Receptor transfer between immune cells by autoantibody-enhanced, CD32-driven trogocytosis is hijacked by HIV-1 to infect resting CD4 T cells.

Immune cell phenotyping frequently detects lineage-unrelated receptors. Here, we report that surface receptors can be transferred from primary macrophages to CD4 T cells and identify the Fcγ receptor CD32 as driver and cargo of this trogocytotic transfer. Filamentous CD32+ nanoprotrusions deposit distinct plasma membrane patches onto target T cells. Transferred receptors confer cell migration and adhesion properties, and macrophage-derived membrane patches render resting CD4 T cells susceptible to infection by serving as hotspots for HIV-1 binding. Antibodies that recognize T cell epitopes enhance CD32-mediated trogocytosis. Such autoreactive anti-HIV-1 envelope antibodies can be found in the blood of HIV-1 patients and, consistently, the percentage of CD32+ CD4 T cells is increased in their blood. This CD32-mediated, antigen-independent cell communication mode transiently expands the receptor repertoire and functionality of immune cells. HIV-1 hijacks this mechanism by triggering the generation of trogocytosis-promoting autoantibodies to gain access to immune cells critical to its persistence.

Composites of Poly(3-hydroxybutyrate) and Mesoporous SBA-15 Silica: Crystalline Characteristics, Confinement and Final Properties.

Several composites based on poly(3-hydroxybutyrate) (PHB) and mesoporous SBA-15 silica were prepared by solvent-casting followed by a further stage of compression molding. The thermal stability, phase transitions and crystalline details of these composites were studied, paying special attention to the confinement of the PHB polymeric chains into the mesopores of the silica. For that, differential scanning calorimetry (DSC) and real-time variable-temperature X-ray scattering at small angles (SAXS) were performed. Confinement was stated first by the existence of a small endotherm at temperatures around 20 °C below the main melting or crystallization peak, being later confirmed by a notable discontinuity in the intensity of the main (100) diffraction from the mesoporous silica observed through SAXS experiments, which is related to the change in the scattering contrast before and after the crystallization or melting of the polymer chains. Furthermore, the usual α modification of PHB was developed in all samples. Finally, a preliminary investigation of mechanical and relaxation parameters was carried out through dynamic-mechanical thermal analysis (DMTA). The results show, in the temperature interval analyzed, two relaxations, named α and ß (the latest related to the glass transition) in order of decreasing temperatures, in all specimens. The role of silica as a filler is mainly observed at temperatures higher than the glass transition. In such cases, stiffness is dependent on SBA-15 content.

Spatial resolution of HIV-1 post-entry steps in resting CD4 T cells.

Resting CD4 T cells resist productive HIV-1 infection. The HIV-2/simian immunodeficiency virus protein viral accessory protein X (Vpx) renders these cells permissive to infection, presumably by alleviating blocks at cytoplasmic reverse transcription and subsequent nuclear import of reverse-transcription/pre-integration complexes (RTC/PICs). Here, spatial analyses using quantitative virus imaging techniques reveal that HIV-1 capsids containing RTC/PICs are readily imported into the nucleus, recruit the host dependency factor CPSF6, and translocate to nuclear speckles in resting CD4 T cells. Reverse transcription, however, remains incomplete, impeding proviral integration and viral gene expression. Vpx or pharmacological inhibition of the deoxynucleotide triphosphohydrolase (dNTPase) activity of the restriction factor SAM domain and HD domain-containing protein 1 (SAMHD1) increases levels of nuclear reverse-transcribed cDNA and facilitates HIV-1 integration. Nuclear import and intranuclear transport of viral complexes therefore do not pose important blocks to HIV-1 in resting CD4 T cells, and the limitation to reverse transcription by SAMHD1's dNTPase activity constitutes the main pre-integration block to infection.

Analysis of Predictive Factors for the Poor Prognosis of Peripheral Facial Paralysis.

PURPOSE: The aim of the study is to evaluate the predictive factors for a poor prognosis in patients with facial paralysis evaluated in the rehabilitation department of a tertiary hospital. METHODS: We have conducted a prospective cohort study. Patients who required elective botulinum toxin infiltration, surgical treatment, or follow-up appointments longer than 6 months due to incomplete recovery were considered to have a poor prognosis. Descriptive and analytical analyses of clinical and epidemiological variables were performed. The follow-up period was 6 mos. RESULTS: A total of 47 adult patients were analyzed, 54.2% of whom were women. The mean age was 53.2 yrs (SD, 15.5 yrs). Twenty-five percent had an unfavorable prognosis. A statistically significant association with prognosis was observed for neurophysiological results and the scores of the House-Brackmann scale and the Sunnybrook Facial Grading System. CONCLUSIONS: Neurophysiological tests are especially useful when evaluating prognosis. Likewise, Sunnybrook Facial Grading System is a useful and accessible tool with prognostic value, especially within a month of initial diagnosis, when a score lower than 65 indicates a poor prognosis with high sensitivity and specificity. These tools can be especially useful to reduce the clinical and psychological impact and to provide patients with early therapeutic management.

Traumatic Human Spinal Cord Injury: Are Single Treatments Enough to Solve the Problem?

Traumatic spinal cord injury (SCI) results in partial or complete motor deficits, such as paraplegia, tetraplegia, and sphincter control, as well as sensory disturbances and autonomic dysregulation such as arterial hypotension, lack of sweating, and alterations in skin lability. All this has a strong psychological impact on the affected person and his/her family, as well as costs to healthcare institutions with an economic burden in the short, medium, and long terms. Despite at least forty years of experimental animal studies and several clinical trials with different therapeutic strategies, effective therapy is not universally accepted. Most of the published works on acute and chronic injury use a single treatment, such as medication, trophic factor, transplant of a cell type, and so on, to block some secondary injury mechanisms or promote some mechanisms of structural/functional restoration. However, despite significant results in experimental models, the outcome is a moderate improvement in muscle strength, sensation, or eventually in sphincter control, which has been considered non-significant in human clinical trials. Here we present a brief compilation of successful individual treatments that have been applied to secondary mechanisms of action. These studies show limited neuroprotective or neurorestorative approaches in animal models and clinical trials. Thus, the few benefits achieved so far represent a rationale to further explore other strategies that seek better structural and functional restoration of the injured spinal cord.

Use of Cells, Supplements, and Peptides as Therapeutic Strategies for Modulating Inflammation after Spinal Cord Injury: An Update.

Spinal cord injury is a traumatic lesion that causes a catastrophic condition in patients, resulting in neuronal deficit and loss of motor and sensory function. That loss is caused by secondary injury events following mechanical damage, which results in cell death. One of the most important events is inflammation, which activates molecules like proinflammatory cytokines (IL-1ß, IFN-γ, and TNF-α) that provoke a toxic environment, inhibiting axonal growth and exacerbating CNS damage. As there is no effective treatment, one of the developed therapies is neuroprotection of the tissue to preserve healthy tissue. Among the strategies that have been developed are the use of cell therapy, the use of peptides, and molecules or supplements that have been shown to favor an anti-inflammatory environment that helps to preserve tissue and cells at the site of injury, thus favoring axonal growth and improved locomotor function. In this review, we will explain some of these strategies used in different animal models of spinal cord injury, their activity as modulators of the immune system, and the benefits they have shown.

A nuclear receptor HR96-related gene underlies large trans-driven differences in detoxification gene expression in a generalist herbivore.

The role, magnitude, and molecular nature of trans-driven expression variation underlying the upregulation of detoxification genes in pesticide resistant arthropod populations has remained enigmatic. In this study, we performed expression quantitative trait locus (eQTL) mapping (n = 458) between a pesticide resistant and a susceptible strain of the generalist herbivore and crop pest Tetranychus urticae. We found that a single trans eQTL hotspot controlled large differences in the expression of a subset of genes in different detoxification gene families, as well as other genes associated with host plant use. As established by additional genetic approaches including RNAi gene knockdown, a duplicated gene with a nuclear hormone receptor HR96-related ligand-binding domain was identified as causal for the expression differences between strains. The presence of a large family of HR96-related genes in T. urticae may enable modular control of detoxification and host plant use genes, facilitating this species' known and rapid evolution to diverse pesticides and host plants.

Causal isotonic calibration for heterogeneous treatment effects.

We propose causal isotonic calibration, a novel nonparametric method for calibrating predictors of heterogeneous treatment effects. In addition, we introduce a novel data-efficient variant of calibration that avoids the need for hold-out calibration sets, which we refer to as cross-calibration. Causal isotonic cross-calibration takes cross-fitted predictors and outputs a single calibrated predictor obtained using all available data. We establish under weak conditions that causal isotonic calibration and cross-calibration both achieve fast doubly-robust calibration rates so long as either the propensity score or outcome regression is estimated well in an appropriate sense. The proposed causal isotonic calibrator can be wrapped around any black-box learning algorithm to provide strong distribution-free calibration guarantees while preserving predictive performance.

Polypropylene Nanocomposites Attained by In Situ Polymerization Using SBA-15 Particles as Support for Metallocene Catalysts: Effect of Molecular Weight and Tacticity on Crystalline Details, Phase Transitions and Rheological Behavior.

In this study, nanocomposites based on polypropylene are synthesized by the in situ polymerization of propene in the presence of mesoporous SBA-15 silica, which acts as a carrier of the catalytic system (zirconocene as catalyst and methylaluminoxane as cocatalyst). The protocol for the immobilization and attainment of hybrid SBA-15 particles involves a pre-stage of contact between the catalyst with cocatalyst before their final functionalization. Two zirconocene catalysts are tested in order to attain materials with different microstructural characteristics, molar masses and regioregularities of chains. Some polypropylene chains are able to be accommodated within the silica mesostructure of these composites. Thus, an endothermic event of small intensity appears during heating calorimetric experiments at approximately 105 °C. The existence of these polypropylene crystals, confined within the nanometric channels of silica, is corroborated by SAXS measurements obtained via the change in the intensity and position of the first-order diffraction of SBA-15. The incorporation of silica also has a very significant effect on the rheological response of the resultant materials, leading to important variations in various magnitudes, such as the shear storage modulus, viscosity and δ angle, when a comparison is established with the corresponding neat iPP matrices. Rheological percolation is reached, thus demonstrating the role of SBA-15 particles as filler, in addition to the supporting role that they exert during the polymerizations.

Intraspecific diversity in the mechanisms underlying abamectin resistance in a cosmopolitan pest.

Pesticide resistance relies on a myriad of mechanisms, ranging from single mutations to a complex and polygenic architecture, and it involves mechanisms such as target-site insensitivity, metabolic detoxification, or a combination of these, with either additive or synergistic effects. Several resistance mechanisms against abamectin, a macrocyclic lactone widely used in crop protection, have been reported in the cosmopolitan pest Tetranychus urticae. However, it has been shown that a single mechanism cannot account for the high levels of abamectin resistance found across different mite populations. Here, we used experimental evolution combined with bulked segregant analyses to map quantitative trait loci (QTL) associated with abamectin resistance in two genetically unrelated populations of T. urticae. In these two independent QTL mapping experiments, three and four QTLs were identified, of which three were shared between experiments. Shared QTLs contained genes encoding subunits of the glutamate-gated chloride channel (GluCl) and harboured previously reported mutations, including G314D in GluCl1 and G326E in GluCl3, but also novel resistance candidate loci, including DNA helicases and chemosensory receptors. Surprisingly, the fourth QTL, present only in only one of the experiments and thus unique for one resistant parental line, revealed a non-functional variant of GluCl2, suggesting gene knock-out as resistance mechanism. Our study uncovers the complex basis of abamectin resistance, and it highlights the intraspecific diversity of genetic mechanisms underlying resistance in a cosmopolitan pest.

Incomplete reproductive barriers and genomic differentiation impact the spread of resistance mutations between green- and red-colour morphs of a cosmopolitan mite pest.

Pesticide resistance represents a clear and trackable case of adaptive evolution with a strong societal impact. Understanding the factors associated with the evolution and spread of resistance is imperative to develop sustainable crop management strategies. The two-spotted spider mite Tetranychus urticae, a major crop pest with worldwide distribution and a polyphagous lifestyle, has evolved resistance to most classes of pesticides. Tetranychus urticae exists as either a green- or a red-coloured morph. However, the extent of genetic divergence and reproductive compatibility vary across populations of these colour morphs, complicating their taxonomic resolution at the species level. Here, we studied patterns of genetic differentiation and barriers to gene flow within and between morphs of T. urticae in order to understand the factors that influence the spread of resistance mutations across its populations. We derived multiple iso-female lines from Tetranychus populations collected from agricultural crops. We generated genomic and morphological data, characterized their bacterial communities and performed controlled crosses. Despite morphological similarities, we found large genomic differentiation between the morphs. This pattern was reflected in the incomplete, but strong postzygotic incompatibility in crosses between colour morphs, while crosses within morphs from different geographical locations were largely compatible. In addition, our results suggest recent/on-going gene flow between green-coloured T. urticae and T. turkestani. By screening the sequences of 10 resistance genes, we found evidence for multiple independent origins and for single evolutionary origins of target-site resistance mutations. Our results indicate that target-site mutations mostly evolve independently in populations on different geographical locations, and that these mutations can spread due to incomplete barriers to gene flow within and between populations.

Antimicrobial Activity and Crystallization Features in Bio-Based Composites of PLLA and MCM-41 Particles Either Pristine or Functionalized with Confined Ag Nanowires.

Composites based on an L-rich poly(lactic acid) (PLLA) and MCM-41, either neat or modified with a silver (MCM-41@Ag), are achieved by solvent casting, being next processed by compression molding. Ag is mainly embedded as nanowires within the hybrid MCM-41@Ag particles, enabling its antimicrobial character. In these composites, the PLLA thermal stability, nucleation efficiency, and mechanical response are dependent on the MCM-41 nature and, to a lesser extent, on its content. Thus, differences in transitions of the PLLA matrix are noticed during cooling at 10 °C/min and in the subsequent heating when composites with neat or modified MCM-41 are compared. A very remarkable nucleation effect is played by pristine MCM-41, being inferior when MCM-41@Ag is incorporated into the PLLA. Wide angle X-ray scattering (WAXS) measurements using synchrotron radiation and performed under variable-temperature conditions in the composites containing MCM-41@Ag indicate that during cold crystallization, the disordered α' polymorph is initially formed, but it rapidly transforms into ordered α crystals. A long spacing peak, clearly seen in pure PLLA, appears as a small shoulder in PLLAMCM@Ag4 and is undetectable in PLLAMCM@Ag9 and PLLAMCM@Ag20. Furthermore, an increase in MH with the silica content is found in the two sets of composites, the higher MH values being observed in the family of PLLA and MCM-41@Ag. Finally, remarkable antimicrobial features are noticeable in the composites with MCM-41@Ag since this modified silica transfers its biocidal characteristics into the PLLA composites.

An unusual case of checkpoint-inhibitor-induced pleuropericarditis.

INTRODUCTION: Pembrolizumab is an immune checkpoint inhibitor that promotes effector T-cell functions on malignant cells by binding to programmed cell death protein 1 (PD-1). Pembrolizumab is well tolerated in most cases with an adverse event profile consisting mainly of pruritus, fatigue, and anorexia. Cardiotoxicity comprises 1% of the total adverse events. CASE REPORT: We present a case of a 64-year-old female with non-small cell lung cancer (NSCLC) who developed pleuropericarditis following pembrolizumab therapy. MANAGEMENT & OUTCOME: The patient was successfully managed with colchicine, furosemide, and timely initiation of methylprednisolone with the improvement of her symptoms. The decision to discontinue pembrolizumab was made, and six months after this intervention, the patient has remained asymptomatic. DISCUSSION: Clinicians should recognize these potential immune-mediated adverse effects to provide effective and timely management and optimize patient care.

The ß Form in PVDF Nanocomposites with Carbon Nanotubes: Structural Features and Properties.

Different amounts of carbon nanotubes (CNT) have been incorporated in materials based on poly(vinylidene fluoride) (PVDF) by solvent blending followed by their further precipitation. Final processing was performed by compression molding. The morphological aspects and crystalline characteristics have been examined, additionally exploring in these nanocomposites the common routes described in the pristine PVDF to induce the ß polymorph. This polar ß phase has been found to be promoted by the simple inclusion of CNT. Therefore, coexistence of the α and ß lattices occurs for the analyzed materials. The real-time variable-temperature X-ray diffraction measurements with synchrotron radiation at a wide angle have undoubtedly allowed us to observe the presence of the two polymorphs and determine the melting temperature of both crystalline modifications. Furthermore, the CNT plays a nucleating role in the PVDF crystallization, and also acts as reinforcement, increasing the stiffness of the nanocomposites. Moreover, the mobility within the amorphous and crystalline PVDF regions is found to change with the CNT content. Finally, the presence of CNT leads to a very remarkable increase in the conductivity parameter, in such a way that the transition from insulator to electrical conductor is reached in these nanocomposites at a percolation threshold ranging from 1 to 2 wt.%, leading to the excellent value of conductivity of 0.05 S/cm in the material with the highest content in CNT (8 wt.%).

Combined Effects from Dual Incorporation of ATBC as Plasticizer and Mesoporous MCM-41 as Nucleating Agent on the PLA Isothermal Crystallization in Environmentally-Friendly Ternary Composite Systems.

Different materials, based on an L-rich polylactide (PLA) as matrix, acetyl tri-n-butyl citrate (ATBC) as plasticizer, and mesoporous Mobile Crystalline Material.41 (MCM-41) particles as nucleating agent, were attained by melt extrusion. These materials are constituted by (a) binary blends of PLA and ATBC with different contents of the latest; (b) a dual compound of PLA and a given amount of MCM-41 silica (5 wt.%); and (c) ternary composites that include PLA, ATBC at several compositions and mesoporous MCM-41 at 5 wt.%. Influence of the incorporation of the plasticizer and nucleating particles has been comprehensively analyzed on the different phase transitions: glass transition, cold crystallization, melt crystallization and melting processes. Presence of both additives moves down the temperature at which PLA phase transitions take place, while allowing the PLA crystallization from the melt at 10 °C/min in the composites. This tridimensional ordering is not noticeable in the pristine PLA matrix and, accordingly, PLA crystallization rate is considerably increased under dynamic conditions and also after isothermal crystallization from either the melt or the glassy state. An important synergistic effect of dual action of ATBC and MCM-41 has been, therefore, found.

Fast and Sustained Axonal Growth by BDNF Released from Chitosan Microspheres.

Brain-derived neurotrophic factor (BDNF) regulates dendritic branching and dendritic spine morphology, as well as synaptic plasticity and long-term potentiation. Consequently, BDNF deficiency has been associated with some neurological disorders such as Alzheimer's, Parkinson's or Huntington's diseases. In contrast, elevated BDNF levels correlate with recovery after traumatic central nervous system (CNS) injuries. The utility of BDNF as a therapeutic agent is limited by its short half-life in a pathological microenvironment and its low efficacy caused by unwanted consumption of non-neuronal cells or inappropriate dosing. Here, we tested the activity of chitosan microsphere-encapsulated BDNF to prevent clearance and prolong the efficacy of this neurotrophin. Neuritic growth activity of BDNF release from chitosan microspheres was observed in the PC12 rat pheochromocytoma cell line, which is dependent on neurotrophins to differentiate via the neurotrophin receptor (NTR). We obtained a rapid and sustained increase in neuritic out-growth of cells treated with BDNF-loaded chitosan microspheres over control cells (p < 0.001). The average of neuritic out-growth velocity was three times higher in the BDNF-loaded chitosan microspheres than in the free BDNF. We conclude that the slow release of BDNF from chitosan microspheres enhances signaling through NTR and promotes axonal growth in neurons, which could constitute an important therapeutic agent in neurodegenerative diseases and CNS lesions.

DDC_Calc, software para diagnosticar la displasia del desarrollo de cadera en lactantes (versión 1)

Fundamento la displasia del desarrollo de la cadera constituye la afección más frecuente del desarrollo del sistema musculoesquelético. En el contexto del diagnóstico radiográfico de esta enfermedad en el lactante, las radiografías digitales ofrecen ventajas que pudieran ser aprovechadas para un diagnóstico más preciso. Objetivo describir el funcionamiento del software DDC_Calc para realizar mediciones radiográficas en formato digital. Métodos se realizó un estudio de innovación tecnológica durante el año 2019, en el Hospital Pediátrico Universitario Paquito González Cueto, de Cienfuegos, concretamente en el Servicio de Ortopedia y con la contribución de personal de la Facultad de Matemática, Física y Computación, de la Universidad Central "Marta Abreu", de Las Villas. Se utilizó el algoritmo de visión artificial Viola-Jones para la detección de las estructuras, así como un sistema basado en reglas con vistas a una sugerencia del diagnóstico. Resultados el software integró las herramientas necesarias para la realización de las mediciones utilizadas (ángulos, distancias, posiciones) en el diagnóstico radiográfico de la displasia del desarrollo de cadera. Fueron descritas sus funcionalidades, requisitos y funcionamiento de la aplicación, partiendo de un caso clínico real, todo esto ilustrado con imágenes. Conclusiones el empleo del software facilita la realización de mediciones más exactas por parte del médico, de modo que garantiza mayor calidad en el diagnóstico y la preservación de los hallazgos radiográficos iniciales, los cuales resultan de gran utilidad en el seguimiento radiográfico de la afección en el tiempo.

Background developmental dysplasia of the hip constitutes the most frequent affection for the development of the musculoskeletal system. In the context of radiographic diagnosis of this disease in infants, digital radiographs offer advantages that could be used for a more accurate diagnosis. Objective to describe the DDC_Calc software operation to perform radiographic measurements in digital format. Methods a technological innovation study was carried out during 2019, at the Paquito González Cueto University Pediatric Hospital, in Cienfuegos, specifically in the Orthopedics Service and with the specialists' contribution from the "Marta Abreu" Central University' Mathematics, Physics and Computing Faculty, Las Villas. The Viola-Jones artificial vision algorithm was used for the detection of the structures, as well as a rule-based system with a view to a diagnostic suggestion. Results the software integrated the necessary tools to carry out the measurements used (angles, distances, positions) in the radiographic diagnosis of developmental dysplasia of the hip. Its functionalities, requirements and operation of the application were described, based on a real clinical case, all illustrated with images. Conclusions the use of the software facilitates the performance of more accurate measurements by the doctor, thus guaranteeing higher quality in the diagnosis and the preservation of the initial radiographic findings, which are very useful in the radiographic follow-up of the condition in time.

Active Postlicensure Safety Surveillance for Recombinant Zoster Vaccine Using Electronic Health Record Data.

Recombinant zoster vaccine (RZV) (Shingrix; GlaxoSmithKline, Brentford, United Kingdom) is an adjuvanted glycoprotein vaccine that was licensed in 2017 to prevent herpes zoster (shingles) and its complications in older adults. In this prospective, postlicensure Vaccine Safety Datalink study using electronic health records, we sequentially monitored a real-world population of adults aged ≥50 years who received care in multiple US Vaccine Safety Datalink health systems to identify potentially increased risks of 10 prespecified health outcomes, including stroke, anaphylaxis, and Guillain-Barré syndrome (GBS). Among 647,833 RZV doses administered from January 2018 through December 2019, we did not detect a sustained increased risk of any monitored outcome for RZV recipients relative to either historical (2013-2017) recipients of zoster vaccine live, a live attenuated virus vaccine (Zostavax; Merck & Co., Inc., Kenilworth, New Jersey), or contemporary non-RZV vaccine recipients who had an annual well-person visit during the 2018-2019 study period. We confirmed prelicensure trial findings of increased risks of systemic and local reactions following RZV. Our study provides additional reassurance about the overall safety of RZV. Despite a large sample, uncertainty remains regarding potential associations with GBS due to the limited number of confirmed GBS cases that were observed.

Mediciones radiográficas y diagnóstico de la displasia de cadera del lactante mediante visión computacional y sistema basado en reglas / Radiographic Measurements and Diagnosis of Hip Dysplasia in Infants Using Computer Vision and a Rule-Based System

RESUMEN Fundamento el uso de radiografías digitales para el diagnóstico de la displasia del desarrollo de la cadera permite, además del diagnóstico precoz y mayor eficiencia del trabajo, realizar mediciones más precisas, el seguimiento del paciente y la planificación quirúrgica. Objetivo describir una herramienta capaz de detectar estructuras y puntos de interés de forma semiautomática para realizar las mediciones y cálculos necesarios con vistas al diagnóstico de la displasia de cadera en lactantes. Métodos estudio de innovación tecnológica, donde se utilizó el algoritmo de visión artificial Viola-Jones para la detección de las estructuras, así como un sistema basado en reglas con vistas a una sugerencia del diagnóstico. La herramienta propuesta (Software para las mediciones radiográficas con vistas al diagnóstico de la displasia del desarrollo de cadera en lactantes) se encuentra en fase de prueba y explotación en el Hospital Pediátrico Universitario Paquito González Cueto, de Cienfuegos. Para validar los resultados se tomaron estudios radiográficos de 12 casos, a los cuales se aplicaron las mediciones con el método tradicional y luego mediante el software. Resultados se obtuvo un sistema con vistas a determinar estructuras en las imágenes de radiografía de cadera, las cuales permiten obtener puntos y líneas para calcular los indicadores de displasia. La tasa de acierto al detectar las estructuras fue del 100 %. Conclusión existió una alta coincidencia entre las medidas calculadas por el algoritmo y las calculadas manualmente. La correspondencia entre el diagnóstico predicho por el sistema y el emitido por los médicos especialistas también fue elevada.

ABSTRACT Background the use of digital radiographs for the diagnosis of developmental dysplasia of the hip allows, in addition to early diagnosis and greater work efficiency, more precise measurements, patient monitoring and surgical planning. Objective to describe a tool capable of detecting structures and points of interest in a semi-automatic way to carry out the necessary measurements and calculations with a view to diagnosing hip dysplasia in infants. Methods study of technological innovation, where the Viola-Jones artificial vision algorithm was used for the detection of structures, as well as a rule-based system with a view to a diagnosis suggestion. The proposed tool (Software for radiographic measurements for diagnosing developmental dysplasia of the hip in infants) is in the testing and exploitation phase at the Paquito González Cueto University Pediatric Hospital, in Cienfuegos. To validate the results, radiographic studies of 12 cases were chosen, to which measurements were applied using the traditional method and then using the software. Results a system was obtained with a view to determining structures in hip radiography images, which allow points and lines to be obtained to calculate dysplasia indicators. The success rate in detecting the structures was 100%. Conclusion there was a high coincidence between the measures calculated by the algorithm and those calculated manually. The correspondence between the diagnosis predicted by the system and that issued by specialist doctors was also high.

Effect of Mexico's vaccination program on Covid-19 cases, hospitalizations, and deaths among older adults in Mexico City.

OBJECTIVE: To characterize the impact of Mexico's Co-vid-19 vaccination campaign of older adults. MATERIALS AND METHODS: We estimated the absolute change in sympto-matic cases, hospitalizations and deaths for vaccine-eligible adults (aged >60 years) and the relative change compared to vaccine-ineligible groups since the campaign started. Re-sults. By May 3, 2021, the odds of Covid-19 cases among adults over 60 compared to 50-59 year olds decreased by 60.3% (95%CI: 53.1, 66.9), and 2 003 cases (95%CI: 1 156, 3 130) were avoided. Hospitalizations and deaths showed similar trends. CONCLUSIONS: Covid-19 events decreased after vaccine rollout among those eligible for vaccination.