Decoding the mechanism governing the structural stability of wheat germ agglutinin and its isolated domains: A combined calorimetric, NMR, and MD simulation study.

Wheat germ agglutinin (WGA) demonstrates potential as an oral delivery agent owing to its selective binding to carbohydrates and its capacity to traverse biological membranes. In this study, we employed differential scanning calorimetry and molecular dynamics simulations to comprehensively characterize the thermal unfolding process of both the complete lectin and its four isolated domains. Furthermore, we present the nuclear magnetic resonance structures of three domains that were previously lacking experimental structures in their isolated forms. Our results provide a collective understanding of the energetic and structural factors governing the intricate unfolding mechanism of the complete agglutinin, shedding light on the specific role played by each domain in this process. The analysis revealed negligible interdomain cooperativity, highlighting instead significant coupling between dimer dissociation and the unfolding of the more labile domains. By comparing the dominant interactions, we rationalized the stability differences among the domains. Understanding the structural stability of WGA opens avenues for enhanced drug delivery strategies, underscoring its potential as a promising carrier throughout the gastrointestinal environment.

Efficacy and Safety of a Tetravalent Dengue Vaccine (TAK-003) in Children With Prior Japanese Encephalitis or Yellow Fever Vaccination.

BACKGROUND: We explored the impact of prior Yellow fever (YF) or Japanese encephalitis (JE) vaccination on the efficacy of Takeda's dengue vaccine candidate, TAK-003 (NCT02747927). METHODS: Children 4-16 years of age were randomized 2:1 to receive TAK-003 or placebo and were under active febrile surveillance. Symptomatic dengue was confirmed by serotype-specific RT-PCR. YF and JE vaccination history was recorded. RESULTS: Of the 20,071 children who received TAK-003 or placebo, 21.1% had a YF and 23.9% had a JE vaccination history at randomization. Fifty-seven months after vaccination, vaccine efficacy was 55.7% (95% CI, 39.7%-67.5%) in those with YF vaccination, 77.8% (70.8%-83.1%) for JE vaccination, and 53.5% (45.4%-60.4%) for no prior YF/JE vaccination. Regional differences in serotype distribution confound these results. The apparent higher vaccine efficacy in the JE vaccination subgroup could be largely explained by serotype-specific efficacy of TAK-003. Within 28 days of any vaccination, the proportions of participants with serious adverse events in the YF/JE prior vaccination population were comparable between the TAK-003 and placebo groups. CONCLUSIONS: The available data do not suggest a clinically relevant impact of prior JE or YF vaccination on TAK-003 performance. Overall, TAK-003 was well-tolerated and efficacious in different epidemiological settings.

Bridging frontiers: The role of a Global Breast Research Working Group.

Breast cancer remains a significant cause of death for women globally, despite advancements in detection and treatment, low- and middle-income countries face unique obstacles. Role of Research Working Group (RWG) can expedite research progress by fostering collaboration between scientists, clinicians, and stakeholders. Benefits of a Global RWG include pooling resources and expertise to develop new research ideas, addressing disparities, and building local research capacity, with the potential to improve breast cancer research and outcomes.

Salud Mental en estudiantes universitarios en aislamiento social durante la pandemia COVID-19. Arequipa, Perú

Introducción: La Pandemia COVID-19, ha tenido impactos negativos en la salud física y mental de las personas, así como las medidas adoptadas por los gobiernos, para prevenir el contagio masivo de la población como el confinamiento, el aislamiento social, el trabajo y educación virtual. Dentro de los afectados por estos cambios, se encontrarían los estudiantes universitarios del área de la salud, que además de estudiar en estas condiciones de pandemia, no han podido hacer sus prácticas de los servicios de salud. Esta situación de exposición al aislamiento, podría afectar la salud mental de los jóvenes estudiantes universitarios. Objetivo: determinar los niveles de depresión, ansiedad y estrés en estudiantes universitarios y su relación con variables sociodemográficas y las características del aislamiento social durante la Pandemia COVID-19. Métodos: Se realizó un estudio descriptivo, observacional, de corte transversal y cuantitativo, con una muestra de 818 estudiantes universitarios de facultades de ciencias de la salud, mediante el cuestionario autoadministrado DASS-21. Resultados: Los principales hallazgos fueron: una mayor prevalencia en niveles altos (severos y extremadamente severos) en la ansiedad, alcanzado casi a 4 de cada 10 de los evaluados; por otro lado, en depresión y el estrés, 2 de cada 10 de los evaluados, se encontraron en los niveles mencionados. En relación con las variables sociodemográficas, las relacionadas con el COVID-19 y aislamiento social, se hallaron diferencias estadísticamente significativas con el género (mujeres > varones), el haber tenido COVID-19 (Sí > No) y vivir con familiares como antes de la pandemia (Sí > No) obtuvieron en promedio mayores puntajes en depresión, ansiedad y estrés. Conclusión: Los estudiantes que presentaron mayor depresión, ansiedad y estrés con una diferencia significativa fueron de género femenino, con antecedentes de haber tenido Covid-19, menor contacto con familiares y haber cumplido con aislamiento social total.

Introduction: The COVID-19 Pandemic has had negative impacts on the physical and mental health of people, as well as the measures adopted by governments to prevent the massive contagion of the population, such as confinement, social isolation, virtual work, and virtual education. Among those affected by these changes would be university students in the health area who, in addition to studying in these pandemic conditions, have been unable to do their health service practices. This situation of exposure to isolation could affect the mental health of young university students. Objective: To determine the levels of depression, anxiety, and stress in university students, their relationship with sociodemographic variables, and the characteristics of social isolation during the COVID-19 Pandemic. Methods: A descriptive, observational, cross-sectional, and quantitative study was carried out with a sample of 818 university students from health sciences faculties using the DASS-21 self-administered questionnaire. Results: The main findings were a higher prevalence of high levels (severe and highly severe) in anxiety, reaching almost 4 out of 10 of those evaluated; On the other hand, in depression and stress, 2 out of 10 of those evaluated were found at the mentioned levels. Concerning the sociodemographic variables, those related to COVID-19 and social isolation, statistically significant differences were found with gender (women > men), having had COVID-19 (Yes > No), and living with relatives as before. On average, the pandemic (Yes > No) obtained higher scores in depression, anxiety, and stress. Conclusion: The students who presented greater depression, anxiety, and stress with a significant difference were female, with a history of having had Covid-19, less contact with family members, and having complied with total social isolation

Protective Role of NS1-Specific Antibodies in the Immune Response to Dengue Virus through Antibody-Dependent Cellular Cytotoxicity.

BACKGROUND: Dengue virus (DENV) non-structural protein 1 (NS1) has multiple functions within infected cells, on the cell surface, and in secreted form, and is highly immunogenic. Immunity from previous DENV infections is known to exert both positive and negative effects on subsequent DENV infections, but the contribution of NS1-specific antibodies to these effects is incompletely understood. METHODS: We investigated the functions of NS1-specific antibodies and their significance in DENV infection. We analyzed plasma samples collected in a prospective cohort study prior to symptomatic or subclinical secondary DENV infection. We measured binding to purified recombinant NS1 protein and to NS1-expressing CEM cells, antibody-mediated NK cell activation by plate-bound NS1 protein, and antibody-dependent cellular cytotoxicity (ADCC) of NS1-expressing target cells. RESULTS: We found that antibody responses to NS1 were highly serotype-cross-reactive and that subjects who experienced subclinical DENV infection had significantly higher antibody responses to NS1 in pre-infection plasma than subjects who experienced symptomatic infection. We observed strong positive correlations between antibody binding and NK activation. CONCLUSIONS: These findings demonstrate the involvement of NS1-specific antibodies in ADCC and provide evidence for a protective effect of NS1-specific antibodies in secondary DENV infection.

Long-term efficacy and safety of a tetravalent dengue vaccine (TAK-003): 4·5-year results from a phase 3, randomised, double-blind, placebo-controlled trial.

BACKGROUND: About half of the world's population lives in dengue-endemic areas. We aimed to evaluate the long-term efficacy and safety of two doses of the tetravalent dengue vaccine TAK-003 in preventing symptomatic dengue disease of any severity and due to any dengue virus (DENV) serotypes in children and adolescents. METHODS: In this ongoing double-blind, randomised, placebo-controlled trial, we enrolled healthy participants aged 4-16 years at 26 medical and research centres across eight dengue-endemic countries (Brazil, Colombia, Dominican Republic, Nicaragua, Panama, Philippines, Sri Lanka, and Thailand). The main exclusion criteria were febrile illness (body temperature ≥38°C) at the time of randomisation, hypersensitivity or allergy to any of the vaccine components, pregnancy or breastfeeding, serious chronic or progressive disease, impaired or altered immune function, and previous receipt of a dengue vaccine. Participants were randomly assigned 2:1 (stratified by age and region) using an interactive web response system and dynamic block assignment to receive two subcutaneous doses of TAK-003 or placebo 3 months apart. Investigators, participants, and their parents or legal guardians were blinded to group assignments. Active febrile illness surveillance and RT-PCR testing of febrile illness episodes were performed for identification of virologically confirmed dengue. Efficacy outcomes were assessed in the safety analysis set (all randomly assigned participants who received ≥1 dose) and the per protocol set (all participants who had no major protocol violations), and included cumulative vaccine efficacy from first vaccination to approximately 4·5 years after the second vaccination. Serious adverse events were monitored throughout. This study is registered with ClinicalTrials.gov, NCT02747927. FINDINGS: Between Sept 7, 2016, and March 31, 2017, 20 099 participants were randomly assigned (TAK-003, n=13 401; placebo, n=6698). 20 071 participants (10 142 [50·5%] males; 9929 [49·5%] females; safety set) received TAK-003 or placebo, with 18 257 (91·0%) completing approximately 4·5 years of follow-up after the second vaccination (TAK-003, 12 177/13 380; placebo, 6080/6687). Overall, 1007 (placebo: 560; TAK-003: 447) of 27 684 febrile illnesses reported were virologically confirmed dengue, with 188 cases (placebo: 142; TAK-003: 46) requiring hospitalisation. Cumulative vaccine efficacy was 61·2% (95% CI 56·0-65·8) against virologically confirmed dengue and 84·1% (77·8-88·6) against hospitalised virologically confirmed dengue; corresponding efficacies were 53·5% (41·6-62·9) and 79·3% (63·5-88·2) in baseline seronegative participants (safety set). In an exploratory analysis, vaccine efficacy was shown against all four serotypes in baseline seropositive participants. In baseline seronegative participants, vaccine efficacy was shown against DENV-1 and DENV-2 but was not observed against DENV-3 and low incidence precluded evaluation against DENV-4. During part 3 of the trial (approximately 22-57 months after the first vaccination), serious adverse events were reported for 664 (5·0%) of 13 380 TAK-003 recipients and 396 (5·9%) of 6687 placebo recipients; 17 deaths (6 in the placebo group and 11 in the TAK-003 group) were reported, none were considered study-vaccine related. INTERPRETATION: TAK-003 demonstrated long-term efficacy and safety against all four DENV serotypes in previously exposed individuals and against DENV-1 and DENV-2 in dengue-naive individuals. FUNDING: Takeda Vaccines. TRANSLATIONS: For the Portuguese, Spanish translations and plain language summary of the abstract see Supplementary Materials section.

Anterolateral Thoracotomy: A Novel and Simple Technique to Improve the Closure Using the Self Locking Knot.

Thoracotomy is defined as an incision made by the surgeon in the chest wall in order to allow visibility of the thoracic cavity content. This can be used by surgeons to treat thoracic cavity content diseases including the heart, lungs, esophagus, and other organs. Thoracic incision closure remains an item with no consensus. Therefore, we present an easy way and give a little tip for closure using the slipknot that will allow the correct approach of ribs and the successful closure of the intercostal space.

Ruptura de hematoma hepático secundario a terapia neural / Rupture of hepatic hematoma secondary to neural therapy

Objetivo: determinar si la terapia neural es una opción de tratamiento que pueda ser utilizada sin la aparición de efectos adversos. Presentación del caso: se presenta y analiza el caso de una paciente que ingresó a urgencias por dolor abdominal generalizado diagnosticándose hematoma hepático y realizándosele una revisión de la literatura científica. Resultados: se procedió a efectuar laparotomía con cirugía de control de daños, obteniendo resultados satisfactorios con egreso hospitalario sin complicaciones agregadas. Conclusiones: la terapia neural es un tratamiento del cual no se tiene suficiente evidencia científica que avale su seguridad en los pacientes

Objective: to determine whether neural therapy is a treatment option which can be used without the occurrence of adverse effects. Case report: we present and analyze the case of a female patient who was admitted to the emergency room for generalized abdominal pain. A hepatic hematoma was diagnosed, and a review of the scientific literature was conducted. Results: a laparotomy with damage control surgery was performed, obtaining satisfactory outcomes, with hospital discharge without any added complications. Conclusions: neural therapy is a treatment for which there is not enough scientific evidence to support its safety in patients

Use of hand-held ultrasound to perform E-FAST by general surgery residents in a trauma reference center: First experience in the Colombian Caribbean region / Uso de ecografía portátil para realizar E-FAST por residentes de cirugía general en un centro de referencia en trauma: primera experiencia en la región del Caribe colombiano

Introduction. Extended focused assessment with sonography for trauma (E-FAST) can be performed with minimal training and achieve ideal results. It allows easy transport and use in austere environments such as the Colombian Caribbean, where many centers do not have 24-hour radiology services. The objective of this study was to determine the performance of the use of E-FAST in the evaluation of trauma by second-year general surgery residents in the emergency department. Methods. Retrospective observational study that evaluated the diagnostic performance of E-FAST with Butterfly IQ, in patients with thoracoabdominal trauma, who attended a referral center in the Colombian Caribbean between November 2021 and July 2022. Sensitivity, specificity, and positive and negative predictive values were evaluated, compared with intraoperative findings or conventional imaging. Results. A total of 46 patients were included, with a mean age of 31.2 ± 13.8 years, 87.4% (n=39) were male. The main mechanism of trauma was penetrating (n=32; 69.5%). It was found that 80.4% (n=37) of the patients had a positive E-FAST result, and of these, 97% (n=35) had a positive intraoperative finding. Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 75%, 94.6%, and 66.6%, respectively. The positive likelihood ratio was 3.68, while the negative likelihood ratio was 0.10. Conclusion. General surgery residents have the competence to perform accurate E-FAST scans. The hand-held ultrasound device is an effective diagnostic tool for trauma and acute care surgery patients.

Introducción. La evaluación enfocada extendida con ecografía en trauma (E-FAST, extended focused assessment with sonography for trauma) puede realizarse con entrenamiento mínimo y lograr resultados ideales. Su fácil transporte permite usarla en entornos austeros, como el Caribe colombiano, donde muchos centros no disponen de servicio radiológico las 24 horas. El objetivo de este estudio fue determinar el rendimiento del uso de E-FAST por residentes de cirugía general de segundo año en la evaluación del paciente con trauma en urgencias. Métodos. Estudio observacional retrospectivo que evaluó el rendimiento diagnóstico de E-FAST con Butterfly IQ, en pacientes con trauma toracoabdominal que acudieron a un centro de referencia del Caribe colombiano, entre noviembre de 2021 y julio de 2022. Se evaluaron sensibilidad, especificidad, valores predictivos positivo y negativo, comparando la descripción de la ecografía con los hallazgos intraoperatorios o imagenología convencional. Resultados. Se incluyeron un total de 46 pacientes, con una media de edad de 31,2 ± 13,8 años, siendo el 87,4 % (n=39) hombres. El principal mecanismo de trauma fue penetrante (n=32; 69,5 %). Se encontró que el 80,4 % (n=37) de los pacientes tuvo resultado E-FAST positivo, y que, de estos, el 97 % (n=35) tuvo un hallazgo positivo intraoperatorio. Se calculó una sensibilidad de 92,1 %, especificidad de 75 %, valor predictivo positivo de 94,6 % y negativo de 66,6 %; la razón de verosimilitud positiva fue de 3,68 y la negativa de 0,10. Conclusión. Los residentes de cirugía general están capacitados para realizar exploraciones E-FAST precisas. El ecógrafo portátil es una herramienta de diagnóstico eficaz para pacientes traumatizados.

Return to play after rotator cuff tear in National Football League athletes.

Background: Rotator cuff tears are rare injuries in National Football League (NFL) athletes and there are limited data to help guide players and team physicians. The purpose of this study was to assess return to play (RTP) rates, performance levels, and career length following a rotator cuff tear during their playing career. Methods: Using publicly available data, we identified players who sustained a rotator cuff tear between 2000 and 2019. Demographic information, treatment (operative vs. nonoperative), RTP rate, preinjury and postinjury performance score, position, and career length were entered into the analysis. Results: Twenty-nine athletes with a mean age of 27.4 years (±3.1) at the time of injury were included in this study. Forty-eight percent were offensive and 52% defensive players. 79.3% (23/29) were able to RTP at the same professional level for an average of 2.8 ± 3.4 years. The average time to RTP after injury was 198.4 ± 125.3 days. The average age of players who RTP was 26.7 ± 2.5 years compared to those who did not (30.3 ± 3.7, P = .02). Similarly, the preinjury NFL career length was 4.0 ± 2.2 in players who RTP compared to those who did not (7.5 ± 2.7, P = .01). Most injuries (82.2%) were treated surgically; however, there was no significant difference (P > .05) in RTP rates, performance score, or career longevity between operative and nonoperative cohorts. Conclusion: Overall RTP rates for NFL athletes following a rotator cuff injury are promising with approximately 80% returning at the same performance level regardless of treatment type. Older, veteran players particularly those over the age of 30 were significantly less likely to RTP and should be counseled accordingly.

Voluntary Hydration with Skimmed Lactose-Free Milk during Exercise in the Heat: Exploring Effectiveness and Tolerance.

Replacement of fluid losses (dehydration) during sports activities in the heat has been investigated with different beverages. Bovine milk has been recommended for post-exercise rehydration, but its use during exercise may provoke gastrointestinal disorders. This study compared voluntary fluid intake, hydration, and incidence and severity of gastrointestinal (GI) disorders during exercise in the heat under three conditions: no drink (ND), water (W), and skimmed lactose-free milk (SM). Sixteen physically active university students exercised at 32 °C and 70% RH for 90 min at 60-75% HRmax while drinking W or SM ad libitum, or ND assigned at random. A questionnaire explored possible GI disorders. Ad libitum intake was higher (p < 0.05) for water (1206.2 mL) than milk (918.8 mL). Dehydration showed significant differences for SM versus W and ND (W = 0.28% BM; SM = -0.07% BM; ND = 1.38% BM, p < 0.05). Urine volume was significantly higher (p < 0.05) in the W condition (W = 220.4 mL; SM = 81.3 mL; ND = 86.1 mL). Thick saliva, belching, and abdominal pain were higher for SM, but scores were low. Skimmed lactose-free milk is a suitable, effective alternative to be consumed as a hydration beverage during moderate-intensity cycling in the heat for 90 min.

Robust neural decoding for dexterous control of robotic hand kinematics.

BACKGROUND: Manual dexterity is a fundamental motor skill that allows us to perform complex daily tasks. Neuromuscular injuries, however, can lead to the loss of hand dexterity. Although numerous advanced assistive robotic hands have been developed, we still lack dexterous and continuous control of multiple degrees of freedom in real-time. In this study, we developed an efficient and robust neural decoding approach that can continuously decode intended finger dynamic movements for real-time control of a prosthetic hand. METHODS: High-density electromyogram (HD-EMG) signals were obtained from the extrinsic finger flexor and extensor muscles, while participants performed either single-finger or multi-finger flexion-extension movements. We implemented a deep learning-based neural network approach to learn the mapping from HD-EMG features to finger-specific population motoneuron firing frequency (i.e., neural-drive signals). The neural-drive signals reflected motor commands specific to individual fingers. The predicted neural-drive signals were then used to continuously control the fingers (index, middle, and ring) of a prosthetic hand in real-time. RESULTS: Our developed neural-drive decoder could consistently and accurately predict joint angles with significantly lower prediction errors across single-finger and multi-finger tasks, compared with a deep learning model directly trained on finger force signals and the conventional EMG-amplitude estimate. The decoder performance was stable over time and was robust to variations of the EMG signals. The decoder also demonstrated a substantially better finger separation with minimal predicted error of joint angle in the unintended fingers. CONCLUSIONS: This neural decoding technique offers a novel and efficient neural-machine interface that can consistently predict robotic finger kinematics with high accuracy, which can enable dexterous control of assistive robotic hands.

La sed ¿un mecanismo suficiente para lograr euhidratación?: una revisión narrativa / Is thirst sufficient as a mechanism for achieving euhydration? a narrative review

Capitán, C. y Aragón, L.F. (2023). La sed ¿un mecanismo suficiente para lograr euhidratación?: una revisión narrativa. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. El papel de la percepción de sed para mantener el balance hídrico ha sido ampliamente estudiado, tanto durante el ejercicio como después de este. Sin embargo, la forma de evaluarla y la eficacia de los instrumentos existentes son aún áreas que necesitan más investigación. El objetivo de esta revisión fue integrar, de forma general, la información disponible en la literatura sobre el funcionamiento del mecanismo de la sed como respuesta a la deshidratación durante y después del ejercicio. Se explican los mecanismos fisiológicos y las respuestas de estos durante y posterior al ejercicio; además, se describen los instrumentos disponibles en la literatura científica, sus debilidades y fortalezas, y se plantea una serie de preguntas que aún no tienen respuesta en el área. En esta revisión se presenta el aspecto teórico de los mecanismos de la sed, además, se discuten los estudios científicos que respaldan o refutan el comportamiento de estos mecanismos en el ejercicio. Finalmente, se hace un resumen de las principales conclusiones extraídas de la literatura científica sobre la sed como un mecanismo suficiente para prevenir la deshidratación tanto durante como después del ejercicio.

Capitán, C. y Aragón, L.F. (2023). Is thirst sufficient as a mechanism for achieving euhydration? a narrative review. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. The role of thirst perception for keeping hydric balance, both during and after exercise, has been extensively studied. However, the way to assess it and the effectiveness of the existing instruments are areas that still require further research. The objective of this review is to integrate, in a general way, the information available in the literature on the functioning of the thirst mechanism as a response to dehydration during and after exercise. The physiological mechanisms and their responses during and after exercise are explained. In addition, a description of the instruments available in scientific literature is included, together with their weaknesses and strengths, and a series of as yet unanswered questions in this area are raised. This review presents the theoretical aspect of thirst mechanisms, and discusses the scientific studies that support or refute the behavior of these mechanisms in exercise. Finally, a summary is made of the major conclusions drawn from the scientific literature on thirst as a sufficient mechanism to prevent dehydration both during and after exercise.

Capitán, C. y Aragón, L.F. (2023). A sede é um mecanismo suficiente para alcançar a hidratação? uma revisão narrativa. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 21(1), 1-16. O papel da percepção da sede na manutenção do equilíbrio hídrico tem sido amplamente estudado, tanto durante quanto após o exercício. Entretanto, como avaliá-la e a eficácia dos instrumentos existentes ainda são áreas que necessitam de mais pesquisas. Esta revisão visou integrar, de forma geral, as informações disponíveis na literatura sobre o funcionamento do mecanismo da sede em resposta à desidratação durante e após o exercício. Ele explica os mecanismos fisiológicos e suas respostas durante e após o exercício, descreve os instrumentos disponíveis na literatura científica, seus pontos fracos e fortes, e levanta uma série de questões que permanecem sem resposta no campo. Esta revisão apresenta o aspecto teórico dos mecanismos da sede e discute os estudos científicos que respaldam ou refutam o comportamento desses mecanismos no exercício. Finalmente, é feito um resumo das principais conclusões extraídas da literatura científica sobre a sede como mecanismo suficiente para prevenir a desidratação tanto durante quanto após o exercício.

Surgical research in Colombia part 3: Authorship and publications of Colombian medical students in surgery in Colombian medical journals-cross-sectional study.

Research training, scientific activity and publications are cornerstones of academic surgery. Knowing the activity and trends of medical students aspiring to become surgeons it allows to identify gaps and skills to be strengthened. Currently, there is no data on the authorship and scientific activity of medical students in surgery in Latin America and Colombia. Methods: A bibliometric cross-sectional study was carried out, in which the Colombian medical journals were reviewed from 2010 to 2020. The articles with topics in general surgery and subspecialties where the authorship of medical students could be identified, were selected. Data on the sociodemographic and scientific characteristics of the authors and their publications were extracted and analyzed. Results: A total of 14 383 articles from 34 Colombian medical journals were reviewed. From 2010 to 2020, 807 articles related to surgery were published in Colombia. The most frequent typology of these articles was original articles (n=298; 37%), followed by case reports (n=222; 28.2%) and reviews (n=137; 17.3%). A total of 132 medical students and 141 authorships and were found, specifically in 9.9% (n=80/807) of these publications, with a higher frequency in original articles (n=32; 40%) and case reports (n=29; 36.2%). Collaboration of students with professors or surgeons was evidenced in 97.5% of the publications. Conclusions: The authorship of Colombian medical students in scientific publications in surgery in Colombian medical journals was low. From 2010 to 2020, student authors were found in 1 out of every 10 publications, mainly in original articles and clinical cases.

De una idea a una publicación original en cirugía: Una guía para futuros cirujanos académicos. Capítulo Futuros Cirujanos, Asociación Colombiana de Cirugía / From an idea to an original publication in surgery: A guide for future academic surgeons. Future Surgeons Chapter, Colombian Surgical Association

Introducción. Recientemente, se ha evidenciado un crecimiento exponencial de artículos de estudiantes y autores jóvenes; sin embargo, la mayoría de esos artículos no han sido citados. El objetivo de este artículo fue presentar un manual de fácil interpretación, aplicable durante el proceso de construcción de un manuscrito académico original en cirugía. Métodos. Se realizó una revisión sistemática de la literatura en las bases de datos académicas, utilizando las palabras clave "manuscrito académico", "cirugía", "investigación" y "how to do it", así como sinónimos. Se incluyeron estudios originales, revisiones y las directrices STROCSS 2021, publicadas hasta marzo de 2023. Resultados. Se logró recopilar una guía empírica, con recomendaciones y directrices útiles para la creación de un manuscrito académico en cirugía, óptima para uso en todos los niveles académicos. Conclusión. Se deben brindar herramientas que sean aplicables en todos los niveles educativos, desde un estudiante hasta cirujano graduado. Con este artículo se buscan dar a conocer un camino para transformar una idea en una publicación científica original de alto impacto, de forma metódica y fácil de entender, actuando como un incentivo y facilitador para la producción científica y académica en cirugía para Colombia y Latinoamérica

Introduction. Recently, there has been an exponential growth of articles by students and young authors; however, most of the articles have not been cited. This review presents an easy-to-interpret manual, applicable during the process of writing an original academic manuscript in surgery. Methods. A systematic literature review was performed in academic databases using the keywords "Academic Manuscript", "Surgery", "Research" and "How to do it", as well as synonyms; the search date was performed until March 2023, where original studies, reviews and STROCSS 2021 guidelines were included. Results. It was possible to compile an empirical guide, with useful recommendations and guidelines for the creation of an academic manuscript in surgery, optimal for use at all academic levels. Conclusion. Tools should be provided that are applicable at all educational levels, from a student to a graduate surgeon. The authors seek to show a way to transform an idea into an original scientific publication of high impact, in a methodical and easy to understand way, so this article acts as an incentive and facilitator for scientific and academic production in surgery in Colombia and Latin America

GRINCIRCAR: una iniciativa para promover la cirugía académica e investigación quirúrgica en el caribe colombiano / GRINCIRCAR: an initiative to promote academic surgery and surgical research in the Colombian Caribbean

Introducción. La investigación quirúrgica es uno de los pilares de la cirugía académica, que integra el microambiente para lograr una adecuada práctica basada en la evidencia, realizar planteamientos y conseguir eventuales soluciones a necesidades quirúrgicas de una población. En el caribe colombiano existen brechas significativas en cuanto al aporte en investigación quirúrgica, comparado con otras regiones del país. Por ende, es necesaria una iniciativa que haga frente a estos retos. Métodos. El Grupo Colaborativo de Investigación en Cirugía General y Subespecialidades del Caribe Colombiano (GRINCIRCAR), es una iniciativa fundada por una colectividad de estudiantes de medicina, médicos residentes de cirugía y cirujanos académicos de universidades del caribe colombiano, que buscan impulsar la investigación quirúrgica y aportar a la resolución de problemas de salud en cirugía de la región. Discusión. De acuerdo al programa de investigación con políticas y prioridades en salud establecidos por el Instituto Nacional de Salud, existen por lo menos dos dimensiones donde se involucra directamente la cirugía. A pesar de esto, no existen datos sobre la distribución de recursos para la investigación quirúrgica en la región del Caribe colombiano, pese a que el acceso al cuidado quirúrgico básico y las enfermedades quirúrgicas, hace parte de las prioridades en salud y cirugía global. Conclusiones. Se necesita promover la cirugía académica y la investigación quirúrgica en la región del caribe colombiano. La investigación colaborativa podría ser una solución al integrar la participación de múltiples centros y participantes

Introduction. Surgical research is one of the cornerstones of academic surgery, which integrates the microenvironment to achieve an adequate evidence-based practice, asking the right questions to achieve eventual solutions to the surgical needs of a population. In the Colombian Caribbean, there are significant gaps in the contribution in surgical research, compared to other regions of the country. Therefore, an initiative is needed to address these challenges. Methods. The Collaborative Group for Research in General Surgery and Subspecialties of the Colombian Caribbean (GRINCIRCAR) is an initiative founded by a group of medical students, surgical residents and academic surgeons from Colombian Caribbean universities, who seek to promote surgical research and contribute to solutions of health problems in surgery in the region. Discussion. According to the research program, health policies and priorities established by the National Institute of Health, there are at least two dimensions where surgery is directly involved. Despite this, there are no data on the distribution of resources for surgical research in the Colombian Caribbean region, despite the fact that access to basic surgical care and surgical diseases are part of the priorities in global health and surgery. Conclusions. There is a need to promote academic surgery and surgical research in the Colombian Caribbean region. Collaborative research in the region could be a solution by integrating the participation of multiple centers and participants

Celiac disease seroprevalence in patients with infertility. A case-control study.

BACKGROUND: Although most patients with celiac disease (CD) have digestive manifestations, in some of them they may be of extraintestinal (atypical) nature, such as chronic anemia, ataxia, and fertility disorders. OBJECTIVE: To determine the prevalence of CD-related antibodies in Mexican women with fertility disorders. MATERIAL AND METHODS: Case-control study of women who attended evaluation for fertility disorders in a specialized center. h-tTG-IgA, gliadin IgA II and gliadin IgG II were quantified; titers > 30 IU were considered positive. RESULTS: One-hundred and seventy-one cases and 171 controls were included; 137 patients (80.1%) had infertility, and 34 (19.9%), sterility. Eight patients (4.6%, 95% CI = 2.3-8.9) had at least one positive marker for CD in comparison with one woman in the control group (0.5%, 95% CI = 0.01-3, p = 0.04, odds ratio = 8.3). Six of the eight patients had unexplained infertility. CONCLUSIONS: Up to 4.6% of women with infertility had at least one positive marker for CD. As in other parts of the world, screening for CD could be recommended in women with infertility, especially in those with unexplained infertility.

ANTECEDENTES: Aunque los pacientes con enfermedad celiaca (EC) tienen en su mayoría manifestaciones digestivas, algunos pueden presentarlas de índole extraintestinal (atípicas), como anemia crónica, ataxia y trastornos de la fertilidad. OBJETIVO: Determinar la prevalencia de anticuerpos relacionados con EC en mujeres mexicanas con trastornos de la fertilidad. MATERIAL Y MÉTODOS: Estudio de casos y controles de mujeres que acudieron a valoración por trastornos de la fertilidad en un centro especializado. Se cuantificó h-tTG IgA, gliadina IgA II y gliadina IgG II; los títulos > 30 UI fueron considerados como positivos. RESULTADOS: Se incluyeron 171 casos y 171 controles; 137 pacientes (80.1 %) tuvieron infertilidad y 34 (19.9 %), esterilidad. Ocho pacientes (4.6 %, IC 95 % = 2.3-8.9) tuvieron al menos un marcador positivo para EC comparadas con una mujer del grupo control (0.5 %, IC 95 % = 0.01-3, p = 0.04, razón de momios = 8.3). Seis de las ocho pacientes presentaron infertilidad inexplicable. CONCLUSIONES: Hasta 4.6 % de las mujeres con infertilidad presentó al menos un marcador positivo para EC. Al igual que en otras partes del mundo, podría recomendarse el escrutinio para EC en mujeres con infertilidad, en especial en quienes padecen infertilidad inexplicable.

Seroprevalencia de enfermedad celiaca en pacientes con infertilidad. Un estudio de casos y controles / Celiac disease seroprevalence in patients with infertility. A case-control study

Resumen Antecedentes: Aunque los pacientes con enfermedad celiaca (EC) tienen en su mayoría manifestaciones digestivas, algunos pueden presentarlas de índole extraintestinal (atípicas), como anemia crónica, ataxia y trastornos de la fertilidad. Objetivo: Determinar la prevalencia de anticuerpos relacionados con EC en mujeres mexicanas con trastornos de la fertilidad. Material y métodos: Estudio de casos y controles de mujeres que acudieron a valoración por trastornos de la fertilidad en un centro especializado. Se cuantificó h-tTG IgA, gliadina IgA II y gliadina IgG II; los títulos > 30 UI fueron considerados como positivos. Resultados: Se incluyeron 171 casos y 171 controles; 137 pacientes (80.1 %) tuvieron infertilidad y 34 (19.9 %), esterilidad. Ocho pacientes (4.6 %, IC 95 % = 2.3-8.9) tuvieron al menos un marcador positivo para EC comparadas con una mujer del grupo control (0.5 %, IC 95 % = 0.01-3, p = 0.04, razón de momios = 8.3). Seis de las ocho pacientes presentaron infertilidad inexplicable. Conclusiones: Hasta 4.6 % de las mujeres con infertilidad presentó al menos un marcador positivo para EC. Al igual que en otras partes del mundo, podría recomendarse el escrutinio para EC en mujeres con infertilidad, en especial en quienes padecen infertilidad inexplicable.

Abstract Background: Although most patients with celiac disease (CD) have digestive manifestations, in some of them they may be of extraintestinal (atypical) nature, such as chronic anemia, ataxia, and fertility disorders. Objective: To determine the prevalence of CD-related antibodies in Mexican women with fertility disorders. Material and methods: Case-control study of women who attended evaluation for fertility disorders in a specialized center. h-tTG-IgA, gliadin IgA II and gliadin IgG II were quantified; titers > 30 IU were considered positive. Results: One-hundred and seventy-one cases and 171 controls were included; 137 patients (80.1%) had infertility, and 34 (19.9%), sterility. Eight patients (4.6%, 95% CI = 2.3-8.9) had at least one positive marker for CD in comparison with one woman in the control group (0.5%, 95% CI = 0.01-3, p = 0.04, odds ratio = 8.3). Six of the eight patients had unexplained infertility. Conclusions: Up to 4.6% of women with infertility had at least one positive marker for CD. As in other parts of the world, screening for CD could be recommended in women with infertility, especially in those with unexplained infertility.

Asynchronous axonal firing patterns evoked via continuous subthreshold kilohertz stimulation.

Objective.Transcutaneous electrical stimulation of peripheral nerves is a common technique to assist or rehabilitate impaired muscle activation. However, conventional stimulation paradigms activate nerve fibers synchronously with action potentials time-locked with stimulation pulses. Such synchronous activation limits fine control of muscle force due to synchronized force twitches. Accordingly, we developed a subthreshold high-frequency stimulation waveform with the goal of activating axons asynchronously.Approach.We evaluated our waveform experimentally and through model simulations. During the experiment, we delivered continuous subthreshold pulses at frequencies of 16.67, 12.5, or 10 kHz transcutaneously to the median and ulnar nerves. We obtained high-density electromyographic (EMG) signals and fingertip forces to quantify the axonal activation patterns. We used a conventional 30 Hz stimulation waveform and the associated voluntary muscle activation for comparison. We modeled stimulation of biophysically realistic myelinated mammalian axons using a simplified volume conductor model to solve for extracellular electric potentials. We compared the firing properties under kHz and conventional 30 Hz stimulation.Main results.EMG activity evoked by kHz stimulation showed high entropy values similar to voluntary EMG activity, indicating asynchronous axon firing activity. In contrast, we observed low entropy values in EMG evoked by conventional 30 Hz stimulation. The muscle forces evoked by kHz stimulation also showed more stable force profiles across repeated trials compared with 30 Hz stimulation. Our simulation results provide direct evidence of asynchronous firing patterns across a population of axons in response to kHz frequency stimulation, while 30 Hz stimulation elicited synchronized time-locked responses across the population.Significance.We demonstrate that the continuous subthreshold high-frequency stimulation waveform can elicit asynchronous axon firing patterns, which can lead to finer control of muscle forces.