Telerehabilitation in Colombia: A Country Report and Qualitative Analysis During the Covid-19 Pandemic - Perceptions of Healthcare Providers and Patients.

Given Colombia's status as a middle-income country with healthcare challenges, leveraging telemedicine could significantly benefit hard-to-reach regions, under-resourced and underserved communities. This study provides a comprehensive overview of the country's telerehabilitation landscape, exploring the clinicians' and patients' perspectives during the COVID-19 pandemic through systematic review and qualitative analysis. Sixteen therapists and three patients were identified via snowball sampling. The literature review was scarce and scattered across various topics in the country; some studies delved into specific aspects like legislative frameworks and patient outcomes from different medical specialties. The qualitative analysis demonstrates that despite the learning curve, telerehabilitation strengthens therapeutic support, enhances patient autonomy, fosters a positive patient-provider relationship, achieves treatment goals, promotes family involvement, reduces time and costs, and ensures continuity of therapy services. This study identified research gaps, challenges, and opportunities in telerehabilitation in a Latin American country. Adopting telemedicine technologies in low- and middle-income countries could significantly enhance their healthcare systems.

Ethics and applications of isotope analysis in archaeology.

This synthesis explores specific ethical questions that commonly arise in isotopic analysis. For more than four decades, isotope analysis has been employed in archeological studies to explore past human and animal dietary habits, mobility patterns, and the environment in which a human or animal inhabited during life. These analyses require consideration of ethical issues. While theoretical concepts are discussed, we focus on practical aspects: working with descendant communities and other rights holders, choosing methods, creating and sharing data, and working mindfully within academia. These layers of respect and care should surround our science. This paper is relevant for specialists in isotope analysis as well as those incorporating these methods into larger projects. By covering the whole of the research process, from design to output management, we appeal broadly to archaeology and provide actionable solutions that build on the discussions in the general field.

Portuguese Results of the ETICC Study: Impact of the Pandemic COVID-19 in the Diagnosis and Management of Colorectal Cancer in 2020 in Portuguese Hospitals.

Introduction: The outbreak of coronavirus disease 2019 (COVID-19) had affected clinical practice in several ways, including the restriction of nonessential endoscopic procedures. Therefore, our aim was to evaluate how colorectal cancer (CRC) diagnosis and management was affected during the first year of pandemics in Portugal. Methods: This is a Portuguese substudy of the French retrospective multicentric study ETICC (Etude de l'Impact de la pandémie COVID-19 sur le diagnostic et la prise en charge du Cancer Colorectal). We compared patients' characteristics, clinical manifestations, CRC staging at diagnosis, delay to first medical appointment, histological diagnosis, surgical and medical treatments between the year previous to the pandemics (control) and the first year of pandemics. Results: We included 766 patients: 496 in the control group and 270 in the COVID group. There was no significant difference in CRC staging at diagnosis between both groups, with 21% being diagnosed as metastatic in the control group and 22% in the first year of pandemics (p = 0.770). Contrary to what happened in France, there was a significant decrease in CRC diagnosis in asymptomatic patients (25-8.4%; p < 0.001) and after a positive fecal immunochemical test (20.8-11.3%; p = 0.002) during the pandemics. Although the increase in the overall complication rate at diagnosis was nonsignificant, in Portugal, there was a significant increase in diagnosis of abdominal occlusion (12.1-18.1%; p = 0.033). In Portugal, time between the beginning of symptoms and the first medical appointment significantly increased from a median of 50 days to 64 days during COVID (p < 0.001). On the contrary, time between histological diagnosis and tumor resection had significantly decreased from a median of 65 to 39 days (p < 0.001). Time between histological diagnosis and neoadjuvant treatment was not statistically different (median of 64-67 days; p = 0.590), as was time between histological diagnosis and palliative chemotherapy (median of 50-51 days; p = 1.000). Time from CRC resection and adjuvant treatment has significantly decreased from a median of 54 to 43 days (p = 0.001). Discussion: We found a significant impact in CRC diagnosis in the first year of pandemics, more pronounced than what was found in France. These are likely related not only with the closing of endoscopy units but also with the difficulties patients had in finding an appointment with their general practitioners. On the other hand, both in France and Portugal, the first year of pandemics did not worsen CRC staging at diagnosis and did not significantly affect medical and surgical treatments once the diagnosis was made.

Introdução: A pandemia provocada pelo coronovírus (COVID-19) condicionou a prática clínica de múltiplas formas, incluindo a restrição a exames endoscópicos não urgentes. Por este motivo, decidimos avaliar o impacto do primeiro ano de pandemia no diagnóstico e tratamento do cancro colorretal (CCR) em Portugal. Métodos: Este é um subestudo do estudo Francês retrospetivo multicêntrico ETICC (Etude de l'Impact de la pandémie COVID-19 sur le diagnostic et la prise en charge du Cancer Colorectal). Foram comparadas as características dos doentes, manifestações clínicas, estadiamento do CCR ao diagnóstico, intervalos entre primeiro contacto médico neste contexto, diagnóstico histológico e tratamentos, entre o primeiro ano de pandemia e o ano precedente. Resultados: Foram incluídos 766 doentes, 496 no grupo controlo e 270 no grupo COVID. Em França e em Portugal não se verificou um agravamento no estadiamento do CCR à data do diagnóstico no primeiro ano de pandemia, com 21% dos casos metastáticos à data de diagnóstico no grupo controlo e 22% no primeiro ano da pandemia (p = 0.770). Contudo, apenas em Portugal se constatou uma redução significativa do número de CCR em doentes assintomáticos (25% para 8.4%; p < 0.001) ou após uma pesquisa de sangue oculto positiva (20.8% para 11.3%; p = 0.002) durante a pandemia. Apesar do aumento na taxa de complicações ao diagnóstico não ser significativa, em Portugal a taxa de diagnósticos em contexto de oclusão intestinal aumentou significativamente (12.1% para 18.1%; p = 0.033). Em Portugal, o tempo entre início dos sintomas e a primeira consulta médica aumentou significativamente, de uma mediana de 50 para 64 dias durante o COVID (p < 0.001). Por outro lado, o tempo entre diagnóstico histológico e resseção tumoral reduziu significativamente de 65 para 39 dias (p < 0.001). O tempo entre diagnóstico histológico e tratamento neoadjuvante (mediana de 64 para 67 dias; p = 0.590) ou quimioterapia paliativa (mediana de 50 para 51 dias; p = 1.000) não foi estatisticamente significativo, tendo decrescido significativamente o tempo entre resseção e adjuvância (mediana de 54 para 43 dias, p = 0.001). Discussão: Este estudo evidenciou um impacto significativo no diagnóstico de CCR durante o primeiro ano de pandemia, mais pronunciado que em França. Este achado dever-se-á não só à limitação do acesso aos exames endoscópicos, mas também à dificuldade da população portuguesa em aceder aos Cuidados de Saúde Primários. Por outro lado, tanto em França como em Portugal, no primeiro ano de pandemia não se verificou um agravamento no estadiamento ou atraso no tratamento médico e cirúrgico do CCR.

Genomic approachesidentifySTT4 as a new component in glucose-induced activation of yeast plasma membrane H+-ATPase.

Many studies have focused on identifying the signaling pathway by which addition of glucose triggers post-translational activation of the plasma membrane H+-ATPase in yeast. They have revealed that calcium signaling is involved in the regulatory pathway, supported for instance by the phenotype of mutants inARG82 that encodes an inositol kinase that phosphorylates inositol triphosphate (IP3). Strong glucose-induced calcium signaling, and high glucose-induced plasma membrane H+-ATPase activation have been observed in a specific yeast strain with the PJ genetic background. In this study, we have applied pooled-segregant whole genome sequencing, QTL analysis and a new bioinformatics methodology for determining SNP frequencies to identify the cause of this discrepancy and possibly new components of the signaling pathway. This has led to the identification of an STT4 allele with 6 missense mutations as a major causative allele, further supported by the observation that deletion of STT4 in the inferior parent caused a similar increase in glucose-induced plasma membrane H+-ATPase activation. However, the effect on calcium signaling was different indicating the presence of additional relevant genetic differences between the superior and reference strains. Our results suggest that phosphatidylinositol-4-phosphate might play a role in the glucose-induced activation of plasma membrane H+-ATPase by controlling intracellular calcium release through the modulation of the activity of phospholipase C.

Assessing the uptake of incentivised physical health checks for people with serious mental illness: a cohort study in primary care.

BACKGROUND: People with serious mental illness are more likely to experience physical illnesses. The onset of many of these illnesses can be prevented if detected early. Physical health screening for people with serious mental illness is incentivised in primary care in England through the Quality and Outcomes Framework (QOF). GPs are paid to conduct annual physical health checks on patients with serious mental illness, including checks of body mass index (BMI), cholesterol, and alcohol consumption. AIM: To assess the impact of removing and reintroducing QOF financial incentives on uptake of three physical health checks (BMI, cholesterol, and alcohol consumption) for patients with serious mental illness. DESIGN AND SETTING: Cohort study using UK primary care data from the Clinical Practice Research Datalink between April 2011 and March 2020. METHOD: A difference-in-difference analysis was employed to compare differences in the uptake of physical health checks before and after the intervention, accounting for relevant observed and unobserved confounders. RESULTS: An immediate change was found in uptake after physical health checks were removed from, and after they were added back to, the QOF list. For BMI, cholesterol, and alcohol checks, the overall impact of removal was a reduction in uptake of 14.3, 6.8, and 11.9 percentage points, respectively. The reintroduction of BMI screening in the QOF increased the uptake by 10.2 percentage points. CONCLUSION: This analysis supports the hypothesis that QOF incentives lead to better uptake of physical health checks.

Seroprevalence of Protective Antibodies Against Influenza and the Reduction of the Influenza Incidence Rate: An Annual Repeated Cross-Sectional Study From 2014 to 2019.

BACKGROUND: Seroepidemiological studies provide estimates of population-level immunity, prevalence/incidence of infections, and evaluation of vaccination programs. We assessed the seroprevalence of protective antibodies against influenza and evaluated the correlation of seroprevalence with the cumulative annual influenza incidence rate. METHODS: We conducted an annual repeated cross-sectional seroepidemiological survey, during June-August, from 2014 to 2019, in Portugal. A total of 4326 sera from all age groups, sex, and regions was tested by hemagglutination inhibition assay. Seroprevalence and geometric mean titers (GMT) of protective antibodies against influenza were assessed by age group, sex, and vaccine status (65+ years old). The association between summer annual seroprevalence and the difference of influenza incidence rates between one season and the previous one was measured by Pearson correlation coefficient (r). RESULTS: Significant differences in seroprevalence of protective antibodies against influenza were observed in the population. Higher seroprevalence and GMT for A(H1N1)pdm09 and A(H3N2) were observed in children (5-14); influenza B seroprevalence in adults 65+ was 1.6-4.4 times than in children (0-4). Vaccinated participants (65+) showed significant higher seroprevalence/GMT for influenza. A strong negative and significant correlation was found between seroprevalence and ILI incidence rate for A(H1N1)pdm09 in children between 5 and 14 (r = -0.84; 95% CI, -0.98 to -0.07); a weak negative correlation was observed for A(H3N2) and B/Yamagata (r ≤ -0.1). CONCLUSIONS: The study provides new insight into the anti-influenza antibodies seroprevalence measured in summer on the ILI incidence rate in the next season and the need for adjusted preventive health care measures to prevent influenza infection and transmission.

Hierarchical organization of human physical activity.

Human physical activity (HPA), a fundamental physiological signal characteristic of bodily motion is of rapidly growing interest in multidisciplinary research. Here we report the existence of hitherto unidentified hierarchical levels in the temporal organization of HPA on the ultradian scale: on the minute's scale, passive periods are followed by activity bursts of similar intensity ('quanta') that are organized into superstructures on the hours- and on the daily scale. The time course of HPA can be considered a stochastic, quasi-binary process, where quanta, assigned to task-oriented actions are organized into work packages on higher levels of hierarchy. In order to grasp the essence of this complex dynamic behaviour, we established a stochastic mathematical model which could reproduce the main statistical features of real activity time series. The results are expected to provide important data for developing novel behavioural models and advancing the diagnostics of neurological or psychiatric diseases.

Catalogue of type specimens deposited in the Polychaeta Collection of the Universidad Autónoma de Nuevo Léon (Mexico).

Background: In Mexico, there are six scientific collections of polychaetous annelids. The "Colección Poliquetológica" from the Universidad Autónoma de Nuevo León houses one of the three most important collections of annelids in the country, based on a number of lots and number of type materials deposited, as well as geographical coverage. New information: A catalogue of type materials of polychaete annelids housed at the "Colección Poliquetológica" from the Universidad Autónoma de Nuevo León (México) is presented for the first time. The Collection contains 37 holotypes, 174 paratypes and one syntype. These type materials are grouped in 15 families, 35 genera and 54 species of marine worms. Types were described mostly from the Mexican waters, with a low number of types from Ecuador, El Salvador, Argentina, USA, Philippines, New Caledonia and Japan.

17-Oxime ethers of oxidized ecdysteroid derivatives modulate oxidative stress in human brain endothelial cells and dose-dependently might protect or damage the blood-brain barrier.

20-Hydroxyecdysone and several of its oxidized derivatives exert cytoprotective effect in mammals including humans. Inspired by this bioactivity of ecdysteroids, in the current study it was our aim to prepare a set of sidechain-modified derivatives and to evaluate their potential to protect the blood-brain barrier (BBB) from oxidative stress. Six novel ecdysteroids, including an oxime and five oxime ethers, were obtained through regioselective synthesis from a sidechain-cleaved calonysterone derivative 2 and fully characterized by comprehensive NMR techniques revealing their complete 1H and 13C signal assignments. Surprisingly, several compounds sensitized hCMEC/D3 brain microvascular endothelial cells to tert-butyl hydroperoxide (tBHP)-induced oxidative damage as recorded by impedance measurements. Compound 8, containing a benzyloxime ether moiety in its sidechain, was the only one that exerted a protective effect at a higher, 10 µM concentration, while at lower (10 nM- 1 µM) concentrations it promoted tBHP-induced cellular damage. Brain endothelial cells were protected from tBHP-induced barrier integrity decrease by treatment with 10 µM of compound 8, which also mitigated the intracellular reactive oxygen species production elevated by tBHP. Based on our results, 17-oxime ethers of oxidized ecdysteroids modulate oxidative stress of the BBB in a way that may point towards unexpected toxicity. Further studies are needed to evaluate any possible risk connected to dietary ecdysteroid consumption and CNS pathologies in which BBB damage plays an important role.

Biomechanical Factors Predisposing to Knee Injuries in Junior Female Basketball Players.

This cross-sectional observational study aims to determine isokinetic normality data at different speeds, and isometric data of ankle and knee joints, in healthy basketball players aged 15-16 years old. The participants were recruited through non-probabilistic convenience sampling. Sociodemographic, anthropometric, and biomechanical variables were collected. The study involved 42 participants. Right-leg dominance was higher in women (85.7%) than in men (78.6%). Men had a higher weight, height, and body mass index compared to women. Statistically significant differences were observed between sex and height (p < 0.001). Significant differences were found between sexes in knee flexor and extensor strength at different isokinetic speeds (30°, 120°, and 180°/s), except for the maximum peak strength knee flexion at 180°/s in the right leg. In the ankle, the variables inversion, eversion, and work strength values at different isokinetic speeds and full RoM, by sex, were not significantly different, except for the right (p = 0.004) and the left (p = 0.035) ankle full RoM. The study found lower knee extensor strength in women, indicating the need to improve knee flexor/extensor strength in women to match that of men, as seen in other joints. The results can guide the development of preventive and therapeutic interventions for lower limb injuries in basketball players.

Re-description of Parasphaerosyllisindica Monro, 1937 (Annelida, Syllidae), with the establishment of a new species from western Mexico.

Background: Parasphaerosyllis Monro, 1937 is a syllid genus, currently composed of four species: P.indica Monro, 1937 from the Arabian Sea, P.uschakovi (Chlebovitsch, 1959) from the Kurile Islands, P.ezoensis Imajima & Hartman, 1964 from Japan and P.malimalii Capa, San Martín & López, 2001 from the Pacific coast of Panama. The distribution of P.indica is circum-tropical to temperate waters, but the presence of species complexes has been suggested. In order to clarify the distribution of P.indica in many areas of the world, a re-description, based on examination of the type material, is required as a first step to a better understanding of its diagnostic features. New information: Parasphaerosyllisindica is re-described, based on holotype examination, a new species is established from the Gulf of California and Parasphaerosyllismalimalii is reported for the first time since its description in 2001. Parasphaerosyllisirregulata sp. nov. is distinguished from its congeners by the following features: 1) Palps are free at their base; 2) Two types of dorsal cirri are present: spherical to bulbous and moniliform cirri; 3) Both types of cirri are distributed irregularly. A spherical/bulbous and moniliform cirrus may appear together within the same segment (asymmetrical segment) or only a spherical/bulbous cirrus may appear in several consecutive segments (not alternating as occurs in congeners); 4) The spherical/bulbous cirri may have distal knobs with 1-3 terminal articles; and 5) Bidentate falcigers with short, sub-triangular blades with a proximal tooth slightly larger that the distal one. A taxonomic key to species of Parasphaerosyllis species is included.

Assessing the uptake of incentivised physical health checks for people with serious mental illness.

BACKGROUND: People with serious mental illness (SMI) are more likely to suffer from physical illnesses. The onset of many of these illnesses can be prevented if detected early. Physical health screening for people with SMI is incentivised in primary care in England through the Quality and Outcomes Framework (QOF). General Practitioners are paid to conduct annual physical health checks (PHCs) on their SMI patients, including checks on body mass index (BMI), cholesterol, and alcohol consumption. AIM: To assess the impact of removing and reintroducing QOF financial incentives on uptake of three PHCs (BMI, cholesterol, and alcohol consumption) for patients with SMI. DESIGN AND SETTING: Cohort study using UK primary care data from the Clinical Practice Research Datalink between April 2011 and March 2020. METHOD: We employed a difference-in-difference analysis to compare differences in the uptake before and after the intervention accounting for relevant observed and unobserved confounders. RESULTS: We found an immediate change in uptake after PHCs were removed from, and after they were added back to the QOF list. For BMI, cholesterol, and alcohol checks the overall impact of removal was a reduction in uptake of 14.3, 6.8, and 11.9 percentage points, respectively. The reintroduction of BMI screening in the QOF increased the uptake by 10.2 percentage points. CONCLUSION: Our analysis supports the hypothesis that QOF incentives lead to better uptake of PHCs.

Advances and Challenges in Cell Biology for Cultured Meat.

Cultured meat is an emerging biotechnology that aims to produce meat from animal cell culture, rather than from the raising and slaughtering of livestock, on environmental and animal welfare grounds. The detailed understanding and accurate manipulation of cell biology are critical to the design of cultured meat bioprocesses. Recent years have seen significant interest in this field, with numerous scientific and commercial breakthroughs. Nevertheless, these technologies remain at a nascent stage, and myriad challenges remain, spanning the entire bioprocess. From a cell biological perspective, these include the identification of suitable starting cell types, tuning of proliferation and differentiation conditions, and optimization of cell-biomaterial interactions to create nutritious, enticing foods. Here, we discuss the key advances and outstanding challenges in cultured meat, with a particular focus on cell biology, and argue that solving the remaining bottlenecks in a cost-effective, scalable fashion will require coordinated, concerted scientific efforts. Success will also require solutions to nonscientific challenges, including regulatory approval, consumer acceptance, and market feasibility. However, if these can be overcome, cultured meat technologies can revolutionize our approach to food.

Microsimulation Models on Mental Health: A Critical Review of the Literature.

OBJECTIVES: To retrieve and synthesize the literature on existing mental health-specific microsimulation models or generic microsimulation models used to examine mental health, and to critically appraise them. METHODS: All studies on microsimulation and mental health published in English in MEDLINE, Embase, PsycINFO, and EconLit between January 1, 2010, and September 30, 2022, were considered. Snowballing, Google searches, and searches on specific journal websites were also undertaken. Data extraction was done on all studies retrieved and the reporting quality of each model was assessed using the Quality Assessment Reporting for Microsimulation Models checklist, a checklist developed by the research team. A narrative synthesis approach was used to synthesize the evidence. RESULTS: Among 227 potential hits, 19 studies were found to be relevant. Some studies covered existing economic-demographic models, which included a component on mental health and were used to answer mental-health-related research questions. Other studies were focused solely on mental health and included models that were developed to examine the impact of specific policies or interventions on specific mental disorders or both. Most models examined were of medium quality. The main limitations included the use of model inputs based on self-reported and/or cross-sectional data, small and/or nonrepresentative samples and simplifying assumptions, and lack of model validation. CONCLUSIONS: This review found few high-quality microsimulation models on mental health. Microsimulation models developed specifically to examine mental health are important to guide healthcare delivery and service planning. Future research should focus on developing high-quality mental health-specific microsimulation models with wide applicability and multiple functionalities.

Prevalence of Neuropathic Pain in Patients with Osteoarthritis.

Objective The aim of this study was to determine the prevalence of neuropathic pain and characterize the quality of life of patients with osteoarthritis who consulted a pain clinic in Southwestern Colombia. Methods A cross-sectional study was conducted via telephone survey. Participants ≥18 years of age with a diagnosis of osteoarthritis were included. The LANSS questionnaire was used to evaluate symptoms and signs of neuropathic pain, and the Short Form-8 was used to evaluate quality of life. Results Response rate was 54.1% (46/85). The male-to-female ratio was 5:1, with an average age of 72 ± 10 years. Most participants (91.3%) had severe pain. The prevalence of neuropathic pain was 28.3% (95%CI = 15.99-43.46), and the prevalence of neuropathic pain amongst women was 84.6% (95%CI = 54.55-98.01). Dysesthesias and paroxysmal pain were present in 92.3% of individuals with neuropathic pain. Regarding quality of life, limitations in physical activity were the most significant, as 63% of individuals reported such limitations. Conclusion Neuropathic pain was found to be prevalent and had a negative impact on physical function, highlighting the need for therapeutic strategies targeted to specific neuropathic pain pathways in patients with osteoarthritis.