of mercury consumption estimated by mass balance and interviews of entables owners, the mercury consumed (and lost) in these 5 municipalities must be around 93tonnes/a. Urban air mercury levels range from 300ng Hg/m(3) (background) to 1million ng Hg/m(3) (inside gold shops) with 10,000ng Hg/m(3) being common in residential areas. The WHO limit for public exposure is 1000ng/m(3). The total mercury release/emissions to the Colombian environment can be as high as 150tonnes/a giving this country the shameful first position as the world's largest mercury polluter per capita from artisanal gold mining. One necessary government intervention is to cut the supply of mercury to the entables. In 2009, eleven companies in Colombia legally imported 130tonnes of metallic mercury, much of it flowing to artisanal gold mines. Entables must be removed from urban centers and technical assistance is badly needed to improve their technology and reduce emissions.

Air mercury contamination in the gold mining town of Portovelo, Ecuador.

Portovelo is one of the oldest gold mining towns in Ecuador. Artisanal gold mining still uses mercury in the process of gold recovery. In this study, mercury concentrations in the air of Portovelo were evaluated. High mercury levels in the ambient were found in El Pache sector, where most gold mining processing plants are located. These varied between 2,356.7 ± 1,807.6 and 3,699.5 ± 1,225.3 ng/m(3) during the rainy and dry seasons, respectively. Lower levels were detected in the urban (central) area of Portovelo, with 214.6 ± 43.7 ng/m(3) in the rainy season and 574.2 ± 72.8 ng/m(3) in the dry season, exceeding the Agency for Toxic Substances and Disease Registry minimum risk level of 200 ng/m(3). Average mercury concentrations in exhaled air from miners, measured before and after amalgam burning ranged between 179-1,352 and 2,007-3,389 ng/m(3), respectively. These data suggest Portovelo air is polluted with mercury and humans are being dangerously exposed. Therefore, strong actions must be undertaken to protect human and environmental health, including changing gold recovery systems.

Isolation of the lysolipin gene cluster of Streptomyces tendae Tü 4042.

Streptomyces tendae Tü 4042 produces the aromatic polyketide antibiotic lysolipin. Lysolipin has strong antibacterial activity against a variety of multidrug-resistant pathogens. The complete lysolipin biosynthetic gene cluster was isolated and fully sequenced. Within a 42-kb genomic region, 42 genes were identified that code for a type II polyketide synthase (llpF, E, and D), cyclases (llpCI-CIII), methyltransferases (llpMI-MVI), a halogenase (llpH), an amidotransferase (llpA), a ferredoxin (llpK), a transporter (llpN) and regulatory proteins (llpRI-RV). In addition, 15 genes encoding enzymes involved in redox modifications of the polyketide precursor molecule (llpOI-OVIII, ZI-ZIV, U, L, and S) were present in the lysolipin biosynthetic gene cluster. With this high number of oxidoreductases, lysolipin is among the most highly modified aromatic polyketides known to date. The heterologous expression of the cluster in Streptomyces albus led to lysolipin production with a yield comparable to that of wild-type, indicating that all biosynthetic genes were successfully cloned.

Patterns of genetic diversity in colonizing plant species: Nassauvia lagascae var. lanata (Asteraceae: Mutisieae) on Volcan Lonquimay, Chile.

The effect of colonization on the distribution of genetic diversity within and among populations in relation to species characteristics remains an open empirical question. The objective of this study was to contrast genetic diversity within and among established and colonizing populations of Nassauvia lagascae var. lanata on Volcán Lonquimay (Araucanía Region, Chile), which erupted on 25 December 1988, and relate genetic diversity to biological characteristics of the populations. We analyzed a total of 240 individuals from 15 populations distributed along the Andes Cordillera using AFLP and obtained a total of 307 AFLP bands, of which 97.7% are polymorphic. Values of population differentiation (F(ST)) did not differ significantly among established and colonizing populations, but colonizing populations did have reduced levels of genetic divergence (as indicated by private and rare bands) and genetic variation (e.g., Shannon index). We conclude that a founder effect through limited numbers of founding propagules derived from nearby source populations has not yet been compensated for by subsequent population growth and migration. Low rates of secondary dispersal via running water, kin-structure within populations, and slow population growth seem to contribute to the slow recovery of genetic diversity.

O aparelho APMMC (aparelho de protrusão mandibular de Morales e Carvalho) / The APMMC appliance(Morales and Carvalho mandibular protucion appliance)

O presente trabalho visa mostrar o desenvolvimento clínico de um aparelho ortopédico fixo criado pelos autores, para o tratamento da classe II por retrusão mandibular. O aparelho é de fácil construção É formado em duas partes, uma para cada lado da boca, paralelas entre si e sem nenhum meio de união entre elas. O aparelho tem como principal característica a sua fixação por palatino nos segundos pré-molares e primeiros molares do arco dentário superior. Quando colocamos na boca, o aparelho obriga o paciente a protrair sua mandíbula sem a possibilidade de levá-la de volta para trás, Devido ao fato de ser um aparelho fixo, este age as 24 horas do dia. Em caso de haver uma discrepância entre maxila e mandíbula muito grande, o avanço da mandíbula pode ser feito em dois tempos. Esse novo posicionamento da mandíbula, mantido aproximadamente por um ano ou mais, acarreta uma série de mudanças de ordem dentária, muscular e especialmente esquelética, que levarão á correção da retrusão mandibular de forma permanente. O aparelho pode agir sozinho na boca ou associado ao aparelho ortodôntico fixo como no presente caso. Apresentamos um caso clinico de uma má-oclusão classe II divisão 2ª com mandíbula curta, tratada com este aparelho, associado ao aparelho ortodôntico fixo.

This article is intended to demonstrate the clinical performance of a fixed orthopedic device, created by the authors for the treatment of class II mandibular retrusion. The appliance is easy to construct and is comprised of two parts, for each side of the mouth, parallel to each other and without any point of connection between them. The primary characteristic of the appliance is that it is set in the palate at the second premolars and first molars of the upper dental arch. When it is placed in the mouth, the appliance obliges the patient to protrude their jaw, and it is impossible for them to move it back. Due to the fact that it is a fixed appliance, it acts 24 hours per day. In the event that the discrepancy between the maxilla and the mandible is very large, the mandibular advance can be done at two different stages. This new positioning of the jaw, when maintained for approximately one year or more, brings about a series of dental, muscular and especially skeletal modifications, which lead to the permanent correction of the mandibular retrusion. The appliance can act only in the mouth or can be associated with a fixed orthodontic appliance, as in this case. Here we present a clinical case of a Class II, 2nd division malocclusion with a short mandible treated with this appliance, associated with the fixed orthodontic device.