Community Members' Perceptions of a Resource-Rich Well-Being Website in California During the COVID-19 Pandemic: Qualitative Thematic Analysis.

BACKGROUND: To address needs for emotional well-being resources for Californians during the COVID-19 pandemic, the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website was developed in collaboration with multiple community partners across California, funded by the California Department of Health Care Services Behavioral Health Division federal emergency response. OBJECTIVE: This qualitative study was designed to explore and describe the perspectives of participants affiliated with California organizations on the T4W/Juntos website, understand their needs for web-based emotional health resources, and inform iterative website development. METHODS: After providing informed consent and reviewing the website, telephone interviews were conducted with 29 participants (n=21, 72% in English and n=8, 28% in Spanish) recruited by partnering community agencies (October 2021-February 2022). A 6-phase thematic analysis was conducted, enhanced using grounded theory techniques. The investigators wrote reflexive memos and performed line-by-line coding of 12 transcripts. Comparative analyses led to the identification of 15 overarching codes. The ATLAS.ti Web software (ATLAS.ti Scientific Software Development GmbH) was used to mark all 29 transcripts using these codes. After examining the data grouped by codes, comparative analyses led to the identification of main themes, each with a central organizing concept. RESULTS: Four main themes were identified: (1) having to change my coping due to the pandemic, (2) confronting a context of shifting perceptions of mental health stigma among diverse groups, (3) "Feels like home"-experiencing a sense of inclusivity and belonging in T4W/Juntos, and (4) "It's a one-stop-shop"-judging T4W/Juntos to be a desirable and useful website. Overall, the T4W/Juntos website communicated support and community to this sample during the pandemic. Participants shared suggestions for website improvement, including adding a back button and a drop-down menu to improve functionality as well as resources tailored to the needs of groups such as older adults; adolescents; the lesbian, gay, bisexual, transgender, and queer community; police officers; and veterans. CONCLUSIONS: The qualitative findings from telephone interviews with this sample of community members and service providers in California suggest that, during the COVID-19 pandemic, the T4W/Juntos website was well received as a useful, accessible tool, with some concerns noted such as language sometimes being too "professional" or "clinical." The look, feel, and content of the website were described as welcoming due to pictures, animations, and videos that showcased resources in a personal, colorful, and inviting way. Furthermore, the content was perceived as lacking the stigma typically attached to mental health, reflecting the commitment of the T4W/Juntos team. Unique features and diverse resources, including multiple languages, made the T4W/Juntos website a valuable resource, potentially informing dissemination. Future efforts to develop mental health websites should consider engaging a diverse sample of potential users to understand how to tailor messages to specific communities and help reduce stigma.

Testing the feasibility, acceptability, and exploring trends on efficacy of the problem management plus for moms: Protocol of a pilot randomized control trial.

Mental health disorders are one of the most common causes that limit the ability of mothers to care for themselves and for their children. Recent data suggest high rates of distress among women in charge of young children in Zambia. Nevertheless, Zambia's public healthcare offers very limited treatment for common mental health distress. To address this treatment gap, this study aims to test the feasibility, acceptability, and potential efficacy of a context-adapted psychosocial intervention. A total of 265 mothers with mental health needs (defined as SRQ-20 scores above 7) were randomly assigned with equal probability to the intervention or control group. The intervention group will receive a locally adapted version of the Problem-Management Plus and "Thinking Healthy" interventions developed by the World Health Organization (WHO), combined with specific parts of the Strong Minds-Strong Communities intervention. Trained and closely supervised wellbeing-community health workers will provide the psychosocial intervention. Mental health distress and attendance to the intervention will be assessed at enrollment and 6 months after the intervention. We will estimate the impact of the intervention on mental health distress using an intention-to-treat approach. We previously found that there is a large necessity for interventions that aim to address mother anxiety/depression problems. In this study, we tested the feasibility and efficacy of an innovative intervention, demonstrating that implementing these mental health treatments in low-income settings, such as Zambia, is viable with an adequate support system. If successful, larger studies will be needed to test the effectiveness of the intervention with increased precision. Trial registration: This study is registered at clinicaltrials.gov as NCT05627206.

Attitudes towards childcare practices in rural and urban caregivers with high rates of multidimensional poverty

Objective: To analyse the relationship between poverty and attitudes towards childcare practices in rural and urban areas of Colombia. Method: This article presents a cross-sectional correlational study conducted in the department of Atlántico, northern Colombia. Attitudes towards childcare and living conditions were assessed among 1189 caregivers of preschool children. The multidimensional poverty index and the participants' area of origin (urban or rural) were considered. Results: No direct relationship was found between attitudes towards childcare and the multidimensional poverty index. However, it was observed that urban participants from deprived areas had a higher poverty index and less positive attitudes towards childcare, especially regarding cognitive, sleep and health care. There was a moderating effect of area on attitudes towards childcare. Conclusions: The study highlights the influence of poverty and social vulnerability on attitudes towards childcare, particularly in urban areas. These findings underline the importance of considering socio-economic and geographical conditions when addressing childcare practices. It also highlights the need to implement specific strategies to promote positive childcare practices in more vulnerable contexts to improve early childhood development in Colombia.

Objetivo: Analizar la relación entre la pobreza y las actitudes hacia las prácticas de cuidado infantil en áreas rurales y urbanas de Colombia. Método: El presente artículo es un estudio transversal correlacional en el departamento del Atlántico, al norte de Colombia. Se indagó sobre las actitudes hacia el cuidado infantil y las condiciones de vida en 1189 cuidadores de niños en edad preescolar. Se tuvo en cuenta el índice de pobreza multidimensional y el área de procedencia de los participantes (urbana o rural). Resultados: No se encontró una relación directa entre las actitudes hacia el cuidado infantil y el índice de pobreza multidimensional. Sin embargo, se observó que los participantes de áreas urbanas provenientes de zonas vulnerables presentaron un mayor índice de pobreza y mostraron actitudes menos positivas hacia el cuidado infantil, especialmente en el cuidado cognitivo, del sueño y de la salud. Se evidenció un efecto moderador del área sobre las actitudes de cuidado. Conclusiones: El estudio destaca la influencia de la pobreza y la vulnerabilidad social en las actitudes de cuidado infantil, especialmente en áreas urbanas. Estos hallazgos subrayan la importancia de considerar las condiciones socioeconómicas y geográficas al abordar el cuidado infantil. Además, se resalta la necesidad de implementar estrategias específicas para promover prácticas de cuidado positivas en contextos más vulnerables, con el fin de mejorar el desarrollo de la primera infancia en Colombia.

Pathways between Adverse Change in Employment and Alcohol Use among U.S. Women during a Global Pandemic: The Moderating Role of Conformity to Masculine Norms.

BACKGROUND: This study examined changes in reported alcohol use among women during the early stages of the COVID-19 pandemic and the relations to adverse changes in employment (e.g. job loss, furlough, reduced pay). Further, this study assessed how the relation between changes in alcohol use and experiencing an adverse change in employment was moderated by four theoretically relevant dimensions of conformity to masculine norms (CMNI, i.e. risk-taking, winning, self-reliance, and primacy of work). METHODS: The sample for the present study is a subset of a survey that was conducted in the spring of 2020 among U.S. adults and includes 509 participants who met the inclusion criteria. We assessed pandemic-related employment change status, changes in reported frequency and quantity of alcohol consumed, and four CMNI dimensions. Relations between these variables were assessed with a multinomial logistic regression path model. RESULTS: Experiencing an adverse change in employment early in the pandemic was related to increased alcohol use when moderated by the CMNI dimension primacy of work. For people higher on primacy of work, an adverse change in employment was associated with a higher likelihood of reporting an increase in frequency, but not quantity, of drinking (rather than a decrease or no change). Not experiencing an adverse change in employment early in the pandemic was associated with an increased likelihood of reporting an increase for quantity but not frequency. CONCLUSION: The results highlight the importance of considering how work-oriented women may be at risk for increasing alcohol use when confronted with changes in work status.

Sphingosine-1-phosphate receptor 2 plays a dual role depending on the stage of cell differentiation in renal epithelial cells.

Epithelial renal cells have the ability to adopt different cellular phenotypes through epithelial-mesenchymal transition (EMT) and mesenchymal-epithelial transition (MET). These processes are increasingly recognized as important repair factors following acute renal tubular injury. Sphingosine-1-phosphate (S1P) is a bioactive sphingolipid with impact on proliferation, growth, migration, and differentiation which has significant implication in various diseases including cancer and kidney fibrosis. Here we demonstrated that S1P can exert by activating S1P receptor 2 (S1PR2) different functions depending on the stage of cell differentiation. We observed that the differences in the migratory profile of Madin-Darby canine kidney (MDCK) cells depend both on their stage of cell differentiation and the activity of S1PR2, a receptor that can either promote or inhibit the migratory process. Meanwhile in non-differentiated cells S1PR2 activation avoids migration, it is essential on fully differentiated cells. This is the first time that an antagonist effect of S1PR2 was reported for the same cell type. Moreover, in fully differentiated cells, S1PR2 activation is crucial for the progression of EMT - characterized by adherent junctions disassembly, ß-catenin and SNAI2 nuclear translocation and vimentin expression- and depends on ERK 1/2 activation and nuclear translocation. These findings provide a new perspective about the different S1PR2 functions depending on the stage of cell differentiation that can be critical to the modulation of renal epithelial cell plasticity, potentially paving the way for innovative research with pathophysiologic relevance.

The impact of breast cancer on social cognition in female Colombian patients.

BACKGROUND: The high prevalence of female breast cancer is a global health concern. Breast cancer and its treatments have been associated with impairments in general cognition, as well as structural and functional brain changes. Considering the social challenges that some of these patients face, it is important to understand the socio-emotional effects of breast cancer as well. Nevertheless, the impact of breast cancer on social cognition has remained underexplored. The objective of this study was to assess social cognition domains and other relevant cognitive and emotional variables (executive functions, anxiety, or depression) in females with breast cancer. METHODS: The participants were 29 female patients diagnosed with breast cancer and 29 female healthy controls. We assessed emotion recognition, theory of mind, empathy, and moral emotions. We also included measures of general cognitive functioning, quality of life, anxiety, and depression. Linear multiple regressions were performed to assess whether the group (patients or controls), GAD-7 scores, emotional and social subscales of EORTC QLQ-C30, and IFS scores predicted the social cognition variables (EET, RMET, MSAT). RESULTS: Patients with breast cancer showed impairments in emotion recognition and in affective theory of mind. In addition, patients had lower scores in some executive functions. Only theory of mind between group differences remained significant after Bonferroni correction. Emotion recognition was associated with executive functioning, but anxiety levels were not a significant predictor of the changes in social cognition. CONCLUSIONS: Social cognition impairments, especially in theory of mind, may be present in breast cancer, which can be relevant to understanding the social challenges that these patients encounter. This could indicate the need for therapeutic interventions to preserve social cognition skills in patients with breast cancer.

Engagement, Use, and Impact of Digital Mental Health Resources for Diverse Populations in COVID-19: Community-Partnered Evaluation.

BACKGROUND: The COVID-19 pandemic increased disparities for communities burdened by structural barriers such as reduced affordable housing, with mental health consequences. Limited data are available on digital resources for public mental health prevention during the COVID-19 pandemic. OBJECTIVE: The study aim was to evaluate engagement in and impact of free digital resources on the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website during COVID-19 in California. METHODS: A pilot evaluation of T4W/Juntos was performed, with partner agencies inviting providers, clients, and partners to visit the website and complete surveys at baseline (September 20, 2021, to April 4, 2022) and at 4-6-week follow-up (October 22, 2021, to May 17, 2022). Website use was assessed by three engagement items (ease of use, satisfaction, relevance), comfort in use, and use of six resource categories. Primary outcomes at follow-up were depression and anxiety (scores≥3 on Patient Health Questionnaire-2 item [PHQ2] and Generalized Anxiety Disorder-2 item [GAD2] scales). Secondary outcomes were post-pre differences in PHQ2 and GAD2 scores, and use of behavioral health hotlines and services the month before follow-up. RESULTS: Of 366 eligible participants, 315 (86.1%) completed baseline and 193 (61.3%) completed follow-up surveys. Of baseline participants, 72.6% identified as female, and 21.3% identified as lesbian, gay, bisexual, transgender, queer/questioning, and others (LGBTQ+). In terms of ethnicity, 44.0% identified as Hispanic, 17.8% as African American, 26.9% as non-Hispanic white, and 11.4% as other ethnicity. Overall, 32.7% had moderate anxiety or depression (GAD2/PHQ2≥3) at baseline. Predictors of baseline website engagement included being Hispanic versus other race/ethnicity (ß=.27, 95% CI .10-.44; P=.002) and number of COVID-19-related behavior changes (ß=.09, 95% CI .05-.13; P<.001). Predictors of comfort using the website were preferring English for website use (odds ratio [OR] 5.57, 95% CI 2.22-13.96; P<.001) and COVID-19-related behavior changes (OR 1.37, 95% CI 1.12-1.66; P=.002); receiving overnight behavioral health treatment in the prior 6 months (OR 0.15, 95% CI 0.03-0.69, P=.015) was associated with less comfort in website use. The main predictor of depression at follow-up (PHQ2≥3) was baseline depression (OR 6.24, 95% CI 2.77-14.09; P<.001). Engagement in T4W/Juntos was associated with lower likelihood of depression (OR 0.54, 95% CI 0.34-0.86; P=.01). Website use the month before follow-up was associated with a post-pre reduction in PHQ2 score (ß=-.62, 95% CI -1.04 to -0.20; P=.004). The main predictor of GAD2≥3 at follow-up was baseline GAD2≥3 (OR 13.65, 95% CI 6.06-30.72; P<.001). Greater baseline website engagement predicted reduced hotline use (OR 0.36, 95% CI 0.18-0.71; P=.004). CONCLUSIONS: Ethnicity/language and COVID-19-related behavior changes were associated with website engagement; engagement and use predicted reduced follow-up depression and behavioral hotline use. Findings are based on participants recommended by community agencies with moderate follow-up rates; however, significance was similar when weighting for nonresponse. This study may inform research and policy on digital mental health prevention resources.

Effect of agricultural activities on surface water quality from páramo ecosystems.

Páramos are high mountain ecosystems strategic for water provision in South America. Currently, páramos are under threat due to agricultural intensification that impairs surface water sources. This research analyzed the effect of agriculture (spring onion-Allium fistulosum, potato-Solanum tuberosum, and livestock farming) on water quality in páramo ecosystems. A Hydrographic Unit upstream of the Jordan river catchment (Colombia) was selected and monitored in two different rainfall regimes, following the paired catchments and upstream-downstream approaches to compare water quality from natural and anthropic areas. Twenty-two parameters related to agricultural activities were analyzed (nutrients, salts, organic matter, sediments, and pathogens). The studied agricultural activities increased loads of surface water in quality in nitrates (0.02 to 2.56 mg N-NO3/L), potassium (0.13 to 1.24 mg K/L), and Escherichia coli (63 to 2718 FCU/100 mL), generating risks on the human health and promoting eutrophication. Total nitrogen and organic matter in the rainy season were higher than dry. BOD5, COD, turbidity, and E. coli were above international standards for direct human consumption. However, water could be used for irrigation, livestock watering, and aquatic life ambient freshwater. The results show that a small land-use change of almost 15% from natural páramo vegetation to agricultural uses in these ecosystems impairs water quality, limiting its uses, and the need to harmonize small-scale livelihoods in the páramo with the sustainability of ecosystem service provision.

Single and mixture toxicity of selected pharmaceuticals to the aquatic macrophyte Lemna minor.

Plants represent uncommon targets to evaluate pharmaceuticals toxicity. In this work, Lemna minor was employed as a plant model to determine the toxicity of selected pharmaceuticals, and to assay if such toxicity could be predicted by QSAR models based on green algae. Among eight compounds, measurable toxicity was determined for ketoprofen (EC50 = 11.8 ± 1.9 mg/L), fluoxetine (EC50 = 27.0 ± 8.7 mg/L) and clindamycin 2-phosphate (EC50 = 57.7 ± 1.7 mg/L). Even though a correlation of r2 = 0.87 was observed between experimental toxicity towards algae and L. minor, QSAR estimations based on algae data poorly predicted the toxicity of pharmaceuticals on the plant. More experimental data for L. minor are necessary to determine the applicability of these predictions; nonetheless, these results remark the importance of measuring experimental ecotoxicological parameters for individual taxa. The toxicity of pharmaceutical binary mixtures (ketoprofen, fluoxetine and clindamycin) revealed in some cases deviations from the concentration addition model; nonetheless these deviations were small, thus the interactions are unlikely to be of severe biological significance. Moreover, the EC50 concentrations determined for these pharmaceuticals are significantly higher than those detected in the environment, suggesting that acute effects on L. minor would not take place at ecosystem level.

Is a higher altitude associated with shorter survival among at-risk neonates?

INTRODUCTION: We hypothesize that high altitudes could have an adverse effect on neonatal health outcomes, especially among at-risk neonates. The current study aims to assess the association between higher altitudes on survival time among at-risk neonates. METHODS: Retrospective survival analysis. Setting: Ecuadorian neonates who died at ≤28 days of life. Patients: We analyzed the nationwide dataset of neonatal deaths from the Surveillance System of Neonatal Mortality of the Ministry of Public Health of Ecuador, registered from 126 public and private health care facilities, between January 2014 to September 2017. Main outcome measures: We retrospectively reviewed 3016 patients. We performed a survival analysis by setting the survival time in days as the primary outcome and fixed and mixed-effects Cox proportional hazards models to estimate hazard ratios (HR) for each altitude stratum of each one of the health care facilities in which those neonates were attended, adjusting by individual variables (i.e., birth weight, gestational age at birth, Apgar scale at 5 minutes, and comorbidities); and contextual variables (i.e., administrative planning areas, type of health care facility, and level of care). RESULTS: Altitudes of health care facilities ranging from 80 to <2500 m, 2500 to <2750m, and ≥2750 m were associated respectively with 20% (95% CI: 1% to 44%), 32% (95% CI:<1% to 79%) and 37% (95% CI: 8% to 75%) increased HR; compared with altitudes at <80 m. CONCLUSION: Higher altitudes are independently associated with shorter survival time, as measured by days among at-risk neonates. Altitude should be considered when assessing the risk of having negative health outcomes during neonatal period.

Síndrome coronario agudo e insuficiencia mitral-aórtica grave en un paciente con rubeola congénita / Acute coronary syndrome and mitral-aortic insufficiency in a patient with congenital rubella

Resumen La rubeola es una enfermedad exantemática que se produce en la infancia. En caso de que se presente durante la gestación y hubiera afectación del producto, este puede desarrollar el síndrome de rubeola congénita, el cual incluye malformaciones cardiacas que se presentan en el 67% de los pacientes, de las cuales la más común es la persistencia del conducto arterioso, seguida de la estenosis valvular pulmonar y la comunicación interauricular. Se presenta el caso de un hombre de 20 años con diagnóstico de síndrome de rubeola congénita, quien desarrolló glaucoma congénito, insuficiencia aórtica grave, insuficiencia mitral grave y enfermedad miocárdica isquémica. Se realizó procedimiento quirúrgico de revascularización coronaria y recambio valvular mitral y aórtico. Los estudios encontrados durante el proceso de investigación mencionan el daño de los vasos sanguíneos y del miocardio producido por el virus. Con los datos obtenidos se corrobora la baja incidencia de presentación con compromiso coronario y valvular, por lo cual se hace énfasis en la importancia de este caso.

Abstract Rubella is an exanthematous disease that occurs in childhood. If it occurs during pregnancy and there is an effect on the product, it can develop congenital rubella syndrome. The congenital rubella syndrome includes cardiac malformations, which occur in 67% of patients, of which the most common is patent ductus arteriosus, followed by pulmonary valvular stenosis and atrial septal defect. We present the case of a 20-year-old man with a diagnosis of congenital rubella syndrome, presenting with congenital glaucoma, severe aortic insufficiency, severe mitral regurgitation and ischemic myocardial disease. In which a surgical procedure is performed by a coronary revascularization and mitral and aortic valve replacement. Studies found during the research process mention the damage to the blood vessels and myocardium produced by the virus. With the required data, the low incidence of presentation with coronary and valvular involvement is corroborated, which is why the importance of the present case is emphasized.

Apoptotic cell extrusion depends on single-cell synthesis of sphingosine-1-phosphate by sphingosine kinase 2.

Collecting duct cells are physiologically subject to the hypertonic environment of the kidney. This condition is necessary for kidney maturation and function but represents a stress condition that requires active strategies to ensure epithelial integrity. Madin-Darby Canine Kidney (MDCK) cells develop the differentiated phenotype of collecting duct cells when subject to hypertonicity, serving as a model to study epithelial preservation and homeostasis in this particular environment. The integrity of epithelia is essential to achieve the required functional barrier. One of the mechanisms that ensure integrity is cell extrusion, a process initiated by sphingosine-1-phosphate (S1P) to remove dying or surplus cells while maintaining the epithelium barrier. Both types start with the activation of S1P receptor type 2, located in neighboring cells. In this work, we studied the effect of cell differentiation induced by hypertonicity on cell extrusion in MDCK cells, and we provide new insights into the associated molecular mechanism. We found that the different stages of differentiation influence the rate of apoptotic cell extrusion. Besides, we used a novel methodology to demonstrate that S1P increase in extruding cells of differentiated monolayers. These results show for first time that cell extrusion is triggered by the single-cell synthesis of S1P by sphingosine kinase 2 (SphK2), but not SphK1, of the extruding cell itself. Moreover, the inhibition or knockdown of SphK2 prevents cell extrusion and cell-cell junction protein degradation, but not apoptotic nuclear fragmentation. Thus, we propose SphK2 as the biochemical key to ensure the preservation of the epithelial barrier under hypertonic stress.

Características craneofaciales de pacientes obesos en Chile. Estudio Preliminar / Craniofacial characteristics of obese patients in Chile. Preliminary study

Resumen Introducción: La obesidad es un problema a nivel global que enfrenta el siglo XXI y Chile no se escapa de esta realidad. Así como existen características mórbidas de pacientes con obesidad, también existen características craneofaciales similares en estos pacientes. El estado nutricional es un factor que influencia el desarrollo de una persona en general, lo que tiene implicancias en el tratamiento ortodóncico, ortopédico y quirúrgico de las alteraciones maxilo - mandibulares de los pacientes. Objetivo: Investigar si la morfología craneofacial difiere entre los adolescentes obesos y los de peso normal. Métodos: Estudio retrospectivo, se basó en la comparación de medidas craneofaciales obtenidas del análisis cefalométrico, utilizando teleradiografías laterales, de dos grupos: grupo estudio (IMC mayor a 30, obeso) y grupo control (IMC normal). Resultados: Se observaron dimensiones maxilares y mandibulares mayores en el grupo estudio comparado con los pacientes del grupo control. Las medidas para la dimensión maxilar tuvieron diferencia significativamente estadística. Conclusiones: El aumento de peso es un factor importante que puede afectar los patrones de crecimiento craneofacial y debe ser tomado en consideración durante la planificación del tratamiento ortodoncico en pacientes adolescentes.

Abstract Introduction: Obesity is a global problem in the the 21st century and Chile does not escape this reality. Just as there are morbid characteristics of patients with obesity, there also share similar craniofacial characteristics. Nutritional status is a factor that influences the a person´s general development , which has implications in the orthodontic, orthopedic and surgical treatments of maxillo-mandibular alterations. Objective: Investigate whether craniofacial morphology differs between obese and average-weight adolescents. Methods: A retrospective study based on the comparison of craniofacial measures obtained from the cephalometric analysis, using lateral cephalograms, from two groups: study group (BMI over 30, obese) and control group (normal BMI). Greater maxillary and mandibular dimensions were observed in the study group compared to the patients in the control group. The measurements for de maxillary dimension had a statistically significant difference. Conclusions: Weight gain is an important factor that can affect craniofacial growth patterns and should be taken into consideration during the planning of orthodontic treatment in adolescent patients.

Sphingosine kinase and sphingosine-1-phosphate regulate epithelial cell architecture by the modulation of de novo sphingolipid synthesis.

Sphingolipids regulate several aspects of cell behavior and it has been demonstrated that cells adjust their sphingolipid metabolism in response to metabolic needs. Particularly, sphingosine-1-phosphate (S1P), a final product of sphingolipid metabolism, is a potent bioactive lipid involved in the regulation of various cellular processes, including cell proliferation, cell migration, actin cytoskeletal reorganization and cell adhesion. In previous work in rat renal papillae, we showed that sphingosine kinase (SK) expression and S1P levels are developmentally regulated and control de novo sphingolipid synthesis. The aim of the present study was to evaluate the participation of SK/S1P pathway in the triggering of cell differentiation by external hypertonicity. We found that hypertonicity evoked a sharp decrease in SK expression, thus activating the de novo sphingolipid synthesis pathway. Furthermore, the inhibition of SK activity evoked a relaxation of cell-cell adherens junction (AJ) with accumulation of the AJ complex (E-cadherin/ß-catenin/α-catenin) in the Golgi complex, preventing the acquisition of the differentiated cell phenotype. This phenotype alteration was a consequence of a sphingolipid misbalance with an increase in ceramide levels. Moreover, we found that SNAI1 and SNAI2 were located in the cell nucleus with impairment of cell differentiation induced by SK inhibition, a fact that is considered a biochemical marker of epithelial to mesenchymal transition. So, we suggest that the expression and activity of SK1, but not SK2, act as a control system, allowing epithelial cells to synchronize the various branches of sphingolipid metabolism for an adequate cell differentiation program.

Long-term outcomes after radiosurgery for glomus jugulare tumors.

AIMS AND BACKGROUND: The treatment of glomus jugulare tumors (GJT) remains controversial due to high morbidity. Historically, these tumors have primarily been managed surgically. The purpose of this retrospective review was to assess the tumor and clinical control rates as well as long-term toxicity of GJT treated with radiosurgery. METHODS: Between 1993 and 2014, 30 patients with GJT (31 tumors) were managed with radiosurgery. Twenty-one patients were female and the median age was 59 years. Twenty-eight patients (93%) were treated with radiosurgery, typically at 14 Gy ( n = 26), and 2 patients (7%) with stereotactic radiosurgery. Sixteen cases (52%) had undergone prior surgery. RESULTS: The mean follow-up was 4.6 years (range 1.5-12). Crude overall survival, tumor control, clinical control, and long-term grade 1 toxicity rates were 97%, 97%, 97%, and 13% (4/30), respectively. No statistically significant risk factor was associated with lower tumor control in our series. Univariate analysis showed a statistically significant association between patients having 1 cranial nerve (CN) involvement before radiosurgery and a higher risk of lack of improvement of symptoms (odds ratio 5.24, 95% confidence interval 1.06-25.97, p = .043). CONCLUSIONS: Radiosurgery is an effective and safe treatment modality for GJT. Patients having 1 CN involvement before radiosurgery show a higher risk of lack of improvement of symptoms.

Estudio de parásitos geohelmintos en arena de playa "el palito ", municipio puerto cabello , estado Carabobo. Venezuela / Study of helminth parasites in beach sand "el palito ", municipality puerto cabello , state carabobo .venezuela

Las playas representan el principal recurso natural del turismo venezolano. Estas cuentan con parámetros que evalúan su calidad ambiental, donde solo tienen establecidos indicadores biológicos bacterianos y no contemplan la identificación de parásitos en arena de playa, lo que constituye un factor de mayor exposición para infecciones por helmintos. Se realizó cinco muestreos de la playa "El Palito" durante el periodo abril 2014 - abril 2015 para un total de 60 muestras en los meses: abril, junio y septiembre 2014; febrero y abril 2015, considerando diversos factores ambientales así como las temporadas pre-vacacionales y post-vacacionales, la humedad relativa de la arena y las estaciones climáticas de lluvia y sequia según los reportes anuales del Instituto Nacional de Meteorología e Hidrología (INAMEH). El objetivo fue analizar la frecuencia y relación de geo helmintos en arena de playa con condiciones ambientales, mediante el método de Lavado con solución salina 0,85% y sedimentación espontánea, método de Willis y método de Rugai Modificado. No se demostró la recuperación de formas parasitarias patógenas para el humano, indicando que existe baja probabilidad de transmisión zoonótica en la playa evaluada.

The beaches are the main natural resource of the Venezuelan tourism, and Government Institutions provides parameters that evaluate the environmental quality; they only have established bacterial biological indicators and excluding the identification of parasites in beach sand, which leads greater exposure to helminths infections. Five samplings from the beach El Palito was conducted during the period April 2014 - April 2015 for a total of 60 samples in April, June and September 2014; February and April 2015, considering various environmental factors such as the pre-holiday and post-holiday seasons, the relative humidity of the sand and the seasons of rain and drought, according to the annual reports of the National Institute of Meteorology and Hydrology (INAMEH). The aim was to analyze the frequency and ratio geohelminths on beach sand with environmental conditions, by the method of irrigation and spontaneous sedimentation using saline 0.85%, the Willis method and the Rugai Modified method. Recovery of pathogenic parasitic forms for human was not demonstrated, indicating that there is low probability of zoonotic transmission on the beach evaluated.

Changes in ceramide metabolism are essential in Madin-Darby canine kidney cell differentiation.

Ceramides (Cers) and complex sphingolipids with defined acyl chain lengths play important roles in numerous cell processes. Six Cer synthase (CerS) isoenzymes (CerS1-6) are the key enzymes responsible for the production of the diversity of molecular species. In this study, we investigated the changes in sphingolipid metabolism during the differentiation of Madin-Darby canine kidney (MDCK) cells. By MALDI TOF TOF MS, we analyzed the molecular species of Cer, glucosylceramide (GlcCer), lactosylceramide (LacCer), and SM in nondifferentiated and differentiated cells (cultured under hypertonicity). The molecular species detected were the same, but cells subjected to hypertonicity presented higher levels of C24:1 Cer, C24:1 GlcCer, C24:1 SM, and C16:0 LacCer. Consistently with the molecular species, MDCK cells expressed CerS2, CerS4, and CerS6, but with no differences during cell differentiation. We next evaluated the different synthesis pathways with sphingolipid inhibitors and found that cells subjected to hypertonicity in the presence of amitriptyline, an inhibitor of acid sphingomyelinase, showed decreased radiolabeled incorporation in LacCer and cells did not develop a mature apical membrane. These results suggest that hypertonicity induces the endolysosomal degradation of SM, generating the Cer used as substrate for the synthesis of specific molecular species of glycosphingolipids that are essential for MDCK cell differentiation.

Perfil clínico epidemiológico de embarazadas con chikungunya bajo vigilancia epidemiológica en corposalud, estado aragua. año 2014 / Clinical epidemiological profile of pregnant with chikungunya in corposalud watch in state epidemiological aragua 2014

Chikungunya en la mujer embarazada constituye un estado nosológico que pone en peligro la vida materno-infantil durante el periodo perinatal. Con el objetivo de determinar el perfil clínico epidemiológico de embarazadas con Chikungunya bajo vigilancia epidemiológica, se realizo un estudio descriptivo y epidemiológico retrospectivo con una muestra de fichas epidemiológicas de 100 embarazadas con Chikungunya durante el segundo semestre del año 2014.Los datos obtenidos fueron procesados y analizados utilizando medidas de tendencia central, porcentajes e intervalos de confianza. Los resultados indican un promedio de 27 años de edad, siendo el eje Metropolitano de la ciudad de Maracay el de mayor incidencia con 86% de los casos de la entidad federal. El promedio del tiempo de embarazo fue entre las semanas 36 y 40 en 30% de ellas. La red pública representó 53% de las referencias. Las manifestaciones clínicas incluyen fiebre 94%, artralgias 84%, cefalea 75%, erupción cutánea 64%, náuseas y vómitos 45% y 43% respectivamente y disminución sustancial del hematocrito. En la evolución de las gestantes con Chikungunya no se encontró un comportamiento distinto al de la triada clínica de la enfermedad. Se evidenció un buen control prenatal con un estándar normal de 6 controles prenatales. Un bajo porcentaje de las embarazadas ingresó a la unidad de cuidados intensivos. Las complicaciones más frecuentes fueron la preeclamsia grave y la amenaza de parto pretérmino. El mal llenado de las fichas e historias clínicas impidió conocer con detalle los avances significativos en la toma de decisiones con respecto a la enfermedad.

Chikungunya in pregnant women is a nosological state that endangers life maternal and child during the perinatal period. In order to determine the clinical and epidemiological profile of pregnant women with Chikungunya under epidemiological surveillance, descriptive and retrospective epidemiological study with a sample of 100 pregnant epidemiological chips with Chikungunya was conducted during the second half of the year 2014.Los data were processed and analyzed using measures of central tendency, percentages and confidence intervals. The results indicate an average of 27 years of age, being the Metropolitan axis of the city of Maracay the highest incidence with 86% of cases the federal entity. The average length of pregnancy was between weeks 36 and 40 in 30% of them. The public network represented 53% of the references. Clinical manifestations include fever 94%, arthralgia 84%, headache 75%, 64% rash, nausea and vomiting 45% and 43% respectively and substantially decreased hematocrit. In the evolution of pregnant women with Chikungunya a different triad clinical behavior of the disease was found. good prenatal care with a normal standard 6 prenatal visits was evident. A low percentage of pregnant entered the intensive care unit. The most frequent complications were severe preeclampsia and preterm labor. The poor completion of clinical histories and files kept detailed knowledge significant advances in making decisions regarding the disease.

Características craneofaciales de pacientes obesos en Chile. Estudio Preliminar

Introducción: La obesidad es un problema a nivel global que enfrenta el siglo XXI y Chile no se escapa de esta realidad. Así como existen características mórbidas de pacientes con obesidad, también existen características craneofaciales similares en estos pacientes. El estado nutricional es un factor que influencia el desarrollo de una persona en general, lo que tiene implicancias en el tratamiento ortodóncico, ortopédico y quirúrgico de las alteraciones maxilo - mandibulares de los pacientes. Objetivo: Investigar si la morfología craneofacial difiere entre los adolescentes obesos y los de peso normal. Métodos: Estudio retrospectivo, se basó en la comparación de medidas craneofaciales obtenidas del análisis cefalométrico, utilizando teleradiografías laterales, de dos grupos: grupo estudio (IMC mayor a 30, obeso) y grupo control (IMC normal). Resultados: Se observaron dimensiones maxilares y mandibulares mayores en el grupo estudio comparado con los pacientes del grupo control. Las medidas para la dimensión maxilar tuvieron diferencia significativamente estadística. Conclusiones: El aumento de peso es un factor importante que puede afectar los patrones de crecimiento craneofacial y debe ser tomado en consideración durante la planificación del tratamiento ortodoncico en pacientes adolescentes.

Introduction: Obesity is a global problem in the the 21st century and Chile does not escape this reality. Just as there are morbid characteristics of patients with obesity, there also share similar craniofacial characteristics. Nutritional status is a factor that influences the a person´s general development , which has implications in the orthodontic, orthopedic and surgical treatments of maxillo-mandibular alterations. Objective: Investigate whether craniofacial morphology differs between obese and average-weight adolescents. Methods: A retrospective study based on the comparison of craniofacial measures obtained from the cephalometric analysis, using lateral cephalograms, from two groups: study group (BMI over 30, obese) and control group (normal BMI). Greater maxillary and mandibular dimensions were observed in the study group compared to the patients in the control group. The measurements for de maxillary dimension had a statistically significant difference. Conclusions: Weight gain is an important factor that can affect craniofacial growth patterns and should be taken into consideration during the planning of orthodontic treatment in adolescent patients.

Vivir Con Un Corazón Saludable: a Community-Based Educational Program Aimed at Increasing Cardiovascular Health Knowledge in High-Risk Hispanic Women.

BACKGROUND: Hispanic women suffer from high rates of cardiometabolic risk factors and an increasingly disproportionate burden of cardiovascular disease (CVD). Particularly, Hispanic women with limited English proficiency suffer from low levels of CVD knowledge associated with adverse CVD health outcomes. METHODS: Thirty-two predominantly Spanish-speaking Hispanic women completed, Vivir Con un Corazón Saludable (VCUCS), a culturally tailored Spanish language-based 6-week intensive community program targeting CVD health knowledge through weekly interactive health sessions. A 30-question CVD knowledge questionnaire was used to assess mean changes in CVD knowledge at baseline and postintervention across five major knowledge domains including CVD epidemiology, dietary knowledge, medical information, risk factors, and heart attack symptoms. RESULTS: Completion of the program was associated with a statistically significant (p < 0.001) increase in total mean CVD knowledge scores from 39 % (mean 11.7/30.0) to 66 % (mean 19.8/30.0) postintervention consistent with a 68 % increase in overall mean CVD scores. There was a statistically significant (p < 0.001) increase in mean knowledge scores across all five CVD domains. CONCLUSION: A culturally tailored Spanish language-based health program is effective in increasing CVD awareness among high CVD risk Hispanic women with low English proficiency and low baseline CVD knowledge.