LA COMUNICACIÓN, OBSERVACIÓN Y ÉTICA COMO ESENCIA DEL CUIDADO CULTURAL DE ENFERMERÍA / COMMUNICATION, OBSERVATION AND ETHICS AS THE ESSENCE OF CULTURAL NURSING CARE

En las dos décadas que llevamos del siglo XXI, pareciera que todo cambia de manera casi instantánea, uno de esos cambios, lo es la situación de migración de los seres humanos que se encuentra presente en los cinco continentes que conforman el mundo, esté hecho requiere de profesionales de enfermería preparados para entender el cuidado desde la cultura de la persona a la que se cuida. Durante el siglo XX, la mayoría de los profesionales de enfermería han sido formados bajo el paradigma occidental, las escuelas y facultades, están más preocupadas por la curación que por la prevención, el objetivo del presente artículo es reflexionar sobre la necesidad de profundizar en las habilidades de comunicación, observación y ética que debe tener el profesional de enfermería para otorgar cuidados culturales al ser humano cultural, ante el hecho de que en la mayoría de los países, el profesional de enfermería tiene contacto con diversos seres humanos culturales. El presente artículo de reflexión incluye en la introducción aspectos generales de la cultura y enfermería, en el cuerpo del artículo se habla sobre como la enseñanza de enfermería ha sido permeada por las necesidades de curación más que de los cuidados culturales, se finaliza con la conclusión de que las escuelas y facultades de enfermería deben ser abiertas a aceptar la diversidad cultural que tienen en su país para la enseñanza del cuidado del ser humano, considerando su cultura en combinación con los cuidados occidentales en que han sido formados los profesionales de enfermería, a partir de considerar que enfermería fue una de las primeras profesiones que durante el siglo XX incluyo en su lenguaje el concepto de cultura, por otro lado es conveniente mencionar que durante el tiempo que llevamos del siglo XXI pocos son los países en donde las escuelas de enfermería incluyen cuidados culturales del ser humano, que en este momento son primordiales dadas las características de movilidad nacional e internacional que tiene la población mundial.

In the two decades that we have been in the 21st century it seems that everything changes almost instantaneously. One of those changes involves the migration of human beings in the five continents that make up the world, a phenomenon that requires nursing professionals to provide care that considers the culture of each person being cared for. During the 20th century, most nursing professionals were trained under the western paradigm, when schools and faculties were more concerned with cure than prevention. The objective of this article is to reflect on the need to develop the skills of communication, observation, and ethics that the nursing professional must have to provide effective care for people from other countries and cultures. Following an introduction to general aspects of cultural and nursing, the body of this reflection article discusses how nursing education has been dominated by healing priorities rather than cultural considerations. The article ends with the conclusion that nursing schools and faculties should recognize the cultural diversity in their country when teaching the principles of care, and that they consider cultural factors in combination with the western concept of care in the training of nursing professionals. Considering that nursing was one of the first professions during the 20th century to include the concept of culture in its language, it is worth mentioning that in the 21st century there are few countries where nursing schools teach culturally sensitive care. This is now essential given the national and international mobility of the world population.

Multidisciplinary Management of Aneurysmal Bone Cyst in Paediatric Patients: A Case Report.

BACKGROUND: The aneurysmal bone cyst is a benign neoplasm that tends to form the appearance of a mass with a bony septum that forms cavities with blood inside. It is estimated to represent 1% of bone tumours and has an incidence of 0.14 per 100,000 people worldwide. Current publications have not shown a multidisciplinary approach that can benefit patients, mainly in the functionality and quality of the management approach. OBJECTIVE: Describe the multidisciplinary approach and the benefits of quality of life and functionality in this diagnosis. CASE: A paediatric patient was diagnosed with an aneurysmal bone cyst located in the cervical spine, which initially manifested with muscle pain, enlargement of the posterior cervical region, and difficulty in performing arcs of movement. He was treated with multidisciplinary management with surgery, embolisation, radiation, and bisphosphonate support. CONCLUSION: The purpose of approaching multidisciplinary management helped to improve the accompanying symptoms that prevented our patient from having an active and quality life. However, more successful cases have not been reported to establish the best therapeutic protocol.

An adenosine derivative prevents the alterations observed in metabolic syndrome in a rat model induced by a rich high-fat diet and sucrose supplementation.

Metabolic syndrome is a multifactorial disease with high prevalence worldwide. It is related to cardiovascular disease, diabetes, and obesity. Approximately 80% of patients with metabolic syndrome have some degree of fatty liver disease. An adenosine derivative (IFC-305) has been shown to exert protective effects in models of liver damage as well as on elements involved in central metabolism; therefore, here, we evaluated the effect of IFC-305 in an experimental model of metabolic syndrome in rats induced by a high-fat diet and 10% sucrose in drinking water for 18 weeks. We also determined changes in fatty acid uptake in the Huh-7 cell line. In the experimental model, increases in body mass, serum triglycerides and proinflammatory cytokines were induced in rats, and the adenosine derivative significantly prevented these changes. Interestingly, IFC-305 prevented alterations in glucose and insulin tolerance, enabling the regulation of glucose levels in the same way as in the control group. Histologically, the alterations, including mitochondrial morphological changes, observed in response to the high-fat diet were prevented by administration of the adenosine derivative. This compound exerted protective effects against metabolic syndrome, likely due to its action in metabolic regulation, such as in the regulation of glucose blood levels and hepatocyte fatty acid uptake.

Effects of artificial canopy shading on vegetative growth and ripening processes of cv. Nero d'Avola (Vitis vinifera L.).

Introduction: The biology of the grapevine (Vitis vinifera L.) is clearly influenced by the climatic conditions of the growing environment, where temperature and light play a major role in modifying plant physiology. In the scenario of climatic changes, radiative excess, correlated to the increase in temperature, can concretely subject the photosynthetic apparatus to a condition of light saturation and cause a drastic reduction in photochemical efficiency, giving rise to chronic photoinhibition phenomena. Undoubtedly, the ripening behavior also undergo evident alterations; the problem of sugar ripening, which is often strongly accelerated, is induced not only by high temperatures but also by the excess concentration of carbon dioxide (CO2), which results in a higher ripening. In addition, high berry temperatures favor a reduction in the concentration of organic acids. The reported trends indicate that the need for urgent action is closely linked to the future environmental impacts that these changes could have on the entire wine sector. In recent years, shade treatments have been applied to the vine canopy to overcome this issue. Methods: The objective of this study was to determine how artificial canopy shading affects the vines vegetative growth and the ripening processes of Vitis vinifera cv. Nero d'Avola during the 2019-2020 vegetative seasons. Three treatments were established: shading treatment with a green net (shade factor 27%), shading treatment with a white net (shade factor 32%), and untreated vines, thus naturally exposed to light radiation. Results and discussion: Artificial shading, applied at full fruit set, interfered with the microclimate of the vines, causing partial effects on the grape ripening processes. At harvest, significant differences were found between the treatments in terms of sugars, also shading treatments increased must acidity and decrease pH. Results obtained on vegetative parameters, suggest that the shading treatment delays leaf fall, with potentially positive effects on the starch accumulation on perennial reserve organs to be exploited at the following season's sprouting. Shading significantly reduced berry size, with obvious consequences on bunch weight and yield per vine. In 2020, shaded plants showed a delay in all the phenological phases. The total anthocyanins content was not changed by the shading treatment. The results obtained confirm the importance of net coverage on the microclimate of the vines, vegetative-productive activity, and grapes quality. From this point of view, the net covering technique can be a tool for controlling grapes ripening dynamics in the context of climate change.

Visuospatial memory profile of patients with Parkinson's disease.

BACKGROUND: In Parkinson's Disease (PD) cognitive impairment may become evident at an early stage of the disease. Performance in the visuospatial domain has been pointed out as a possible predictor of cognitive decline for dementia. OBJECTIVES: The goal was to characterize the visuospatial memory profile, explore the predictive value of a set of visuospatial measures that better distinguish patients from controls, and investigate the relevance of the 10/36 SPART, providing cutoff scores. METHODS: A total of 43 PD patients and 45 healthy controls (HC) were recruited from the Centro Hospitalar Universitário de São João and the community, respectively. The protocol included a set of tests assessing global cognitive functioning, visuoperceptive abilities, and visuospatial memory. RESULTS: PD patients performed significantly worse than HC, showing difficulties in global cognition, visuospatial learning, and visuoconstructive and perceptive abilities. Through a discriminant analysis, the Clock Drawing Test and ACE-R's visuospatial domain were revealed as good tools to be included in the evaluation protocol. Regarding the 10/36 SPART's performance, four predictors were found (age, sex, education, and emotional distress) and cutoff scores were determined. CONCLUSIONS: The visuospatial memory profile found was congruent with that described in the literature. The results were discussed according to their relevance for clinical practice and future research.

Handicap as a Measure of Perceived-Health Status in Parkinson's Disease.

Background: Handicap is a patient-centered measure of health status that encompasses the impact of social and physical environment on daily living, having been assessed in advanced and late-stage Parkinson's Disease (PD). Objective: To characterize the handicap of a broader sample of patients. Methods: A cross-sectional study of 405 PD patients during the MDS-UPDRS Portuguese validation study, using the MDS-UPDRS, Unified Dyskinesias Rating Scale, Nonmotor symptoms questionnaire, PDQ-8 and EQ-5D-3L. Handicap was measured using the London Handicap Scale (LHS). Results: Mean age was 64.42 (±10.3) years, mean disease duration 11.30 (±6.5) years and median HY 2 (IQR, 2-3). Mean LHS was 0.652 (±0.204); "Mobility," "Occupation" and "Physical Independence" were the most affected domains. LHS was significantly worse in patients with longer disease duration, older age and increased disability. In contrast, PDQ-8 did not differentiate age groups. Handicap was significantly correlated with disease duration (r = -0.35), nonmotor experiences of daily living (EDL) (MDS-UPDRS-I) (r = -0.51), motor EDL (MDS-UPDRS-II) (r = -0.69), motor disability (MDS-UPDRS-III) (r = -0.49), axial signs of MDS-UPDRS-III (r = -0.55), HY (r = -0.44), presence of nonmotor symptoms (r = -0.51) and PDQ-8 index (r = -0.64) (all P < 0.05). Motor EDL, MDS-UPDRS-III and PDQ-8 independently predicted Handicap (adjusted R 2 = 0.582; P = 0.007). Conclusions: The LHS was easily completed by patients and caregivers. Patients were mild-moderately handicapped, which was strongly determined by motor disability and its impact on EDL, and poor QoL. Despite correlated, handicap and QoL seem to differ in what they measure, and handicap may have an added value to QoL. Handicap seems to be a good measure of perceived-health status in a broad sample of PD.

Identification of Radiomic Signatures in Brain MRI Sequences T1 and T2 That Differentiate Tumor Regions of Midline Gliomas with H3.3K27M Mutation.

BACKGROUND: Radiomics refers to the acquisition of traces of quantitative features that are usually non-perceptible to human vision and are obtained from different imaging techniques and subsequently transformed into high-dimensional data. Diffuse midline gliomas (DMG) represent approximately 20% of pediatric CNS tumors, with a median survival of less than one year after diagnosis. We aimed to identify which radiomics can discriminate DMG tumor regions (viable tumor and peritumoral edema) from equivalent midline normal tissue (EMNT) in patients with the positive H3.F3K27M mutation, which is associated with a worse prognosis. PATIENTS AND METHODS: This was a retrospective study. From a database of 126 DMG patients (children, adolescents, and young adults), only 12 had H3.3K27M mutation and available brain magnetic resonance DICOM file. The MRI T1 post-gadolinium and T2 sequences were uploaded to LIFEx software to post-process and extract radiomic features. Statistical analysis included normal distribution tests and the Mann-Whitney U test performed using IBM SPSS® (Version 27.0.0.1, International Business Machines Corp., Armonk, NY, USA), considering a significant statistical p-value ≤ 0.05. RESULTS: EMNT vs. Tumor: From the T1 sequence 10 radiomics were identified, and 14 radiomics from the T2 sequence, but only one radiomic identified viable tumors in both sequences (p < 0.05) (DISCRETIZED_Q1). Peritumoral edema vs. EMNT: From the T1 sequence, five radiomics were identified, and four radiomics from the T2 sequence. However, four radiomics could discriminate peritumoral edema in both sequences (p < 0.05) (CONVENTIONAL_Kurtosis, CONVENTIONAL_ExcessKurtosis, DISCRETIZED_Kurtosis, and DISCRETIZED_ExcessKurtosis). There were no radiomics useful for distinguishing tumor tissue from peritumoral edema in both sequences. CONCLUSIONS: Less than 5% of the radiomic characteristics identified tumor regions of medical-clinical interest in T1 and T2 sequences of conventional magnetic resonance imaging. The first-order and second-order radiomic features suggest support to investigators and clinicians for careful evaluation for diagnosis, patient classification, and multimodality cancer treatment planning.

Novel Studies in the Designs of Natural, Synthetic, and Compound Hydrogels with Biomedical Applications / Novedosos Estudios en el Diseño de Hidrogeles Naturales, Sintéticos y Compuestos con Aplicaciones Biomédicas

ABSTRACT Hydrogels are gaining widespread popularity in the biomedical field due to their extraordinary properties, such as biocompatibility, biodegradability, zero toxicity, easy processing, and similarity to physiological tissue. They have applications in controlled drug release, wound dressing, tissue engineering, and regenerative medicine. Among these applications, hydrogels as a controlled drug delivery system stands out, which releases active substances in precise amounts and at specific times. To explore the latest advances in the design of hydrogels, a literature review of articles published in indexed scientific journals, in Scopus and Science Direct, was carried out. This review aimed to discover and describe the most innovative hydrogel research with applications in the biomedical field; hydrogels synthesized with polymers of different origins were selected, such as; i. Natural (dextran, agarose, chitosan, etc.); ii. Synthetic (polyacrylamide, polyethylene glycol, polyvinyl alcohol, etc.); iii. Composites (interpenetrants, hybrid crosslinkers, nanocomposites, etc.). Comparative analysis revealed that hydrogels with composite materials show the most promise. These composite hydrogels combine the advantages of different polymers or incorporate additional components, offering enhanced properties and functionalities. In summary, hydrogels are versatile biomaterials with immense potential in biomedicine. Their unique properties make them suitable for diverse applications. However, innovative designs and formulations must continue to be explored to further advance the capabilities of hydrogels and expand their biomedical applications.

RESUMEN Los hidrogeles están ganando una extensa popularidad en el campo biomédico gracias a que presentan propiedades extraordinarias como biocompatibilidad, biodegradabilidad, nula toxicidad, fácil procesamiento, y similitud con el tejido fisiológico. tienen aplicaciones en la liberación controlada de fármacos, el vendaje de heridas, la ingeniería de tejidos y la medicina regenerativa. Entre estas aplicaciones, destaca el uso de hidrogeles como sistema de administración controlada de fármacos, que liberan sustancias activas en cantidades precisas y en momentos concretos. Para explorar los últimos avances en el diseño de hidrogeles, se realizó una revisión bibliográfica de artículos publicados en revistas científicas indexadas, en Scopus y Science Direct. El objetivo de esta revisión fue descubrir y describir las investigaciones de hidrogeles más innovadoras con aplicaciones en el campo biomédico, se seleccionaron hidrogeles sintetizados con polímeros de diferente índole como; i. Naturales (dextrano, agarosa, quitosano, etc.); ii. Sintéticos (poliacrilamida, polietilenglicol, alcohol polivinílico, etc); iii. Compuestos (interpenetrantes, reticulantes híbridos, nanocompuestos, etc.). El análisis comparativo reveló que los hidrogeles que utilizan materiales compuestos son los más prometedores. Estos hidrogeles compuestos combinan las ventajas de distintos polímeros o incorporan componentes adicionales, ofreciendo propiedades y funcionalidades mejoradas. En resumen, los hidrogeles son biomateriales versátiles con un inmenso potencial en biomedicina. Sus propiedades únicas los hacen adecuados para diversas aplicaciones, sin embargo, se debe seguir explorando diseños y formulaciones innovadores para seguir avanzando en las capacidades de los hidrogeles y ampliar sus aplicaciones biomédicas.

Bilateral deep brain stimulation of the subthalamic nucleus: Targeting differences between the first and second side / Estimulación cerebral profunda bilateral del núcleo subtalámico: diferencias de posicionamiento entre el primer y el segundo lado

Introduction and objectives Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a recognized treatment for drug-refractory Parkinson's disease (PD). However, the therapeutic success depends on the accuracy of targeting. This study aimed to evaluate potential accuracy differences in the placement of the first and second electrodes implanted, by comparing chosen electrode trajectories, STN activity detected during microelectrode recording (MER), and the mismatch between the initially planned and final electrode positions on each side. Materials and methods In this retrospective cohort study, we analyzed data from 30 patients who underwent one-stage bilateral DBS. For most patients, three arrays of microelectrodes were used to determine the physiological location of the STN. Final target location depended also on the results of intraoperative stimulation. The choice of central versus non-central channels was compared. The Euclidean vector deviation was calculated using the initially planned coordinates and the final position of the tip of the electrode according to a CT scan taken at least a month after the surgery. Results The central channel was chosen in 70% of cases on the first side and 40% of cases on the second side. The mean length of high-quality STN activity recorded in the central channel was longer on the first side than the second (3.07±1.85mm vs. 2.75±1.94mm), while in the anterior channel there were better MER recordings on the second side (1.59±2.07mm on the first side vs. 2.78±2.14mm on the second). Regarding the mismatch between planned versus final electrode position, electrodes on the first side were placed on average 0.178±0.917mm lateral, 0.126±1.10mm posterior and 1.48±1.64mm inferior to the planned target (AU)

Introducción y objetivos La estimulación cerebral profunda (ECP) del núcleo subtalámico (NST) es reconocida como un tratamiento para la enfermedad de Parkinson (EP) refractaria al tratamiento farmacológico. Sin embargo, el éxito de esta intervención depende de la precisión de la colocación de los electrodos. Este estudio tuvo como objetivo evaluar las posibles diferencias de precisión entre la colocación del primer y segundo electrodo, comparando las trayectorias elegidas para cada lado, la actividad del NST detectada durante el microrregistro (MER) y la discrepancia entre las posiciones inicialmente planeadas y las finales. Materiales y métodos En este estudio retrospectivo analizamos datos de 30 pacientes sometidos a ECP bilateral. En la mayoría de los casos se usaron tres conjuntos de microelectrodos para determinar la ubicación fisiológica del NST. El posicionamiento final del electrodo estuvo asimismo condicionado por los resultados de la estimulación intraoperatoria. Se comparó la elección de canales centrales vs. no centrales. El vector euclidiano del desvío se calculó a partir de las coordenadas planeadas inicialmente y la posición final de la punta del electrodo, según una tomografía computarizada realizada al menos un mes después de la cirugía. Resultados La trayectoria central se eligió en 70% de los casos en el primer lado y en el 40% de los casos en el segundo lado. La duración media de la actividad de alta calidad del NST registrada en el canal central fue mayor en el primer lado que en el segundo (3,07±1,85mm vs. 2,75±1,94mm), mientras que en el canal anterior hubo mejores registros de MER en el segundo lado (1,59±2,07mm en el primer lado vs. 2,78±2,14mm en el segundo) (AU)

Significados psicológicos sobre sexualidad, deseo y placer sexual en la adultez mayor / Psychological meanings on sexuality, desire, and sexual pleasure in seniorhood

Resumen Los significados sobre la sexualidad en la adultez mayor se encuentran sobre la base de una compleja interrelación entre factores sociales, culturales y personales. La presente investigación tuvo como objetivo explorar los significados psicológicos que personas adultas mayores de la Ciudad de México le confieren a la sexualidad, al placer sexual y al deseo sexual, mediante el empleo de las redes semánticas naturales (modificadas). La muestra estuvo constituida por 204 personas: 162 mujeres y 40 hombres, entre los 60 y 100 años, asistentes a centros de educación continua para personas adultas mayores en la Ciudad de México. El estudio fue mixto, descriptivo, no experimental, con muestreo no probabilístico y por conveniencia. Los resultados muestran que los significados psicológicos que las personas adultas mayores estudiadas refieren sobre la sexualidad, el deseo y el placer sexual son predominantemente positivos, y abarcan sentimientos, comportamientos y sensaciones. Se identifican diferencias por género tal como se planteó en la hipótesis de investigación, pero también se encontraron similitudes dentro de dichos significados. En las adultas mayores predomina la interrelación entre significados afectivos y contacto físico, mientras que en los hombres predominan las sensaciones. En general la muestra describe la sexualidad, el deseo y el placer sexual de manera muy similar, lo cual lleva a comprender que las fronteras entre los términos son sensibles, de tal manera que los significados y referentes de las propias personas llegan a permearse.

Abstract The meanings of sexuality in seniorhood are found at the base of a complex interrelation between social, cultural and personal factors. The present research aimed to explore the psychological meanings that senior adults in Mexico City confer on sexuality, sexual pleasure and sexual desire; through the use of modified natural semantic networks. The sample consisted of 204 people: 162 senior women and 40 senior men, between 60 and 100 years old, attending a continuing education centers for senior adults in Mexico City. The study was mixed, descriptive, non-experimental, with non-probability and convenience sampling. The results show how the psychological meanings that the studied senior adults have related to sexuality, desire and sexual pleasure are predominantly positive, encompassing feelings, behaviors and sensations. Differences by gender are identified as proposed in the research hypothesis, but similarities within these meanings were also found. The senior women studied define sexuality from the interrelation between affective meanings and physical contact; the word "love" was the most referenced. In addition, they mentioned "pleasure", "desire", "caresses", "satisfaction", "kisses", "joy", "hugs", "health", "attraction", and "knowledge". Senior men, for their part, consider sexuality mainly as an attraction and include others such as: "satisfaction", "pleasure", "respect", "life", "fidelity", "complete", "unique", "woman", "touch", "important", "love", "knowledge", "passion", "desire", "need", and "affection". Women and men in the sample describe sexual desire and pleasure in a very similar way to their sexuality referents, which leads us to understand that the boundaries between the two terms are sensitive. Regarding sexual desire, senior women cite defining words such as: "caresses", "kisses", "love", "hugs", "pleasure", "desire", "necessary", "satisfaction", "natural", "attraction", "partner", "happiness", and "respect". In relation to sexual pleasure, they include the words: "enjoyment", "tenderness", "affection", "friendship", "joy", "it is the maximum", and "relaxing". For their part, senior men defined sexual desire as: "attraction", "love", "caresses", "satisfaction", "looks", "necessary", "natural", "woman", "kisses", "being alive", "respect", "passion", "libido", "important", "moving", "pleasure", "hug", "energy", "games", "excitement", "communication", "masturbation", "eroticism", and "taste". Sexual pleasure includes: "important", "fullness", "enjoyment", "respect", "pleasure", "joy", and "naturalness". The results show that the stage of sexuality in seniorhood is diverse and it is influenced by gender and social beliefs, which evidences the psychological complexity of this sphere of life.

Machine versus physician-based programming of deep brain stimulation in isolated dystonia: A feasibility study.

BACKGROUND: Deep brain stimulation of the internal globus pallidus effectively alleviates dystonia motor symptoms. However, delayed symptom control and a lack of therapeutic biomarkers and a single pallidal sweetspot region complicates optimal programming. Postoperative management is complex, typically requiring multiple, lengthy follow-ups with an experienced physician - an important barrier to widespread adoption in medication-refractory dystonia patients. OBJECTIVE: Here we prospectively tested the best machine-predicted programming settings in a dystonia cohort treated with GPi-DBS against the settings derived from clinical long-term care in a specialised DBS centre. METHODS: Previously, we reconstructed an anatomical map of motor improvement probability across the pallidal region using individual stimulation volumes and clinical outcomes in dystonia patients. We used this to develop an algorithm that tests in silico thousands of putative stimulation settings in de novo patients after reconstructing an individual, image-based anatomical model of electrode positions, and suggests stimulation parameters with the highest likelihood of optimal symptom control. To test real-life application, our prospective study compared results in 10 patients against programming settings derived from long-term care. RESULTS: In this cohort, dystonia symptom reduction was observed at 74.9 ± 15.3% with C-SURF programming as compared to 66.3 ± 16.3% with clinical programming (p < 0.012). The average total electrical energy delivered (TEED) was similar for both the clinical and C-SURF programming (262.0 µJ/s vs. 306.1 µJ/s respectively). CONCLUSION: Our findings highlight the clinical potential of machine-based programming in dystonia, which could markedly reduce the programming burden in postoperative management.

Analysis of the Pediatric Radiotherapy Landscape in Mexico and a Subsequent Educational e-Contouring Intervention.

PURPOSE: Mexico and Central America have the highest childhood cancer incidence in the West. Pediatric-specific oncology knowledge contributes to the disparity. We sought to (1) determine the self-identified treatment patterns and needs of Mexican pediatric radiation oncologists and (2) pilot a workshop to improve contouring accuracy. MATERIALS AND METHODS: Partnering with local experts and the Sociedad Mexicana de Radioterapeutas (SOMERA), a 35-question survey was designed to ascertain pediatric radiotherapy capacity and distributed through the SOMERA listserv. The most challenging malignancies were selected for workshop. Participants received precontouring and postcontouring homework to assess improvement per the Dice metric. The Wilcoxon sign-rank test was used for comparative statistics. RESULTS: Ninety-four radiation oncologists attempted and 79 completed the survey. Forty-four (76%) felt comfortable treating a pediatric patient, and 36 (62%) were familiar with national protocols for pediatric treatment. Most had access to nutrition, rehabilitation, endocrinology, and anesthesia; 14% had access to fertility services and 27% to neurocognitive support; 11% noted no support, and only one respondent had child-life support. The postsurvey contouring workshop was conducted for high-grade glioma, medulloblastoma, and Hodgkin lymphoma. Significant improvements were seen in all target volumes. CONCLUSION: We present the first national survey of Mexico's pediatric radiotherapy capacity and Latin American e-contouring educational intervention with preworkshop and postworkshop Dice metrics, noting statistically significant improvement in all target volumes. Participation improved compared with prior experience through SOMERA partnership and Continuing Medical Education incentivization.

Diagnostic Performance of Selected MRI-Derived Radiomics Able to Discriminate Progression-Free and Overall Survival in Patients with Midline Glioma and the H3F3AK27M Mutation.

BACKGROUND: Radiomics refers to a recent area of knowledge that studies features extracted from different imaging techniques and subsequently transformed into high-dimensional data that can be associated with biological events. Diffuse midline gliomas (DMG) are one of the most devastating types of cancer, with a median survival of approximately 11 months after diagnosis and 4-5 months after radiological and clinical progression. METHODS: A retrospective study. From a database of 91 patients with DMG, only 12 had the H3.3K27M mutation and brain MRI DICOM files available. Radiomic features were extracted from MRI T1 and T2 sequences using LIFEx software. Statistical analysis included normal distribution tests and the Mann-Whitney U test, ROC analysis, and calculation of cut-off values. RESULTS: A total of 5760 radiomic values were included in the analyses. AUROC demonstrated 13 radiomics with statistical significance for progression-free survival (PFS) and overall survival (OS). Diagnostic performance tests showed nine radiomics with specificity for PFS above 90% and one with a sensitivity of 97.2%. For OS, 3 out of 4 radiomics demonstrated between 80 and 90% sensitivity. CONCLUSIONS: Several radiomic features demonstrated statistical significance and have the potential to further aid DMG diagnostic assessment non-invasively. The most significant radiomics were first- and second-order features with GLCM texture profile, GLZLM_GLNU, and NGLDM_Contrast.

Bilateral deep brain stimulation of the subthalamic nucleus: Targeting differences between the first and second side.

INTRODUCTION AND OBJECTIVES: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a recognized treatment for drug-refractory Parkinson's disease (PD). However, the therapeutic success depends on the accuracy of targeting. This study aimed to evaluate potential accuracy differences in the placement of the first and second electrodes implanted, by comparing chosen electrode trajectories, STN activity detected during microelectrode recording (MER), and the mismatch between the initially planned and final electrode positions on each side. MATERIALS AND METHODS: In this retrospective cohort study, we analyzed data from 30 patients who underwent one-stage bilateral DBS. For most patients, three arrays of microelectrodes were used to determine the physiological location of the STN. Final target location depended also on the results of intraoperative stimulation. The choice of central versus non-central channels was compared. The Euclidean vector deviation was calculated using the initially planned coordinates and the final position of the tip of the electrode according to a CT scan taken at least a month after the surgery. RESULTS: The central channel was chosen in 70% of cases on the first side and 40% of cases on the second side. The mean length of high-quality STN activity recorded in the central channel was longer on the first side than the second (3.07±1.85mm vs. 2.75±1.94mm), while in the anterior channel there were better MER recordings on the second side (1.59±2.07mm on the first side vs. 2.78±2.14mm on the second). Regarding the mismatch between planned versus final electrode position, electrodes on the first side were placed on average 0.178±0.917mm lateral, 0.126±1.10mm posterior and 1.48±1.64mm inferior to the planned target, while the electrodes placed on the second side were 0.251±1.08mm medial, 0.355±1.29mm anterior and 2.26±1.47mm inferior to the planned target. CONCLUSION: There was a tendency for the anterior trajectory to be chosen more frequently than the central on the second side. There was also a statistically significant deviation of the second electrodes in the anterior and inferior directions, when compared to the electrodes on the first side, suggesting that another cause other than brain shift may be responsible. We should therefore factor this during planning for the second implanted side. It might be useful to plan the second side more anteriorly, possibly reducing the number of MER trajectories tested and the duration of surgery.

MTA-Based Cements: Biocompatibility and Effects on the Gene Expression of Collagen Type 1 and TGF-ß1.

Objective: This study sought to evaluate the biocompatibility of Neomineral Trioxide Aggregate (Neo-MTA), MTA Repair High Plasticity (MTA-HP), and Mineral Trioxide Aggregate-Angelus white (MTA-Ang) in fibroblasts of human dental pulp. Materials and Methods: Morphology was evaluated after 24 h of incubation. LIVE/DEAD assay and cell adhesion tests were performed at 24 h of treatment. Cell proliferation assays (MTSs) and Annexin V were performed at 48 h incubation with different treatments. The expression of Col-1 and TGF-ß1 was tested by endpoint PCR at 5 days of treatment. Results: Morphological changes were observed in all groups. Neo-MTA and MTA-Ang were associated with increased cell viability, and all materials induced apoptosis, with a higher percentage in the MTA-HP group than in the other groups. In the LIVE/DEAD assay, there was more damage to the cell membrane in the group of cells treated with MTA-HP than in the other groups. Conclusion: Neo-MTA and MTA-Ang presented similar biocompatibility, and both showed greater biocompatibility than MTA-HP. MTA-HP and MTA-Ang increased Col-1A gene expression, and Neo-MTA and MTA-Ang increased TGF-ß1 gene expression in a similar way.

Associations of neurotransmitters and the gut microbiome with emotional distress in mixed type of irritable bowel syndrome.

Evidence highlights the comorbidity between emotional distress and irritable bowel syndrome (IBS) through the gut-brain axis. However, the underlying mechanism is largely unknown. Thus, the present study aimed to evaluate the associations among neurotransmitter levels and the gut microbiome profiles in persons with IBS and emotional distress. In this nested case-controlled study, emotional symptoms, including anxiety and depressive symptoms, were evaluated in 40 persons with IBS and 20 healthy controls (HC). Plasma neurotransmitters levels (serotonin and norepinephrine) and the gut microbiome profile of the collected fecal samples were examined. Emotional distress and microbiome profile were significantly different between IBS and HC groups. Lower but not significant neurotransmitters' levels (serotonin and norepinephrine) were observed in the IBS group compared to the HC. A negative correlation was found between norepinephrine levels and alpha diversity (Shannon and Simpson indices) in the IBS group. Moreover, serotonin levels were positively associated with the abundance of Proteobacteria, and norepinephrine were positively correlated with Bacteroidetes, but negatively associated with Firmicutes phylum. The present study demonstrated alteration in the gut microbiome between persons with IBS and emotional distress compared to HC. The correlations between plasma neurotransmitters and the gut microbiome suggest that the gut microbiome may impact the regulation of neurotransmitters.

CRISPR Approaches for the Diagnosis of Human Diseases.

CRISPR/Cas is a prokaryotic self-defense system, widely known for its use as a gene-editing tool. Because of their high specificity to detect DNA and RNA sequences, different CRISPR systems have been adapted for nucleic acid detection. CRISPR detection technologies differ highly among them, since they are based on four of the six major subtypes of CRISPR systems. In just 5 years, the CRISPR diagnostic field has rapidly expanded, growing from a set of specific molecular biology discoveries to multiple FDA-authorized COVID-19 tests and the establishment of several companies. CRISPR-based detection methods are coupled with pre-existing preamplification and readout technologies, achieving sensitivity and reproducibility comparable to the current gold standard nucleic acid detection methods. Moreover, they are very versatile, can be easily implemented to detect emerging pathogens and new clinically relevant mutations, and offer multiplexing capability. The advantages of the CRISPR-based diagnostic approaches are a short sample-to-answer time and no requirement of laboratory settings; they are also much more affordable than current nucleic acid detection procedures. In this review, we summarize the applications and development trends of the CRISPR/Cas13 system in the identification of particular pathogens and mutations and discuss the challenges and future prospects of CRISPR-based diagnostic platforms in biomedicine.