Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk.

BACKGROUND: A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures. METHODS: Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia. RESULTS: A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women (p < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm2 and 3.66 cm2 for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women. CONCLUSIONS: Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice.

Sustained aviremia despite anti-retroviral therapy non-adherence in male children after in utero HIV transmission.

After sporadic reports of post-treatment control of HIV in children who initiated combination anti-retroviral therapy (cART) early, we prospectively studied 284 very-early-cART-treated children from KwaZulu-Natal, South Africa, after vertical HIV transmission to assess control of viremia. Eighty-four percent of the children achieved aviremia on cART, but aviremia persisting to 36 or more months was observed in only 32%. We observed that male infants have lower baseline plasma viral loads (P = 0.01). Unexpectedly, a subset (n = 5) of males maintained aviremia despite unscheduled complete discontinuation of cART lasting 3-10 months (n = 4) or intermittent cART adherence during 17-month loss to follow-up (n = 1). We further observed, in vertically transmitted viruses, a negative correlation between type I interferon (IFN-I) resistance and viral replication capacity (VRC) (P < 0.0001) that was markedly stronger for males than for females (r = -0.51 versus r = -0.07 for IFN-α). Although viruses transmitted to male fetuses were more IFN-I sensitive and of higher VRC than those transmitted to females in the full cohort (P < 0.0001 and P = 0.0003, respectively), the viruses transmitted to the five males maintaining cART-free aviremia had significantly lower replication capacity (P < 0.0001). These data suggest that viremic control can occur in some infants with in utero-acquired HIV infection after early cART initiation and may be associated with innate immune sex differences.

Jawbone quality classification in dental implant planning and placement studies. A scoping review.

Aim: Cone beam computed tomography has become an attractive method for implant planning. However, in most cases, not all the information is taken advantage of and often the radiographic evaluation of bone quality is based on subjective assessment by the individual clinician. Therefore, the aim of this study was to examine classifications of bone tissue characteristics and methods for assessing them in dental implant planning and placement studies. Materials and Methods: Three databases (Pubmed, Scopus, Web of Science) were searched using specific index terms: "Bone quality, bone quantity, bone density, cone-beam CT and cone-beam computed tomography". Three reviewers selected titles and analyzed abstracts according to inclusion and exclusion criteria. Some descriptions of bone tissue characteristics (bone quality, density, and quantity) used before or during dental implant placement were selected and categorized. Results: The search yielded 442 titles. A total of 32 articles were selected and read in full text. Seventeen articles were considered relevant. Different classification systems were found to evaluate bone tissue characteristics as well as different examination protocols. Thirteen publications included in this review reported on bone quality and quantity using the Lekholm and Zarb classification. However, only four studies implemented and/or proposed modifications of the Lekholm and Zarb system. Four other publications described bone quality according to different classification systems such as Misch, University of California Los Angeles (UCLA), or Trisi and Rao. The assessment methods were often briefly described (or not described at all in one publication). Of the articles analyzed, five presented observer performance, whereas three presented diagnostic accuracy of the assessment method. Conclusion: Currently, there are different classification systems applied to dental implant planning and placement, particularly regarding whether bone quality or quantity affects treatment outcomes. However, most authors have not validated the diagnostic accuracy and reproducibility of the classification used. Therefore, it is necessary to develop a classification system consistent with characteristics of bone tissue, taking into consideration an adequate description of bone tissue assessment methods, their diagnostic accuracy, and observer performance.

Sexual dimorphism of maxillary sinuses in adult population using cone-beam computed tomography. A pilot study.

Objective: This study aims to evaluate the sexual dimorphism of maxillary sinuses (MS) using cone-beam computed tomography (CBCT). Method: A total of 80 CBCT scans were taken from Peruvian patients aged between 20 and 70 years-old. The dimensions (length, width, and height) of the MS were measured and evaluated. The data were analyzed using the Mann-Whitney U test with a significance level of p < 0.05. Results: The left MS was wider than the right MS. Meanwhile, the right MS was longer than the left MS. In addition, the height of the right and left MS was significantly different in males and females, with p-value of 0.003 and 0.044 respectively. Bigger dimension of height of the MS was found in patients aged between 30 and 39 as well as patients aged between 40 and 49, whereas smaller dimension of height of the MS was found in patients aged between 60 and 70. Furthermore, the height of the right MS was significantly different in dentate and edentulous patients, with p-value of 0.033 and 0.043 respectively. The height of the right MS was predicted at 65 % in males and 70 % in females (p = 0.002). Conclusion: The morphometry of the maxillary sinuses can be used for predicting sexual dimorphism.

HPN328, a Trispecific T Cell-activating Protein Construct Targeting DLL3-Expressing Solid Tumors.

Delta-like ligand 3 (DLL3) is expressed in more than 70% of small cell lung cancers (SCLCs) and other neuroendocrine-derived tumor types. SCLC is highly aggressive and limited therapeutic options lead to poor prognosis for patients. HPN328 is a tri-specific T cell activating construct (TriTAC) consisting of three binding domains: a CD3 binder for T cell engagement, an albumin binder for half-life extension, and a DLL3 binder for tumor cell engagement. In vitro assays, rodent models and non-human primates were used to assess the activity of HPN328. HPN328 induces potent dose-dependent killing of DLL3-expressing SCLC cell lines in vitro concomitant with T cell activation and cytokine release. In an NCI-H82 xenograft model with established tumors, HPN328 treatment led to T cell recruitment and anti-tumor activity. In an immunocompetent mouse model expressing a human CD3ε epitope, mice previously treated with HPN328 withstood tumor rechallenge, demonstrating long-term anti-tumor immunity. When repeat doses were administered to cynomolgus monkeys, HPN328 was well tolerated up to 10 mg/kg. Pharmacodynamic changes, such as transient cytokine elevation, were observed, consistent with the expected mechanism of action of T cell engagers. HPN328 exhibited linear pharmacokinetic in the given dose range with a serum half-life of 78 to 187 hours, supporting weekly or less frequent administration of HPN328 in humans. Preclinical and nonclinical characterization suggests that HPN328 is a highly efficacious, safe, and novel therapeutic candidate. A phase 1/2 clinical trial is currently underway testing safety and efficacy in patients with DLL3 expressing malignancies.

Periodontitis and Neuropathic Diseases: A Literature Review.

Aim: This narrative review aimed at identifying the existing scientific literature investigating periodontitis and neuropathic diseases. Materials and Methods: A search of the literature published between 2000 and 2022 was carried out in the electronic databases of Scopus and PubMed. Studies in which the eligible articles were mainly published in English were included. Descriptive correlational studies, case-control studies, comparative studies, and cohort studies were also included. The following main keywords were used: "Neuropathic diseases," "Periodontitis," "Alzheimer's disease," and "Porphyromonas gingivalis." Results: This narrative review found that cognitively impaired persons with severe periodontitis had a higher prevalence and incidence of periodontal diseases than the rest of the population. A significant positive correlation of salivary interleukin (IL)-1beta and immediate recall scores involved in cognition was also evident. It indicates that the most investigated parameter was whether there is any common link between periodontal disease and neurodegeneration. No randomized controlled clinical studies were found in the current literature review. Conclusions: Based on the literature reviewed, there is currently no strong scientific evidence to support or discourage the cause-effect relationship of periodontal diseases and neurodegenerative diseases.

Relación entre la capacidad adquirida y el riesgo suicida / Relationship between acquired capacity and suicidal risk

La Teoría interpersonal del suicidio señala que la capacidad adquirida hace referencia a que la exposición repetida al dolor conlleva una habituación a estas experiencias, esto es lo que conlleva que el individuo, si cuenta también con la ideación suicida, pueda llevar a cabo el suicidio consumado. Por eso, el objetivo de este estudio es analizar las diferencias en la capacidad adquirida sobre la base de la existencia o no de riesgo suicida. Los resultados avalan los encontrados en otras investigaciones, observándose que, entre las personas con riesgo suicida y sin riesgo, existen diferencias estadísticamente significativas, siendo los que están en riesgo los que obtienen las medias más elevadas. Por lo tanto, la variable capacidad adquirida se muestra como una variable altamente relacionada con el riesgo suicida. (AU)

The Interpersonal Theory of Suicide states that acquired capability refers to the fact that repeated exposure to pain leads to habituation to these experiences, which is what leads the individual, if he or she also has suicidal ideation, to commit suicide. Therefore, the aim of this study is to analyze the differences in the acquired capability on the basis of the existence or not of suicidal risk. The results support those found in other studies, showing that there are statistically significant differences between those at risk and those not at risk, with those at risk having the highest mean scores. Therefore, the acquired capability variable is shown to be a variable highly related to suicidal risk. (AU)

Factors Associated with Worsening Interstitial Fibrosis/Tubular Atrophy in Lupus Nephritis Patients Undergoing Repeat Kidney Biopsy.

Background: Lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE). Interstitial fibrosis/tubular atrophy (IFTA) on kidney biopsies strongly predicts progression to end-stage renal disease. However, factors associated with progression of IFTA are not known. The objective of this study was to evaluate the demographic, clinical, and histopathological factors at the time of index kidney biopsies that are associated with worsening IFTA on repeat biopsies. Methods: Patients with LN Class I to V or mixed LN on index biopsies who underwent a clinically indicated repeat biopsy between 2004 and 2020 were identified. None-mild IFTA was defined as < 25% acreage of the interstitium affected by fibrosis and atrophy, and moderate-severe IFTA was defined as ≥ 25% of the interstitium affected. Patients with none-mild IFTA on index biopsies who progressed to moderate-severe IFTA on repeat biopsies were defined as progressors. Patients with none-mild IFTA on both biopsies were defined as non-progressors. Results: Seventy-two patients who underwent clinically indicated repeat kidney biopsies were included, and 35 (49%) were identified as progressors. Compared to non-progressors, progressors had a higher proportion of proliferative LN (20 [57%] vs. 6 [17%], p = 0.002) and crescents (9 [26%] vs. 3 [8%], p = 0.045) on index biopsies. There was no difference regarding the time to repeat biopsy or the baseline characteristics, including eGFR, presence of hypertension and diabetes, urine protein to creatinine ratio, or the initial treatments. Conclusions: Proliferative LN and the presence of crescents on index biopsies were associated with subsequent IFTA progression on repeat biopsies. This association indicates that glomerular damage is one of the major drivers of tubulointerstitial scarring in SLE. IFTA progression may, in turn, be the driving factor of poor treatment response and progression to chronic kidney disease.

Effects of extrusion screw speed, feed moisture content, and barrel temperature on the physical, techno-functional, and microstructural quality of texturized lentil protein.

Utilizing lentil protein as a novel ingredient for producing texturized vegetable proteins (TVPs) can provide new opportunities for the production of next-generation hybrid meat products. TVPs from lentil protein isolate were manufactured using low-moisture extrusion cooking at different combinations of screw speed (SS), feed moisture content (MC), and barrel temperature (BT) profile. In total, seven different combinations of processing treatments were tested, and the resulting TVPs were characterized for their physical (rehydration ratio, texture profile analysis, color, and bulk density), techno-functional (oil and water holding capacities), and microstructural properties. The processing conditions of higher SS and lower MC resulted in increased values of several textural profile attributes (springiness, cohesiveness, and resilience), increased water holding capacity (WHC), and decreased bulk density. Compared to raw lentil protein, TVPs showed enhanced oil holding capacity, though WHC either decreased or remained constant. The extrusion response parameters (die pressure, torque, and specific mechanical energy) showed positive correlations with several physical properties (texture, WHC, and total color change), revealing their potential for serving as important TVP quality indicators. TVPs produced at SS, MC, and BT of 450 rpm, 30%, and 140°C, respectively, showed relatively better overall physical and techno-functional quality and can be used as meat extenders in hybrid meat patties. Overall, this research evidenced the viability of lentil protein as a potential ingredient for producing low-moisture TVPs.

Effect of Bariatric Surgery on Gut Microbiota: A Scientometric Analysis.

Objective: To perform a bibliometric analysis of the scientific production related to intestinal microbiota and bariatric surgery between January 2016 and December 2022. Materials and Methods: A bibliographic search was performed in the Scopus database to identify published papers. Free and controlled terms (MeSH and Emtree) were used. The information collected was analyzed with SciVal. Results: A total of 518 published papers were included in the analysis. Carel Le Roux was the author with the highest scientific production; however, Edi Prifti had the highest impact. French National Institute of Health and Medical Research (Institut national de la santé et de la recherche médicale) was the institution with the highest number of published articles. Six of the 10 institutions with the highest production were in France, yet the United States had the highest volume of scientific production in this research topic. Most papers were published in first quartile journals. Articles with international collaboration had the highest impact. There is a sustained increase in the number of publications since 2019. Conclusions: The study found that the vast majority of research on gut microbiota changes following bariatric surgery are conducted in the United States and European countries. In addition, the sustained increase in production coupled with the articles being published in high-quality journals and having good citation impact are indictors of the current interest in this research field.

The Comparative Effect of Occupational and Musical Enrichment on Fecal Glucocorticoid Metabolite Levels in a Captive Colony of Stumptail Macaques (Macaca arctoides).

Environmental enrichment improves captive animal welfare by reducing stress-related behaviors. Previous studies in a captive colony of stumptail macaques (Macaca arctoides) reported a reduction of aggression, coprophilia, and stereotypic behaviors after an occupational enrichment program; however, the effect on stress hormones such as glucocorticoids has not been investigated yet. The goal of this study was to compare the effect of sex, age, and social rank on changes in fecal glucocorticoid metabolites (fGCM) after applying two kinds of enrichments (occupational vs. musical) in a captive colony of stumptail macaques. We collected 234 fecal samples from 25 stumptail macaques under the following conditions: (1) basal (no enrichment), (2) three weeks of occupational enrichment, and (3) three weeks of relaxing/classical music. The Generalized Estimated Equation Model showed an increase in fGCM levels after the occupational enrichment only in adult subjects (p = 0.003 compared to basal). The fGCM levels reached by the adults after the occupational enrichment was higher than that of juveniles (p = 0.002) and subadults (p = 0.02). Occupational and musical enrichment decreased fGCM levels only in middle-ranking individuals (p < 0.001 and p = 0.013, respectively). No sex differences were found. In conclusion, there were age and rank differences in individuals' physiological reactivity to the effects of environmental enrichment which need to be considered when planning enrichment programs.

Clinical Application of Liquid Biopsy in Pancreatic Cancer: A Narrative Review.

Pancreatic ductal adenocarcinoma contributes significantly to global cancer-related deaths, featuring only a 10% survival rate over five years. The quest for novel tumor markers is critical to facilitate early diagnosis and tailor treatment strategies for this disease, which is key to improving patient outcomes. In pancreatic ductal adenocarcinoma, these markers have been demonstrated to play a crucial role in early identification, continuous monitoring, and prediction of its prognosis and have led to better patient outcomes. Nowadays, biopsy specimens serve to ascertain diagnosis and determine tumor type. However, liquid biopsies present distinct advantages over conventional biopsy techniques. They offer a noninvasive, easily administered procedure, delivering insights into the tumor's status and facilitating real-time monitoring. Liquid biopsies encompass a variety of elements, such as circulating tumor cells, circulating tumor DNA, extracellular vesicles, microRNAs, circulating RNA, tumor platelets, and tumor endothelial cells. This review aims to provide an overview of the clinical applications of liquid biopsy as a technique in the management of pancreatic cancer.

Statistical analysis plan for the multicenter, open, randomized controlled clinical trial to assess the efficacy and safety of intravenous tirofiban vs aspirin in acute ischemic stroke due to tandem lesion, undergoing recanalization therapy by endovascular treatment (ATILA trial).

RATIONALE: In-stent reocclusion after endovascular therapy has a negative impact on outcomes in acute ischemic stroke (AIS) due to tandem lesions (TL). Optimal antiplatelet therapy approach in these patients to avoid in-stent reocclusion is yet to be elucidated. AIMS: To assess efficacy and safety of intravenous tirofiban versus intravenous aspirin in patients undergoing MT plus carotid stenting in the setting of AIS due to TL. SAMPLE SIZE ESTIMATES: Two hundred forty patients will be enrolled, 120 in every treatment arm. METHODS AND DESIGN: A multicenter, prospective, randomized, controlled (aspirin group), assessor-blinded clinical trial will be conducted. Patients fulfilling the inclusion criteria will be randomized at MT onset to the experimental or control group (1:1). Intravenous aspirin will be administered at a 500-mg single dose and tirofiban at a 500-mcg bolus followed by a 200-mcg/h infusion during the first 24 h. All patients will be followed for up to 3 months. STUDY OUTCOMES: Primary efficacy outcome will be the proportion of patients with carotid in-stent thrombosis within the first 24 h after MT. Primary safety outcome will be the rate of symptomatic intracranial hemorrhage. DISCUSSION: This will be the first clinical trial to assess the best antiplatelet therapy to avoid in-stent thrombosis after MT in patients with TL. TRIAL REGISTRATION: The trial is registered as NCT05225961. February, 7th, 2022.

Designing an early selection morphological traits index for reproductive efficiency in Pura Raza Española mares.

The low rate of reproductive efficiency in horses may be linked to the equine industry's practice of maintaining breeding stock that stands out for its athletic or morphological performance but exhibits poor reproductive efficiency. In this study, the age at first foaling, age at last foaling, interval between first and second foaling, average interval between foaling, foaling number and reproductive efficiency, and their relationship with the morphological records in 19,758 Pura Raza Española (PRE) mares were analyzed. After a partial least squares analysis height at withers, lateral hock angle, dorsal-sternal diameter, perimeter of anterior cannon bone, angle of shoulder, thoracic perimeter, hip-stifle distance, and angle of croup were the most important traits related with reproductive traits in PRE mares. A multivariate animal model with both morphological and reproductive traits was applied, including age, geographical area, coat color, and average stud size in the decade of the mare's first foaling. The results indicate that reproductive selection is feasible, and is enhanced by the use of morphological traits, given the moderate to high magnitudes of heritability values in both types of traits, which oscillated between 0.1 (interval between first and second foaling) and 0.95 (height at withers). The resulting genetic parameters were used to develop a series of selection indexes based on morphological or morphological and reproductive combination traits to improve reproductive efficiency traits in PRE mares and thus compute the expected genetic response (EGR) for the different strategies. The increase in EGR, when comparing EGR using only reproductive traits as selection criteria vs. using a combined index of both morphological and reproductive traits, oscillated between 4.0% for the age at first foaling to 46.8% for the interval between first and second foaling. In addition, two precocity indexes showed positive EGR when the age at last foaling and the interval between first and second foaling, both with and without morphological traits, were used as selection criteria. Therefore, this analysis reveals that the preselection of reproductive traits based on morphological traits is possible in PRE mares. Ultimately, this knowledge will help breeders achieve genetic progress in reproductive traits, leading to healthier and more successful breeding outcomes in horses.

Historically in livestock production, employing combinations of traits as selection criteria for indirect selection of related traits has been a challenging task, particularly when this implies selection for reproductive traits based on the animal morphology. However, if the decision about animal selection is based on morphological traits that are quick and easy to obtain, in addition to early reproductive traits, selection responses can be improved and made earlier. This is particularly significant in sport horse breeds like the Pura Raza Española horse, which is primarily used for dressage competitions. Mares belonging to this breed commonly engage in several years of competition before transitioning to breeding, without the breeders having prior knowledge of their reproductive efficiency. Nonetheless, the availability of existing morphological information enables us to make informed decisions in this regard. While a selection index using morphology alone would not yield as good a response as direct selection for reproductive traits, there are cases, such as age at last foaling, where the correlated response can be very high. Our study further illustrates a substantial increase in selection response when morphological and reproductive traits are jointly included as selection criteria, with the aim of enhancing reproductive efficiency.

Resultados de una estrategia para la internacionalización en el desarrollo de la educación médica superior desde la experiencia Cuba - México

La internacionalización de las universidades cubanas favorece el cumplimiento de la misión de la educación superior, propicia que la universidad sea cada vez más innovadora y contribuye, de esa manera, al logro de los objetivos de desarrollo sostenible propuestos en la Agenda 2030. La internacionalización constituye una gran fuerza para el desarrollo de una universidad moderna fundamentada en esquemas de formación: ante todo humanista, de alto nivel, con gran sensibilidad social, lo que sólo se puede alcanzar con el desarrollo de Instituciones de Educación Superior de mayor trascendencia académica, en el contexto internacional. Con estos fundamentos se realizó una investigación con el objetivo de sistematizar los resultados de una estrategia para la internacionalización de la educación médica superior. Se enmarca en un convenio de colaboración entre instituciones de Cuba y México y la creación de una red académica, que impulsa actividades de investigación y docencia en pre y posgrado. Se trata de una investigación de naturaleza documental. La revisión de textos, en formato impreso y digital, se orientó al análisis de los resultados de la experiencia de Cuba- México, en los ámbitos: intercambio académico, movilidad docente, participación en proyectos científicos colaborativos y formación doctoral, que se materializan en los resultados obtenidos.

The internationalization of Cuban universities favors the fulfillment of the mission of higher education, encourages the university to be increasingly innovative and thus contributes to the achievement of the sustainable development goals proposed in the 2030 Agenda. Internationalization constitutes a great force for the development of a modern university based on training schemes: above all humanistic, high level, with great social sensitivity, which can only be achieved with the development of Higher Education Institutions of greater academic significance, in the international context. With these foundations, an investigation was carried out with the objective of systematizing the results of a strategy for internationalization of higher medical education. It is part of a collaboration agreement between institutions in Cuba and Mexico and the creation of an academic network, which promotes research and teaching activities in undergraduate and postgraduate courses. This is an investigation of a documentary nature, in which the review of texts, in printed and digital format, was oriented to the analysis of the results of the Cuba-Mexico exchange experience, in the areas: academic exchange, teacher mobility , participation in collaborative scientific projects and doctoral training, which materialize in the results obtained. From the critical and contrasted reading, the systematization was carried out.

Acquisition of Desiccation Tolerance Unveiled: Polar Lipid Profiles of Streptophyte Algae Offer Insights.

Terrestrialization by photosynthetic eukaryotes took place in the two branches of green microalgae: Chlorophyta and Charophyta. Within the latter, the paraphyletic streptophytic algae divide into two clades. These are named Klebsormidiophyceae-Chlorokybophyceae-Mesostigmatophyceae (KCM), which is the oldest, and Zygnematophyceae-Coleochaetophyceae-Charophyceae (ZCC), which contains the closest relatives of vascular plants. Terrestrialization required the emergence of adaptations in response to new challenges, such as irradiance, temperature oscillations and water deprivation. In this study, we evaluated lipid composition in species representative of distinct phylogenetic clusters within Charophyta and Chlorophyta. We aim to study whether the inherent thylakoid lipid composition, as well as its adaptability in response to desiccation, were fundamental factors for the evolutionary history of terrestrial plants. The results showed that the lipid composition was similar to that found in flowering land plants, differing only in betaine lipids. Likewise, the largest constitutive pool of oligogalactolipids (OGL) was found only in the fully desiccation-tolerant species Klebsormidium nitens. After desiccation, the content of polar lipids decreased in all species. Conversely, the content of OGL increased, particularly trigalactosyldiacylglycerol and tetragalactosyldiacylglycerol in the ZCC clade. The analysis of the molecular species composition of the newly formed OGL may suggest a different biosynthetic route for the KCM and ZCC clades. We speculate that the appearance of a new OGL synthesis pathway, which eventually arose during the streptophyte evolutionary process, endowed algae with a much more dynamic regulation of thylakoid composition in response to stress, which ultimately contributed to the colonization of terrestrial habitats.

Lymphocele Complication After Kidney Transplant: Current Literature Review and Management Algorithm.

Kidney transplant is the best treatment option for patients with end-stage renal disease. It reduces mortality and improves the quality of life. However, kidney transplant presents medical and surgical complications, and one of the most common is the posttransplant lymphocele. Lymphocele complication has an incidence of up to 20% and presents with variable clinical symptoms, which are directly associated with the size and compression effect on the adjacent organs. There are reported risk factors that favor the appearance of lymphocele. Despite known factors, there are more relevant factors (male sex, deceased donor, and corticosteroids) to carry out a stricter follow-up. The treatment of lymphoceles can vary according to the severity of the symptoms, characteristics of the collection, and the patient's clinical status. Despite the high recurrence, percutaneous intervention is the initial approach in this condition. If percutaneous aspiration, drainage, and sclerotherapy are unsuccessful, then open or laparoscopic fenestration can be performed; laparoscopy is the standard of treatment since it is highly effective and has few adverse effects.

Resonance Frequency Analysis Mapping During Implant Healing Using a Nanostructured Hydroxyapatite Surface.

Aim: Stability measured by resonance frequency analysis (RFA) is an important factor to be considered in the success of dental implant treatments, which can be evaluated from the implant stability quotient (ISQ). The aim of the present case series was to map the RFA during healing of implants with nanostructured hydroxyapatite surface to describe the behavior of ISQ values related to individual factors. Materials and Methods: Twenty-three implants were placed in eight patients by conventional surgical protocol, and ISQ values were monitored from the day of implant placement until week 20. To obtain the ISQ values, an Osstell device was used and the placed implants were grouped in proportional amounts to describe the ISQ behavior considering the length (≤10 or >10 mm), the diameter (3.5 or 4.3 mm), the insertion torque (<40 N-cm or ≥40 N-cm), and the placement area (maxilla or mandible). Results: All the implants assessed decreased their values in the first 3 weeks after placement. Subsequently, the ISQ values increased by amounts similar to those obtained at the time of the placement and even more. Implants with length >10 mm, diameter 4.3 mm, and insertion torque ≥40 N-cm showed the highest ISQ values. Conclusions: A decrease in the ISQ values of dental implants with nanostructured hydroxyapatite surface was evidenced between weeks 2 and 3 considering length, diameter, insertion torque, and maxillary or mandibular placement site.

Enhancing accessibility and scalability of school-based programs to improve youth attention and behavior: Open feasibility trial of the remote CLS-R-FUERTE program in Mexico.

Neurodevelopmental disorders of inattention and disruptive behavior, such as attention-deficit/hyperactivity disorder and oppositional defiant disorder, are among the most common youth mental health conditions across cultures. There is a need to develop more accessible school-based intervention and training programs, as well as create a system with clinical research capacity for scalable school clinician training and evaluation, to support students with attention and behavior concerns worldwide. We adapted the collaborative life skills program for Mexico (i.e., CLS-FUERTE) for remote delivery (i.e., CLS-R-FUERTE) and conducted a three-school open trial with N = 67 participants (n = 7-8 students per school [ages 6-12] and their parents, teachers, and school clinicians). We examined fidelity to program content, attendance and adherence records, in vivo observations of program delivery, and postmeeting feedback informing iterative program changes between each school cohort. We also examined improvements in youth attention and behavior rated by parents and teachers to evaluate the remote program effectiveness. CLS-R-FUERTE feasibility, acceptability, and usability findings were promising. Iterative program changes between each school cohort were minor and included adapted curriculum order, enhanced engagement strategies, and technology adjustments. Many students demonstrated reliable change, and the pre-post program improvements were comparable to outcomes from the in-person CLS-FUERTE trial, indicating preliminary effectiveness. Our pilot CLS-R-FUERTE effort supports the process of iteratively adapting, implementing, and evaluating remote school-based intervention and training programs to enhance potential flexibility, accessibility, and scalability. Challenges emerging from technological problems and in context of the COVID-19 pandemic, as well as solutions, are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).