Effects of a Primary Care Antimicrobial Stewardship Program on Meticillin-Resistant Staphylococcus aureus Strains across a Region of Catalunya (Spain) over 5 Years.

Primary care antimicrobial stewardship program (ASP) interventions can reduce the over-prescription of unnecessary antibiotics, but the impact on the reduction in bacterial resistance is less known, and there is a lack of available data. We implemented a prolonged educational counseling ASP in a large regional outpatient setting to assess its feasibility and effectiveness. Over a 5-year post-implementation period, which was compared to a pre-intervention period, a significant reduction in antibiotic prescriptions occurred, particularly those associated with greater harmful effects and resistance selection. There was also a decrease in methicillin-resistant Staphylococcus aureus (MRSA) strains and in their co-resistance to other antibiotics, particularly those with an ecological impact.

Unpacking the Drivers of LGBT+ Legislation.

This paper stems from the hypothesis that there are various key factors rooted in economic, political, and social grounds which actively influence and determine the adoption and evolution of LGBT+ rights in the legal framework of any country. The goal of this research is to analyze these factors and understand how they channel the LGBT+ legislation in our present world. Assuming there is an asymmetry in this application and by extension in LGBT+ individuals' human rights, which are often ignored if not deprived in many parts of the world, this study seeks to understand the reasons behind that asymmetry. Based on a sample of 127 countries, a correlation analysis and a Panel data model were developed to analyze the real impact of these factors.

Unlocking the Potential of Nanoribbon-Based Sb2S3/Sb2Se3 van-der-Waals Heterostructure for Solar-Energy-Conversion and Optoelectronics Applications.

High-performance nanosized optoelectronic devices based on van der Waals (vdW) heterostructures have significant potential for use in a variety of applications. However, the investigation of nanoribbon-based vdW heterostructures are still mostly unexplored. In this study, based on first-principles calculations, we demonstrate that a Sb2S3/Sb2Se3 vdW heterostructure, which is formed by isostructural nanoribbons of stibnite (Sb2S3) and antimonselite (Sb2Se3), possesses a direct band gap with a typical type-II band alignment, which is suitable for optoelectronics and solar energy conversion. Optical absorption spectra show broad profiles in the visible and UV ranges for all of the studied configurations, indicating their suitability for photodevices. Additionally, in 1D nanoribbons, we see sharp peaks corresponding to strongly bound excitons in a fashion similar to that of other quasi-1D systems. The Sb2S3/Sb2Se3 heterostructure is predicted to exhibit a remarkable power conversion efficiency (PCE) of 28.2%, positioning it competitively alongside other extensively studied two-dimensional (2D) heterostructures.

Surgical care and trauma patients capacity in Piura, Perú - Cross-sectional study.

Introduction: Low and medium income countries face challenges in access and delivery of surgical care, resulting in a high number of deaths and disabled individuals. Objective: To estimate the capacity to provide surgical and trauma care in public hospitals in the Piura region, Perú, a middle income country. Methods: A survey was administered in public hospitals in the Peruvian region of Piura, which combined the Spanish versions of the PIPES and INTACT surveys, and the WHO situational analysis tool. The extent of the event was assessed based in the absolute differences between the medians of the scores estimated, and the Mann-Whitney bilateral tests, according to the geographical location and the level of hospital complexity. Results: Seven public hospitals that perform surgeries in the Piura region were assessed. Three provinces (3/8) did not have any complexity healthcare institutions. The average hospital in the peripheral provinces tended to be smaller than in the capital province in INTACT (8.25 vs. 9.5, p = 0.04). Additionally, water supply issues were identified (2/7), lack of incinerator (3/7), lack of uninterrupted availability of a CT-scanner (5/7) and problems with working hours; in other words, the blood banks in two hospitals were not open 24 hours. Conclusions: There is a significant inequality among the provinces in the region in terms of their trauma care capacities and several shortfalls in the public sector healthcare infrastructure. This information is required to conduct future research on capacity measurements in every public and private institution in the Peruvian region of Piura.

Introducción: Los países de ingresos bajos y medianos tienen problemas en el acceso y la provisión de atención quirúrgica, lo cual ocasiona un alto número de fallecimientos y de personas con discapacidad. Objetivo: Estimar la capacidad para la atención quirúrgica y de pacientes traumatizados en los hospitales públicos en la región de Piura, Perú, un país de ingreso mediano. Métodos: En los hospitales públicos de la región peruana de Piura se aplicó una encuesta que combinaba las versiones en español de las encuestas PIPES e INTACT y de la herramienta de análisis situacional de la Organizacion Mundial de la Salud (OMS). Se evaluó la magnitud del evento mediante las diferencias absolutas entre las medianas de los puntajes calculados y pruebas bilaterales de Mann-Whitney según la ubicación geográfica y el nivel de complejidad hospitalaria. Resultados: Se evaluaron siete hospitales públicos que realizan cirugía en la región de Piura. Tres provincias (3/8) no contaban con instituciones sanitarias con complejidad de hospital. La mediana de los hospitales de las provincias periféricas tuvo tendencia a ser menor que la de la provincia capital en la INTACT (8,25 vs. 9,5, p = 0,04). Asimismo, se hallaron problemas de abastecimiento de agua (2/7), ausencia de incinerador (3/7), falta de funcionamiento permanente de tomógrafo (5/7) y problemas con el horario de funcionamiento de los bancos de sangre, ya que no funcionaban las 24 horas del día en 2 hospitales (2/7). Conclusiones: Se describe la alta desigualdad entre las provincias de la región en la capacidad de atención de trauma y varias carencias en la infraestructura sanitaria del sector público. Esta información es necesaria para desarrollar futura investigación de medición de capacidades en todos los establecimientos públicos y privados de la región peruana de Piura.

Modeling study of the effect of placebo and medical therapy on storage and voiding symptoms, nocturia, and quality of life in men with prostate enlargement at risk for progression.

BACKGROUND: Modeling studies using large datasets from men with lower urinary tract symptoms/benign prostate enlargement (LUTS/BPE) can predict changes in International Prostate Symptom Score (IPSS) and risk of acute urinary retention/surgery under different treatment regimens and according to predictors (baseline characteristics) that commonly define risk of progression. We assessed the impact of treatments on different symptom types (storage, voiding, and nocturia), quality of life (QoL; IPSS Q8), and BPH Impact Index [BII]). METHODS: Generalized least squares models were used to predict each outcome. Data from the CombAT study were used to predict outcomes for active treatments (dutasteride, tamsulosin, combination therapy). Predictors included: age; IPSS total, storage, voiding, nocturia and QoL (IPSS Q8) scores; BII; prostate volume; maximum urine flow rate (Qmax), prostate-specific antigen, postvoid residual urine (PVR); alpha-blocker usage within 12 months. Data from phase III dutasteride monotherapy studies were used to predict placebo outcomes. Results were visualized using an interactive web-based tool ( www.bphtool.com ). RESULTS: Combination therapy provided greater predicted benefit than either monotherapy for all five outcomes for most patient profiles within the CombAT inclusion criteria. PVR and corresponding subscores were significant predictors of change in both storage and voiding subscores. Alpha-blocker use within 12 months, age (storage subscore), and Qmax (voiding subscore) were also significant predictors. PVR, age, Qmax, and nocturia score were significant predictors of change in nocturia. PVR, Qmax, previous alpha-blocker use, total IPSS, and QoL (IPSS Q8) score were significant predictors of change in QoL (IPSS Q8) score. For BII, significant predictors were PVR, age, total IPSS, and BII score. The multivariable effect of covariates and treatments is best visualized through the interactive web-based tool. CONCLUSIONS: This predictive modeling study informs our understanding of how risk factors for disease progression interact and affect treatment impact on different symptom types and QoL scores.

Twitter Sentiment Geographical Index Dataset.

Promoting well-being is one of the key targets of the Sustainable Development Goals at the United Nations. Many national and city governments worldwide are incorporating Subjective Well-Being (SWB) indicators into their agenda, to complement traditional objective development and economic metrics. In this study, we introduce the Twitter Sentiment Geographical Index (TSGI), a location-specific expressed sentiment database with SWB implications, derived through deep-learning-based natural language processing techniques applied to 4.3 billion geotagged tweets worldwide since 2019. Our open-source TSGI database represents the most extensive Twitter sentiment resource to date, encompassing multilingual sentiment measurements across 164 countries at the admin-2 (county/city) level and daily frequency. Based on the TSGI database, we have created a web platform allowing researchers to access the sentiment indices of selected regions in the given time period.

Resultado funcional y mortalidad en pacientes ancianos con amputación mayor de extremidad inferior / Functional results and mortality in elderly patients with major lower limb amputation

Introducción y objetivos: los objetivos de este trabajo han sido conocer qué factores influyen en la recupera ción funcional de los pacientes ancianos que sufren una amputación mayor de una extremidad inferior (AMeI) de etiología vascular y analizar la recuperación de la marcha y de la mortalidad al año de la amputación. Material y métodos: estudio longitudinal observacional de los pacientes mayores de 70 años valorados por el servicio de rehabilitación tras una AMeI desde el 1 enero de 2019 hasta el 1 enero de 2021. Se recogieron las siguientes variables: edad, sexo, etiología, índice de masa corporal, comorbilidad (escala de Charlson), independencia en las AVd básicas (índice de Barthel) y capacidad de marcha (FAC) previas. Al año se analizaron la capacidad de marcha y la mortalidad. Resultados: el estudio se realizó en 45 pacientes con una edad media de 80,3 años (el 64,3 % varones). Todos fueron de etiología vascular. el nivel de amputación fue supracondíleo en 31 pacientes e infracondíleo en 14. Se protetizaron 13. Al año solo caminaban 5 pacientes y habían fallecido 21. Las variables relacionadas con la posibilidad de rehabilitación-protetización fueron: presentar menos comorbilidad (p = 0,004) y tener una mayor independencia funcional y de marcha previa a la amputación (p = 0,000), al igual que las relacionadas con la no mortalidad, con p = 0,005 y p = 0,017 (p = 0,013), respectivamente. Conclusión: la mejor situación funcional y clínica previa a la amputación son los factores más importantes tanto para la posibilidad de rehabilitación protésica como para la supervivencia de nuestros ancianos amputados.(AU)

Introduction and objectives: the objectives of this work have been to know what factors influence in thefunctional recovery of elderly patients who suffer a major lower limb amputation (SMA) of vascular etiology andto analyze the recovery of gait and mortality one year after the amputation. Material and methods: longitudinal observational study of patients older than 70 years assessed by the Reha-bilitation Service after SMA from January 1, 2019 to January 1, 2021. The following variables were collected: Age, sex, etiology, body mass index, comorbidity (Charlson scale), independence in basic ADL (Barthel index) and previous walking capacity (FAC). One year later, walking ability and mortality. Results: the study was conducted in 45 patients with a mean age of 80.3 years, 64.3 % male. All were of vascularetiology. The level of amputation was: supracondylar 31 and infracondylar 14. After a year, only 5 patients werewalking and 21 had died. The variables related to the possibility of rehabilitation-fitting were: having less comorbidity (p = 0.004) as well as having greater functional and gait independence prior to amputation (p = 0.000), as well as those related to nomortality, with a (p = 0.005) and (p = 0.017) (p = 0.013) respectively. Conclusion: the best functional and clinical situation prior to amputation are the most important factors both forthe possibility of prosthetic rehabilitation and for the survival of our elderly amputees.(AU)

Tratamientos empleados para el síndrome de Dravet / Treatments used for Dravet syndrome / Tratamentos usados para a síndrome de Dravet

Se estima que el síndrome de Dravet (SD) es una encefalopatía epiléptica y de desarrollo grave, que ocurre en 1 de cada 15000 nacidos vivos. Se caracteriza por una epilepsia resistente a los medicamentos que se presenta en el primer año de vida con convulsiones prolongadas acompañadas de fiebre o cambios de temperatura, a menudo de naturaleza hemiclónica, seguidas de convulsiones no provocadas de diversos tipos. Objetivo. Describir los tratamientos empleados para el Síndrome de Dravet. Metodología. Se realizó una revisión sistemática. Para ello, se ejecutó una búsqueda en múltiples bases de datos, como Pubmed, Dialnet, Sciencedirect, Scielo y Scopus. La búsqueda se limitó a los artículos publicados desde el año 2017 hasta el 2022. Después de recopilar los artículos, se aplicaron varios criterios de filtrado para asegurarse de que sólo se incluyeran aquellos estudios que eran pertinentes para el análisis. Conclusión. Los tratamientos actuales, como los medicamentos antiepilépticos, las dietas cetogénicas y la estimulación nerviosa, han demostrado ser efectivos para reducir la frecuencia y la gravedad de las convulsiones en los pacientes. Es importante que los pacientes y sus cuidadores trabajen en conjunto con un equipo médico para lograr la mejor gestión posible de la enfermedad. Aunque no se dispone de una cura definitiva para el Síndrome de Dravet, los avances médicos continúan proporcionando esperanza y opciones de tratamiento a los pacientes y sus familias.

Dravet syndrome (DS) is estimated to be a severe developmental and epileptic encephalopathy, occurring in 1 in 15000 live births. It is characterized by drug-resistant epilepsy presenting in the first year of life with prolonged seizures accompanied by fever or temperature changes, often hemiclonic in nature, followed by unprovoked seizures of various types. Objective. To describe the treatments used for Dravet syndrome. Methodology. A systematic review was performed. For this purpose, a search was carried out in multiple databases, such as Pubmed, Dialnet, Sciencedirect, Scielo and Scopus. The search was limited to articles published from 2017 to 2022. After collecting the articles, several filtering criteria were applied to ensure that only those studies that were relevant to the analysis were included. Conclusion. Current treatments, such as antiepileptic drugs, ketogenic diets, and nerve stimulation, have been shown to be effective in reducing the frequency and severity of seizures in patients. It is important that patients and their caregivers work together with a medical team to achieve the best possible management of the disease. Although there is no definitive cure for Dravet syndrome, medical advances continue to provide hope and treatment options for patients and their families.

Estima-se que a síndrome de Dravet (SD) seja uma encefalopatia epiléptica e de desenvolvimento grave, que ocorre em 1 a cada 15.000 nascidos vivos. Caracteriza-se por epilepsia resistente a medicamentos que se apresenta no primeiro ano de vida com convulsões prolongadas acompanhadas de febre ou alterações de temperatura, muitas vezes de natureza hemiclônica, seguidas de convulsões não provocadas de vários tipos. Objetivo. Descrever os tratamentos usados para a síndrome de Dravet. Metodologia. Foi realizada uma revisão sistemática. Para isso, foi realizada uma pesquisa em vários bancos de dados, como Pubmed, Dialnet, Sciencedirect, Scielo e Scopus. A pesquisa foi limitada a artigos publicados de 2017 a 2022. Após a coleta dos artigos, vários critérios de filtragem foram aplicados para garantir que apenas os estudos relevantes para a análise fossem incluídos. Conclusão. Os tratamentos atuais, como medicamentos antiepilépticos, dietas cetogênicas e estimulação nervosa, demonstraram ser eficazes na redução da frequência e da gravidade das convulsões nos pacientes. É importante que os pacientes e seus cuidadores trabalhem em conjunto com uma equipe médica para obter o melhor controle possível da doença. Embora não haja uma cura definitiva para a Síndrome de Dravet, os avanços médicos continuam a oferecer esperança e opções de tratamento para os pacientes e suas famílias.

Short-Term Effectiveness, Safety, and Potential Predictors of Response of Secukinumab in Patients with Severe Hidradenitis Suppurativa Refractory to Biologic Therapy: A Multicenter Observational Retrospective Study.

INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Biologic drugs have a key role in the long-term anti-inflammatory treatment of moderate to severe patients due to their immunomodulatory properties. The aim of this study is to evaluate the effectiveness and safety of secukinumab in patients with moderate to severe HS after 16 weeks of treatment, and to explore potential predictors of clinical response to the drug. METHODS: Multicenter observational retrospective study. Patients treated with secukinumab 300 mg every 2 or 4 weeks who had completed at least 16 weeks of follow-up from nine hospitals based in southern Spain (Andalusia) were included in this study. Treatment effectiveness was assessed using the Hidradenitis Suppurativa Clinical Response (HiSCR). Information about adverse events was collected, the therapeutic burden of the patients was calculated as the summation of systemic medical treatments and surgical interventions (excluding incision and drainage) experienced until the start of secukinumab treatment. RESULTS: Forty-seven patients with severe HS were included for analysis. At week 16, 48.9% (23/47) of patients achieved HiSCR. Adverse events were present in 6.4% (3/47) of the patients. The multivariate analysis showed that female sex and, to a lesser extent, lower body mass index (BMI) and a lower therapeutic burden were potentially associated with a higher probability of HiSCR achievement. CONCLUSIONS: Favorable short-term effectiveness and safety of secukinumab in the treatment of severe HS patients were observed. Female sex, lower BMI and a lower therapeutic burden may be associated with a higher probability of achieving HiSCR.

Surgical care and trauma patients capacity in Piura, Peru - Cross-sectional study / Capacidades para la atención quirúrgica y de pacientes traumatizados en la región de Piura, Perú. Estudio de corte transversal

Abstract Introduction: Low and medium income countries face challenges in access and delivery of surgical care, resulting in a high number of deaths and disabled individuals. Objective: To estimate the capacity to provide surgical and trauma care in public hospitals in the Piura region, Perú, a middle income country. Methods: A survey was administered in public hospitals in the Peruvian region of Piura, which combined the Spanish versions of the PIPES and INTACT surveys, and the WHO situational analysis tool. The extent of the event was assessed based in the absolute differences between the medians of the scores estimated, and the Mann-Whitney bilateral tests, according to the geographical location and the level of hospital complexity. Results: Seven public hospitals that perform surgeries in the Piura region were assessed. Three provinces (3/8) did not have any complexity healthcare institutions. The average hospital in the peripheral provinces tended to be smaller than in the capital province in INTACT (8.25 vs. 9.5, p = 0.04). Additionally, water supply issues were identified (2/7), lack of incinerator (3/7), lack of uninterrupted availability of a CT-scanner (5/7) and problems with working hours; in other words, the blood banks in two hospitals were not open 24 hours. Conclusions: There is a significant inequality among the provinces in the region in terms of their trauma care capacities and several shortfalls in the public sector healthcare infrastructure. This information is required to conduct future research on capacity measurements in every public and private institution in the Peruvian region of Piura.

Resumen Introducción: Los países de ingresos bajos y medianos tienen problemas en el acceso y la provisión de atención quirúrgica, lo cual ocasiona un alto número de fallecimientos y de personas con discapacidad. Objetivo: Estimar la capacidad para la atención quirúrgica y de pacientes traumatizados en los hospitales públicos en la región de Piura, Perú, un país de ingreso mediano. Métodos: En los hospitales públicos de la región peruana de Piura se aplicó una encuesta que combinaba las versiones en español de las encuestas PIPES e INTACT y de la herramienta de análisis situacional de la Organización Mundial de la Salud (OMS). Se evaluó la magnitud del evento mediante las diferencias absolutas entre las medianas de los puntajes calculados y pruebas bilaterales de Mann-Whitney según la ubicación geográfica y el nivel de complejidad hospitalaria. Resultados: Se evaluaron siete hospitales públicos que realizan cirugía en la región de Piura. Tres provincias (3/8) no contaban con instituciones sanitarias con complejidad de hospital. La mediana de los hospitales de las provincias periféricas tuvo tendencia a ser menor que la de la provincia capital en la INTACT (8,25 vs. 9,5, p = 0,04). Asimismo, se hallaron problemas de abastecimiento de agua (2/7), ausencia de incinerador (3/7), falta de funcionamiento permanente de tomógrafo (5/7) y problemas con el horario de funcionamiento de los bancos de sangre, ya que no funcionaban las 24 horas del día en 2 hospitales (2/7). Conclusiones: Se describe la alta desigualdad entre las provincias de la región en la capacidad de atención de trauma y varias carencias en la infraestructura sanitaria del sector público. Esta información es necesaria para desarrollar futura investigación de medición de capacidades en todos los establecimientos públicos y privados de la región peruana de Piura.

Schiff Bases and Stereocontrolled Formation of Fused 1,3-Oxazolidines from 1-Amino-2-Indanol: A Systematic Study on Structure and Mechanism.

This paper thoroughly explores the formation of Schiff bases derived from salicylaldehydes and a conformationally restricted amino alcohol (1-amino-2-indanol), as well as the generation of 1,3-oxazolidines, a key heterocyclic core present in numerous bioactive compounds. We provide enough evidences, both experimental-including crystallographic analyses and DFT-based calculations on imine/enamine tautomerism in the solid state and solution. In the course of imine formation, a pentacyclic oxazolidine-oxazine structure could be isolated with complete stereocontrol, whose configuration has been determined by merging theory and experiment. Mechanistic studies reveal that, although oxazolidines can be obtained under kinetic conditions, the prevalence of imines obeys to thermodynamic control as they are the most stable structures. The stereochemical outcome of imine cyclization under acylating conditions leads to formation of 2,4-trans-oxazolidines.

Chiral Single-Molecule Potentiometers Based on Stapled ortho- Oligo(phenylene)ethynylenes.

We report on the chemical design of chiral molecular junctions with stress-dependent conductance, whose helicity is maintained during the stretching of a single molecule junction due to the stapling of both ends of the inner helix. In the reported compounds, different conductive pathways are observed, with clearly different conductance values and plateau-length distributions, attributed to different conformations of the helical structures. The large chiro-optical responses and the potential use of these molecules as unimolecular spin filters have been theoretically proved using state-of-the-art Density Functional Theory (DFT) calculations, including a fully ab-initio estimation of the CISS-originating spin polarization which is done, for the first time, for a realistic molecular system.

Theoretical Approach for Electron Dynamics and Ultrafast Spectroscopy (EDUS).

In this manuscript, we present a theoretical framework and its numerical implementation to simulate the out-of-equilibrium electron dynamics induced by the interaction of ultrashort laser pulses in condensed-matter systems. Our approach is based on evolving in real time the density matrix of the system in reciprocal space. It considers excitonic and nonperturbative light-matter interactions. We show some relevant examples that illustrate the efficiency and flexibility of the approach to describe realistic ultrafast spectroscopy experiments. Our approach is suitable for modeling the promising and emerging ultrafast studies at the attosecond time scale that aim at capturing the electron dynamics and the dynamical electron-electron correlations via X-ray absorption spectroscopy.

Monitoring Indicators of Universal Access to Accessible and Safe Anesthetic and Surgical Care in a Peruvian Region: An Ambispective Study.

INTRODUCTION: The Lancet Commission on Global Surgery indicators for monitoring anesthetic and surgical care allow the identification of access barriers, evaluate the safety of surgeries, facilitate planning, and assess changes over time. The primary objective was to measure these indicators in all health facilities of a Peruvian region in 2020. METHODS: This was an ambispective observational study to measure the anesthetic and surgical care indicators in Piura, a region in Peru, between January 2020 and June 2021. Public and private health facilities in the Piura region that performed surgical care or had specialists from any surgical specialty participated in the study. Data were collected from all regional health facilities that provided surgical care to estimate the density of surgical workforce. Likewise, the percentage of the population with access to an operating room within 2 h was estimated using georeferenced tools. Finally, a public database was accessed to determine the surgical volume, the percentage of the regional population protected with health insurance. RESULTS: In 2020, 88.4% of the inhabitants of this Peruvian region had access to timely essential surgery. There were 18.4 surgical specialists and 1174 surgeries per 100,000 populations, and 91% of the population had health insurance. In addition, there was a rate of 2.1 working operating rooms per 100,000 inhabitants in 2021. CONCLUSIONS: This Peruvian region presented an increasing trend with respect to the population's access to essential and timely surgical care, and health insurance coverage. However, the workforce distribution was inequitable among the provinces of the region, the surgical volume was reduced, and timely access was hindered because of the SARS-CoV-2 pandemic.

Impact of a Primary Care Antimicrobial Stewardship Program on Bacterial Resistance Control and Ecological Imprint in Urinary Tract Infections.

Antimicrobial stewardship programs (ASPs) are a central component in reducing the overprescription of unnecessary antibiotics, with multiple studies showing benefits in the reduction of bacterial resistance. Less commonly, ASPs have been performed in outpatient settings, but there is a lack of available data in these settings. We implemented an ASP in a large regional outpatient setting to assess its feasibility and effectiveness. Over a 5-year post-implementation period, compared to the pre-intervention period, a significant reduction in antibiotic prescription occurred, with a reduction in resistance in E. coli urinary isolates. ASP activities also were found to be cost-effective, with a reduction in medication prescription.

Measuring daily-life fear perception change: A computational study in the context of COVID-19.

COVID-19, as a global health crisis, has triggered the fear emotion with unprecedented intensity. Besides the fear of getting infected, the outbreak of COVID-19 also created significant disruptions in people's daily life and thus evoked intensive psychological responses indirect to COVID-19 infections. In this study, we construct a panel expressed fear database tracking the universe of social media posts (16 million) generated by 536 thousand individuals between January 1st, 2019 and August 31st, 2020 in China. We employ deep learning techniques to detect expressions of fear emotion within each post, and then apply topic model to extract the major topics of fear expressions in our sample during the COVID-19 pandemic. Our unique database includes a comprehensive list of topics, not being limited to post centering around COVID-19. Based on this database, we find that sleep disorders ("nightmare" and "insomnia") take up the largest share of fear-labeled posts in the pre-pandemic period (January 2019-December 2019), and significantly increase during the COVID-19. We identify health and work-related concerns are the two major sources of non-COVID fear during the pandemic period. We also detect gender differences, with females having higher fear towards health topics and males towards monetary concerns. Our research shows how applying fear detection and topic modeling techniques on posts unrelated to COVID-19 can provide additional policy value in discerning broader societal concerns during this COVID-19 crisis.

Turner syndrome associated with Down syndrome: about a case / Síndrome Turner asociado a síndrome Down: a propósito de un caso

The coexistence of double aneuploidy of Down and Turner syndromes is rare; most cases have been due to double mitotic errors. The objective of the study was to report a case with monosomy of the X chromosome and trisomy of chromosome 21, in mosaic variety, highlighting the phenotypic effect that the presence of different chromosomal abnormalities can produce and compare with those reported in the literature. A 10-year-old Ecuadorian female, born to a multipregnant mother with 46 years at conception, is seen in consultation with a predominant clinical phenotype of Down syndrome, associated with menarche, presence of pubic and axillary villu, where a karyotype is verified 45 X[7]/47XX+ 21 [3]/46, X, der (X)(: p11.1-> q11.1)[1]/46,XX [1]. The present case is a double Turner-Down aneuploidy, with predominantly X monosomy cell line, who shows important mental retardation and some signs of puberal development not usually in Turner syndrome. These features highlight the clinical importance of doing a karyotype in mental retardation cases and searching low mosaics of another aneuploidies in atypical cases. Its complex chromosomal formula and support with molecular cytogenetics allowed diagnostic confirmation and genetic counseling.

La coexistencia de doble aneuploidía de los síndromes de Down y Turner es rara; la mayoría de los casos se han debido a dobles errores mitóticos. Reportar un caso con trisomía del cromosoma 21 y monosomía del cromosoma en X, en variedad mosaico, que curiosamente presenta un despertar puberal precoz y comparar con los reportados en la literatura. Paciente ecuatoriana de sexo femenino, de 10 años de edad, nacida de madre multigesta con 46 años a la concepción, que es vista en consulta con fenotipo clínico predominante de Síndrome Down, asociado a menarquia y telarquia, donde se constata un cariotipo. El presente caso es el primero informado de mosaicismo de doble aneuploidía de Turner-Down asociado con un despertar puberal precoz. Su fórmula cromosómica compleja y el apoyo con la citogenética molecular permitió la confirmación diagnostica y la asesoría genética.

Prevalence of premature loss of deciduous teeth and its relationship with gender among children from Acapulco, Guerrero: a cross-sectional study.

BACKGROUND: Premature loss of deciduous teeth is the exfoliation or extraction before physiological replacement with < 50% or < 75% of the root of the substitute tooth formed or if there is > 1 mm of alveolar bone covering the permanent successor tooth organ. This study aimed to estimate the prevalence of premature tooth loss in children and identify associated factors in a health center in Acapulco, Guerrero. METHODS: We conducted a cross-sectional study in which we collected information from 109 clinical records of children examined from January 2019 to August 2021. Sociodemographic data of the children and parents were collected: socioeconomic level, non-pathological personal history, and the history of premature deciduous tooth loss. Multivariate analysis to identify factors associated with premature deciduous tooth loss was performed with CIETmap statistical software. Odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the strength of the association. RESULTS: The prevalence of premature loss of primary teeth was 40% (43/109). The leading cause was caries (84%, 36/43). The tooth organ with the highest loss occurrence was the lower right second molar (33%, 14/43). Gender was identified as an associated factor, with males having a higher risk of loss (ORa = 2.97; CI95% = 1.33-6.65). CONCLUSIONS: Our results were similar to those reported in other studies. Strategies aimed at health promotion directed at parents and children should be reinforced.

INTRODUCCIÓN: Se considera como pérdida prematura de dientes deciduos a la exfoliación o extracción antes del recambio fisiológico con < 50% o < 75% de la raíz del diente sustituto formado, o si existe > 1 mm de hueso alveolar cubriendo al órgano dentario sucesor permanente. El objetivo de este trabajo fue estimar la prevalencia de pérdida prematura dental en niños e identificar factores asociados en un centro de salud de Acapulco, Guerrero. MÉTODOS: Se llevó a cabo un estudio transversal en el que se recopiló información de 109 expedientes clínicos de niños atendidos de enero de 2019 a agosto de 2021. Se recolectaron datos sociodemográficos de los niños y los padres: nivel socioeconómico, antecedentes personales no patológicos y el antecedente de la pérdida prematura del diente deciduo. Se realizó un análisis multivariado para identificar factores asociados con la pérdida prematura de dientes deciduos con el software estadístico CIETmap. Se calcularon la razón de momios (OR) y el intervalo de confianza (IC) del 95% para estimar el grado de la asociación. RESULTADOS: La prevalencia de pérdida prematura de dientes primarios fue del 40% (43/109). La principal causa fue por caries (84%, 36/43). El órgano dentario con más ocurrencia de pérdida fue el segundo molar inferior derecho (33%, 14/43). Se identificó el sexo como factor asociado, y se observó que el sexo masculino presenta mayor riesgo de pérdida (ORa = 2.97; IC95% = 1.33-6.65). CONCLUSIONES: Nuestros resultados fueron similares a lo reportado en otros estudios. Deben reforzarse las estrategias de promoción de la salud dirigidas a los padres de familia y a sus hijos.