Development of an Online Distance Learning Platform Combining Anatomy, Imaging, and Surgical Practice to Support Mastery Learning of the Equine Locomotor Apparatus.

There are many challenges in teaching veterinary anatomy, such as available classroom time, costs, and difficulties accessing animal cadavers, mainly due to animal welfare concerns. Furthermore, veterinary surgeons and radiologists complain that recent graduates lack anatomical knowledge. On the other hand, the current limitations of face-to-face teaching due to the COVID-19 pandemic suggest that the development of online distance education tools is necessary, mainly in specialties that lack this type of material. Teaching platforms promoting the integration of anatomy with other applied disciplines such as imaging and surgery in the horse were not found in the consulted literature. Therefore, this work aimed to develop an online distance education platform for studying the surgical anatomy of a horse's locomotor apparatus as a complementary tool for training students enrolled in undergraduate courses in veterinary surgery. The locomotor apparatus was chosen as the focus as it is the most commonly found in equine surgeries. Anatomical pieces referring to the locomotor apparatus were prepared. These were complemented with material related to diagnostic imaging, surgery videos, theoretical explanations, and an interactive radiological anatomy tool. Finally, all the material was uploaded to a virtual platform accessible via the Internet. The platform is expected to be a tool that helps students in surgical training and prepares them with a better understanding of anatomy and its application in surgery.

Inflammation and pro-resolution inflammation after hepatobiliary surgery.

BACKGROUND: The magnitude of the perioperative inflammatory response plays a role in surgical outcomes. However, few studies have explored the mechanisms of the resolution of inflammation in the context of surgery. Here, we described the temporal kinetics of interleukin-6, cortisol, lipoxin A4, and resolvin D in patients who underwent oncologic liver resections. METHODS: All patients gave written informed consent. Demographic and perioperative surgical data were collected, along with blood samples, before surgery and on the mornings of postoperative days 1, 3, and 5. Interleukin-6, cortisol, lipoxin-A4, and resolvin D were measured in plasma. A P value < 0.05 was considered statistically significant. RESULTS: Forty-one patients were included in the study. Liver resection for colorectal metastatic disease was the most commonly performed surgery. The plasma concentrations of interleukin-6 were highest on day 1 after surgery and remained higher than the baseline up to postoperative day 1. Postoperative complications occurred in 14 (24%) patients. Cortisol concentrations spiked on postoperative day 1. The concentrations of lipoxin A4 and resolvin D were lowest on day 1 after surgery. CONCLUSIONS: The inflammatory response associated with hepatobiliary surgery is associated with low circulating concentrations of lipoxin A4 and resolvin D that mirror, in an opposite manner, the kinetics of interleukin 6 and cortisol. TRIAL REGISTRATION: NCT01438476.

Towards Low Energy Atrial Defibrillation.

A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF) power transmitter (ex vivo) and a passive (battery free) implantable power receiver (in vivo) that enables measurement of the intracardiac impedance (ICI) during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter) and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform). An initial prototype was implemented and tested. In low-power (sense) mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock) mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR) or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR) chronosymmetric (6ms/6ms) amplitude asymmetric (negative phase at 50% magnitude) shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current) power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50-300 V). Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ) = 1.62 Ω), p < 0.01) while spectral analysis across frequency also revealed a significant variation in the impedance-amplitude-spectrum-area (IAMSA) within the same patient group (|∆(IAMSAS1-IAMSAS3)[1 Hz - 20 kHz] = 20.82 Ω-Hz (SD(σ) = 10.77 Ω-Hz), p < 0.01); both trends being absent in all patients that failed to cardiovert. Efficient transcutaneous power transfer and sensing of ICI during cardioversion are evidenced as key to the advancement of low-energy atrial defibrillation.

Characterization of Radiation Shielding Capabilities of High Concentration PLA-W Composite for 3D Printing of Radiation Therapy Collimators.

This work evaluates the radiation shielding capabilities of the PLA-W composite for MV energy photons emitted by a linear accelerator and the feasibility of manufacturing a clinically-used collimator grid in spatially fractionated radiotherapy (SFRT) using the material extrusion (MEX) 3D printing technique. The PLA-W filament used has a W concentration of 93% w/w and a green density of 7.51 g/cm3, characteristics that make it suitable for this purpose. Relevant parameters such as the density and homogeneity distribution of W in the manufactured samples determine the mass attenuation coefficient, directly affecting the radiation shielding capacities, so different printing parameters were evaluated, such as layer height, deposition speed, nozzle temperature, and infill, to improve the protection performance of the samples. Additionally, physical and mechanical tests were conducted to ensure structural stability and spatial variability over time, which are critical to ensure precise spatial modulation of radiation. Finally, a complete collimator grid measuring 9.3 × 9.3 × 7.1 cm3 (consisting of 39 conical collimators with a diameter of 0.92 cm and center-to-center spacing of 1.42 cm) was manufactured and experimentally evaluated on a clinical linear accelerator to measure the radiation shielding and dosimetric parameters such as mass attenuation coefficient, half-value layer (HVL), dosimetric collimator field size, and inter-collimator transmission using radiochromic films and 2D diode array detectors, obtaining values of 0.04692 cm2/g, 2.138 cm, 1.40 cm, and 15.6%, respectively, for the parameters in the study. This shows the viability of constructing a clinically-used collimator grid through 3D printing.

Posttraumatic Amputations Epidemiology and Outcomes Within the National Trauma Data Bank: Improved Survival Over Time Results in Increased Population in Need of Rehabilitation Support.

OBJECTIVE: Acute trauma care has significantly reduced mortality over the last two decades. The last study to examine the epidemiology of traumatic amputees predates these gains. The majority of those who sustain traumatic amputation are male; therefore, limited data exist on female amputees. This study aimed to (1) provide a current epidemiological analysis of traumatic amputees and (2) compare male and female amputees. DESIGN: All patients sustaining a major limb amputation in the National Trauma Data Bank from 2013 to 2017 were identified. First, descriptive analyses of patient demographics and injury characteristics were performed and compared with a previous 2000-2004 National Trauma Data Bank study. Second, female and male traumatic amputees were compared in this study. RESULTS: From 2013 to 2017, we identified 7016 patients who underwent major limb amputation. Compared with previous years, the current amputees were older and more severely injured. Mortality was 6.3% in the current years compared with 13.4% in the previous years (odds ratio, 0.44, 95% CI = 0.37-0.51, P < 0.001). After multivariable analysis, mortality remained significantly decreased, with no difference in hospital length of stay. CONCLUSIONS: Contemporary National Trauma Data Bank analysis demonstrated that patients with traumatic amputations, regardless of sex, often survive until hospital discharge, despite more severe injuries.

Complete chloroplast genome of the marine red alga Rhodochorton tenue (Rhodochortonaceae, Rhodophyta) from San Juan Island, Washington.

We present the complete chloroplast genome sequence of Rhodochorton tenue from San Juan Island, Washington. The chloroplast genome of R. tenue is 192,037 bp in length, contains 244 genes, and is similar in content to Acrochaetium secundatum. Rhodochorton tenue is genetically distinct from Rhodochorton purpureum from the North Atlantic Ocean.

Advancing tree genomics to future proof next generation orchard production.

The challenges facing tree orchard production in the coming years will be largely driven by changes in the climate affecting the sustainability of farming practices in specific geographical regions. Identifying key traits that enable tree crops to modify their growth to varying environmental conditions and taking advantage of new crop improvement opportunities and technologies will ensure the tree crop industry remains viable and profitable into the future. In this review article we 1) outline climate and sustainability challenges relevant to horticultural tree crop industries, 2) describe key tree crop traits targeted for improvement in agroecosystem productivity and resilience to environmental change, and 3) discuss existing and emerging genomic technologies that provide opportunities for industries to future proof the next generation of orchards.

[Development of the INSABI educational strategy: a lesson learned from the COVID-19 epidemic]. / Desarrollo de la estrategia educativa del INSABI: una lección aprendida a partir de la epidemia de COVID-19.

The Institute for Health for Well-being (INSABI according to its initials in Spanish), in collaboration with the National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), instituted the Continuous Training on clinical management "Mexico against COVID-19" in 2020, with the purpose of training the frontline health personnel in the care for patients with COVID-19 in the context of hospital reconversion through the COVIDUTI platform. Virtual conferences were held for medical personnel from all over the country with the possibility of interacting with various specialists. In 2020, 215 sessions were held and 158 in 2021. That year educational content was expanded and included topics for other health categories, such as nursing and social work. In October 2021, it was established the Health Educational System for Well-being (SIESABI), with the aim of promoting continuous and permanent education for health workers. It currently offers face-to-face and virtual courses, permanent seminars, and telementoring, with the possibility of providing academic follow-up to its subscribers and linking priority courses that are on other platforms. The educational platform is an opportunity to unify the efforts of the health system in Mexico in the continuous and permanent education of professionals who care for people without social security and thereby contribute to the implementation of a model of care based on primary health care (PHC).

El Instituto de Salud para el Bienestar (INSABI), en colaboración con el Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), instituyó el entrenamiento continuo sobre manejo clínico "México contra COVID-19" en 2020, con el propósito de capacitar al personal de salud de primera línea en la atención de pacientes con COVID-19 en el contexto de la reconversión hospitalaria mediante la plataforma COVIDUTI. Se realizaron conferencias virtuales dirigidas a personal médico de todo el país con la posibilidad de interactuar con diversos especialistas. En 2020 se realizaron 215 sesiones y 158 en 2021. Ese año se ampliaron contenidos educativos y se incluyeron temas para otras categorías de salud, como enfermería y trabajo social. En octubre de 2021 se estableció el Sistema Educativo de Salud para el Bienestar (SIESABI), con el objetivo de promover la educación continua y permanente para los trabajadores de la salud. Actualmente ofrece cursos presenciales, virtuales, seminarios permanentes y telementorías, con la posibilidad de dar seguimiento académico a sus suscriptores y vincular cursos prioritarios que están en otras plataformas. La plataforma educativa es una oportunidad para unificar los esfuerzos del sistema de salud en México en la educación continua y permanente de los profesionales que atienden a personas sin seguridad social y, con ello, contribuir en la implementación de un modelo de atención basado en Atención Primaria de Salud (APS).

Dorsal root ganglion toll-like receptor 4 signaling contributes to oxaliplatin-induced peripheral neuropathy.

ABSTRACT: Activation of toll-like receptor 4 (TLR4) in the dorsal root ganglion (DRG) and spinal cord contributes to the generation of paclitaxel-related chemotherapy-induced peripheral neuropathy (CIPN). Generalizability of TLR4 signaling in oxaliplatin-induced CIPN was tested here. Mechanical hypersensitivity developed in male SD rats by day 1 after oxaliplatin treatment, reached maximum intensity by day 14, and persisted through day 35. Western blot revealed an increase in TLR4 expression in the DRG of oxaliplatin at days 1 and 7 after oxaliplatin treatment. Cotreatment of rats with the TLR4 antagonist lipopolysaccharide derived from Rhodobacter sphaeroides ultrapure or with the nonspecific immunosuppressive minocycline with oxaliplatin resulted in significantly attenuated hyperalgesia on day 7 and 14 compared with rats that received oxaliplatin plus saline vehicle. Immunostaining of DRGs revealed an increase in the number of neurons expressing TLR4, its canonical downstream signal molecules myeloid differentiation primary response gene 88 (MyD88) and TIR-domain-containing adapter-inducing interferon-ß, at both day 7 and day 14 after oxaliplatin treatment. These increases were blocked by cotreatment with either lipopolysaccharide derived from Rhodobacter sphaeroides or minocycline. Double staining showed the localization of TLR4, MyD88, and TIR-domain-containing adapter-inducing interferon-ß in subsets of DRG neurons. Finally, there was no significant difference in oxaliplatin-induced mechanical hypersensitivity between male and female rats when observed for 2 weeks. Furthermore, upregulation of TLR4 was detected in both sexes when tested 14 days after treatment with oxaliplatin. These findings suggest that the activation of TLR4 signaling in DRG neurons is a common mechanism in CIPN induced by multiple cancer chemotherapy agents.

After a disaster: Validation of PTSD checklist for DSM-5 and the four- and eight-item abbreviated versions in mental health service users.

Posttraumatic stress disorder (PTSD) is a common and disabling condition developing in one of four survivors after an earthquake. Brief and self-reported validated measures for assessing PTSD symptom severity are necessary to improve care access and assess disorder progress and treatment response. Therefore, we evaluated the psychometric properties of the PTSD-Checklist for the DSM-5 (PCL-5) of 20-, 8- and 4-item in patients that sought specialized mental health services after a catastrophic earthquake that stroke Mexico on September 19th, 2017. The internal consistency of 20-, 8- and 4-item PCL-5 was adequate (≥.7). Using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) as a reference, signal detection analyses revealed a PCL-5 score of 27 as optimal (sensitivity = .96, specificity = .73) for identifying probable PTSD cases. The shortened versions highly correlated with the full PCL-5 and had comparable diagnostic utility. Our results indicate that the 20-item PCL-5 and the abridged versions can effectively identify possible PTSD cases. The 8-item version has better psychometric properties and more consistent diagnostic utility across time and civil populations. These measures must be evaluated in independent samples to corroborate their utility in different populations and regarding diverse traumatic events.

Evaluation of the Covalent Functionalization of Carbon Nano-Onions with Pyrene Moieties for Supercapacitor Applications.

Herein, we report the surface functionalization of carbon nano-onions (CNOs) through an amidation reaction that occurs between the oxidized CNOs and 4-(pyren-4-yl)butanehydrazide. Raman and Fourier transform infrared spectroscopy methods were used to confirm the covalent functionalization. The percentage or number of groups in the outer shell was estimated with thermal gravimetric analysis. Finally, the potential applications of the functionalized CNOs as electrode materials in supercapacitors were evaluated by cyclic voltammetry and electrochemical impedance spectroscopy. Functionalization increased the specific capacitance by approximately 138% in comparison to that of the pristine CNOs, while acid-mediated oxidation reduced the specific capacitance of the nanomaterial by 24%.

α-DTC70 Fullerene Performs Significantly Better than ß-DTC70 as Electron Transporting Material in Perovskite Solar Cells.

In this work, two new C70 isomers, α and ß bis(2-(thiophen-2-yl)ethyl)-C70-fullerene mono-adducts (DTC70), were synthesized, characterized and used as electron transporting materials (ETMs) in perovskite solar cells (PSCs). Our results show that the α isomer improves both the J sc and FF values of the devices, when compared to the results for the ß-isomer and to those for phenyl-C70-butyric acid methyl ester (PC71BM), used as control. Devices based on α-DTC70 achieved a power conversion efficiency (PCE) of 15.9%, which is higher than that observed with PC71BM (15.1%).

Preparation of Chitosan/Poly(Vinyl Alcohol) Nanocomposite Films Incorporated with Oxidized Carbon Nano-Onions (Multi-Layer Fullerenes) for Tissue-Engineering Applications.

Recently, tissue engineering became a very important medical alternative in patients who need to regenerate damaged or lost tissues through the use of scaffolds that support cell adhesion and proliferation. Carbon nanomaterials (carbon nanotubes, fullerenes, multi-wall fullerenes, and graphene) became a very important alternative to reinforce the mechanical, thermal, and antimicrobial properties of several biopolymers. In this work, five different formulations of chitosan/poly(vinyl alcohol)/oxidized carbon nano-onions (CS/PVA/ox-CNO) were used to prepare biodegradable scaffolds with potential biomedical applications. Film characterization consisted of Fourier-transform infrared (FTIR) spectroscopy, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), tension strength, Young's modulus, X-ray diffraction spectroscopy (XRD), scanning electron microscopy (SEM), and energy-dispersive spectroscopy (EDS). The degradation in a simulated body fluid (FBS) demonstrated that all the formulations lost between 75% and 80% of their weight after 15 days of treatment, but the degradation decreased with the ox-CNO content. In vivo tests after 90 days of subdermal implantation of the nanocomposite films in Wistar rats' tissue demonstrated good biocompatibility without allergenic reactions or pus formation. There was a good correlation between FBS hydrolytic degradation and degradation in vivo for all the samples, since the ox-CNO content increased the stability of the material. All these results indicate the potential of the CS/PVA/ox-CNO nanocomposite films in tissue engineering, especially for long-term applications.

Autonomic Dysfunction in α-Synucleinopathies.

The α-synucleinopathies are a group of neurodegenerative diseases characterized by abnormal accumulation of insoluble α-synuclein in neurons and glial cells, comprising Parkinson's disease (PD), dementia with Lewy bodies (DLB) and multiple system atrophy (MSA). Although varying in prevalence, symptom patterns, and severity among disorders, all α-synucleinopathies have in common autonomic nervous system dysfunctions, which reduce quality of life. Frequent symptoms among α-synucleinopathies include constipation, urinary and sexual dysfunction, and cardiovascular autonomic symptoms such as orthostatic hypotension, supine hypertension, and reduced heart rate variability. Symptoms due to autonomic dysfunction can appear before motor symptom onset, particularly in MSA and PD, hence, detection and quantitative analysis of these symptoms can enable early diagnosis and initiation of treatment, as well as identification of at-risk populations. While patients with PD, DLB, and MSA show both central and peripheral nervous system involvement of α-synuclein pathology, pure autonomic failure (PAF) is a condition characterized by generalized dysregulation of the autonomic nervous system with neuronal cytoplasmic α-synuclein inclusions in the peripheral autonomic small nerve fibers. Patients with PAF often present with orthostatic hypotension, reduced heart rate variability, anhydrosis, erectile dysfunction, and constipation, without motor or cognitive impairment. These patients also have an increased risk of developing an α-synucleinopathy with central involvement, such as PD, DLB, or MSA in later life, possibly indicating a pathophysiological disease continuum. Pathophysiological aspects, as well as developments in diagnosing and treating dysautonomic symptoms in patients with α-synucleinopathies are discussed in this review.