Investigation of the relationship between red blood cell distribution width and mortality in patients with hemophagocytic lymphohistiocytosis: a retrospective study

ABSTRACT BACKGROUND: Red blood cell distribution width (RDW) is related to sepsis-related mortality. Hemophagocytic lymphohistiocytosis (HLH) is a syndrome caused by severe infection, tumors, or autoimmunity without a specific diagnosis. OBJECTIVE: To explore the correlation between RDW and mortality in patients with HLH. DESIGN AND SETTING: A retrospective study conducted in a hospital in China. METHODS: A total of 101 inpatients with HLH from January 1, 2017 to December 31, 2021 were divided into non-survivor (n = 52) and survivor (n = 49) groups. A non-parametric test was used to analyze demographic, clinical, and laboratory data between groups. Independent variables with P < 0.05 were analyzed using binary logistic regression to screen out mortality-related variables. Selected variables were subjected to multivariate logistic regression analysis, and those with strong correlations were screened. Receiver operating characteristic (ROC) curves of strongly correlated variables and area under curve (AUC) values were obtained. RESULTS: The APACHE II score, RDW, and platelet (PLT) and fibrinogen (FIB) levels (P < 0.05) different significantly. RDW, PLT, FIB were correlated with mortality. The AUC values of RDW, PLT, and FIB were 0.857, 0.797, and 0.726, respectively. RDW was associated with mortality in patients with HLH (P < 0.01, cut-off value: 16.9). The sensitivity and specificity of predicting mortality were 97.96% and 96.1%, respectively. CONCLUSION: Logistic regression analysis showed a correlation between RDW and patients' mortality. Therefore, RDW can be used to predict mortality in patients with HLH.

Correlation between mental quality and training intensity in university swimmers / Correlação entre qualidade mental e intensidade de treinamento de nadadores universitários / Correlación entre la calidad mental y la intensidad del entrenamiento en nadadores universitarios

ABSTRACT Introduction: We should pay attention to physical and psychological training still in the growth phase of athletes to ensure a better overall performance quality. Psychological training can be an effective tool to improve the technical level and skills of swimming. Objective: This paper discusses the relationship between mental health education and training intensity in college swimmers. Methods: The mental health of professional swimmers in college sports is explored with study subjects undergoing a 10-week training trial. The comparison of clinical effects between various psychological training modalities and swimmers' self-management is analyzed. In a second step, this paper performs statistics and analysis on the questionnaire and experimental data. Results: The exercise ability of the control group was significantly improved after relaxation training, tension training, and thought control training (P<0.05). The results showed that the learning effect of the experimental group was significantly better than that of the control group (P<0.05). Conclusion: Psychological training and self-regulation in training have a good effect on improving the mental quality of competitive sports players. This approach improves athletes' performance more effectively than other approaches. The psychological self-regulation training method is one that swimming coaches should pay attention to and advocate vigorously. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Devemos prestar atenção aos exercícios físicos e psicológicos ainda na fase do crescimento dos atletas para garantir uma melhor qualidade geral de seu desempenho. O treinamento psicológico pode ser uma ferramenta eficaz para melhorar o nível técnico e as habilidades da natação. Objetivo: Este artigo discute a relação entre educação em saúde mental e intensidade de treinamento nos nadadores universitários. Métodos: A saúde mental de nadadores profissionais em esportes universitários é explorada com os sujeitos do estudo sendo submetidos a um teste de treinamento de 10 semanas. A comparação dos efeitos clínicos entre diversas modalidades de formação psicológica é executada e analisa-se a autogestão dos nadadores. Num segundo momento, este artigo realiza estatísticas e análises sobre o questionário e dados experimentais. Resultados: A capacidade de exercício do grupo controle foi significativamente melhorada após o treinamento de relaxamento, treinamento de tensão e treinamento de controle de pensamento (P<0,05). Os resultados mostraram que o efeito de aprendizagem do grupo experimental foi significativamente melhor do que o do grupo controle (P<0,05). Conclusão: O treinamento psicológico da autorregulação no treinamento tem um bom efeito na melhoria da qualidade mental dos jogadores esportivos competitivos. Essa abordagem melhora o desempenho do atleta de forma mais eficaz do que outras abordagens. O método de treinamento psicológico da autorregulação é um método que os treinadores de natação devem prestar atenção e defender vigorosamente. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Debemos prestar atención al entrenamiento físico y psicológico todavía en la fase de crecimiento de los deportistas para garantizar una mejor calidad general de su rendimiento. El entrenamiento psicológico puede ser una herramienta eficaz para mejorar el nivel técnico y las habilidades de natación. Objetivo: Este trabajo analiza la relación entre la educación en salud mental y la intensidad del entrenamiento en nadadores universitarios. Métodos: Se explora la salud mental de los nadadores profesionales de deportes universitarios con sujetos de estudio sometidos a una prueba de entrenamiento de 10 semanas. Se realiza la comparación de los efectos clínicos entre varias modalidades de entrenamiento psicológico y se analiza la autogestión de los nadadores. En un segundo paso, este documento realiza estadísticas y análisis sobre el cuestionario y los datos experimentales. Resultados: La capacidad de ejercicio del grupo de control mejoró significativamente tras el entrenamiento de relajación, el entrenamiento de tensión y el entrenamiento de control del pensamiento (P<0,05). Los resultados mostraron que el efecto de aprendizaje del grupo experimental fue significativamente mejor que el del grupo de control (P<0,05). Conclusión: El entrenamiento psicológico de la autorregulación en el entrenamiento tiene un buen efecto en la mejora de la calidad mental de los jugadores deportivos de competición. Este enfoque mejora el rendimiento de los atletas de forma más eficaz que otros enfoques. El método de entrenamiento de autorregulación psicológica es uno de los que los entrenadores de natación deberían prestar atención y defender enérgicamente. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Matrix-assisted laser desorption/ionisation-time of flight mass spectrometry azole susceptibility assessment in Candida and Aspergillus species

BACKGROUND Matrix-assisted laser desorption/ionisation-time of flight mass spectrometry (MALDI-TOF MS) allows rapid pathogen identification and potentially can be used for antifungal susceptibility testing (AFST). OBJECTIVES We evaluated the performance of the MALDI-TOF MS in assessing azole susceptibility, with reduced incubation time, by comparing the results with the reference method Broth Microdilution. METHODS Resistant and susceptible strains of Candida (n = 15) were evaluated against fluconazole and Aspergillus (n = 15) against itraconazole and voriconazole. Strains were exposed to serial dilutions of the antifungals for 15 h. Microorganisms' protein spectra against all drug concentrations were acquired and used to generate a composite correlation index (CCI) matrix. The comparison of autocorrelations and cross-correlations between spectra facilitated by CCI was used as a similarity parameter between them, enabling the inference of a minimum profile change concentration breakpoint. Results obtained with the different AFST methods were then compared. FINDINGS The overall agreement between methods was 91.11%. Full agreement (100%) was reached for Aspergillus against voriconazole and Candida against fluconazole, and 73.33% of agreement was obtained for Aspergillus against itraconazole. MAIN CONCLUSIONS This study demonstrates MALDI-TOF MS' potential as a reliable and faster alternative for AFST. More studies are necessary for method optimisation and standardisation for clinical routine application.

Assisted training model for improving the three-point shootout in basketball / Modelo de treinamento assistido para aperfeiçoamento da cesta de três pontos no basquetebol / Modelo de entrenamiento asistido para mejorar las canastas de tres puntos en baloncesto

ABSTRACT Introduction The outcome of basketball games is based on scoring, and basketball rules are discussed from a qualitative point of view. The three-point basket is the key to the game's success; improving this shot's percentage will ensure success. Objective Explore the key elements of a successful three-point shot, discussing its effective improvements. Methods This paper randomly selects 26 students from a particular basketball class as volunteers for the research. Before starting the experiment, the subjects were divided into control and experimental groups; they were grouped according to their test scores. Four data of three-point shot rate, jump shot, and shot after dribbling are analyzed according to the grouping of players. The data were statistically treated for better appreciation of the results. Results Although the throws improved in both groups, the improvement was insignificant (P>0.05). After nine weeks of exercise, the success rate of three-point baskets in both the experimental and control groups improved. The improvement in the three-point basket was the greatest in the experimental group (P<0.05). Conclusion Functional strength training can significantly improve the rate of long-range 3-point baskets in basketball players. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O resultado dos jogos de basquetebol é baseado na pontuação e as regras do basquete são discutidas de um ponto de vista qualitativo. A cesta de três pontos é a chave para o sucesso do jogo e melhorar a porcentagem desse lançamento garantirá o sucesso na partida. Objetivo Explorar os elementos-chave de uma tacada de três pontos de sucesso, discutindo suas melhoras efetivas. Métodos Este artigo seleciona aleatoriamente 26 alunos de uma determinada turma de basquetebol como voluntários para a pesquisa. Antes de iniciar a experiência, os sujeitos foram divididos em grupos controle e experimental, foram agrupados de acordo com os resultados do teste. Analisa-se quatro dados de taxa de lance com três pontos, lance com salto e lance após drible, de acordo com o agrupamento de jogadores. Os dados foram tratados estatisticamente para melhor apreciação dos resultados. Resultados Embora os lances tenham melhorado em ambos os grupos, a melhoria não foi significativa (P>0,05). Após nove semanas de exercício, a taxa de sucesso de cestas com três pontos, tanto no grupo experimental quanto no grupo de controle demonstrou um aperfeiçoamento. A melhora na cesta em três pontos foi a maior no grupo experimental (P<0,05). Conclusão O treinamento de força funcional pode melhorar significativamente a taxa de cestas de 3 pontos de longo alcance nos jogadores de basquetebol. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El resultado de los partidos de baloncesto se basa en la puntuación y las reglas del baloncesto se discuten desde un punto de vista cualitativo. La canasta de tres puntos es la clave del éxito del juego y mejorar el porcentaje de este tiro asegurará el éxito en el juego. Objetivo Explorar los elementos clave de un tiro de tres puntos exitoso, discutiendo sus mejoras efectivas. Métodos Este trabajo selecciona al azar a 26 estudiantes de una clase particular de baloncesto como voluntarios para la investigación. Antes de comenzar el experimento, los sujetos se dividieron en grupos de control y experimentales, y se agruparon en función de las puntuaciones obtenidas en las pruebas. Se analizan cuatro datos de la tasa de tiros de tres puntos, de los tiros en salto y de los tiros después de driblar según la agrupación de jugadores. Los datos fueron tratados estadísticamente para una mejor apreciación de los resultados. Resultados Aunque los lanzamientos se optimizaron en ambos grupos, la mejora no fue significativa (P>0,05). Después de nueve semanas de ejercicio, la tasa de éxito en las canastas de tres puntos, tanto en el grupo experimental como en el de control, mostró una mejora. La mejora en la canasta de tres puntos fue mayor en el grupo experimental (P<0,05). Conclusión El entrenamiento de fuerza funcional puede mejorar significativamente el índice de canastas de 3 puntos de largo alcance en jugadores de baloncesto. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Differential levels of soybean resistance to the whitefly Bemisia tabaci (Hemiptera: Aleyrodidae) under controlled and uncontrolled environments are associated with plant age, damage intensity, and trichome density

Whiteflies are a severe threat to soybean production in the tropics. This study aimed to evaluate the soybean resistance level of the whitefly Bemisia tabaci in controlled and uncontrolled environments that is associated with plant age, damage intensity, and trichome density. The research was conducted under two conditions: non-sprayed (NS) and sprayed (SP). This study used 50 soybean genotypes arranged in a randomized block design with three replicates. The whitefly population was derived from natural infestations. The results showed that the highest wild population of B. tabaci occurred at 40 days after planting (DAP), i.e., 126.08 adults/plant in the NS environment and 22.57 adults/plant in the SP environment. The peak damage intensity occurred at 50 DAP, 20.71% in the NS environment, and 17.15% in the SP environment. In the NS environment, there were six resistant genotypes (including the resistant control G100H), 25 moderate, and 19 susceptible genotypes. In the SP environment, 19 genotypes were resistant, 22 genotypes were moderate, and nine genotypes were susceptible, respectively. Six soybean genotypes showed consistent resistance to B. tabaci in NS and SP environments. The low density of leaf trichomes in soybean may influence the high resistance to B. tabaci. The resistant genotypes identified in this study could be utilized in breeding programs for B. tabaci resistance.

Analysis of Suitable Processing Time of Rehmanniae Radix Praeparata Processed with Amomi Fructus and Citri Reticulatae Pericarpium Based on UPLC-Q-TOF-MS / 中国实验方剂学杂志

ObjectiveTo investigate the relative content changes of differential metabolites and reducing sugars during the processing process of Rehmanniae Radix Praeparata （RRP） processed with Amomi Fructus （AF） and Citri Reticulatae Pericarpium （CRP）， and to lay the foundation for revealing the processing principle of this characteristic variety. MethodThe samples of the 0-54 h processing process of RRP processed with AF and CRP were taken as the research object， and their secondary metabolites were detected by ultra performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS）. The 0.1% formic acid aqueous solution （A）-acetonitrile （B） was used as the mobile phase for gradient elution （0-1 min， 1%-3%B； 1-10 min， 3%-9%B； 10-15 min， 9%-12%B； 15-22 min， 12%-18%B； 22-31 min， 18%-24%B； 31-35 min， 24%-100%B； 35-36 min， 100%-5%B； 36-40 min， 5%-1%B； 40-45 min， 1%B）， column temperature was 40 ℃， injection volume was 3 μL， flow rate was 0.3 mL·min-1. Electrospray ionization （ESI） was used to scan and collect MS data in the negative ion mode， the scanning range was m/z 50-1 250. Data analysis was carried out using PeakView 1.2 software， and the chemical composition of RRP processed with AF and CRP was identified by combining the literature information and chemical composition databases. The MS data were normalized by MarkerView 1.2， and then the multivariate statistical analysis was applied to screen the differential metabolites， and the changes of the relative contents of the differential metabolites with different processing times was analyzed， finally， correlation analysis was performed between the differential metabolites， the change of the reducing sugar content was combined to determine the most suitable processing time of RRP processed with AF and CRP. ResultA total of 121 compounds were identified from RRP processed with AF and CRP at different processing times， and 12 differential metabolites were screened out by multivariate statistical analysis， including catalpol， hesperidin， isoacteoside， acteoside， narirutin， echinacoside， isomartynoside， decaffeoylacteoside， 6-O-E-feruloylajugol， dihydroxy-7-O-neohesperidin， jionoside D， and rehmapicroside. With the prolongation of processing time， the relative contents of these 12 differential metabolites and reducing sugars changed slightly at 52-54 h. ConclusionUPLC-Q-TOF-MS can comprehensively and accurately identify the chemical constituents of RRP processed with AF and CRP at different processing times， and the suitable processing time of 52-54 h is determined according to the content changes of different metabolites and reducing sugars， which provides a basis for revealing the scientific connotation of the processing principle of this variety.

Comprehensive evaluation of the quality of Eriobotrya japonica leaves from different producing areas based on entropy weight TOPSIS method / 中国药房

OBJECTIVE To comprehensively evaluate the quality of Eriobotrya japonica leaves from different producing areas. METHODS The contents of alcohol-soluble extracts were determined by hot-dipping method using 30 batches of E. japonica leaves from different producing areas as samples. The contents of total flavonoids and total triterpene acids were determined by ultraviolet spectrophotometry. The contents of five kinds of triterpenic acids （euscaphic acid，crataegolic acid，corosolic acid，oleanolic acid and ursolic acid） were determined by HPLC. The quality of E. japonica leaves from different producing areas was comprehensively evaluated by using entropy weight technique for order preference by similarity to an ideal solution （TOPSIS）. The bivariate correlation analysis of E. japonica leaves was conducted by SPSS 22.0 software in terms of weight， comprehensive evaluation value， the content of alcohol-soluble extract， the contents of total flavonoids， total triterpene acids and five triterpenic acids. RESULTS The contents of alcohol-soluble extract in 30 batches of E. japonica leaves were （24.56±0.08）%-（34.85±0.13）%； the contents of total flavonoids were （4.69±0.11）-（14.23±0.27） mg/g； the contents of total triterpene acid were （27.58±0.59）- （63.95±1.27） mg/g； the contents of euscaphic acid， crataegolic acid， corosolic acid， oleanolic acid and ursolic acid were （0.728± 0.011）-（6.064±0.063）， （0.526±0.013）-（3.245±0.022）， （1.222±0.025）-（8.807±0.094）， （0.856±0.021）-（2.931±0.075）， （4.704±0.087）-（11.806±0.283） mg/g， respectively. The analysis result of entropy weight TOPSIS method showed that the top three samples with comprehensive evaluation values （No.Kjcx-5） were S14 （Huotian Town， Yunxiao County， Zhangzhou，Fujian）， S19 （Qinnan District， Qinzhou， Guangxi） and S29 （Guoyang County， Bozhou， Anhui）. Comprehensive evaluation 0596-2559522。E-mail：jxrcwxp@163.com of E. japonica leaves was positively correlated with the contents of five kinds of triterpenic acids， such as euscaphic acid， crataegolic acid， corosolic acid， oleanolic acid and ursolic acid （P＜0.01）. The weight of E. japonica leaves was positively correlated with the comprehensive evaluation value （P＜0.01）. CONCLUSIONS The qualities of E. japonica leaves from different producing areas are very different. Among them， the qualities of E. japonica leaves from Huotian Town， Yunxiao County， Zhangzhou of Fujian， Qinzhou Qinnan District of Guangxi， and Bozhou Guoyang County of Anhui are relatively better. The weight of E. japonica leaves is positively correlated with their quality.

Research progress on the correlation between breastfeeding and occurrence of breast cancer / 公共卫生与预防医学

Breast cancer is the most common malignant tumor of the female reproductive system with a high incidence rate and is one of the main causes of cancer-related deaths in women. Modern research believes that pregnancy, breastfeeding, and other reproductive behaviors can cause the changes in the levels of female estrogen and progesterone and related receptors, and affect the morphology and function of breast tissue, which are associated with the occurrence of breast cancer. This paper aims to summarize the impact of breastfeeding on the occurrence of breast cancer and analyze their correlation to increase the maternal breastfeeding rate, reduce the occurrence of breast cancer, and lower the risk of breast cancer in women.

Investigation of pharmacodynamic material basis of Schisandra chinensis in the treatment of allergic asthma / 中国药房

OBJECTIVE To study the pharmacological basis of Schisandra chinensis in the treatment of allergic asthma. METHODS The common components of 10 batches of S. chinensis from different habitats were analyzed by UPLC-Q-TOF-MS/MS. Furthermore， the allergic asthma model was established by intraperitoneal injection of ovalbumin （OVA） and aluminum hydroxide for stimulation combined with atomization exitation； general behavioral observation and the contents of interferon γ （IFN-γ）， interleukin-4 （IL-4） and immunoglobulin E （IgE） in serum were taken as criteria for evaluating the therapeutic effect of S. chinensis from different habitats in the treatment of allergic asthma. Correlation coefficients between common peak area and efficacy evaluation index of each batch of medicinal material were analyzed through grey correlation degree and Pearson correlation analysis. RESULTS A total of 21 common components were identified in 10 batches of S. chinensis from different habitats. After administration of S. chinensis， symptoms such as shortness of breath， sneezing and curling of rats were alleviated. In addition， the content of IFN-γ was significantly increased while the contents of IL-4 and IgE in serum were distinctly decreased （P＜0.01）. Grey correlation analysis showed that 11 common components had high correlation coefficients with IFN-γ， IL-4 and IgE （rˉ＞0.8）. Pearson correlation analysis showed that 8 components were significantly positively correlated with the content of IFN-γ （P＜ 0.05）， and 9， 8 components were significantly negatively correlated with the content of IL-4 and IgE （P＜0.05）. Based on the results of grey correlation degree and Pearson correlation analysis， 7 components such as peak 3， 4， 6， 7， 9， 19 and 20， were highly related to S. chinensis in the treatment of allergic asthma. CONCLUSIONS Schisandrol A， schisandrin B， schisandrin C， gomisin M2， gomisin J， pregomisin and angeloylgomisin H are the potential pharmacodynamic substance basis of S. chinensis in the treatment of allergic asthma.

Association of epidemiological characteristics and dietary patterns with risk of type 2 diabetic nephropathy / 公共卫生与预防医学

Objective To study the prevalence of diabetic nephropathy (DN) and the relationship between dietary pattern and risk. Methods From August 2018 to May 2021, 655 T2DM patients in Wuhan Puren Hospital, including 338 males and 317 females, were divided into T2DM group (n=368 cases) and DN group (n=287 cases) according to whether patients had DN. The uniformly trained staff of our hospital used the simplified version of food intake frequency questionnaire designed for diabetes to investigate the reasonable dietary intake of patients in nearly one year. Clinical data of patients in the two groups were collected and the intake of protein, fat, carbohydrate and dietary fiber in the two groups was statistically analyzed. Logistics regression was used to analyze the formula independent risk factors of DN in T2DM, and Pearson correlation analysis was performed on the incidence of diabetic nephropathy and dietary pattern. Results Among of 655 T2DM patients, there were 287 (43.82%) patients with DN, including 149 males and 138 females. The average age, duration of diabetes, smoking in DN group were significantly higher than those in T2DM group (P0.05). Energy, protein intake, carbohydrate and fat intake in DN group were significantly higher than those in T2DM group (P<0.05). Multivariate logistic regression analysis showed that protein, carbohydrate and fat intake were independent risk factors for DEVELOPING DN in T2DM patients (P<0.05). According to Pearson correlation analysis, the risk of developing DN in T2DM patients was positively correlated with protein and fat intake (r=0.449 , 0.517, P<0.05). Conclusion PATIENTS with T2DM have a higher risk of DEVELOPING DN, which is closely related to dietary intake. Reasonable allocation of dietary intake can reduce the risk of developing DN.

Government effectiveness and child development in low-middle income countries: COVID-19 pre-pandemic time / Efectividad del gobierno y desarrollo infantil en países de ingresos bajos-medianos: período previo a la pandemia COVID-19

ABSTRACT Introduction: The effect of the COVID- 19 pandemic on the development of children is still uncertain; therefore, it is essential to estimate their development status in the time before the pandemic. The sustainable development goals favor all the resources and strategies to stimulate early childhood development. Government effectiveness is the central axis of developing such actions, policies, and procedures. Methods: We used the early child development module and index from national health surveys (MICS) of 33 countries to calculate the children on track. We also use the World Bank Governance Index, specifically the effective governance score. In addition, we carry out analysis with ArcGIS and GeoDa software to evaluate geographic correlations between the variables studied and identify geographic patterns of child development levels and effective governance. Pearson and Spearman correlation tests were performed in Stata 15.1 software. Results: We studied children from 33 low and middle-income countries; from 7 world regions. Thailand (91.1%) and Turkmenistan (90.7%) have the highest percentages of child development and the lowest in Burundi (39.6%). The lowest value on GE estimate is in Burundi (-1.3), and the highest in the Democratic Republic of Korea (1.0). In the GE Rank, the highest values are again in Korea (82.1%), and the lowest in Haiti (0.9%). The correlation grade between ECDI and GE Estimate was moderate positive (0.522, P-0.001, Correlation Spearman test), similarly to (0.518, P-0001, Pearson correlation test). The general spatial pattern prevails that the African regions present low government effectiveness and early child development scores, positively correlated in this study. Conclusions: With the most up-to-date data reported by countries, it is possible to establish the level of child development before 2019, the year in which the COVID-2019 pandemic began. Studies must be carried out during and after the pandemic to develop the direct and indirect damage received by children in the dimensions of development, in which the government response is decisive.

Resumen Introducción: El efecto que tendrá la pandemia de COVID- 19 en el desarrollo de los niños aún es incierto, por lo que es importante estimar su estado en el tiempo anterior a la pandemia. Los objetivos de desarrollo sostenible exigen favorecer todos los recursos y estrategias para estimular el desarrollo de la primera infancia. La efectividad del gobierno es el eje central del desarrollo de tales acciones, políticas y estrategias en todos los países, especialmente en los países de ingresos bajos y medianos. Métodos: se usó El módulo de desarrollo infantil temprano y el índice de las encuestas nacionales de salud (MICS) de 33 países, para calcular los niños que van por buen camino en su desarrollo. También se utilizó el Índice de Gobernanza del Banco Mundial, específicamente el puntaje de Gobernanza Efectiva. Además, se realizaron análisis con el software ArcGIS y GeoDa para evaluar correlaciones geográficas entre las variables estudiadas e identificar patrones geográficos de niveles de desarrollo infantil y gobernabilidad efectiva. Las pruebas de correlación de Pearson y Spearman se realizaron en el software Stata 15.1. Resultados: Se estudiaron niños de 33 países de ingresos bajos y medios; de 7 regiones del mundo. Tailandia (91,1%) y Turkmenistán (90,7%) tienen los porcentajes más altos de desarrollo infantil y Burundi el más bajo (39,6%). Según la estimación de GE, el valor más bajo se encuentra en Burundi (-1,3) y el más alto en la República Democrática de Corea (1). En el GE Rank, los valores más altos se encuentran en Corea con 82,1% y los más bajos en Haití (0,9%). El grado de correlación entre el ECDI y la estimación de GE fue positivo moderado (0,522, P-0,001, prueba de correlación de Spearman), similar (0,518, P-0001, prueba de correlación de Pearson). El patrón espacial general que prevalece es que las regiones africanas presentan un puntaje bajo de efectividad del gobierno y desarrollo infantil temprano, que se correlacionan positivamente en este estudio. Conclusiones: Con los datos más actualizados reportados por los países sobre desarrollo infantil, se pudo establecer el nivel de desarrollo infantil antes de 2019, año en que comenzó la pandemia de COVID-2019. Es crucial que se realicen estudios durante y después de la pandemia con el objetivo de establecer los daños directos e indirectos que reciben los niños en las dimensiones del desarrollo, en las que la respuesta del gobierno es determinante.

Correlation between PET-CT and ct in the staging after the treatment of head and neck squamous cell carcinoma

Abstract Objective: The aim of this study is to find out if a single imaging test is enough to follow-up on an oncological post-treatment patient. In such a case, we would know which was more valuable after comparing the two, by CT or PET-CT. Methods: Between January 2012 and July 2018, we collected data from all patients with previous medical history who were treated with a head and neck squamous cell carcinoma in our hospital, through surgery or by using an organ preservation protocol which we had done. Patients were required to have a CT and a PET-CT performed in a maximum period of 30 days between techniques. We compared the post post-treatment stage given to each case by using only the physical examination (only the CT and the PET-CT), with the ones given by the Tumor Board. After treatment, we analysed the similarity through Cramer's V statistic test. Results: We performed a comparative analysis, obtaining a correlation of 0.426 between the stages given by the Tumor Board and the one assigned based on physical examination, without imaging techniques. By only using the computed tomography as an imaging method the correlation was 0.565, whereas with only the use of positron emission computed technology, it was estimated at 0.858. When we compared the statistical association between stages using exclusively one of the two imaging techniques, the correlation was 0.451. Conclusion: Independent of the modality, we have demonstrated that in patients who have received previous treatment, there was a higher correlation in the stages with respect to the diagnostic method conducted by the Tumor Board using PET-CT as the sole image. Level of evidence: Level 1.

Confiabilidad de una escala de valoración de resúmenes para congresos

Introducción: En 2013, desarrollamos una escala, para evaluar resúmenes de congresos de la Sociedad de Cirujanos de Chile (SOCICH). Objetivo: Determinar consistencia interna y confiabilidad interobservador de una escala para evaluar resúmenes de congresos. Material y Método: Estudio de confiabilidad. Doce cirujanos fueron capacitados de forma virtual durante 8 horas, para aplicar la escala. Una vez finalizado el entrenamiento, se les envió un cuestionario para evaluar contenidos de la capacitación, y varios resúmenescasos para ser evaluados con la escala antes señalada. Se aplicó estadística descriptiva, luego se estimó el grado de acuerdo entre observadores para cada ítem de la escala. Posteriormente, se evaluó el coeficiente de correlación (CCI), utilizando un modelo de dos factores mixtos en el que los efectos de los evaluadores son aleatorios y los ítems fijos; utilizando una definición de acuerdo absoluto. Además, se evaluó la consistencia interna de los ítems utilizando alfa de Cronbach, considerando intérvalos de confianza del 95% (IC 95%). Resultados: Luego de analizar las mediciones de los 9 ítems por los 12 observadores, se verificó que el CCI fue de 0,871; con un IC 95% de 0,700; 0,965. El valor de la consistencia interna fue de 0,7 considerando los 9 ítems, no se recomienda eliminar ningún ítem. Conclusión: La escala tiene buena confiabilidad interobservador y los ítems son consistentes entre sí; por lo que puede ser considerada como un instrumento confiable para la valoración de resúmenes de congresos.

Background: In 2013, we developed a scale to evaluate the abstracts of the congresses of the Society of Surgeons of Chile (SOCICH). Objective: To determine internal consistency and interobserver reliability of a scale to evaluate conference abstracts. Material and Methods: Reliability study. Twelve surgeons were trained virtually for 8 hours, to apply the scale. Once the training was finished, they were sent a questionnaire to evaluate the contents of the training, and several summaries-cases to be evaluated with the aforementioned scale. Descriptive statistics were applied, then the degree of agreement between observers was estimated for each item of the scale. Subsequently, intraclass correlation coefficient (ICC) was evaluated, using a mixed two-factor model where the effects of the evaluators are random and the items are fixed, using a definition of absolute agreement. In addition, the internal consistency of the items was evaluated using Cronbach's alpha, considering 95% confidence intervals (95% CI). Results: After analyzing the measurements of the 9 items by the 12 observers, it was verified that the ICC was 0.871; with a 95% CI of 0.700; 0.965. The internal consistency value was 0.7 considering the 9 items, it is not recommended to delete any item. Conclusions: The scale has good internal consistency and interobserver reliability. Therefore, it can be considered as reliable instrument to be used in the evaluation of abstracts for congresses.

Correlación entre dos metodologías para la medición de anticuerpos contra la proteína spike del coronavirus del Síndrome Respiratorio Agudo Grave 2 / Correlation between two methodologies for the measurement of antibodies against the spike protein of coronavirus of the Severe Acute Respiratory Syndrome 2 / Correlação entre duas metodologias para a medição de anticorpos contra a proteína spike do coronavírus da Síndrome Respiratória Aguda Grave 2

Resumen El coronavirus del Síndrome Respiratorio Agudo Grave 2 (SARS-CoV-2) posee diversas proteínas estructurales que incluyen la proteína spike (S), principal blanco de las vacunas actuales. Existen diversas metodologías para la medición de anticuerpos contra ésta que brindan información acerca de la respuesta inmune frente a la vacunación. El objetivo de este trabajo fue determinar la correlación entre quimioluminiscencia (CLIA) y enzimoinmunoanálisis de adsorción (ELISA) para la medición de anticuerpos IgG anti-proteína S (IgG anti-S). Se recolectaron resultados serológicos de 169 individuos y se determinaron los niveles de anticuerpos por ambas metodologías. Del total de muestras, 106 arrojaron un resultado positivo por ambas metodologías y 15 resultaron discordantes (CLIA+, ELISA-), con índice Kappa de 0,80. La correlación entre ambas metodologías fue buena. Este estudio podría aportar al manejo y seguimiento de la población vacunada, con la finalidad de obtener un valor de corte para evaluar la aplicación de una dosis adicional.

Abstract Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has several structural proteins including the spike (S) protein, which is the main target of current vaccines. There are various methodologies for the measurement of antibodies against it that provide information about the immune response to vaccination. The objective of this study was to determine the correlation between chemiluminescence (CLIA) and enzyme-linked immunoassay (ELISA) for the measurement of IgG anti-S protein (IgG anti-S) antibodies. Serological results were collected from 169 individuals and antibody levels were determined by both methodologies. Out of the total samples, 106 were positive by both methodologies and 15 were discordant (CLIA+, ELISA-), with a Kappa index of 0.80. The correlation between both methodologies was good. This study could contribute to the management and follow-up of the vaccinated population, in order to obtain a cut-off value to evaluate the application of an additional dose.

Resumo O coronavírus da Síndrome Respiratória Aguda Grave 2 (SARS-CoV-2) possui várias proteínas estruturais, incluindo a proteína spike (S), principal alvo das vacinas atuais. Existem várias metodologias para medir anticorpos contra ela que fornecem informações sobre a resposta imune diante da vacinação. O objetivo deste trabalho foi determinar a correlação entre quimioluminescência (CLIA) e enzimoimunoanálise de absorção (ELISA) para a medição de anticorpos IgG anti-proteína S (IgG anti-S). Foram coletados resultados sorológicos de 169 indivíduos e os níveis de anticorpos foram determinados por ambas as metodologias. Do total de amostras, 106 deram resultados positivos nas duas metodologias e 15 foram discordantes (CLIA+, ELISA-), com índice Kappa de 0,80. A correlação entre as duas metodologias foi boa. Este estudo poderia contribuir para a gestão e seguimento da população vacinada, visando a obter um valor de corte para avaliar a aplicação de uma dose adicional.

Asociación entre tiempo de uso de teléfono celular, nivel de actividad física y rendimiento académico en universitarios / Association between time spent on a cell phone, physical activity level, and academic performance in college students

Introducción: El aumento del uso de teléfono celular y la baja actividad física en universitarios se han asociado a un bajo rendimiento académico. Objetivo: Analizar la relación entre tiempo de uso del teléfono celular, el nivel de actividad física y rendimiento académico en estudiantes universitarios. Materiales y métodos: Estudio de alcance correlacional y temporalidad longitudinal. Participaron 36 estudiantes universitarios, a quienes se evaluó durante un semestre, el tiempo que destinaron al uso de teléfono celular, a través de la aplicación "Moment" y la actividad física mediante la aplicación "Pacer". Se registró el rendimiento académico con el promedio de notas. Resultados: Durante el semestre, los hombres realizaron mayor actividad física y utilizaron por mayor tiempo el teléfono. En periodos de evaluación, las mujeres tuvieron mayor actividad física y menor uso del teléfono celular (p=0,019 y p=0,033, respectivamente). Además, los hombres que tuvieron mejores notas promedio hacían un menor número de pickups diarios (p=0,032). Conclusiones: Los hombres universitarios son físicamente más activos y usan más el celular durante el semestre, aunque en periodo de evaluaciones las mujeres tienden a ser más activas y usar menos tiempo su celular. Los universitarios que usan menos el teléfono celular tienen mejor rendimiento académico.

Introduction: Low academic performance of college students has been associated with an increase in time spent on cell phones and a low physical activity. Objective: To analyze the relationship between time spent on cell phones, physical activity level, and academic performance in college students. Materials and methods: A study with a correlational and longitudinal temporality approach. During a semester, 36 college students were assessed on the time they spent using cell phones and their physical activity levels through the Moment and Pacer applications, respectively. Academic performance was monitored through report cards. Results: Men engaged in more physical activity and used cell phones more frequently during the analyzed period, while women showed higher physical activity levels and lower cell phone usage during evaluation periods (p=0.019 y p=0.033, respectively). Also, men who had better grade averages showed lower number of daily pickups (p=0.032). Conclusions: College men show higher physical activity levels and longer cell phone usage during the semester, while women tend to be more active and use their cell phones less frequently during evaluation periods. College students who use cell phones less regularly also have a better academic performance.

Correlación del índice de masa corporal y de la circunferencia de cintura de las niñas y adolescentes con su ascendencia femenina hasta la tercera generación

RESUMEN Introducción: La intergeneracionalidad nutricional es reconocida como uno de los factores que influye en el aumento de la prevalencia de obesidad, principalmente a través de generaciones maternas. Poco se conoce sobre esta situación en nuestro país. Objetivo: evaluar la correlación del índice de masa corporal (IMC) y la circunferencia de cintura (CC) de niñas y adolescentes con su ascendencia femenina hasta la tercera generación durante los meses de julio a setiembre del 2019. Materiales y Métodos: Estudio analítico de corte transversal en 98 tríos (niñas y adolescentes, madres y abuelas maternas). Se recolectaron datos antropométricos de los tríos (peso, talla y CC). Se realizaron correlaciones entre: el IMC de la madre y la abuela con el puntaje Z del IMC/E de las niñas y adolescentes y la CC de la madre con las niñas y adolescentes. Se aplicó el coeficiente de correlación de Pearson. Investigación aprobada por Comité de Ética (Dictamen 460/19). Resultados: en promedio las niñas y adolescentes tuvieron 10,1±1,1 años, 0,8±1,6 DE puntaje Z IMC/Edad y 69,5±9,7 cm de CC; las madres tenían 37,4±6,8 años, 13 años de escolaridad, 28,8±7,3 kg/m2 de IMC y 92,1±13,4 cm de CC; y las abuelas 64,9±10,8 años, 7 años de escolaridad y 28,7±6,9 kg/m2 de IMC (Sobrepeso). La correlación del IMC de la madre con el puntaje Z de las niñas y adolescentes fue r: 0,2937 (p0,05). La correlación de CC entre madre-niña fue r: 0,264, (p<0,05). Conclusión: el IMC y la CC de las niñas y adolescentes se correlaciona con el IMC y CC de las madres, pero su potencia no es muy fuerte. Las hijas de madres obesas tienen mayor IMC medido por puntaje Z.

ABSTRACT Introduction: Nutritional intergenerationality is recognized as one of the factors that influences the increase in obesity prevalence, mainly through maternal generations. Little is known about this situation in our country. Objective: to evaluate the correlation of the body mass index (BMI) and the waist circumference (WC) of girls and adolescents compared to their female ancestry up to the third generation during the months of July to September 2019. Materials and methods: This was an analytical, cross-sectional study of 98 trios (girls and adolescents, maternal mothers and grandmothers). Anthropometric data of the trios (weight, height and WC) were collected. Correlations were made between: the BMI of the mother and the grandmother with the Z score of the BMI/E of the girls and adolescents and the WC of the mother with the girls and adolescents. Pearson's correlation coefficient was applied. The study was approved by the Ethics Committee (Approval # 460/19). Results: On average, the girls and adolescents were 10.1±1.1 years old, had a BMI/Age Z score of 0.8±1.6 SD and a WC of 69.5±9.7 cm; the mothers were 37.4±6.8 years old, had 13 years of schooling, BMI 28.8±7.3 kg/m2 and WC 92.1±13.4 cm; and the grandmothers 64.9±10.8 years, had 7 years of schooling and 28.7±6.9 kg/m2 BMI (Overweight). The correlation of the BMI of the mother with the Z score of the girls and adolescents was r: 0.2937 (p0.05). The WC correlation between mother and girl was r: 0.264, (p<0.05). Conclusion: The BMI and WC of girls and adolescents correlate with the BMI and WC of mothers, but its power is not very strong. The daughters of obese mothers have higher BMI measured by Z score.

Rendimiento del sistema Bethesda en el diagnóstico citopatológico del nódulo tiroideo en un centro universitario (Hospital de Clínicas) de Uruguay, diez años de experiencia / Performance of the Bethesda SYSTEM in the cytopathological diagnosis of the thyroid nodule in a university center (Hospital de Clínicas) in Uruguay, ten years of experience / Desempenho do sistema Bethesda no diagnóstico citopatológico de nódulos tireoidianos em um centro universitário (Hospital de Clínicas) no Uruguai, dez anos de experiencia

Resumen: Introducción: el estudio citológico por punción ecoguiada se caracteriza por ser rápido, confiable, mínimamente invasivo y rentable. Permite reducir procedimientos quirúrgicos innecesarios y clasifica apropiadamente a los pacientes con nódulos sospechosos o malignos para una intervención quirúrgica oportuna. Objetivo: el objetivo del presente estudio es evaluar la correlación citológica-anatomopatológica del sistema Bethesda en un centro universitario (Hospital de Clínicas) de Uruguay. Metodología: se realizó un estudio de tipo observacional, retrospectivo, descriptivo, basado el análisis de historias clínicas de pacientes sometidos a cirugía tiroidea en el Hospital de Clínicas, en el período comprendido entre enero de 2008 y diciembre de 2018. Resultados: del total inicial de 119 pacientes, 93 cumplieron los criterios de inclusión. El rango de edad de la muestra fue entre 15 y 79 años. Del total de puncionados 49,5% (46) fueron informados como benignos y 50,5% (47) como malignos. Se calculó en forma global una sensibilidad de 96% (0,96) con IC 1,0-0,90, especificidad de 98% (0,97) con IC 1,0-0,93, un VPP de 98% y VPN de 96%. La sensibilidad diagnóstica para la categoría IV, V y VI fue de 96%, con una especificidad de 100, 94 y 100% respectivamente. Conclusiones: el sistema Bethesda aplicado a las PAAF de nódulos tiroideos potencia la certeza diagnóstica y asiste en la decisión terapéutica. En nuestra institución contamos con una buena correlación citopatológica, similar a otros trabajos reportados en la literatura, lo que permite predecir adecuadamente el riesgo de malignidad y facilitar la toma de decisiones.

Summary: Introduction: the ultrasound-guided fine needle aspiration biopsy (FNAB) study is characterized by being fast, reliable, minimally invasive, and cost-effective. It reduces unnecessary surgical procedures and appropriately classifies patients with suspicious or malignant nodules for timely surgical intervention. Objective: the objective of this study is to evaluate the cytological-pathological correlation of the Bethesda System in a university center (Hospital de Clínicas) in Uruguay. Methodology: an observational, retrospective, descriptive study was carried out, based on the analysis of medical records of patients undergoing thyroid surgery at the Hospital de Clínicas, in the period between January 2008 and December 2018. Results: of the initial total of 119 patients, 93 met the inclusion criteria. The age range of the sample was between 15 and 79 years. Of the total of punctured, 49.5% (46) were reported as benign and 50.5% (47) as malignant. A sensitivity of 96% (0.96) with CI 1.0-0.90, specificity of 98% (0.97) with CI 1.0-0.93, a PPV of 98% and NPV of 96%. The diagnostic sensitivity for categories IV, V and VI was 96% with a specificity of 100, 94 and 100% respectively. Conclusions: the Bethesda system applied to FNA of thyroid nodules enhances diagnostic certainty and assists in the therapeutic decision. In our institution we have a good cytopathological correlation, similar to other works reported in the literature. This makes it possible to adequately predict the risk of malignancy and facilitate decision-making.

Resumo: Introdução: o estudo citológico por punção guiada por ultrassom caracteriza-se por ser rápido, confiável, minimamente invasivo e de baixo custo. Permite reduzir procedimentos cirúrgicos desnecessários e classificar adequadamente pacientes com nódulos suspeitos ou malignos para intervenção cirúrgica oportuna. Objetivo: avaliar a correlação citológico-patológica do Sistema Bethesda em um centro universitário (Hospital de Clínicas) no Uruguai. Metodologia: foi realizado um estudo observacional, retrospectivo, descritivo, baseado na análise de prontuários de pacientes submetidos à cirurgia de tireoide no Hospital de Clínicas, no período janeiro de 2008-dezembro de 2018. Resultados: do total inicial de 119 pacientes, 93 preencheram os critérios de inclusão. A faixa etária da amostra foi entre 15 e 79 anos. Do total de punções, 49,5% (46) foram relatadas como benignas e 50,5% (47) como malignas. No geral, uma sensibilidade de 96% (0,96) com IC 1,0-0,90, uma especificidade de 98% (0,97) com IC 1,0-0,93, um VPP de 98% e VPN de 96%. A sensibilidade diagnóstica para as categorias IV, V e VI foi de 96% com especificidade de 100, 94 e 100%, respectivamente. Conclusões: o sistema Bethesda aplicado à PAAF de nódulos tireoidianos aumenta a certeza diagnóstica e auxilia na decisão terapêutica. Em nossa instituição temos uma boa correlação citopatológica, semelhante a outros trabalhos relatados na literatura. Isso permite prever adequadamente o risco de malignidade e facilitar a tomada de decisão.

Training of neurologists for the 21st century: cultural and professional skills / O treinamento do Neurologista para o século XXI: habilidades profissionais e culturais

Abstract Training of neurologists for the near future is a challenge due to the likely advances in neuroscientific methods, which will change much of our knowledge on diagnosis and treatment of neurological diseases. Objective: to comment on what may be more likely to be a constant in the very near future and to recommend how to prepare the neurologist for the 21st century. Methods: through a critical review of recent articles on the teaching of Neurology, to present a personal view on the subject. Results: Diagnostic methods and therapeutic resources in Neurology will be greatly improved, but the central core of teaching young neurologists will continue to be the clinical/anatomical correlation. The neurologist must be prepared to be the primary physician in the care of patients with neurological disorders, although the roles of consultant and clinical neuroscientist must also be considered. In addition to technical knowledge, the neurologist must be prepared to discuss not only distressing issues related to the specialty, such as the risks of genetic diseases for family members of their patients, the inexorable progression of some diseases and the need for palliative care, but also problems not directly related to Neurology that cause anxiety and depression in the patient or that are the main reason for the initial consultation. Conclusion: neurology will be an even more important area of medicine and the neurologist must be well prepared to be the primary doctor to diagnose, treat and follow the patient with neurological disorders. In addition to technical knowledge, training in doctor-patient relations should be highlighted.

Resumo A formação do neurologista para o futuro próximo é um desafio devido aos prováveis avanços nos métodos da neurociência, que mudarão muito do nosso conhecimento sobre diagnóstico e tratamento de doenças neurológicas. Objetivo: comentar o que pode ser mais constante no futuro próximo e propor como preparar o neurologista para o século XXI. Métodos: por meio de uma revisão crítica de artigos recentes sobre o ensino da Neurologia, apresentar uma visão pessoal sobre o assunto. Resultados: Os métodos diagnósticos e os recursos terapêuticos em Neurologia serão muito aprimorados, mas o núcleo central do ensino de jovens neurologistas continuará sendo a correlação clínico-anatômica. O neurologista deve estar preparado para ser o médico principal no atendimento de pacientes com distúrbios neurológicos, embora os papéis de consultor e neurocientista clínico também devam ser considerados. Além do conhecimento técnico, o neurologista deve estar preparado para discutir não apenas questões angustiantes relacionadas à especialidade, como os riscos de doenças genéticas para os familiares de seus pacientes, a progressão inexorável de algumas doenças e a indicação de cuidados paliativos, mas também problemas não diretamente relacionados à Neurologia que causam ansiedade e depressão no paciente ou que são a principal causa da consulta. Conclusão: a neurologia será uma área ainda mais importante da medicina e o neurologista deve estar bem-preparado para ser o médico principal para diagnosticar, tratar e acompanhar o paciente com distúrbios neurológicos. Além do conhecimento técnico, a formação humanística deve ter destaque.

Assessing compatibility of excipients selected for a sustained release formulation of bilberry leaf extract

Abstract The study is aimed to assess the compatibility of bilberry leaf powder extract (BLPE) with six excipients selected for sustained-release (SR) tablet formulation. The BLPE was obtained with the addition of L-arginine and Myo-inositol as the carriers. Thermogravimetric (TG-DTG) analysis and Fourier-transform infrared spectroscopy (FTIR), supported by Pearson correlation analysis, were applied to detect possible interactions in the binary mixtures (1:1) of the BLPE with each excipient. The TG-DTG showed some deviations in the thermal behavior of the BLPE / excipient mixtures. However, only the thermal behavior of magnesium stearate in the mixture significantly differed from individual samples, which suggested chemical interaction for this excipient. The FTIR analysis confirmed that the BLPE is compatible with Eudragit L100, Methocel K4M, Methocel K100LV, Avicel PH-101, and Plasdone S-630. Whereas it undergoes solid-state chemical interaction in the binary mixture with magnesium stearate. According to the FTIR-spectra, it is suggested that this interaction results in the formation of stearic acid and alkalization of the medium. These findings evidence for the possibility of using TG-DTG analysis as an independent thermal technique for compatibility studies and also confirm the earlier reported interaction of basic lubricants, e.g., stearic salts, with active ingredients containing amino groups.

Cellular consequences of small supernumerary marker chromosome derived from chromosome 12: mosaicism in daughter and father

Constitutional genomic imbalances are known to cause malformations, disabilities, neurodevelopmental delay, and dysmorphia and can lead to dysfunctions in the cell cycle. In extremely rare genetic conditions such as small supernumerary marker chromosomes (sSMC), it is important to understand the cellular consequences of this extra marker, as well the factors that contribute to their maintenance or elimination through successive cell cycles and phenotypic impact. The study of chromosomal mosaicism provides a natural model to characterize the effect of aneuploidy on genome stability and compare cells with the same genetic background and environment exposure, but differing in the presence of sSMC. Here, we report the functional characterization of different cell lines from two familial patients with mosaic sSMC derived from chromosome 12. We performed studies of proliferation dynamics, stability, and variability of these cells using fluorescent in situ hybridization (FISH), sister chromatid exchanges (SCE), and conventional staining. We also quantified the telomere-related genomic instability of sSMC cells using 3D telomeric profile analysis by quantitative-FISH. sSMC cells exhibited differences in the cell cycle dynamics compared to normal cells. First, the sSMC cells exhibited lower proliferation index and higher frequency of SCE than normal cells, associated with a higher level of chromosomal instability. Second, sSMC cells exhibited more telomeric-related genomic instability. Lastly, the differences of sSMC cells distribution among tissues could explain different phenotypic repercussions observed in patients. These results will help in our understanding of the sSMC stability, maintenance during cell cycle, and the cell cycle variables involved in the different phenotypic manifestations.