Evaluation of the incorporation of an IOTA-ADNEX model in the discrimination of adnexal masses in our third-level hospital centre, taking into account the menopausal status of patients. Five years of experience / Evaluación de la incorporación del IOTA-ADNEX model en la discriminación de las masas anexiales en nuestro centro hospitalario de tercer nivel teniendo en cuenta el estado menopáusico en la predicción de malignidad. Cinco años de experiencia

Objective: The objectives were to estimate the performance of the IOTA-ADNEX model test after its incorporation into the ultrasound tests of our third-grade hospital gynecology service, as well as to assess whether its capacity of accuracy is modified when taking into account the patient's menopausal status. Methods: A cross-sectional study was conducted to clinically evaluate the diagnostic performance of the IOTA-ADNEX model test, which was performed between January 2016 and December 2021. The study included 573 women with an adnexal injury who underwent surgical excision within 180 days after ultrasound diagnosis and histological confirmation (gold standard). After the ultrasound exam, the injuries were classified using the ADNEX model. The study estimated the area under the receiver-operating-characteristics curve (AUC) of the ADNEX model for classifying between benign and malignant adnexal masses and compared the performance by menopausal state. Sensitivity and specificity were determined for different cut-off points. Results: Out of the 573 women, 183 (31.9%) had a malignant tumor. The AUC of the ADNEX model for differentiating between benign and malignant adnexal masses at the time of ultrasound examination was 0.92 and the best malignancy threshold, detected by Youden index, was 22.5%. At this cut-off, the sensitivity of the ADNEX model was 91.8% and the specificity was 76.4%. However, it varies according to menopausal status: in the group of pre-menopausal patient, sensitivity was 86.1% (95% CI, 85.4%–86.8%) and specificity was 81.3% (95% CI, 85.4%–86.8%). In the postmenopausal group, sensitivity was 96.1% (95% CI, 95.6%–96.7%) and specificity was 68.5% (95% CI, 68.1%–68.8%)...(AU)

Objetivo: Los objetivos eran estimar el rendimiento del test IOTA ADNEX model después de su incorporación en el estudio ecográfico en nuestro servicio de ginecología, en un hospital de tercer nivel, así como evaluar si su capacidad de precisión se modifica al tener en cuenta el estado menopáusico de la paciente. Método: Se llevó a cabo un estudio transversal para evaluar clínicamente el rendimiento diagnóstico del test IOTA ADNEX model, el cual se realizó entre enero de 2016 y diciembre de 2021. El estudio incluyó a 573 mujeres con una lesión anexial que se sometieron a tratamiento quirúrgico en un plazo de 180 días después del diagnóstico por ecografía y confirmación histológica (gold standard). Después de realizar la ecografía, las lesiones fueron clasificadas utilizando el modelo ADNEX. El estudio estimó el área bajo la curva (AUC) del modelo ADNEX para diferenciar entre masas anexiales benignas y malignas, y se comparó el rendimiento según el estado menopáusico. Se determinó la sensibilidad y la especificidad para diferentes puntos de corte. Resultados: De las 573 mujeres, 183 (31,9%) tenían un tumor maligno. El AUC del modelo ADNEX para diferenciar entre masas anexiales benignas y malignas en el momento del examen ecográfico fue de 0,92 y el umbral de malignidad óptimo, detectado por el índice de Youden, fue del 22,5%. Con este punto de corte, la sensibilidad (SE) del modelo ADNEX fue del 91,8% y la especificidad (SP) fue del 76,4%. Sin embargo, esto varía según el estado menopáusico: en el grupo de pacientes premenopáusicas, la sensibilidad fue del 86,1% (IC del 95%: 85,4-86,8%) y la especificidad fue del 813% (IC del 95%: 85,4-86,8%). En el grupo de pacientes posmenopáusicas, la sensibilidad fue del 96,1% (IC del 95%: 95,6-96,7%) y la especificidad fue del 68,5% (IC del 95%: 68,1-68,8%)...(AU)

Downed woody debris carbon emissions in a European temperate virgin forest as driven by species, decay classes, diameter and microclimate.

Downed woody debris (DWD) plays an important role as regulator of nutrient and carbon (C) cycling in forests, accounting for up to the 20 % of the total C stocks in primary forests. DWD persistence is highly influenced by microbial decomposition, which is determined by various environmental factors, including fluctuations in temperature and moisture, as well as in intrinsic DWD properties determined by species, diameter, or decay classes (DCs). The relative importance of these different drivers, as well as their interactions, remains largely unknown. Moreover, the importance of DWD for C cycling in virgin forests remains poorly understood, due to their scarcity and poor accessibility. To address this research gap, we conducted a study on DWD respiration (RDWD), in a temperate virgin forest dominated by European beech and silver fir. Our investigation analysed the correlation between RDWD of these two dominant tree species and the seasonal changes in climate (temperature and moisture), considering other intrinsic DWD traits such as DCs (1, 2 and 4) and diameters (1, 10 and 25 cm). As anticipated, RDWD (normalized per gram of dry DWD) increased with air temperature. Surprisingly, DWD diameter also had a strong positive correlation with RDWD. Nonetheless, the sensitivity to both variables and other intrinsic traits (DC and density) was greatly modulated by the species. On the contrary, water content, which exhibited a considerable spatial variation, had an overall negative effect on RDWD. Virgin forests are generally seen as ineffective C sinks due to their lack of net productivity and high respiration and nutrient turnover. However, the rates of RDWD in this virgin forest were significantly lower than those previously estimated for managed forests. This suggests that DWD in virgin forests may be buffering forest CO2 emissions to the atmosphere more than previously thought.

Contribution of the MP2RAGE 7T Sequence in MS Lesions of the Cervical Spinal Cord.

BACKGROUND AND PURPOSE: The detection of spinal cord lesions in patients with MS is challenging. Recently, the 3D MP2RAGE sequence demonstrated its usefulness at 3T. Benefiting from the high spatial resolution provided by ultra-high-field MR imaging systems, we aimed to evaluate the contribution of the 3D MP2RAGE sequence acquired at 7T for the detection of MS lesions in the cervical spine. MATERIALS AND METHODS: Seventeen patients with MS participated in this study. They were examined at both 3T and 7T. The MR imaging examination included a Magnetic Imaging in MS (MAGNIMS) protocol with an axial T2*-WI gradient recalled-echo sequence ("optimized MAGNIMS protocol") and a 0.9-mm isotropic 3D MP2RAGE sequence at 3T, as well as a 0.7-mm isotropic and 0.3-mm in-plane-resolution anisotropic 3D MP2RAGE sequences at 7T. Each data set was read by a consensus of radiologists, neurologists, and neuroscientists. The number of lesions and their topography, as well as the visibility of the lesions from one set to another, were carefully analyzed. RESULTS: A total of 55 lesions were detected. The absolute number of visible lesions differed among the 4 sequences (linear mixed effect ANOVA, P = .020). The highest detection was observed for the two 7T sequences with 51 lesions each (92.7% of the total). The optimized 3T MAGNIMS protocol and the 3T MP2RAGE isotropic sequence detected 41 (74.5%) and 35 lesions (63.6%), respectively. CONCLUSIONS: The 7T MP2RAGE sequences detected more lesions than the 3T sets. Isotropic and anisotropic acquisitions performed comparably. Ultra-high-resolution sequences obtained at 7T improve the identification and delineation of lesions of the cervical spinal cord in MS.

Refractory hypotension secondary to chronic treatment with high doses of quetiapine.

Quetiapine is an atypical antipsychotic used in the treatment of depressive, schizophrenic, or bipolar disorders. It acts on dopamine D1 and D2, histamine, and 5HT1A and 5HT2 receptors. However, it also acts as an antagonist for α1 receptors causing cardiovascular side effects, including hypotension. We present the case of a patient chronically medicated with Quetiapine who developed hypotension refractory to vasoconstrictors and intraoperative fluid therapy. Noradrenalin has a strong α1 effect with lower affinity for ß2 receptors unlike adrenalin. This translates into peripheral vasoconstriction and an improved clinical picture. Therefore, it should be considered the vasoactive drug of choice in patients on high doses of Quetiapine.

Hipotensión refractaria secundaria a tratamiento crónico con altas dosis de quetiapina / Refractory hypotension secondary to chronic treatment with high doses of quetiapine

La quetiapina es un antipsicótico atípico que se usa en el tratamiento del trastorno depresivo, esquizofrénico o bipolar. Su acción reside en su acción sobre los receptores de la dopamina D1 y D2, histamina y serotonina 5HT1A y 5HT2. Sin embargo, también tiene antagonismo para los receptores α1, provocando efectos secundarios cardiovasculares, entre ellos la hipotensión. Presentamos el caso de un paciente medicado crónicamente con quetiapina que presentó hipotensión refractaria a vasoconstrictores y fluidoterapia intraoperatoria. La noradrenalina tiene un fuerte efecto α1 con una menor afinidad para los receptores β2 a diferencia de la adrenalina. Esto se traduce en una vasoconstricción periférica y la resultante mejoría del cuadro clínico. Por lo tanto, se debe considerar el fármaco vasoactivo de elección en la hipotensión refractaria en pacientes que tomen altas dosis de quetiapina.(AU)

Quetiapine is an atypical antipsychotic used in the treatment of depressive, schizophrenic, or bipolar disorders. It acts on dopamine D1 and D2, histamine, and 5HT1A and 5HT2 receptors. However, it also acts as an antagonist for α1 receptors causing cardiovascular side effects, including hypotension. We present the case of a patient chronically medicated with quetiapine who developed hypotension refractory to vasoconstrictors and intraoperative fluid therapy. Noradrenalin has a strong α1 effect with lower affinity for β2 receptors unlike adrenalin. This translates into peripheral vasoconstriction and an improved clinical picture. Therefore, it should be considered the vasoactive drug of choice in patients on high doses of quetiapine.(AU)

[Prevalence of neurodevelopmental disorders in children from the rural population of Oaxaca evaluated by means of the Child Development Evaluation test]. / Prevalencia de alteraciones en el neurodesarrollo en niños de población rural de Oaxaca evaluados mediante la prueba Evaluación de Desarrollo Infantil.

INTRODUCTION: During child's growth, access to health, nutrition, opportunities for stimulation, and early learning are necessary for an optimal development of the central nervous system. In rural areas there is a lack of access to them, and this has an impact on children's neurodevelopment. OBJECTIVE: To identify the prevalence of lag or delay in the development of children in rural areas. SUBJECTS AND METHODS: A descriptive, cross-sectional and prospective study, with non-probabilistic convenience sampling, where 97 infants from 1 month of age to one day before their 5th birthday, all belonging to rural communities in the state of Oaxaca, Mexico, were applied the Child Development Evaluation, designed and validated for the Mexican population in the early detection of neurodevelopmental problems. RESULTS: The prevalence of developmental disorders was 43%, with predominance in the male sex. The area of development with the greatest affectation was language, with a total of 29%, and in second place gross motor skills, with 18%; however, neurological affectation as the only one occurred in 2% of the participants, the most prevalent risk factors were the urinary tract infections in 56% of mothers. CONCLUSION: There is a percentage greater than 30% of neurodevelopmental disorders in rural communities due to social risk factors that infants face, such as the difficult access to medical care, a poorly stimulating environment and bad nutrition.

TITLE: Prevalencia de alteraciones en el neurodesarrollo en niños de población rural de Oaxaca evaluados mediante la prueba Evaluación de Desarrollo Infantil.Introducción. Durante el desarrollo del niño, el acceso a la salud, la nutrición, las oportunidades de estimulación y el aprendizaje temprano son necesarios para un óptimo desarrollo del sistema nervioso central. En zonas rurales se denota la falta de acceso a ellas, y esto repercute en el neurodesarrollo de los niños. Objetivo. Identificar la prevalencia de rezago o retraso en el desarrollo de niños de población rural. Sujetos y métodos. Estudio descriptivo, transversal y prospectivo, con muestreo no probabilístico de conveniencia, en el que a 97 niños a partir de 1 mes de edad y hasta un día antes de cumplir los 5 años, pertenecientes a comunidades rurales del estado de Oaxaca, México, se les aplicó la Evaluación de Desarrollo Infantil, diseñada y validada para la población mexicana en la detección de problemas del neurodesarrollo. Resultados. La prevalencia de las alteraciones del desarrollo fue del 43%, con predominio en el sexo masculino. El área de desarrollo con mayor afectación fue el lenguaje, con un 29%, y en segundo lugar la motricidad gruesa, con un 18%; sin embargo, las afectaciones neurológicas sólo se presentaron en el 2% de los participantes. Los factores de riesgo de mayor prevalencia fueron las infecciones de las vías urinarias, presentes en el 56% de las madres. Conclusión. Existe un porcentaje mayor del 30% de alteraciones en el neurodesarrollo en comunidades rurales debido a los factores de riesgo social que viven los niños, como el difícil acceso a la atención médica, un ambiente poco estimulante y una mala nutrición.

Prevalencia de alteraciones en el neurodesarrollo en niños de población rural de Oaxaca evaluados mediante la prueba Evaluación de Desarrollo Infantil / Prevalence of neurodevelopmental disorders in children from the rural population of Oaxaca evaluated by means of the Child Development Evaluation test

Introducción: Durante el desarrollo del niño, el acceso a la salud, la nutrición, las oportunidades de estimulación y el aprendizaje temprano son necesarios para un óptimo desarrollo del sistema nervioso central. En zonas rurales se denota la falta de acceso a ellas, y esto repercute en el neurodesarrollo de los niños. Objetivo: Identificar la prevalencia de rezago o retraso en el desarrollo de niños de población rural.Sujetos y métodos: Estudio descriptivo, transversal y prospectivo, con muestreo no probabilístico de conveniencia, en el que a 97 niños a partir de 1 mes de edad y hasta un día antes de cumplir los 5 años, pertenecientes a comunidades rurales del estado de Oaxaca, México, se les aplicó la Evaluación de Desarrollo Infantil, diseñada y validada para la población mexicana en la detección de problemas del neurodesarrollo. Resultados: La prevalencia de las alteraciones del desarrollo fue del 43%, con predominio en el sexo masculino. El área de desarrollo con mayor afectación fue el lenguaje, con un 29%, y en segundo lugar la motricidad gruesa, con un 18%; sin embargo, las afectaciones neurológicas sólo se presentaron en el 2% de los participantes. Los factores de riesgo de mayor prevalencia fueron las infecciones de las vías urinarias, presentes en el 56% de las madres. Conclusión: Existe un porcentaje mayor del 30% de alteraciones en el neurodesarrollo en comunidades rurales debido a los factores de riesgo social que viven los niños, como el difícil acceso a la atención médica, un ambiente poco estimulante y una mala nutrición.(AU)

Introduction: During child’s growth, access to health, nutrition, opportunities for stimulation, and early learning are necessary for an optimal development of the central nervous system. In rural areas there is a lack of access to them, and this has an impact on children’s neurodevelopment. Objective: To identify the prevalence of lag or delay in the development of children in rural areas. Subjects and methods: A descriptive, cross-sectional and prospective study, with non-probabilistic convenience sampling, where 97 infants from 1 month of age to one day before their 5th birthday, all belonging to rural communities in the state of Oaxaca, Mexico, were applied the Child Development Evaluation, designed and validated for the Mexican population in the early detection of neurodevelopmental problems. Results: The prevalence of developmental disorders was 43%, with predominance in the male sex. The area of development with the greatest affectation was language, with a total of 29%, and in second place gross motor skills, with 18%; however, neurological affectation as the only one occurred in 2% of the participants, the most prevalent risk factors were the urinary tract infections in 56% of mothers. Conclusion: There is a percentage greater than 30% of neurodevelopmental disorders in rural communities due to social risk factors that infants face, such as the difficult access to medical care, a poorly stimulating environment and bad nutrition.(AU)

SAFIIRA: A heavy-ion multi-purpose irradiation facility in Brazil.

This work describes the new facility for applied nuclear physics at the University of Sao Paulo, mainly for irradiation of electronic devices. It is a setup composed of a quadrupole doublet for beam focusing/defocusing plus multiple scattering through gold foils to produce low intensity, large-area, and high-uniformity heavy-ion beams from 1H to 107Ag. Beam intensities can be easily adjusted from 102 particles cm2/s to hundreds of nA for an area as large as 2.0 cm2 and uniformity better than 90%. Its irradiation chamber has a high-precision motorized stage, and the system is controlled by a LabViewTM environment, allowing measurement automation. Design considerations and examples of use are presented.

Overwhelming genetic heterogeneity and exhausting molecular diagnostic process in chronic and progressive ataxias: facing it up with an algorithm, a gene, a panel at a time.

Ataxias are one of the most frequent complaints in Neurogenetics units worldwide. Currently, more than 50 subtypes of spinocerebellar ataxias and more than 60 recessive ataxias are recognized. We conducted an 11-year prospective, observational, analytical study in order to estimate the frequency of pediatric and adult genetic ataxias in Argentina, to describe the phenotypes of this cohort and evaluate the diagnostic yield of the algorithm used in our unit. We included 334 ataxic patients. Our diagnostic approach was successful in one-third of the cohort. A final molecular diagnosis was reached in 113 subjects. This rate is significantly higher in the subgroup of patients with a positive family history, where the diagnostic yield increased to 55%. The most prevalent dominant and recessive ataxias in Argentina were SCA-2 (36% of dominant ataxias) and FA (62% of recessive ataxias), respectively. Next generation sequencing-based assays were diagnostic in the 65% of the patients requiring these tests. These results provide relevant epidemiological information, bringing a comprehensive knowledge of the most prevalent subtypes of genetic ataxias and their phenotypes in our territory and laying the groundwork for rationally implementing genetic diagnostic programs for these disorders in our country.

Copper Content and Resistance Mechanisms in the Terrestrial Moss Ptychostomum capillare: A Case Study in an Abandoned Copper Mine in Central Spain.

We present a case study on the tissue absorption of copper of a widely distributed moss species, Ptychostomum capillare in the polluted soil of an abandoned copper mine in central Spain. We studied the soil properties in a copper soil pollution gradient and sampled the moss tufts growing on them in four plots with contrasted soil copper levels. We determined the copper content in the soil and in the moss tissues. On these moss samples, we also performed histochemical tests and X-ray dispersive spectrometry coupled with scanning electron microscopy (SEM-EDX), both in untreated shoots and in samples where surface waxes were removed. We checked the behavior of this species using a metallophillous moss, Scopelophila cataractae, for comparative purposes. Copper contents in P. capillare seem to depend more on available, rather than total soil copper contents. Our results indicate that this moss is able to concentrate 12-fold the available soil copper in soil with low available copper content, whereas in the most polluted soil the concentration of Cu in the moss was only half those levels. Both histochemical and SEM-EDX tests show no surface copper in the mosses from the least polluted plot, whereas in samples from the soil with highest copper content, the removal of surface waxes also reduces or removes copper from the moss shoots. Our observations point at a mixed strategy in P. capillare in this copper mine, with metal accumulation behavior in the lowest Cu plot, and an exclusion mechanism involving wax-like substances acting as a barrier in the most polluted plots. These distortions impede the estimation of environmental levels and thus compromise the value of this moss in biomonitoring. We highlight the need of extending these studies to other moss species, especially those used in biomonitoring programs.

The Diagnostic Laboratory Hub: A New Health Care System Reveals the Incidence and Mortality of Tuberculosis, Histoplasmosis, and Cryptococcosis of PWH in Guatemala.

BACKGROUND: A Diagnostic Laboratory Hub (DLH) was set up in Guatemala to provide opportunistic infection (OI) diagnosis for people with HIV (PWH). METHODS: Patients newly presenting for HIV, PWH not receiving antiretrovirals (ARVs) for >90 days but returned to care (Return/Restart), and PWH on ARVs with symptoms of OIs (ARV treatment) were prospectively included. Screening for tuberculosis, nontuberculous mycobacteria (NTM), histoplasmosis, and cryptococcosis was done. Samples were couriered to the DLH, and results were transmitted electronically. Demographic, diagnostic results, disease burden, treatment, and follow-up to 180 days were analyzed. RESULTS: In 2017, 1953 patients were included, 923 new HIV infections (an estimated 44% of all new HIV infections in Guatemala), 701 on ARV treatment, and 315 Return/Restart. Three hundred seventeen (16.2%) had an OI: 35.9% tuberculosis, 31.2% histoplasmosis, 18.6% cryptococcosis, 4.4% NTM, and 9.8% coinfections. Histoplasmosis was the most frequent AIDS-defining illness; 51.2% of new patients had <200 CD4 cells/mm3 with a 29.4% OI incidence; 14.3% of OIs in new HIV infections occurred with CD4 counts of 200-350 cells/mm3. OIs were the main risk factor for premature death for new HIV infections. At 180 days, patients with OIs and advanced HIV had 73-fold greater risk of death than those without advanced disease who were OI-free. CONCLUSIONS: The DLH OI screening approach provides adequate diagnostic services and obtains relevant data. We propose a CD4 screening threshold of <350 cells/mm3. Mortality remains high, and improved interventions are required, including expansion of the DLH and access to antifungal drugs, especially liposomal amphotericin B and flucytosine.

Hipnosis anestésica inducida por profesional de Enfermería. Reporte de un caso / Nursing staff induced anesthetic hypnosis: A case report / Hipnose anestésica induzida por profissional de Enfermagem. Relatório de um caso

Resumen Introducción: La hipnosis anestésica puede ser un recurso útil para procedimientos dolorosos. Desarrollo: Se reporta caso de una joven que requiere exodoncia de terceros molares, con uso de hipnosis como único anestésico. El proceso de enfermería inicia con la valoración según patrones funcionales, impresiona lo sana que se encuentra, sin antecedentes mórbidos relevantes ni contraindicación para anestesia química. Se selecciona diagnóstico NANDA de Disposición para mejorar el confort. Dentro del plan se incorporan el NIC 5920 Hipnosis y 5922 Facilitar la autohipnosis, con buena evolución según lo planificado. Resultados: La extracción con hipnosis anestésica se desarrolló de forma similar a la cirugía con anestesia química, la cual se realizó sin dolor. En posoperatorio, paciente practica autohipnosis, sin necesitar analgésicos y evolucionó favorablemente. Discusión: La hipnosis requiere mayor evidencia científica, pero su uso es prometedor. Se constataron los beneficios de la hipnosis en el abordaje del dolor. Conclusión: La hipnosis anestésica, fue útil como intervención de enfermería en cirugía dental. La autohipnosis contribuyó al buen resultado. El profesional de Enfermería entrenado en hipnosis está en condiciones de incorporarla en la gestión del cuidado. El caso resulta interesante, dado que la paciente opta por la hipnosis, sin contraindicación para anestesia química, ya que no se encontró otro reporte de hipnoanestesia inducida por profesional de Enfermería, como anestésico único. Anecdóticamente, durante la filmación del procedimiento, una periodista entra espontáneamente en trance, por lo que requiere intervención del profesional de Enfermería para salir de él.

Abstract Introduction: Anesthetic hypnosis can be a useful resource to address painful procedures. Development: The case is of a young female patient requiring third-molars exodontia who underwent it under anesthetic hypnosis. The nursing process began with the assessment according to functional patterns. The patient was found healthy and without relevant morbid antecedents nor drug-anesthesia contraindications. A comfort improving disposition NANDA diagnosis was selected. NIC 5922 and 5920 were incorporated to the intervention plan. Results: The extraction under anesthetic hypnosis was performed in a similar form in comparison to a drug-anesthesia extraction procedure. During the post operatory stage, the patient used self-hypnosis and responded favorably without analgesics. Discussion: While hypnosis requires more scientific evidence, its use appears to be promising. In this case, diverse benefits from using hypnosis to address a painful procedure were acknowledged. Conclusion: Anesthetic hypnosis proved being helpful in a dental-surgery related nursing intervention. Self-hypnosis also contributed to the favorable outcome. A nursing professional who is well trained in hypnosis can incorporate this kind of procedure into her care management approach. This particular case was interesting because the patient chose hypnosis over drug anesthesia, and no other report on a nursing staff induced anesthetic hypnosis was found. Anecdotally, during the filming of this procedure, a journalist suffered an emotional trance which required immediate nursing intervention.

Resumo Introdução: A hipnose anestésica pode ser um recurso útil para procedimentos dolorosos. Desenvolvimento: Informa-se o caso de uma garota que requer exodontia de terceiros molares, com uso de hipnoses como único anestésico. O processo de enfermagem inicia com a valoração segundo padrões funcionais, impressiona o saudável que se encontra, sem antecedentes mórbidos relevantes nem contraindicação para anestesia química. Seleciona-se diagnóstico NANDA de Disposição para melhorar o conforto. Dentro do plano se incorporam o NIC 5920 Hipnose e 5922 Facilitar a auto-hipnose, com boa evolução segundo o planejado. Resultados: A extração com hipnose anestésica desenvolveu-se de forma similar à cirurgia com anestesia química, a qual se realizou sem dor. Em pós-operatório, o paciente prática auto-hipnose, sem precisar analgésicos e evolucionou favoravelmente. Discussão: A hipnose requer maior evidencia científica, mas seu uso é promissor. Verificaram os benefícios da hipnose na abordagem da dor. Conclusão: A hipnose anestésica foi útil como intervenção de enfermagem em cirurgia dental. A auto-hipnose contribuiu para o bom resultado. O profissional de Enfermagem treinado em hipnose está em condições de incorporá-la na gestão do cuidado. O caso resulta interessante, dado que a paciente opta pela hipnose, sem contraindicação para anestesia química, já que não se encontrou outro relatório de hipnoanestesia induzida por profissional de Enfermagem, como anestésico único. Anedoticamente, durante a filmagem do procedimento, uma jornalista entrou espontaneamente em transe, pelo qual se requereu intervenção do profissional de Enfermagem para sair dele.

The NUMEN project: Heavy-Ion Double Charge Exchange reactions towards 0νββ NME determination / El proyecto NUMEN: reacciones de intercambio de cargas dobles de iones pesados hacia la determinación de 0νββ NME

Abstract NUMEN proposes cross sections measurements of Heavy-Ion double charge exchange reactions as an innovative tool to access the nuclear matrix elements, entering the expression of the life time of Neutrinoless double beta decay (0νββ). A key aspect of the projectis the use at INFN-Laboratori Nazionali del Sud (LNS) of the Superconducting Cyclotron (CS) for the acceleration of the required high resolution and low emittance heavy-ion beams and of MAGNEX large acceptance magnetic spectrometer for the detection of the ejectiles. The experimental measurements of double charge exchange reactions induced by heavy ions present a number of challenging aspects, since such reactions are characterized by very low cross sections. First experimental results give encouraging indication on the capability to access quantitative information towards the determination of the Nuclear Matrix Elements for 0νββ decay.

Resumen NUMEN propone mediciones de secciones eficaces de reacciones de intercambio de carga doble de iones pesados como una herramienta innovadora para acceder a los elementos de la matriz nuclear, entrando en la expresión del tiempo de vida de la desintegración beta doble sin neutrino (0νββ). Un aspecto clave del proyecto es el uso en INFN-Laboratori Nazionali del Sud (LNS) del ciclotrón superconductor (CS) para la aceleración de los haces de iones pesados de alta resolución y baja emitancia requeridos y del espectrómetro magnético de gran aceptación MAGNEX para la detección de los residuos eyectados. Las mediciones experimentales de reacciones de intercambio de carga doble inducidas por iones pesados presentan una serie de aspectos desafiantes, ya que tales reacciones se caracterizan por secciones eficaces muy bajas. Los primeros resultados experimentales dan una indicación alentadora sobre la capacidad de acceder a información cuantitativa para la determinación de los Elementos de la Matriz Nuclear para la descomposición de 0νββ.

Phylogenetic and paleobotanical evidence for late Miocene diversification of the Tertiary subtropical lineage of ivies (Hedera L., Araliaceae).

BACKGROUND: Hedera (ivies) is one of the few temperate genera of the primarily tropical Asian Palmate group of the Araliaceae, which extends its range out of Asia to Europe and the Mediterranean basin. Phylogenetic and phylogeographic results suggested Asia as the center of origin and the western Mediterranean region as one of the secondary centers of diversification. The bird-dispersed fleshy fruits of ivies suggest frequent dispersal over long distances (e.g. Macaronesian archipelagos), although reducing the impact of geographic barriers to gene flow in mainland species. Genetic isolation associated with geographic barriers and independent polyploidization events have been postulated as the main driving forces of diversification. In this study we aim to evaluate past and present diversification patterns in Hedera within a geographic and temporal framework to clarify the biogeographic history of the genus. RESULTS: Phylogenetic (biogeographic, time divergence and diversification) and phylogeographic (coalescence) analyses using four DNA regions (nrITS, trnH-psbA, trnT-trnL, rpl32) revealed a complex spatial pattern of lineage divergence. Scarce geographic limitation to gene flow and limited diversification are observed during the early-mid Miocene, followed by a diversification rate increase related to geographic divergence from the Tortonian/Messinian. Genetic and palaeobotanical evidence points the origin of the Hedera clade in Asia, followed by a gradual E-W Asian extinction and the progressive E-W Mediterranean colonization. The temporal framework for the E Asia - W Mediterranean westward colonization herein reported is congruent with the fossil record. Subsequent range expansion in Europe and back colonization to Asia is also inferred. Uneven diversification among geographic areas occurred from the Tortonian/Messinian onwards with limited diversification in the newly colonized European and Asian regions. Eastern and western Mediterranean regions acted as refugia for Miocene and post-Miocene lineages, with a similar role as consecutive centers of centrifugal dispersal (including islands) and speciation. CONCLUSIONS: The Miocene Asian extinction and European survival of Hedera question the general pattern of Tertiary regional extinction of temperate angiosperms in Europe while they survived in Asia. The Tortonian/Messinian diversification increase of ivies in the Mediterranean challenges the idea that this aridity period was responsible for the extinction of the Mediterranean subtropical Tertiary flora. Differential responses of Hedera to geographic barriers throughout its evolutionary history, linked to spatial isolation related to historical geologic and climatic constraints may have shaped diversification of ivies in concert with recurrent polyploidy.

Burden of serious fungal infections in Guatemala.

Guatemala is a developing country in Central America with a high burden of HIV and endemic fungal infections; we attempted to estimate the burden of serious fungal infections for the country. A full literature search was done to identify epidemiology papers reporting fungal infections from Guatemala. We used specific populations at risk and fungal infection frequencies in the population to estimate national rates. The population of Guatemala in 2013 was 15.4 million; 40% were younger than 15 and 6.2% older than 60. There are an estimated 53,000 adults with HIV infection, in 2015, most presenting late. The estimated cases of opportunistic fungal infections were: 705 cases of disseminated histoplasmosis, 408 cases of cryptococcal meningitis, 816 cases of Pneumocystis pneumonia, 16,695 cases of oral candidiasis, and 4,505 cases of esophageal candidiasis. In the general population, an estimated 5,568 adult asthmatics have allergic bronchopulmonary aspergillosis (ABPA) based on a 2.42% prevalence of asthma and a 2.5% ABPA proportion. Amongst 2,452 pulmonary tuberculosis patients, we estimated a prevalence of 495 for chronic pulmonary aspergillosis in this group, and 1,484 for all conditions. An estimated 232,357 cases of recurrent vulvovaginal candidiasis is likely. Overall, 1.7% of the population are affected by these conditions. The true fungal infection burden in Guatemala is unknown. Tools and training for improved diagnosis are needed. Additional research on prevalence is needed to employ public health measures towards treatment and improving the reported data of fungal diseases.

Draft Genome Sequence of a Hypermucoviscous Extended-Spectrum-ß-Lactamase-Producing Klebsiella quasipneumoniae subsp. similipneumoniae Clinical Isolate.

A clinical isolate of extended-spectrum-ß-lactamase-producing Klebsiella quasipneumoniae subsp. similipneumoniae 06-219 with hypermucoviscosity phenotypes obtained from a urine culture of an adult patient was used for whole-genome sequencing. Here, we report the draft genome sequences of this strain, consisting of 53 contigs with an ~5.6-Mb genome size and an average G+C content of 57.36%. The annotation revealed 6,622 coding DNA sequences and 77 tRNA genes.

DESEMPEÑO PRODUCTIVO DE POLLOS DE ENGORDE SUPLEMENTADOS CON BIOMASA DE Saccharomyces cerevisiae DERIVADA DE LA FERMENTACIÓN DE RESIDUOS DE BANANO / PRODUCTION PERFORMANCE OF BROILERS SUPPLEMENTED WITH Saccharomyces cerevisiae DERIVED FROM THE FERMENTATION OF BANANA RESIDUES

El objetivo de esta investigación fue evaluar el efecto de la inclusión de diferentes niveles de biomasa de levaduras, producidos al fermentar hidrolizados de residuos de la industria bananera, sobre los parámetros zootécnicos de pollos de engorde, evaluando además el impacto económico de su uso en las dietas. Se utilizaron 210 pollos de engorde de un día de edad, distribuidos completamente al azar en cinco tratamientos, en una relación de seis réplicas por tratamiento y siete pollos por réplica. El periodo experimental comprendió 42 días; el alimento y el agua se dispensaron a voluntad. Las dietas experimentales fueron: T1- Control negativo sin levadura, T2- Control positivo con levadura comercial a razón de 1,5 kg ton-1 de alimento, T3- Levadura experimental a razón de 0,5 kg ton-1 de la dieta, T4- Levadura experimental a razón de 1,0 kg ton-1 de la dieta y T5- Levadura experimental a razón de 1,5 kg ton-1 de la dieta. Se observó mayor consumo de acumulado alimento en el tratamiento 4 (1kg ton-1 de levadura) con respecto a los demás tratamientos evaluados. No hubo diferencias significativas (P>0.05) en las otras variables evaluadas en el estudio. Se constató beneficio económico con el uso del tratamiento 4 pues se obtuvieron mejores retornos (precio de venta del pollo - costo de la alimentación) que fueron mayores a los observados en los tratamientos 1, 2, 3 y 5 en 153, 82, 62 y 161 pesos($) ave-1, respectivamente.

The objective of this study was to evaluate both the effect of including different levels of yeast biomass produced during the fermentation of banana waste residues on broiler productivity and the economic return of the exercise. We used 210 one-day-old broilers, which were distributed at random into five treatments, with six replicates per treatment and seven chicks per replicate, housed in vertical batteries equipped with electric heating. Feed and water were provided ad libitum. The experimental period lasted 42 days and the experimental diets were: T1- Negative control without yeast, T2- Positive control with commercial yeast at 1.5 kg ton-1 of feed, T3- experimental yeast at 0.5 kg ton-1 of diet, T4- experimental yeast at 1.0 kg ton-1 of diet and T4- experimental yeast at 1.5 kg ton-1 of the diet. Both animal productivity and economical return were evaluated. Significant differences (P>0.05) were present in the cumulative feed intake in treatment 4 (1kg ton-1 yeast) with respect to the other treatments. No significant differences were found in the other variables assessed in the study. There was an economic benefit to including treatment 4, in the form of higher returns (chicken sale price minus feed costs) of 153, 82, 62 and 161 Colombian pesos ($) bird-1, compared to those observed in treatments 1, 2, 3 and 5, respectively.

A system to measure isomeric state half-lives in the 10 ns to 10 µs range.

The Isomeric State Measurement System (SISMEI) was developed to search for isomeric nuclear states produced by fusion-evaporation reactions. The SISMEI consists of 10 plastic phoswich telescopes, two lead shields, one NaI(Tl) scintillation detector, two Compton suppressed HPGe γ-ray detectors, and a cone with a recoil product catcher. The new system was tested at the 8 UD Pelletron tandem accelerator of the University of São Paulo with the measurement of two known isomeric states: (54)Fe, 10(+) state (E = 6527.1 (11) keV, T(1/2) = 364(7) ns) and the 5/2(+) state of (19)F (E = 197.143 (4) keV, T(1/2) = 89.3 (10) ns). The results indicate that the system is capable of identifying delayed transitions, of measuring isomeric state lifetimes, and of identifying the feeding transitions of the isomeric state through the delayed γ-γ coincidence method. The measured half-life for the 10(+) state was T(1/2) = 365(14) ns and for the 5/2(+) state, 100(36) ns.