Adenosine Increases the Immunosuppressive Capacity of Cervical Cancer Cells by Increasing PD-L1 Expression and TGF-ß Production through Its Interaction with A2AR/A2BR.

The present study provides evidence showing that adenosine (Ado) increases the expression of programmed death ligand 1 (PD-L1) in cervical cancer (CeCa) cells by interacting with A2AR/A2BR and that TGF-ß1 acts in an autocrine manner to induce PD-L1 expression, enhancing the immunosuppressive effects of CeCa cells on activated T lymphocytes (ATLs) and CD8+ cytotoxic T lymphocytes (CTLs) specific for antigenic peptides derived from E6 and E7 proteins of HPV-16. Interestingly, the addition of the antagonists ZM241385 and MRS1754, which are specific for A2AR and A2BR, respectively, or SB-505124, which is a selective TGF-ß1 receptor inhibitor, to CeCa cell cultures significantly inhibited PD-L1 expression. In addition, supernatants from CeCa cells that were treated with Ado (CeCa-Ado Sup) increased the expression of PD-1, TGF-ß1, and IL-10 and decreased the expression of IFN-γ in ATLs. Interestingly, the addition of an anti-TGF-ß neutralizing antibody strongly reversed the effect of CeCa-Ado Sup on PD-1 expression in ATLs. These results strongly suggest the presence of a feedback mechanism that involves the adenosinergic pathway, the production of TGF-ß1, and the upregulation of PD-L1 expression in CeCa cells that suppresses the antitumor response of CTLs. The findings of this study suggest that this pathway may be clinically important and may be a therapeutic target.

Central American and Caribbean Consensus Document for the Optimal Management of Oral Anticoagulation in Patients with Non-Valvular Atrial Fibrillation Endorsed by the Central American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention.

Atrial fibrillation (AF) is the most common arrhythmia in adults. Prevention of the ischaemic risk with oral anticoagulants (OACs) is widely recommended, and current clinical guidelines recommend direct oral anticoagulants (DOACs) as preference therapy for stroke prevention. However, there are currently no clinical practice guidelines or recommendation documents on the optimal management of OACs in patients with AF that specifically address and adapt to the Central American and Caribbean context. The aim of this Delphi-like study is to respond to doubts that may arise in the management of OACs in patients with non-valvular AF in this geographical area. A consensus project was performed on the basis of a systematic review of the literature, a recommended ADOLOPMENT-like approach, and the application of a two-round Delphi survey. In the first round, 31 recommendations were evaluated and 30 reached consensus, of which, 10 unanimously agreed. The study assessed expert opinions in a wide variety of contextualized recommendations for the optimal management of DOACs in patients with non-valvular atrial fibrillation (NVAF). There is a broad consensus on the clinical practice guideline (CPG) statements used related to anticoagulation indication, patient follow-up, anticoagulation therapy complications, COVID-19 management and prevention, and cardiac interventions.

Can team coaching provide healthcare the remedy it needs?

The healthcare industry is inadvertently a teamwork industry - and yet - little time is devoted to improving teamwork on the field. As a response to this issue, team development intervention (TDI) tools have flourished. Findings suggest the capability for TDIs to better team competencies, and potentially mitigate prominent healthcare problems. However, team coaching has been excluded as a potential TDI for healthcare. For this reason, we seek to 1) discuss existing team coaching models, integrating findings across the literature, 2) highlight the advantages of Hackman and Wageman (2005)'s model over others, 3) display its empirically-corroborated propositions, and finally, 4) provide general guidance on how to move forward. We move beyond extant literature by providing an outline on what outcomes team coaching can and cannot yield, accumulating evidence from fields outside of healthcare and incorporating team coaching into the TDI literature. By doing so, we hope empirical research on team coaching is incentivized, resulting in an efficient and accessible TDI for healthcare professionals and the field of interprofessional care.

Asociación del riesgo a desarrollar diabetes mellitus tipo 2 según la calculadora de la asociación americana de diabetes (ADA) y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana / Association of the risk of developing type 2 diabetes mellitus according to the American Diabetes Association (ADA) calculator and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic

Introducción: la diabetes mellitus tipo 2 (DM2) se define como un trastorno metabólico caracterizado por niveles de glucosa en sangre crónicamente elevados. La DM2 representa el paradigma de las enfermedades crónicas en las que existe una estrecha asociación entre factores familiares y ambientales. Por este motivo, este estudio tiene como finalidad determinar la asociación del riesgo a desarrollar DM2 y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana. Tales incluyen: alcohol, café y té. Metodología: Estudio observacional, transversal, analítico y prospectivo. Se aplicó cuestionario, recolectaron datos antropométricos y se determinó glucosa capilar a la muestra (n=304). Resultados: la prevalencia a presentar un alto riesgo a desarrollar DM2 en la población es de 35.5%, mientras que la prevalencia a presentar riesgo bajo es de 64.5%. En cuanto a hábitos tóxicos, no existió correlación positiva entre consumo de té y desarrollo de DM2. Sin embargo, sí entre el consumo de café y alcohol. Conclusiones: los habitantes de salinas presentan un bajo riesgo a desarrollar DM2, pero utilizan factores de riesgos modificables que aumentan la prevalencia a DM2.

Introduction: Type 2 diabetes mellitus (DM2) is defined as a metabolic disorder characterized by chronically elevated blood glucose levels. DM2 represents the paradigm of chronic diseases in which there is a close association between family and environmental factors. Therefore, the purpose of this study is to determine the association of the risk of developing DM2 and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic. Such habits include alcohol, coffee and tea. Methodology: Observational, cross-sectional, analytical and prospective study. A questionnaire was applied, anthropometric data was collected, and capillary glucose was determined in the study sample (n=304). Results: the prevalence of presenting a high risk of developing DM2 in the population is 35.5%, while the prevalence of presenting low risk is 64.5%. Regarding toxic habits, there was no positive correlation between tea consumption and the development of DM2. However, this result differed between consumption of coffee and alcohol. Conclusions: the inhabitants of Salinas have a low risk of developing DM2 but are subject to modifiable risk factors that increase said prevalence.

Infections and risk factors for infection-related mortality after pediatric allogeneic hematopoietic stem cell transplantation in Mexico: A single center retrospective study.

OBJECTIVE: To identify the type of infections and risk factors for infection-related mortality (IRM) after allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: Retrospective cohort study of patients <16 years of age treated in 2010-2019 was conducted. Unadjusted hazard ratios (HR) and adjusted hazard ratios (aHR) with 95% confidence intervals (95% CIs) were estimated using Cox regression. Cumulative incidence was calculated. RESULTS: Data for 99 pediatric patients were analyzed. The myeloablative conditioning was the most used regimen (78.8%) and the hematopoietic stem cell source was predominantly peripheral blood (80.8%). Primary graft failure occurred in 19.2% of patients. Frequency of acute graft-versus-host disease was 46.5%. Total of 136 infectious events was recorded, the most common of which were bacterial (76.4%) followed by viral infection (15.5%) and then fungal infection (8.1%). The best predictors for infection subtypes where the following: a) for bacterial infection (the age groups of 10.1-15 years: aHR = 3.33; 95% CI: 1.62-6.85 and. >15 years: aHR = 3.34; 95% CI: 1.18-9.45); b) for viral infection (graft versus host disease: aHR = 5.36; 95% CI: 1.62-17.68), however, for fungal infection statistically significant predictors were not identified. Related mortality was 30% (n = 12). Increased risk for infection-related mortality was observed in patients with unrelated donor and umbilical cord stem cells recipients (HR = 3.12; 95% CI: 1.00-9.85). CONCLUSIONS: Frequencies of infections and infection-related mortality appear to be similar to those reported. Unrelated donors and stem cells from umbilical cord recipients were associated with a high risk of mortality.

Antigenotoxicidad de la isoflavona de soya genisteína en ratones expuestos a compuestos cancerígenos del cromo hexavalente / Antigenotoxicity of the soy isoflavone genistein in mice exposed to carcinogenic hexavalent chromium compounds

Introducción: el consumo de alimentos ricos en antioxidantes como las isoflavonas de la soya puede ser una alternativa en la protección y modulación de la genotoxicidad de metales con potencial cancerígeno asociado al estrés oxidativo. Objetivo: evaluar el efecto antigenotóxico de la isoflavona de soya genisteína en ratones expuestos a compuestos cancerígenos de cromo hexavalente (Cr[VI]). Material y método: veinticinco ratones Hsd:ICR macho fueron divididos en cinco grupos tratados de la siguiente forma: a) vehículo 1 (agua destilada estéril, vía-oral); b) vehículo 2 (aceite de maíz para compuestos liposolubles, vía-intraperitoneal); c) 15 mg/kg de genisteína, vía-oral; d) 20 mg/kg de CrO3 vía-intraperitoneal; y e) 15 mg/kg de genisteína cuatro horas antes de la aplicación de 20 mg/kg de CrO3. Se realizaron evaluaciones de micronúcleos (MN), apoptosis, relación de eritrocitos policromáticos/normocromáticos (EPC/ENC) y viabilidad celular en sangre periférica obtenida a las 0, 24, 48 y 72 horas. Resultados: el tratamiento con genisteína redujo los MN cuando fue administrada previamente al tratamiento con CrO3, siendo mayor el efecto a las 48 horas (reducción del 84 %). La viabilidad celular se redujo con los tratamientos de genisteína y CrO3 solos, siendo mayor el efecto en este último. Conclusiones: la genisteína bloqueó eficazmente la acción genotóxica del CrO3. El hecho de que se redujeran los MN y la apoptosis en el grupo tratado con la genisteína y el CrO3 sugiere que la genisteína pudo haber inhibido el daño oxidativo del Cr(VI) ya que, al no haber células con daño, las vías apoptóticas no se activaron. (AU)

Introduction: the consumption of antioxidant-rich foods such as soy isoflavones may be an alternative in the protection and modulation against metal-induced genotoxicity with carcinogenic potential associated with oxidative stress.Objective: to evaluate the antigenotoxic effects of soy isoflavone genistein in mice exposed to carcinogenic compounds of hexavalent chromium (Cr[VI]).Material and method: twenty-five male Hsd:ICR mice were divided into five groups treated as follows: a) vehicle 1 (sterile distilled water, intraperitoneally); b) vehicle 2 (corn oil for fat-soluble compounds, orally); c) 15 mg/kg of genistein, orally; d) 20 mg/kg of CrO3, intraperitoneally; and e) 15 mg/kg of genistein four hours before the application of 20 mg/kg of CrO3. Evaluations of micronuclei (MN), apoptosis, ratio of polychromatic/normochromatic erythrocytes (EPC/ENC) and cell viability in peripheral blood obtained at 0, 24, 48 and 72 hours were performed.Results: the treatment with genistein reduced MN when administered prior to treatment with CrO3, the effect being greater at 48 hours (reduction of 84 %). Cell viability was reduced with genistein and CrO3 treatments alone, the effect being greater in the latter.Conclusions: genistein effectively blocked the genotoxic action of CrO3. The fact that MN and apoptosis were reduced in the group treated with genistein and CrO3 suggests that genistein could have inhibited the oxidative damage of Cr(VI) since, as there were no cells with damage, the apoptotic pathways were not activated. (AU)

[Antigenotoxicity of the soy isoflavone genistein in mice exposed to carcinogenic hexavalent chromium compounds]. / Antigenotoxicidad de la isoflavona de soya genisteína en ratones expuestos a compuestos cancerígenos del cromo hexavalente.

Introduction: Introduction: the consumption of antioxidant-rich foods such as soy isoflavones may be an alternative in the protection and modulation against metal-induced genotoxicity with carcinogenic potential associated with oxidative stress. Objective: to evaluate the antigenotoxic effects of soy isoflavone genistein in mice exposed to carcinogenic compounds of hexavalent chromium (Cr[VI]). Material and method: twenty-five male Hsd:ICR mice were divided into five groups treated as follows: a) vehicle 1 (sterile distilled water, intraperitoneally); b) vehicle 2 (corn oil for fat-soluble compounds, orally); c) 15 mg/kg of genistein, orally; d) 20 mg/kg of CrO3, intraperitoneally; and e) 15 mg/kg of genistein four hours before the application of 20 mg/kg of CrO3. Evaluations of micronuclei (MN), apoptosis, ratio of polychromatic/normochromatic erythrocytes (EPC/ENC) and cell viability in peripheral blood obtained at 0, 24, 48 and 72 hours were performed. Results: the treatment with genistein reduced MN when administered prior to treatment with CrO3, the effect being greater at 48 hours (reduction of 84 %). Cell viability was reduced with genistein and CrO3 treatments alone, the effect being greater in the latter. Conclusions: genistein effectively blocked the genotoxic action of CrO3. The fact that MN and apoptosis were reduced in the group treated with genistein and CrO3 suggests that genistein could have inhibited the oxidative damage of Cr(VI) since, as there were no cells with damage, the apoptotic pathways were not activated.

Introducción: Introducción: el consumo de alimentos ricos en antioxidantes como las isoflavonas de la soya puede ser una alternativa en la protección y modulación de la genotoxicidad de metales con potencial cancerígeno asociado al estrés oxidativo. Objetivo: evaluar el efecto antigenotóxico de la isoflavona de soya genisteína en ratones expuestos a compuestos cancerígenos de cromo hexavalente (Cr[VI]). Material y método: veinticinco ratones Hsd:ICR macho fueron divididos en cinco grupos tratados de la siguiente forma: a) vehículo 1 (agua destilada estéril, vía-oral); b) vehículo 2 (aceite de maíz para compuestos liposolubles, vía-intraperitoneal); c) 15 mg/kg de genisteína, vía-oral; d) 20 mg/kg de CrO3 vía-intraperitoneal; y e) 15 mg/kg de genisteína cuatro horas antes de la aplicación de 20 mg/kg de CrO3. Se realizaron evaluaciones de micronúcleos (MN), apoptosis, relación de eritrocitos policromáticos/normocromáticos (EPC/ENC) y viabilidad celular en sangre periférica obtenida a las 0, 24, 48 y 72 horas. Resultados: el tratamiento con genisteína redujo los MN cuando fue administrada previamente al tratamiento con CrO3, siendo mayor el efecto a las 48 horas (reducción del 84 %). La viabilidad celular se redujo con los tratamientos de genisteína y CrO3 solos, siendo mayor el efecto en este último. Conclusiones: la genisteína bloqueó eficazmente la acción genotóxica del CrO3. El hecho de que se redujeran los MN y la apoptosis en el grupo tratado con la genisteína y el CrO3 sugiere que la genisteína pudo haber inhibido el daño oxidativo del Cr(VI) ya que, al no haber células con daño, las vías apoptóticas no se activaron.

Evidence that cervical cancer cells cultured as tumorspheres maintain high CD73 expression and increase their protumor characteristics through TGF-ß production.

Recently, a link between the biological activity of CD73 and tumorigenicity in solid tumors has been proposed. We previously reported that the generation of adenosine (Ado) by the activity of CD73 in cervical cancer (CC) cells induces transforming growth factor-beta 1 (TGF-ß1) production to maintain CD73 expression. In the present study, we analyzed the participation of TGF-ß1 in CD73 expression and the development of protumoral characteristics in CaSki CC cells cultured as tumorspheres (CaSki-T) and in monolayers (CaSki-M). Compared with those in CaSki-M cells, CD73 expression and Ado generation ability were significantly increased in CaSki-T cells. CaSki-T cells exhibited enrichment in the CSC-like phenotype due to increases in the expression levels of stem cell markers (CD49f, CK17, and P63; OCT4 and SOX2), greater sphere formation efficiency (SFE), and an increase in the percentage of side population (SP) cells. Interestingly, compared with CaSki-M cells, CaSki-T cells produced a greater amount of TGF-ß1 and presented a marked protumor phenotype characterized by a significant decrease in the expression of major histocompatibility complex class-I (MHC-I) molecules, an increase in the expression of multidrug resistance protein-I (MRP-I) and vimentin, and an increase in the protein expression levels of Snail-1 and Twist, which was strongly reversed with TGF-ß1 inhibition. These results suggest that the presence of TGF-ß1-CD73-Ado feedback loop can promote protumoral characteristics in the CC tumor microenvironment.

Estrés académico, procrastinación y usos del Internet en universitarios durante la pandemia por covid-19 / Academic Stress, Procrastination, and Internet Uses Among College Students During the covid-19 Pandemic / Estresse acadêmico, procrastinação e uso da Internet em estudantes universitários durante a pandemia de covid-19

La pandemia por covid-19 repercutió en las prácticas educativas y convirtió a las tecnologías de la información y la comunicación ­sobre todo Internet­ en medios indispensables para continuar con las actividades académicas; pero a la par incrementaron el riesgo de que los estudiantes usen mal estas herramientas y con ello aparezcan fenómenos como la procrastinación. Por tanto, el objetivo fue analizar la relación entre el estrés académico, el uso problemático de Internet, la adicción a las redes sociales y la procrastinación académica. Materiales y métodos: estudio cuantitativo, no experimental, de corte transversal. Se utilizó el inventario sisco de estrés académico, el cupo para uso problemático de Internet, la smas-sf de adicción a redes sociales y la Escala de Procrastinación Académica. La muestra la conformaron 448 estudiantes universitarios mexicanos entre los 17 y los 34 años. Resultados: se hallaron diferencias significativas por sexo, en cuanto a las reacciones ante el estrés académico, y en la categoría de la autorregulación, donde los hombres indicaron una baja autorregulación. Por su parte, en la sub-muestra de mujeres se encontró una relación positiva y significativa entre el uso de las redes sociales y la procrastinación académica; mientras que, en los hombres, entre los problemas por el uso de las redes sociales y las reacciones psicológicas ante el estrés. Conclusión: el cambio de modalidad de estudio (de presencial a virtual) ha generado consecuencias en los universitarios, como estrés académico, procras-tinación y usos inadecuados de Internet.

The covid-19 pandemic has affected educational practices, turning the information and communication technologies and the Internet into essential means to continue academic activities while increasing the risk of students misusing these tools, favoring phenomena such as procrastination. This study aimed to analyze the relationship between academic stress, problematic Internet use, social media addiction, and academic procrastination. Materials and methods: In this quantitative, non-experimen-tal, and cross-sectional study, the sisco inventory for academic stress, cupi for problematic Internet use, smas-sf for addiction to social networks, and academic procrastination scale were used. The sample was made up of 448 Mexican university students aged 17­34 years. Results: Significant differences were found by sex in terms of reactions to academic stress and in the category of self-regulation, where men indicated low self-regulation. Moreover, a positive and significant relationship was found between the use of social networks and academic procrastination in women and the problems due to the use of social networks and psychological reactions to stress in men. Conclusion: The change from face-to-face to virtual modality has led to consequences such as academic stress, procrastination, and inappropriate use of the Internet among university students.

a pandemia do covid-19 impactou as práticas educacionais, tornando as Tecnologias da Informação e Comunicação (tic) e principalmente a Internet meios indispensáveis para a continuidade das atividades acadêmicas; mas ao mesmo tempo aumenta o risco de que os alunos façam mau uso dessas ferramentas e com isso apareçam fenômenos como a procrastinação. Portanto, o objetivo do presente estudo foi analisar a relação entre estresse acadêmico, uso problemático da Internet, vício em redes sociais e procrastinação acadêmica. Materiais e métodos: estudo quantitativo, não experimental e transversal. Foram utilizados o Inventário sisco de estresse acadêmico, o cupi para uso problemático da Internet, o smas-sf para vício em redes sociais e a escala de procrastinação acadêmica (epa). A amostra foi composta por 448 estudantes universitários mexicanos com idades entre 17 e 34 anos. Resultados: foram encontradas diferenças significativas em função do sexo nas reações ao estresse acadêmico e na catego-ria de auto-regulamentação, onde os homens indicaram baixa auto-regulamentação. Por outro lado, foi encontrada uma relação positiva e significativa, na subamostra de mulheres, entre o uso de redes sociais e procrastinação acadêmica, enquanto que para os homens houve relação positiva e significativa entre problemas devido ao uso de redes sociais e reações psicológicas ao estresse. Conclusão: a mudança da modalidade presencial para a virtual gerou consequências em universitários como estresse acadêmico, procrastinação e uso inadequado da Internet.

Delineation of blacktip shark (Carcharhinus limbatus) nursery habitats in the north-western Gulf of Mexico.

Coevolution with predators leads to the use of low-risk habitats by many prey species, which promotes survival during early developmental phases. These nurseries are valued by conservation and management agencies because of their contributions to adult populations. However, the physical and geographic characteristics, like shallow depths and isolation from other marine habitats, that restrict access to predators and thereby reduce risk to juvenile animals can also limit scientific research. Consequently, many nursery habitats are still unidentified and understudied. Here we used gillnet monitoring from 1982 to 2018 to delineate blacktip shark (Carcharhinus limbatus) nurseries in the north-western Gulf of Mexico and elucidated their physical, environmental and biological characteristics. Nursery habitats within estuaries (<2% of spatial area) were proximate to the Gulf of Mexico and exhibited significantly lower variability in salinity than non-nurseries. However, relative abundances of predators and prey were not significant delineators of nursery habitats. As such, food and risk may not influence juvenile blacktip habitat use as expected. Alternatively, reduced osmoregulatory stress attributed to predictable environments likely provides advantageous conditions for blacktips to develop foraging and antipredator tactics, which is vital prior to the winter migration of juvenile sharks into the Gulf of Mexico.

Influence of invertor and evertor muscle fatigue on functional jump tests and postural control: A prospective cross-sectional study.

OBJECTIVE: Fatigue of the ankle's stabilizing muscles may influence the performance of functional activities and postural control. The purpose of this study was to evaluate the performance of healthy young adults using functional jump tests and static posturography control under pre- and post-fatigue conditions of the ankle invertor and evertor muscles. METHODS: Thirty physically active healthy male and female (15 male and 15 female) volunteers (24.3 years) were enrolled in this prospective cross-sectional study. Participants performed tests on one day under a non-fatigued state of invertor and evertor muscles and on the second day in a fatigued state. Tests included static posturography on a force platform in a bipedal stance with eyes open and closed and in one-legged support with eyes open and functional jump tests (figure-of-8, side hop, 6-m crossover hop, and square hop). Fatigue of the ankle invertor and evertor muscles was induced using isokinetic dynamometry with 30 repetitions at 120°/s. RESULTS: Participants had an average age of 24.3 years (SD ± 2.08), the height of 1.73 m (SD ± 0.08), and a weight of 68.63 kg (SD ± 10.29). The average Body Mass Index (BMI) was 22.88 (SD ± 2.46). A decrease in performance was observed in functional activities and postural control under all conditions after the induction of muscle fatigue, except for the speed at a bipedal stance with eyes open. CONCLUSIONS: Functional jump tests are low cost and useful for clinical practice and evaluation of the effects of muscle fatigue and could be used in clinical practice.

Effect of a Community Gerontology Program on the Control of Metabolic Syndrome in Mexican Older Adults.

Background: Metabolic syndrome (MS) is highly prevalent in older adults; it constitutes a risk factor for cognitive deterioration, frailty, and Alzheimer's disease. For this reason, the WHO has pointed out the importance of the implementation of community programs for the training of healthy aging. The aim of this study was to evaluate the effect of a community gerontology program framed in active aging on the control of metabolic syndrome in older adults. Methods: An experimental study was carried out in a convenience sample of 80 older adults diagnosed with MS according to the ATPIII criteria, comprising (1) experimental group (EG), n = 40; (2) control group (CG), n = 40. During a 6-month period, the EG participated in a supervised community gerontology program, and the CG was assessed monthly. Results: A statistically significant decrease was observed in the number of components for the diagnosis of MS. In this regard, of the total of participants with a diagnosis of MS in EG, only 28% maintained the diagnosis of MS (ATPIII ≥ 3 criteria), in contrast to 83% of the CG participants (p < 0.0001). Conclusions: Our findings suggest that health self-care training within the framework of active aging is effective for the control of MS in older adults.

Influence of invertor and evertor muscle fatigue on functional jump tests and postural control: A prospective cross-sectional study

ABSTRACT Objective: Fatigue of the ankle's stabilizing muscles may influence the performance of functional activities and postural control. The purpose of this study was to evaluate the performance of healthy young adults using functional jump tests and static posturography control under pre- and post-fatigue conditions of the ankle invertor and evertor muscles. Methods: Thirty physically active healthy male and female (15 male and 15 female) volunteers (24.3 years) were enrolled in this prospective cross-sectional study. Participants performed tests on one day under a non-fatigued state of invertor and evertor muscles and on the second day in a fatigued state. Tests included static posturography on a force platform in a bipedal stance with eyes open and closed and in one-legged support with eyes open and functional jump tests (figure-of-8, side hop, 6-m crossover hop, and square hop). Fatigue of the ankle invertor and evertor muscles was induced using isokinetic dynamometry with 30 repetitions at 120°/s. Results: Participants had an average age of 24.3 years (SD ± 2.08), the height of 1.73 m (SD ± 0.08), and a weight of 68.63 kg (SD ± 10.29). The average Body Mass Index (BMI) was 22.88 (SD ± 2.46). A decrease in performance was observed in functional activities and postural control under all conditions after the induction of muscle fatigue, except for the speed at a bipedal stance with eyes open. Conclusions: Functional jump tests are low cost and useful for clinical practice and evaluation of the effects of muscle fatigue and could be used in clinical practice.

Detecting security attacks in cyber-physical systems: a comparison of Mule and WSO2 intelligent IoT architectures.

The Internet of Things (IoT) paradigm keeps growing, and many different IoT devices, such as smartphones and smart appliances, are extensively used in smart industries and smart cities. The benefits of this paradigm are obvious, but these IoT environments have brought with them new challenges, such as detecting and combating cybersecurity attacks against cyber-physical systems. This paper addresses the real-time detection of security attacks in these IoT systems through the combined used of Machine Learning (ML) techniques and Complex Event Processing (CEP). In this regard, in the past we proposed an intelligent architecture that integrates ML with CEP, and which permits the definition of event patterns for the real-time detection of not only specific IoT security attacks, but also novel attacks that have not previously been defined. Our current concern, and the main objective of this paper, is to ensure that the architecture is not necessarily linked to specific vendor technologies and that it can be implemented with other vendor technologies while maintaining its correct functionality. We also set out to evaluate and compare the performance and benefits of alternative implementations. This is why the proposed architecture has been implemented by using technologies from different vendors: firstly, the Mule Enterprise Service Bus (ESB) together with the Esper CEP engine; and secondly, the WSO2 ESB with the Siddhi CEP engine. Both implementations have been tested in terms of performance and stress, and they are compared and discussed in this paper. The results obtained demonstrate that both implementations are suitable and effective, but also that there are notable differences between them: the Mule-based architecture is faster when the architecture makes use of two message broker topics and compares different types of events, while the WSO2-based one is faster when there is a single topic and one event type, and the system has a heavy workload.

Comunicación en el consultorio de medicina familiar: trabajo multicéntrico, cualitativo cuantitativo, en los meses de abril a julio de 2014, en Buenos Aires, Rosario y Tucumán / Communication in Family Medicine practice: multicenter research trial, qualitative and quantitative, from April to June 2014. in the City of Buenos Aires, Rosario and Tucumán

Introducción: la comunicación es trascendental para la vida en sociedad. El éxito de cualquier entrevista clínica depende de la calidad de la comunicación entre el médico y el paciente. Distintos factores pueden interferir en esta, como el ambiente, el tiempo y las interrupciones. Objetivo: Evaluar el grado de comprensión del mensaje transmitido por el médico hacia el paciente. Material y método: Trabajo multicéntrico, cualitativo cuantitativo. Componente cuantitativo: descriptivo de corte transversal de abril a julio de 2014. Se incluyeron 1200 adultos de ambos sexos, que asistieron a los Ce.M.A.P y 40 médicos de familia. Componente cualitativo: Muestreo no probabilístico, intencional, hasta saturación de datos. Triangulación y convergencia de datos. Resultados y discusión: Respecto al componente cuantitativo, se encontró que nuestras hipótesis acerca de la falta de comprensión del mensaje (indicaciones y problema de salud) no pudieron comprobarse. Ya que las indicaciones realizadas por el médico tuvieron una adecuación total del 60% y comprendieron el problema de salud un 77% de los pacientes entrevistados. Para el componente cualitativo luego del análisis temático se obtuvieron barreras (tiempo, paciente polidemandante, ideas previas, omisión de indicaciones no farmacológicas) y facilitadores (conocimiento previo del problema de salud, longitudinalidad, paciente acompañado) para la comprensión del mensaje. Conclusiones: Los pacientes entienden el mensaje de sus médicos de familia, ya que contamos con herramientas concretas como la escucha empática, el proceso clínico centrado en la persona y la longitudinalidad en la atención (AU)

Introduction: communication is important for life in a society. Success in any clinical interview depends on the quality of patient-doctor communication. Different factors may interfere, like the environment, time and interruptions. Objective: Asses the level of understanding of the message given to the patient by the doctor. Material and method: Multicenter research trial, qualitative and quantitative. Quantitative component: cross sectional descriptive from April to June 2014. 1200 adults of both sexes who assisted to the primary health care center: "Ce.M.A.P." in the City of Buenos Aires, Rosario and Tucumán and 40 family practitioners. Qualitative component: nonprobability, intentional sampling upon data saturation. Data triangulation and convergence. Results and discussion: as regards the quantitative component, we found out that our hypothesis in relation to the lack of understanding in the message (indications and health problem) could not be proven. Since 60% of the practitioner's indications were followed and 77% of the interviewed patients understood the health problem. Considering the qualitative component after the thematic analysis, barriers (time, highly demanding patient, previous knowledge, omission of non-pharmacological indications) and facilitators were obtained (previous knowledge of health problem, longitudinality, accompanied patient) to understand the message. Conclusion: patients understand their family practitioner's message since we have specific tools like empathic listening, patient centered healthcare and longitudinality in attention (AU)

Detection of CD39 and a Highly Glycosylated Isoform of Soluble CD73 in the Plasma of Patients with Cervical Cancer: Correlation with Disease Progression.

Persistent infection with high-risk human papillomavirus (HR-HPV) is the main factor in the development of cervical cancer (CC). The presence of immunosuppressive factors plays an important role in the development of this type of cancer. To determine whether CD39 and CD73, which participate in the production of immunosuppressive adenosine (Ado), are involved in the progression of CC, we compared the concentrations and hydrolytic activity of these ectonucleotidases in platelet-free plasma (PFP) samples between patients with low-grade squamous intraepithelial lesions (LSILs) (n = 18), high-grade squamous intraepithelial lesions (HSILs) (n = 12), and CC (n = 19) and normal donors (NDs) (n = 15). The concentrations of CD39 and CD73 in PFP increased with disease progression (r = 0.5929, p < 0.001). The PFP of patients with HSILs or CC showed the highest concentrations of CD39 (2.3 and 2.2 times that of the NDs, respectively) and CD73 (1.7 and 2.68 times that of the NDs, respectively), which were associated with a high capacity to generate Ado from the hydrolysis of adenosine diphosphate (ADP) and adenosine monophosphate (AMP). The addition of POM-1 and APCP, specific inhibitors of CD39 and CD73, respectively, inhibited the ADPase and AMPase activity of PFP by more than 90%. A high level of the 90 kD isoform of CD73 was detected in the PFP of patients with HSILs or CC. Digestion with endoglycosidase H and N-glycanase generated CD73 with weights of approximately 90 kD, 85 kD, 80 kD, and 70 kD. In addition, the levels of transforming grow factor-ß (TGF-ß) in the PFPs of patients with LSIL, HSIL and CC positively correlated with those of CD39 (r = 0.4432, p < 0.001) and CD73 (r = 0.5786, p < 0.001). These results suggest that persistent infection by HR-HPV and the concomitant production of TGF-ß promote the expression of CD39 and CD73 to favor CC progression through Ado generation.