Complex Karyotype Detection in Chronic Lymphocytic Leukemia: A Comparison of Parallel Cytogenetic Cultures Using TPA and IL2+DSP30 from a Single Center.

Current CLL guidelines recommend a two parallel cultures assessment using TPA and IL2+DSP30 mitogens for complex karyotype (CK) detection. Studies comparing both mitogens for CK identification in the same cohort are lacking. We analyzed the global performance, CK detection, and concordance in the complexity assessment of two cytogenetic cultures from 255 CLL patients. IL2+DSP30 identified more altered karyotypes than TPA (50 vs. 39%, p = 0.031). Moreover, in 71% of those abnormal by both, IL2+DSP30 identified more abnormalities and/or abnormal metaphases. CK detection was similar for TPA and IL2+DSP30 (10% vs. 11%). However, 11/33 CKs (33%) were discordant, mainly due to the detection of a normal karyotype or no metaphases in the other culture. Patients requiring treatment within 12 months after sampling (active CLL) displayed significantly more CKs than those showing a stable disease (55% vs. 12%, p < 0.001). Disease status did not impact cultures' concordance (κ index: 0.735 and 0.754 for stable and active). Although CK was associated with shorter time to first treatment (TTFT) using both methods, IL2+DSP30 displayed better accuracy than TPA for predicting TTFT (C-index: 0.605 vs. 0.580, respectively). In summary, the analysis of two parallel cultures is the best option to detect CKs in CLL. Nonetheless, IL2+DSP30 could be prioritized above TPA to optimize cytogenetic assessment in clinical practice.

Forearm Posture Affects the Corticospinal Excitability of Intrinsic and Extrinsic Hand Muscles in Dominant and Nondominant Sides.

Different forearm postures can modulate corticospinal excitability. However, there is no consensus on whether handedness plays a role in such a mechanism. This study investigated the effects of 3 forearm postures (pronation, neutral, and supination) on the corticospinal excitability of muscles from the dominant and nondominant upper limbs. Surface electromyography was recorded from the abductor digiti minimi, flexor pollicis brevis, and flexor carpi radialis from both sides of 12 right-handed volunteers. Transcranial magnetic stimulation pulses were applied to each muscle's hotspot in both cerebral hemispheres. Motor-evoked potential peak-to-peak amplitude and latency and resting motor threshold were measured. The data were evaluated by analysis of variance. The level of significance was set at 5%. The resting motor threshold was similar for the 3 muscles and both sides. Motor-evoked potential peak-to-peak amplitude from flexor pollicis brevis was lower during supination, and the dominant upper limb latency was longer. The flexor carpi radialis presented lower motor-evoked potential peak-to-peak amplitudes for neutral and shorter latencies during supination. Abductor digiti minimi seemed not to be affected by posture or side. Different muscles from dominant and nondominant sides may undergo corticospinal modulation, even distally localized from a particular joint and under rest.

Correction: Beyond words: From jaguar population trends to conservation and public policy in Mexico.

[This corrects the article DOI: 10.1371/journal.pone.0255555.].

Effect of muscle length in a handgrip task on corticomotor excitability of extrinsic and intrinsic hand muscles under resting and submaximal contraction conditions.

The neurophysiological mechanisms underlying muscle force control for different wrist postures still need to be better understood. To further elucidate these mechanisms, the present study aimed to investigate the effects of wrist posture on the corticospinal excitability by transcranial magnetic stimulation (TMS) of extrinsic (flexor [FCR] and extensor carpi radialis [ECR]) and intrinsic (flexor pollicis brevis (FPB)) muscles at rest and during a submaximal handgrip strength task. Fourteen subjects (24.06 ± 2.28 years) without neurological or motor disorders were included. We assessed how the wrist posture (neutral: 0°; flexed: +45°; extended: -45°) affects maximal handgrip strength (HGSmax ) and the motor evoked potentials (MEP) amplitudes during rest and active muscle contractions. HGSmax was higher at 0° (133%) than at -45° (93.6%; p < 0.001) and +45° (73.9%; p < 0.001). MEP amplitudes were higher for the FCR at +45° (83.6%) than at -45° (45.2%; p = 0.019) and at +45° (156%; p < 0.001) and 0° (146%; p = 0.014) than at -45° (106%) at rest and active condition, respectively. Regarding the ECR, the MEP amplitudes were higher at -45° (113%) than at +45° (60.8%; p < 0.001) and 0° (72.6%; p = 0.008), and at -45° (138%) than +45° (96.7%; p = 0.007) also at rest and active conditions, respectively. In contrast, the FPB did not reveal any difference among wrist postures and conditions. Although extrinsic and intrinsic hand muscles exhibit overlapping cortical representations and partially share the same innervation, they can be modulated differently depending on the biomechanical constraints.

Type D Adipsia with Severe Hypernatremia: A Unique Presentation of an Extensive Intracranial Germinoma.

Intracranial germ cell tumors are uncommon brain tumors; germinoma is the most common tumor in children and young adults, and the most common regions affected are pineal gland and suprasellar region. Germinomas of the suprasellar region are accompanied by endocrine alterations, with adipsia being a rare presentation. Here, we present the case of a patient with an extensive intracranial germinoma whose initial presentation was adipsia, without any other endocrinological alteration, with development of severe hypernatremia and unusual manifestations derived from it, such as deep vein thrombosis, myopathy with rhabdomyolysis, and neurological axonal damage.

La población gitana tiene miedos sobre la donación de órganos propios para trasplante / The Roma population's fear of donating their own organs for transplantation

Introducción: La tasa de negativas a la donación entre el pueblo gitano es muy superior a la de cualquier otro grupo social. Objetivo: Analizar la actitud hacia la donación de los órganos propios entre la población gitana residente en España. Métodos: Tipo de estudio: estudio sociológico observacional nacional español estratificado por género y edad. Población a estudio: población gitana con edad≥15 años residente en España. Tamaño muestral: 1.253 encuestados. Instrumento de valoración: cuestionario validado de actitud hacia la donación de órganos para trasplante PCID-DTO Ríos. Trabajo de campo: selección aleatoria en función de la estratificación. Cumplimentación anónima y autoadministrada. Fue precisa la colaboración de personas de etnia gitana. Estadística: test de t de Student, χ2, Fisher y un análisis de regresión logística. Resultados: El grado de cumplimentación fue del 18,2% (n=228). De los que han cumplimentado el cuestionario, están a favor de la donación el 42,1% (n=96), indeciso el 30,3% (n=69) y en contra el 27,6% restante (n=63). De los 1.025 (81,8%) que rechazaron cumplimentar el cuestionario, 1.004 (98%) indicaron que era por miedo a hablar y rellenar un cuestionario que plantee el tema de la muerte y la donación de órganos tras fallecer. Si se considera que los que no han cumplimentado el cuestionario por miedo a la muerte y la donación de órganos tras fallecer no están a favor, los resultados serían los siguientes: el 7,8% (n=96) a favor de donar sus órganos frente al 92,2% (n=1.136) no a favor (en contra o indecisos). Conclusiones: La población gitana presenta un rechazo mayoritario a plantear el tema de la muerte y la donación de órganos tras fallecer. Estos hallazgos muestran que las campañas actuales para promover la donación de órganos no son efectivas en este grupo de población. (AU)

Introduction: The refusal rate for donating organs among the Roma people is much higher than that of any other social group. Objective: To analyze the attitude towards the donation of one's own organs among the Roma population living in Spain. Methods: Type of study: Spanish national observational sociological study stratified by gender and age. Study population: Roma population aged≥15 years living in Spain. Sample size: 1253 respondents. Assessment instrument: validated questionnaire on attitude towards organ donation for transplantation PCID-DTO Ríos. Field work: random selection based on stratification. Anonymous and self-administered completion. The collaboration of people of Roma ethnicity was required. Statistics: Student's t test, χ2, Fisher's exact test and a logistic regression analysis. Results: The degree of completion was 18.2% (n=228). Of those who completed the questionnaire, 42.1% (n=96) were in favor of donation, 30.3% (n=69) were undecided and the remaining 27.6% (n=63) were against it. Of the 1025 (81.8%) who declined to complete the questionnaire, 1004 (98%) indicated that it was for fear of speaking about and filling in a questionnaire that raises the issue of death and organ donation after death. If those who did not complete the questionnaire due to fear of death and donating organs after death are considered not in favor, the results would be as follows: 7.8% (n=96) in favor of donating their organs compared to 92.2% (n=1136) not in favor (against or undecided). Conclusions: A majority of the Roma population prefer not speak of death nor organ donation after death. These findings show that current campaigns to promote organ donation are not effective in this population group. (AU)

Response of masticatory muscles to treatment with orthodontic aligners: a preliminary prospective longitudinal study.

INTRODUCTION: The emergence of orthodontic aligners has provided an aesthetic and comfortable option for orthodontic treatment. However, the encapsulated design of the aligners can influence the masticatory muscles, and might compromise safe treatment. OBJECTIVE: This preliminary longitudinal study aimed to investigate whether the use of orthodontic aligners affects the biting force and myoelectric activity of the superficial masseter and anterior temporal muscles. METHODS: Ten subjects participated in the study and underwent treatment during an 8-month follow-up period. The root mean square (RMS), the median power frequency (MPF) of the surface electromyography (sEMG) signals, and the biting force (kgf) were recorded and normalized relative to the pretreatment condition. The data were analyzed by repeated-measure analysis of variance (ANOVA), with the significance level set at 5%. RESULTS: Both the superficial masseter and the anterior temporal muscles presented an increase in sEMG signal activity during the treatment, with a marked increase in the latter compared to the former (p<0.05). Moreover, a significant decrease in bite force was evidenced (p<0.05). CONCLUSIONS: This preliminary study observed that the orthodontic aligners affected the muscle recruitment pattern of masticatory muscles, and reduced biting performance during the 8-month follow-up period.

Association Between Protocols of the Sit-to-Stand Test and Lower Limb Muscle Force Output in Patients on Hemodialysis and Subjects Without Chronic Kidney Disease.

OBJECTIVE: To evaluate the association of three protocols of the sit-to-stand (STS) test with muscle force output of knee extension (KE) and knee flexion (KF) in patients on hemodialysis and subjects without chronic kidney disease. METHODS: This cross-sectional study included a hemodialysis group [n = 60, 59.5 (16.8) years, 55% female] and a control group [n = 60, 43.0 (11.8) years, 50% female]. The assessments were performed in 2 days, and the participants were submitted to three protocols of STS test (5-repetition STS, 10-repetition STS and 30-s STS) or muscle force output of the KE and KF evaluation by handheld dynamometer based on randomization. RESULTS: The hemodialysis group presented reduced muscle force output of the KE and KF, a longer time to perform the 5 STS and 10 STS tests, and a lower number of repetitions in the 30-s STS test. The three STS tests were associated with muscle force output of the KE in the hemodialysis group, in which the 10-repetition STS test showed the best association (R2 = 0.47; adjusted R2 = 0.42). However, the only association between the STS test and muscle force output of the KE in the control group was found in the 10-repetition STS test (R2 = 0.20; adjusted R2 = 0.13). CONCLUSIONS: The three protocols of STS tests were associated with muscle force output of the KE in patients on hemodialysis. However, the 10-repetition STS test was the best protocol to estimate the quadriceps muscle torque in these patients.

Cardiorespiratory and Emotional Responses During Balance Exercises.

Purpose: Physical exercises on unstable surfaces have been largely applied for clinical practice as well as in sports training. Although the unsteadiness can lead to physiological and psychological adaptations, little is known about the autonomic and emotional acute responses during the practice of balance exercises. This study aimed to evaluate both cardiorespiratory and emotional responses while standing on different unstable surfaces. Methods: Eighty-eight healthy participants performed postural balance tasks in three experimental conditions: (1) a rigid surface (control); (2) balance pad; and (3) the Both Sides Up (BOSU) ball. Respiratory activity was recorded through the thoracic movement and the heart rate variability by the electrocardiographic signal during the balance tasks. After the participants evaluated the level of perceived stability and emotional aspects related to each experimental condition. Results: The main results showed that BOSU condition was perceived as more unstable, unpleasant, with higher arousal and lower dominance levels (p < .05). Accordingly, participants had also an increase in the mean respiratory frequency and heart rate (p < .05). Conclusion: These results showed that the postural task with greater instability prompted congruent physiological adjustments to ensure the homeostasis in the more challenging condition. Therefore, the cardiorespiratory and emotional responses should be considered to ensure the safety and benefits in rehabilitation programs in which the exercise progression is based on unstable surfaces.

The Roma population's fear of donating their own organs for transplantation.

BACKGROUND: The refusal rate for donating organs among the Roma people is much higher than that of any other social group. OBJECTIVE: To analyze the attitude towards the donation of one's own organs among the Roma population living in Spain. METHOD: . TYPE OF STUDY: Spanish national observational sociological study stratified by gender and age. STUDY POPULATION: Roma population aged ≥15 years living in Spain. SAMPLE SIZE: 1,253 respondents. Assessment instrument: Validated questionnaire on attitude towards organ donation for transplantation "PCID - DTO Ríos". Field work: Random selection based on stratification. Anonymous and self-administered completion. The collaboration of people of Roma ethnicity was required. STATISTICS: Student's t test, χ2, Fisher's exact test and a logistic regression analysis. RESULTS: The degree of completion was 18.2% (n = 228). Of those who completed the questionnaire, 42.1% (n = 96) were in favor of donation, 30.3% (n = 69) were undecided and the remaining 27.6% (n = 63) were against it. Of the 1,025 (81.8%) who declined to complete the questionnaire, 1,004 (98%) indicated that it was for fear of speaking about and filling in a questionnaire that raises the issue of death and organ donation after death. If those who did not complete the questionnaire due to fear of death and donating organs after death are considered not in favor, the results would be as follows: 7.8% (n = 96) in favor of donating their organs compared to 92.2% (n = 1166) not in favor (against or undecided). CONCLUSIONS: A majority of the Roma population prefer not speak of death nor organ donation after death. These findings show that current campaigns to promote organ donation are not effective in this population group.

Response of masticatory muscles to treatment with orthodontic aligners: a preliminary prospective longitudinal study

ABSTRACT Introduction: The emergence of orthodontic aligners has provided an aesthetic and comfortable option for orthodontic treatment. However, the encapsulated design of the aligners can influence the masticatory muscles, and might compromise safe treatment. Objective: This preliminary longitudinal study aimed to investigate whether the use of orthodontic aligners affects the biting force and myoelectric activity of the superficial masseter and anterior temporal muscles. Methods: Ten subjects participated in the study and underwent treatment during an 8-month follow-up period. The root mean square (RMS), the median power frequency (MPF) of the surface electromyography (sEMG) signals, and the biting force (kgf) were recorded and normalized relative to the pretreatment condition. The data were analyzed by repeated-measure analysis of variance (ANOVA), with the significance level set at 5%. Results: Both the superficial masseter and the anterior temporal muscles presented an increase in sEMG signal activity during the treatment, with a marked increase in the latter compared to the former (p<0.05). Moreover, a significant decrease in bite force was evidenced (p<0.05). Conclusions: This preliminary study observed that the orthodontic aligners affected the muscle recruitment pattern of masticatory muscles, and reduced biting performance during the 8-month follow-up period.

RESUMO Introdução: O surgimento dos alinhadores ortodônticos tem proporcionado uma opção estética e confortável para o tratamento ortodôntico. No entanto, o design encapsulado dos alinhadores pode influenciar os músculos mastigatórios e comprometer a segurança do tratamento. Objetivo: Este estudo longitudinal preliminar teve como objetivo investigar se o uso de alinhadores ortodônticos afeta a força de mordida e a atividade mioelétrica dos músculos masseter superficial e temporal anterior. Métodos: Dez indivíduos participaram do estudo e foram submetidos a tratamento durante um período de acompanhamento de 8 meses. A raiz quadrada média (RMS), a frequência mediana de potência (FMP) dos sinais de superfície da eletromiografia (sEMG) e a força de mordida (kgf) foram registradas e normalizadas em relação à condição de pré-tratamento. Os dados foram analisados por análise de variância para medidas repetidas (ANOVA), com nível de significância estabelecido em 5%. Resultados: Tanto o masseter superficial quanto o temporal anterior apresentaram aumento da atividade do sinal sEMG durante o tratamento, com aumento acentuado desse último em comparação ao primeiro (p<0,05). Além disso, foi evidenciada uma diminuição significativa da força de mordida (p<0,05). Conclusões: Esse estudo preliminar observou que os alinhadores ortodônticos afetaram o padrão de recrutamento muscular dos músculos mastigatórios e reduziram o desempenho da mordida durante o período de acompanhamento de oito meses.

Attitude Toward Organ Donation Among Cuban Residents in Florida.

BACKGROUND: The Cuban population residing in the state of Florida in the United States forms the largest population group of immigrants in that state. It has been described as a population with little awareness of organ donation. The objective is to analyze the factors that Cubans residing in the Florida refer to when expressing an unfavorable attitude toward organ donation and to determine the psychosocial factors associated with the attitude toward organ donation of this population group. METHODS: We performed a cross-sectional observational study. From the Proyecto Colaborativo Internacional Donante (International Donor Collaborative Project), a sample stratified by age and sex of Cubans residing in Florida (N = 1224) is obtained. The sample is analyzed using the validated questionnaire (PCID-DTO-RIOS). The reasons against organ donation were analyzed using a specific multiresponse item, with an open response option. For the analysis of the psychosocial variables, a logistic regression analysis is carried out. RESULTS: A total of 38.2% (n = 468) of the individuals under study declared themselves against organ donation. Of those who were against, the reasons stated were (1) leave the dead in peace (n = 440; 57.6%); (2) religious reasons (n = 192; 25.1%); (3) fear of mutilation (n = 160; 20.9%); (4) assertive refusal (n = 128; 16.8%); (5) apparent death (n = 16; 2.1%); and (6) other reasons (n = 764; 62.4%). CONCLUSIONS: The Cuban population residing in Florida who is against organ donation expresses various reasons. In addition, there are factors associated with the psychosocial profile toward organ donation of this important population group.

Clinical Application of Epithelial Sodium Channel (ENaC) as a Biomarker for Arterial Hypertension.

Arterial hypertension (HTN) is a global public health concern and an important risk factor for cardiovascular diseases and renal failure. We previously reported overexpression of ENaC on the plasma membrane of human platelets is a hallmark of HTN. In this double-blinded study of an open population (n = 167), we evaluated the sensitivity and specificity of a diagnostic assay based on gold nanoparticles (AuNPs) conjugated to an antibody against epithelial sodium channel (ENaC) expressed on platelets, which is detected using a fluorescent anti-ENaC secondary antibody and spectrofluorometry. Using the cutoff value for the AuNP-anti-ENaC assay, we confirmed the diagnosis for 62.1% of patients with clinical HTN and detected 59.7% of patients had previously undiagnosed HTN. Although some shortcomings in terms of accurately discriminating healthy individuals and patients with HTN still need to be resolved, we propose this AuNP-anti-ENaC assay could be used for initial screening and early diagnosis to critically improve opportune clinical management of HTN.