The Impact of Environmental Gaseous Pollutants on the Cultivable Bacterial and Fungal Communities of the Aerobiome.

Understanding air microbial content, especially in highly polluted urban areas, is crucial for assessing its effect on human health and ecosystems. In this context, the impact of gaseous pollutants on the aerobiome remains inconclusive due to a lack of studies separating this factor from other contaminants or environmental factors. In this study, we aimed to experimentally assess the influence of contrasting concentrations of atmospheric gaseous pollutants as isolated variables on the composition of the aerobiome. Our study sites were contrasting Air Quality Index (AQI) sites of the Metropolitan Region of Chile, where nitric oxide (NO) was significantly lower at the low-AQI site than at the high-AQI site, while ozone (O3) was significantly higher. Cultivable aerobiome communities from the low-AQI site were exposed to their own pollutants or those from the high-AQI site and characterized using high-throughput sequencing (HTS), which allowed comparisons between the entire cultivable communities. The results showed increased alpha diversity in bacterial and fungal communities exposed to the high-AQI site compared to the low-AQI site. Beta diversity and compositional hierarchical clustering analyses revealed a clear separation based on NO and O3 concentrations. At the phylum level, four bacterial and three fungal phyla were identified, revealing an over-representation of Actinobacteriota and Basidiomycota in the samples transferred to the high-AQI site, while Proteobacteria were more abundant in the community maintained at the low-AQI site. At the functional level, bacterial imputed functions were over-represented only in samples maintained at the low-AQI site, while fungal functions were affected in both conditions. Overall, our results highlight the impact of NO and/or O3 on both taxonomic and functional compositions of the cultivable aerobiome. This study provides, for the first time, insights into the influence of contrasting pollutant gases on entire bacterial and fungal cultivable communities through a controlled environmental intervention.

The utility of coping through emotional approach: A meta-analysis.

OBJECTIVE: A systematic review and meta-analysis was conducted to examine associations between attempts to cope with stressors through the two facets of emotional approach coping (EAC; i.e., processing and expressing stressor-related emotions) and indicators of physical and mental health. METHOD: EBSCO databases including MEDLINE, PsycINFO, and Cochrane Collections were searched from inception to November 2022. In all, 86 studies were included in a meta-analytic evaluation using a random-effects model and meta-regression analysis. RESULTS: EAC was associated with better overall health (r = .05; p = .04; 95% confidence interval = [.003, .10]). Emotional expression (EE) and emotional processing (EP) also were positively associated with better overall health, although these relationships were not statistically significant. In meta-regressions examining specific health domains, EAC was linked to better health in biological/physiological, physical, and resilience-related psychological adjustment domains, as well as to worse outcomes in the risk-related psychological adjustment and mental/emotional distress domains. Results for EE and EP mirrored this pattern; however, only EP was associated with more engagement in health-promoting behaviors. CONCLUSIONS: Coping with stressors through emotional approach appears to be associated with better mental and physical health, with some observed differences for EE and EP. The literature on EAC and health is marked by heterogeneity across study methodologies and measures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Aproximación al diagnóstico infarto cerebral isquémico en adultos jóvenes / Approach to the diagnosis of ischemic cerebral infarction in Young adults / Approach to the diagnosis of ischemic cerebral infarction in Young adults / Abordagem para o diagnóstico de infarto cerebral isquêmico em adultos jovens

Introducción: El infarto cerebral isquémico (ICI) en adultos jóvenes ha emergido como un relevante problema de salud debido al incremento de su incidencia, alta mortalidad, larga duración del tiempo de la discapacidad y consecuencias sociales. Objetivo: Describir una aproximación al diagnóstico del infarto cerebral isquémico en adultos jóvenes sobre la base de la clasificación etiopatogénica, historia e investigaciones complementarias. Método: Se realizó una extensa revisión bibliográfica con el buscador Google Académico, en las bases de datos bibliográficas PubMed, SciELO y Medline, y con la búsqueda de palabras claves; siendo escogidos 32 artículos cuyo título y resumen se relacionaron con el tema de la presente revisión. Desarrollo: Los subtipos etiopatogénicos del infarto cerebral isquémico en adultos jóvenes difieren al compararlo con adultos mayores, y sus causas etiológicas son más variadas y heterogéneas. Los factores de riesgo, antecedentes patológicos personales y familiares, manifestaciones clínicas no neurológicas y neurológicas, permiten un acercamiento al diagnóstico, mientras que las investigaciones complementarias facilitan la confirmación del diagnóstico, la localización y tamaño del infarto isquémico, el establecimiento de la causa etiológica y el sustento de las decisiones terapéuticas. Consideraciones finales: La historia y manifestaciones clínicas obtenidas mediante el interrogatorio y examen físico, unido a las investigaciones complementarias, posibilita la aproximación al diagnóstico del subtipo etiopatogénico y a la causa del infarto cerebral isquémico en adultos jóvenes, lo que mejora las posibilidades de tratamiento del mismo.(AU)

Introduction: Ischemic stroke in young adults has emerged as a relevant health problem today due to its increased incidence, high mortality, the duration of the disability and social consequences. Objective: To describe an approach in diagnosis of ischemic stroke in young adults based on etiopathogenic classification, history and complementary investigations. Method: A wide-ranging bibliographic review was carried out using Google Scholar, searching in bibliographic databases like PubMed, SciELO and Medline, and searching different keywords; 32 articles were chosen in the process with title and abstract were linked with the subject of this review. Development: The etiopathogenic subtypes of ischemic stroke in young adults differ with regard to older adults, and its etiologic causes are more diverse and heterogeneous. Risk factors, personal and family pathological history, non-neurological and neurological clinical manifestations, allow an approach to diagnosis, while complementary investigations facilitate the confirmation of diagnosis, the location and size of the ischemic infarction, definition of the etiological cause and the support of therapeutic decisions. Final considerations: The history and clinical manifestations obtained through interrogation and physical examination, in association with complementary investigations, made it possible an approach to diagnosis of etiopathogenic subtype and the cause of ischemic brain infarction in young adults improving treatment possibilities.(AU)

Introdução: O acidente vascular cerebral (AVC) isquêmico em adultos jovens emergiu como um problema de saúde relevante devido à sua crescente incidência, elevada mortalidade, longa duração da incapacidade e consequências sociais. Objetivo: Descrever uma abordagem ao diagnóstico do AVC isquêmico em adultos jovens baseada na classificação etiopatogénica, na história e em exames complementares. Método: Foi realizado uma extensa revisão bibliográfica utilizando o motor de busca Google Scholar, as bases de dados bibliográficas PubMed, SciELO e Medline, e uma pesquisa por palavras-chave; foram selecionados 32 artigos cujo título e resumo estavam relacionados com o tema desta revisão. Desenvolvimento: Os subtipos etiopatogênicos do AVC isquêmico em adultos jovens diferem quando comparados aos adultos mais velhos, e suas causas etiológicas são mais variadas e heterogêneas. Os fatores de risco, os antecedentes patológicos pessoais e familiares, as manifestações clínicas não neurológicas e neurológicas permitem uma aproximação ao diagnóstico, enquanto as investigações complementares facilitam a confirmação do diagnóstico, a localização e o tamanho do infarto isquêmico, o estabelecimento da causa etiológica e o apoio às decisões terapêuticas. Considerações finais: A história e as manifestações clínicas obtidas por meio de questionamento e exame físico, juntamente com investigações complementares, permitem abordar o diagnóstico do subtipo etiopatogênico e a causa do AVC isquêmico em adultos jovens, melhorando as possibilidades de seu tratamento.(AU)

Corrected and republished from: "VP4 Is a Determinant of Alpha-Defensin Modulation of Rotaviral Infection".

IMPORTANCE: Rotavirus is a leading cause of severe diarrhea in young children. Like other fecal-oral pathogens, rotaviruses encounter abundant, constitutively expressed defensins in the small intestine. These peptides are a vital part of the vertebrate innate immune system. By investigating the impact that defensins from multiple species have on the infectivity of different strains of rotavirus, we show that some rotaviral infections can be inhibited by defensins. We also found that rotaviruses may have evolved resistance to defensins in the intestine of their host species, and some even appropriate defensins to increase their infectivity. Because rotaviruses infect a broad range of animals and rotaviral infections are highly prevalent in children, identifying immune defenses against infection and how they vary across species and among viral genotypes is important for our understanding of the evolution, transmission, and zoonotic potential of these viruses as well as the improvement of vaccines.

Hindbrain Stimulation Modulates Object Recognition Discrimination Efficiency and Hippocampal Synaptic Connections.

(1) Background: The cerebellum is well known to have functionalities beyond the control of motor function. However, brain stimulation studies have not explored the potential of this region to impact downstream processes which are imperative to multiple neurological conditions. Our study aimed to look at preliminary evidence that hindbrain-targeted repetitive transcranial magnetic stimulation (rTMS) in mice could alter motor, cognitive and anxiety measures; (2) Methods: Male B6129SF2/J mice (n = 16) were given rTMS (n = 9) over lambda at 10 Hz for 10 min or Sham (n = 7) for 14 consecutive days. Mice then underwent a battery of behavioral measures. (3) Results: In the object recognition test, only rTMS-treated mice distinguished between the novel object at 5 min, whereas those that received Sham treatment continued to improve discrimination from 5 to 10 min. Additionally, over the 10 min test phase, rTMS-stimulated mice explored the objects less than the Sham mice. This was accompanied by increased colocalization of presynaptic and postsynaptic markers in the hippocampus in the rTMS mice (4) Conclusions: Hindbrain rTMS stimulation elicits improved processing speed in the object recognition test via structural plasticity mechanisms in the hippocampus and could provide additional ways of targeting these important substructures of the brain.

Challenges associated with follow-up care after implementation of an HPV screen-and-treat program with ablative therapy for cervical cancer prevention in Iquitos, Peru: a mixed methods study.

Background: Cervical cancer is a preventable cancer; however, decreasing its prevalence requires early detection and treatment strategies that reduce rates of loss to follow-up. This study explores factors associated with loss to follow-up among HPV-positive women after implementation of a screen-and-treat approach with visual triage and ablative therapy for cervical cancer prevention in Iquitos, Peru. Methods: We conducted semi-structured interviews with nurse-midwives (n = 15) working in cervical cancer prevention and women (n = 24) who were recorded as lost to follow-up after positive HPV results. We used the Health Care Access Barriers Model to guide analysis. We utilize manifest content analysis to describe barriers to follow-up according to the nurse-midwives and thematic analysis to report themes from the women's perspectives. We also report the steps and time taken to contact women and report discrepancies and concordances between nurse-midwives and women regarding reasons for loss to follow-up. Results: Women in this study expressed a desire to receive treatment. Barriers, including fragmented and incomplete registry systems, made receiving follow-up care more challenging. Nurse-midwives faced structural barriers in attempting to deliver positive results to women who were challenging to contact, and women did not have clear knowledge of how to receive their HPV results. Women faced cognitive barriers including a lack of understanding about HPV results and treatment procedures, fear or anxiety about HPV or treatment, and confusion about the follow-up process. Women also reported having important work matters as a barrier. Reported financial barriers were minimal. There was agreement between women's and nurse-midwives' reported barriers to follow-up in slightly over half of the cases. Conclusion: This study highlights the barriers to follow-up after implementation of a primary-level HPV-based screen-and-treat approach. While some barriers that have previously been associated with loss to follow-up were not observed in this study (e.g., financial), we emphasize the need for screen-and-treat programs to focus on strategies that can address incomplete registry systems, structural challenges in results delivery, cognitive barriers in understanding results and treatment, and work-related barriers.

Escala de discapacidad de Oswestry en la corrección de la cifosis toracolumbar por espondilitis anquilopoyética

Introducción: Cuando se valora la cifosis toracolumbar por espondilitis anquilopoyética, se debe medir la repercusión funcional para mejorar la calidad de vida del paciente y solucionar los problemas de una atención adecuada. En consecuencia, se necesitan nuevos conocimientos que implementen una técnica quirúrgica y la escala de discapacidad de Oswestry, método innovador con cambios cualitativos en beneficio de los enfermos. Objetivo: Evaluar los resultados funcionales con la escala de Oswestry en la corrección de la cifosis toracolumbar por espondilitis anquilopoyética. Método: Se realizó un estudio tipo descriptivo, retrospectivo, longitudinal a 16 pacientes con cifosis toracolumbar por espondilitis anquilopoyética, intervenidos con la técnica de osteotomía de sustracción pedicular, en el Servicio de Ortopedia del Hospital Clínico Quirúrgico "Hermanos Ameijeiras", durante el período de marzo de 2001 a marzo de 2021. Resultados: Se obtuvo un buen resultado funcional y mejoró la calidad de vida de los pacientes. Conclusiones: La escala de Oswestry resulta viable, fácil de administrar y puntuar; además, presenta características métricas adecuadas para la evaluación funcional en la corrección de la cifosis toracolumbar por espondilitis anquilopoyética.

Introduction: When evaluating thoracolumbar kyphosis due to ankylopoietic spondylitis, the functional impact should be measured to improve the patient's quality of life and solve the problems of adequate care. Consequently, knowledge is needed to implement a surgical technique and the Oswestry disability scale, an innovative method with qualitative changes for the benefit of patients. Objective: To evaluate the functional results with the Oswestry scale in the correction of thoracolumbar kyphosis by ankylopoietic spondylitis. Method: A descriptive, retrospective, longitudinal study was performed on 16 patients with thoracolumbar kyphosis due to ankylopoietic spondylitis, who underwent surgery using the technique of pediatric subtractive osteotomy, in the Orthopedic Service of "Hermanos Ameijeiras" Clinical Surgical Hospital during the period from March 2001 and March 2021. Results: A good functional result was obtained and the quality of life of the patients improved. Conclusions: The Oswestry scale is feasible, easy to administer and score; in addition, it has adequate metric characteristics for the functional evaluation in the correction of thoracolumbar kyphosis by ankylopoietic spondylitis.

Effect sizes in ANCOVA and difference-in-differences designs.

It is common practice in both randomized and quasi-experiments to adjust for baseline characteristics when estimating the average effect of an intervention. The inclusion of a pre-test, for example, can reduce both the standard error of this estimate and-in non-randomized designs-its bias. At the same time, it is also standard to report the effect of an intervention in standardized effect size units, thereby making it comparable to other interventions and studies. Curiously, the estimation of this effect size, including covariate adjustment, has received little attention. In this article, we provide a framework for defining effect sizes in designs with a pre-test (e.g., difference-in-differences and analysis of covariance) and propose estimators of those effect sizes. The estimators and approximations to their sampling distributions are evaluated using a simulation study and then demonstrated using an example from published data.

Empathy, psychometrics, cut-off points in nursing students from Latin America.

BACKGROUND: Currently, there are no cut-off points for levels of empathy, making it difficult to assess the change experienced in its development or as a result of its intervention. It is an unsolved problem. INTRODUCTION: Empathy is a cognitive-affective attribute that enables nursing staff to maintain a professional relationship that entails various benefits for the patient. Its strengthening and development during university education is desirable. Empathy studies in Latin American nursing students are based on the direct scores obtained on an empathy test, based on which the variable is described and groups are compared. Statistical comparisons are not enough to discriminate substantive changes since two statistical values can show differences without implying that the post-intervention levels may correspond to a higher category in relation to those of pre-intervention or that two compared groups are qualitatively different. The above applies to empathic behaviour and is valid for students and professionals of health. This study aimed to establish cut-off points that allow defining ordinal categories in empathy. METHODS: In this multicenter and cross-sectional study, 3712 students from 11 Latin American nursing schools participated. The Jefferson Empathy Scale (JES) was applied; the psychometric properties were confirmed by Factor Analysis Confirmatory and Invariance. RESULTS: The JSE empathy scale is a measure with adequate reliability and construct validity. Examined cut-offs determined a structure of five empathy intervals that allowed them to be classified as empathy values in very high, high, medium, low and very low. DISCUSSION: The sequence of statistical tests carried out allowed us to determine ranges of categorical values in the empathy levels of groups of students. However, the determined categories may constitute a specific characteristic of them. It is not possible to extrapolate these results to regions other than those of Latin America. CONCLUSION: The estimated rankings allow comparing levels of empathy between groups of nursing students and the real effect of empathic interventions. IMPLICATIONS FOR NURSING: To contribute with strategies to evaluate changes in the empathic skills of nursing students, resulting in a well-valued skill in health services. IMPLICATIONS FOR NURSING POLICY: The cut-off points define evaluative categories (very low, low, medium, high and very high) that allow objective classification of levels of empathy achieved after (for example) an empathic intervention. This allows assessment of substantive changes experienced by nursing students (and professionals).

Women's perspectives on the acceptability and feasibility of an HPV screen-and-treat approach to cervical cancer prevention in Iquitos, Peru: a qualitative study.

BACKGROUND: The objective of this study was to explore women's experiences of a screen-and-treat approach with ablative therapy (referred to by the Spanish acronym TVT-TA) as a method of treatment following a positive HPV test in Iquitos, Peru. METHODS: A total of 111 in-depth interviews were conducted with 47 HPV positive women who attended the TVT-TA procedure at a primary-level healthcare facility. Interviews were conducted immediately before, immediately after, and six-weeks after TVT-TA. RESULTS: Most interviewed women reported experiencing moderate pain during ablative therapy and minimal pain immediately after and six weeks after ablative therapy. Women also stated that the pain was less intense than they had expected. The most common physical after-effects of treatment were bleeding and vaginal odor. Women experienced oscillating emotions with fear upon receiving a positive HPV result, calming after hearing about ablative therapy treatment, worry about pain from the treatment itself, relaxation with counseling about the procedure, and relief following treatment. CONCLUSIONS: Nearly all participants emphasized that they were pleased with the TVT-TA process even if they had experienced pain during TVT-TA, recommended that TVT-TA be expanded and available to more women, and stated that TVT-TA was faster and easier than expected. This study found that TVT-TA is a feasible and acceptable means of treating HPV according to the women receiving the treatment.

Sistemas de instrumentación espinal en la corrección de la cifosis toracolumbar por espondilitisanquilopoyética / Spinal Instrumentation Systems in The Correction of Thoracolumbar Kyphosis Due to AnkylosingSpondylitis

Introducción: En pocas áreas de la cirugía ortopédica se han producido cambios técnicos tan importantes en las últimas décadas como en la cirugía correctora espinal. Los cambios fundamentales han sobrevenido con los nuevos sistemas de instrumentación espinal, que se han modificado y mejorado sustancialmente para facilitar la corrección tridimensional de la deformidad y aportar fijación segura de la columna, corrección y estabilidad. Objetivo: Evaluar los resultados alcanzados con los sistemas de instrumentación espinal utilizados en la corrección de la cifosis toracolumbar por espondilitis anquilopoyética. Método: Se realizó un estudio tipo descriptivo, retrospectivo y longitudinal a 16 pacientes con cifosis toracolumbar por espondilitis anquilopoyética intervenidos con la técnica de osteotomía de sustracción pedicular e instrumentados con sistemas pediculares y sublaminar tipo Luque, en el servicio de Ortopedia del Hospital Clínico Quirúrgico Hermanos Ameijeiras, durante el período comprendido entre marzo de 2001 y marzo de 2021. Resultados: La totalidad de los pacientes correspondieron al sexo masculino, color de la piel blanca y edad promedio de 39 años. Se logró más del 80 por ciento de corrección en el perfil sagital y un promedio de 34,3° por osteotomía, sin complicaciones neurológicas mayores. Se obtuvo un buen resultado funcional, con un alto grado de satisfacción de los pacientes y mejora de su calidad de vida. Conclusiones: La utilización de ambos sistemas instrumentación espinal es eficaz para mantener la corrección de la cifosis toracolumbar por espondilitis anquilopoyética(AU)

Introduction: Few areas of orthopedic surgery have had such important technical changes in recent decades as in corrective spinal surgery. Fundamental changes have come with the new spinal instrumentation systems, which have been substantially modified and improved to facilitate three-dimensional correction of the deformity and provide secure spinal fixation, correction and stability. Objective: To evaluate the results achieved with the spinal instrumentation systems used in the correction of thoracolumbar kyphosis due to ankylosing spondylitis. Methods: A descriptive, retrospective and longitudinal study was carried out on 16 patients with thoracolumbar kyphosis due to ankylosing spondylitis operated on with the pedicle subtraction osteotomy technique and instrumented with Luque-type pedicle and sublaminar systems, in the Orthopedics service at Hermanos Ameijeiras Surgical Clinical Hospital, from March 2001 to March 2021. Results: All the patients were male, white skin color and average age of 39 years. More than 80 percent correction was achieved in the sagittal profile and an average of 34.3° per osteotomy, without major neurological complications. Good functional results were obtained, with high degree of patient satisfaction and improvement in their quality of life. Conclusions: The use of both spinal instrumentation systems is effective in maintaining the correction of thoracolumbar kyphosis due to ankylosing spondylitis(AU)

On the bias of complete- and shifting-case meta-regressions with missing covariates.

Missing covariates is a common issue when fitting meta-regression models. Standard practice for handling missing covariates tends to involve one of two approaches. In a complete-case analysis, effect sizes for which relevant covariates are missing are omitted from model estimation. Alternatively, researchers have employed the so-called "shifting units of analysis" wherein complete-case analyses are conducted on only certain subsets of relevant covariates. In this article, we clarify conditions under which these approaches generate unbiased estimates of regression coefficients. We find that unbiased estimates are possible when the probability of observing a covariate is completely independent of effect sizes. When that does not hold, regression coefficient estimates may be biased. We study the potential magnitude of that bias assuming a log-linear model of missingness and find that the bias can be substantial, as large as Cohen's d = 0.4-0.8 depending on the missingness mechanism.

VP4 Is a Determinant of Alpha-Defensin Modulation of Rotaviral Infection.

Fecal-oral pathogens encounter constitutively expressed enteric alpha-defensins in the intestine during replication and transmission. Alpha-defensins can be potently antiviral and antibacterial; however, their primary sequences, the number of isoforms, and their activity against specific microorganisms often vary greatly between species, reflecting adaptation to species-specific pathogens. Therefore, alpha-defensins might influence not only microbial evolution and tissue tropism within a host but also species tropism and zoonotic potential. To investigate these concepts, we generated a panel of enteric and myeloid alpha-defensins from humans, rhesus macaques, and mice and tested their activity against group A rotaviruses, an important enteric viral pathogen of humans and animals. Rotaviral adaptation to the rhesus macaque correlated with resistance to rhesus enteric, but not myeloid, alpha-defensins and sensitivity to human alpha-defensins. While mouse rotaviral infection was increased in the presence of mouse enteric alpha-defensins, two prominent genotypes of human rotaviruses were differentially sensitive to human enteric alpha-defensins. Furthermore, the effects of cross-species alpha-defensins on human and mouse rotaviruses did not follow an obvious pattern. Thus, exposure to alpha-defensins may have shaped the evolution of some, but not all, rotaviruses. We then used a genetic approach to identify the viral attachment and penetration protein, VP4, as a determinant of alpha-defensin sensitivity. Our results provide a foundation for future studies of the VP4-dependent mechanism of defensin neutralization, highlight the species-specific activities of alpha-defensins, and focus future efforts on a broader range of rotaviruses that differ in VP4 to uncover the potential for enteric alpha-defensins to influence species tropism. IMPORTANCE Rotavirus is a leading cause of severe diarrhea in young children. Like other fecal-oral pathogens, rotaviruses encounter abundant, constitutively expressed defensins in the small intestine. These peptides are a vital part of the vertebrate innate immune system. By investigating the impact that defensins from multiple species have on the infectivity of different strains of rotavirus, we show that some rotaviral infections can be inhibited by defensins. We also found that some, but not all, rotaviruses may have evolved resistance to defensins in the intestine of their host species, and some even appropriate defensins to increase their infectivity. Because rotaviruses infect a broad range of animals and rotaviral infections are highly prevalent in children, identifying immune defenses against infection and how they vary across species and among viral genotypes is important for our understanding of the evolution, transmission, and zoonotic potential of these viruses as well as the improvement of vaccines.

Exploratory Analyses for Missing Data in Meta-Analyses and Meta-Regression: A Tutorial.

OBJECTIVES: In this tutorial, we examine methods for exploring missingness in a dataset in ways that can help to identify the sources and extent of missingness, as well as clarify gaps in evidence. METHODS: Using raw data from a meta-analysis of substance abuse interventions, we demonstrate the use of exploratory missingness analysis (EMA) including techniques for numerical summaries and visual displays of missing data. RESULTS: These techniques examine the patterns of missing covariates in meta-analysis data and the relationships among variables with missing data and observed variables including the effect size. The case study shows complex relationships among missingness and other potential covariates in meta-regression, highlighting gaps in the evidence base. CONCLUSION: Meta-analysts could often benefit by employing some form of EMA as they encounter missing data.

Abnormal Liver Tests during Hospitalization Predict Mortality in Patients with COVID-19: A Multicenter Study from South America.

Background: The role of liver function tests (LFT) as prognostic factors in patients admitted with COVID-19 has not been fully investigated, particularly outside resource-rich countries. We aimed at evaluating the prognostic value of abnormal LFT on admission and during hospitalization of patients with COVID-19. Methods: We performed a retrospective study that included 298 adult patients hospitalized for COVID-19, between 05/2020 and 02/2021, in 6 hospitals from 5 countries in South America. We analyzed demographic and comorbid variables and laboratory tests on admission and during hospitalization. LFT over twice the upper limit of normal (ALEx2) were also evaluated in relation to a variety of factors on admission and during hospitalization. De novo-ALEx2 was defined as the presence of ALEx2 at one week of hospitalization in patients without ALEx2 on admission. Patients were followed until hospital discharge or death. Multivariable analysis was used to evaluate the association between ALEx2 on admission and during hospitalization and mortality. Results: Of the total of 298 patients, 60% were male, with a mean age of 60 years, and 74% of patients had at least one comorbidity. Of those, 137 (46%) patients were transferred to the intensive care unit and 66 (22.1%) patients died during hospitalization. ALEx2 on admission was present in 87 (29.2%) patients and was found to be independently associated with 1-week mortality (odds ratio (OR) = 3.55; 95% confidence interval (95%CI) 1.05-12.05). Moreover, 84 (39.8%) out of 211 patients without ALEx2 at admission developed de novo-ALEx2, which was independently associated with mortality during second week of hospitalization (OR = 6.09; 95%CI 1.28-29) and overall mortality (OR = 2.93, 95%CI 1.05-8.19). Conclusions: A moderate elevation of LFT during admission was associated with a poor short-term prognosis in patients hospitalized with COVID-19. In addition, moderate elevation of LFT at one week of hospitalization was an independent risk factor for overall mortality in these patients.

Empatía y declinación empática por curso y sexo en estudiantes de enfermería / Empathy and Empathic Decline by Academic Year and Sex in Nursing Students

Introducción: La empatía es un atributo importante en la comunicación entre el profesional de salud (médicos y enfermeras de todas las especialidades) y el paciente; permite la conexión intersubjetiva entre ellos y contribuye a una mejor atención, mayor adherencia al tratamiento, entre otros muchos beneficios. Dada la complejidad de la empatía, la formación de este atributo es una tarea que se debe asumir durante la formación de pregrado y no durante la formación de especialistas. Por lo tanto, los estudios de empatía, así como las intervenciones que pueden derivarse de un diagnóstico empático adecuado, deben realizarse precisamente en dicho nivel formativo. Objetivo: Determinar la presencia de declinación empática, atendiendo a las variables curso y sexo, sobre la base de los niveles de empatía y de sus dimensiones en estudiantes de enfermería. Métodos: Estudio exploratorio, transversal. Se estudiaron 166 estudiantes de un total poblacional de 188, utilizando la Escala de Empatía de Jefferson, estudiando las posibles diferencias en la empatía y sus componentes mediante pruebas no paramétricas. Resultados: No hubo diferencias en los componentes de la empatía en relación con la variable curso; sin embargo, la empatía (en general) si las tuvo. La empatía y los componentes no se diferenciaron en el sexo, con excepción de Toma de Perspectiva que fue mayor en mujeres. Conclusiones: Los niveles de empatía entre los cursos no fueron diferentes y no se manifestó la declinación empática. No existieron diferencias entre los sexos y solo el componente Toma de Perspectiva fue mayor en mujeres(AU)

Introduction: Empathy is an important attribute for communication between the health professional (doctors and nurses of all specialties) and the patient; it allows intersubjective connection between them and contributes to better care, greater adherence to treatment, among many other benefits. Given the complexity of empathy, educating this attribute is a task that must be assumed during undergraduate training and not during specialized training. Therefore, studies about empathy, as well as the interventions that can be derived from an adequate empathic diagnosis, must be carried out precisely at this training level. Objective: To determine the presence of empathic decline, with a focus on the variables academic years and sex, based on the levels of empathy and its dimensions in Nursing students. Methods: Exploratory and cross-sectional study carried out with 166 students, from a total population of 188. The Jefferson Empathy Scale was used. The possible differences in empathy and its components were studied using nonparametric tests. Results: There were no differences in the components of empathy regarding the variable academic year; however, empathy, in general, did have differences. Empathy and its components did not differ by sex, with the exception of perspective taking, which was higher in women(AU) Conclusions: The levels of empathy between academic years were not different and empathic decline was not manifested. There were no differences between the sexes and only the component perspective taking was higher in women.

Defensin-driven viral evolution.

Enteric alpha-defensins are potent effectors of innate immunity that are abundantly expressed in the small intestine. Certain enteric bacteria and viruses are resistant to defensins and even appropriate them to enhance infection despite neutralization of closely related microbes. We therefore hypothesized that defensins impose selective pressure during fecal-oral transmission. Upon passaging a defensin-sensitive serotype of adenovirus in the presence of a human defensin, mutations in the major capsid protein hexon accumulated. In contrast, prior studies identified the vertex proteins as important determinants of defensin antiviral activity. Infection and biochemical assays suggest that a balance between increased cell binding and a downstream block in intracellular trafficking mediated by defensin interactions with all of the major capsid proteins dictates the outcome of infection. These results extensively revise our understanding of the interplay between defensins and non-enveloped viruses. Furthermore, they provide a feasible rationale for defensins shaping viral evolution, resulting in differences in infection phenotypes of closely related viruses.

Case Report of Acquired Stuttering After Soccer-Related Concussion: Functional Magnetic Resonance Imaging as a Prognostic Tool.

BACKGROUND: Acquired stuttering has been reported resulting from various forms of traumatic brain injury. In stuttering patients, there has been an association with higher activity of right frontal operculum activity on functional magnetic resonance imaging (MRI). This report looked to identify any structural lesions in a patient with postconcussive stuttering after a head injury playing soccer. CASE DESCRIPTION: A 16-year-old girl presented with acquired stuttering after striking the back of her head during a soccer match. She did not lose consciousness. She complained of a mild headache, complained of blurred vision, and was slightly lethargic. The next morning, she was noted to have a significant problem with stuttering. Examination was remarkable for some mild occipital tenderness. Speech was noted to have significant stuttering. She was unable to sing without stuttering. Remaining neurologic examination was normal. Brain computed tomography scan and MRI were normal, with no evidence of any bleeding or contusions. Functional MRI was performed, and no increased activity was seen in the right frontal operculum. The patient was referred for speech therapy. Her symptoms continued for 6 weeks and slowly started to improve and resolved by 9 weeks after her accident. At 6 months, she had no residual speech problems. CONCLUSIONS: Stuttering can occur after mild to moderate head trauma. Patients with permanent stuttering have been found to have increased activity in the right frontal operculum. If no identifiable lesion can be seen, the stuttering may resolve spontaneously. Functional MRI maybe helpful in differentiating between permanent versus transient stuttering after head trauma.

Habilidades pedagógicas en docentes cirujanos de la carrera de medicina de la Universidad de Antofagasta / Pedagogical skills in teaching surgeons of the medicine career of the University of Antofagasta

Introducción: Como parte de las actividades de perfeccionamiento académico del Departamento de Ciencias Médicas, se aplicó un cuestionario a médicos especialistas en cirugía de la carrera de medicina de la Universidad de Antofagasta que desarrollan actividades curriculares en el ámbito clínico o teórico en el internado de cirugía y asignaturas clínicas del plan de estudios, con el fin de caracterizar su experiencia en docencia universitaria. Sujetos y métodos: Estudio cuantitativo transversal de carácter exploratorio y descriptivo, en el que participaron 13 médicos cirujanos especialistas que cumplen labores docentes en el internado de cirugía y asignaturas clínicas de la carrera de medicina de la Universidad de Antofagasta. El procedimiento de recogida de información consistió en una encuesta descriptiva. Resultados: La mayoría de los docentes posee trayectoria en docencia entre 1 y 15 años; no obstante, es importante realizar perfeccionamiento académico considerando que un 53,8% refiere no poseer capacitaciones en docencia, lo que se refleja en una mayor utilización de estrategias de aprendizaje y de evaluación tradicionales. Además, las necesidades de capacitación aluden a estrategias metodológicas de enseñanza y de evaluación. Conclusión: La investigación realizada da cuenta de la oportunidad del Departamento de Ciencias Médicas para capacitar en habilidades pedagógicas a sus docentes médicos especialistas en cirugía, para la adopción de estrategias metodológicas y evaluativas centradas en el estudiante

Introduction: As part of the academic improvement activities of the Department of Medical Sciences, a questionnaire was applied to medical specialists in surgery of the medicine career of the University of Antofagasta, who develop curricular activities in the clinical and/or theoretical field in the internship of surgery and clinical subjects of the plan of studies, to characterize their experience in university teaching. Subjects and methods: A cross-sectional quantitative study of an exploratory-descriptive nature, in which 13 specialized surgeon physicians participated in teaching at the surgery board and clinical subjects of the medicine career at the University of Antofagasta. The information collection procedure consisted of a descriptive survey. Results: Most teachers have a teaching career between 1 and 15 years, however, it is important to perform academic improvement, considering that 53.8% say they do not have teaching skills, which is reflected in a greater use of learning strategies and traditional evaluation. In addition, the training needs refer to methodological strategies of teaching and evaluation. Conclusion: The research carried out shows the opportunity of the Department of Medical Sciences to train their teaching physicians specialized in surgery in pedagogical skills, for the adoption of methodological and evaluative strategies centered on the student