Earlier detection of gestational diabetes impacts on medication requirements, neonatal and maternal outcomes.

AIM: Gestational diabetes (GD) is a global health concern with significant implications for maternal and neonatal outcomes. This study investigates the association between early GD (eGD) diagnosis (<24 weeks), pharmacotherapy requirements and adverse neonatal outcomes. MATERIALS AND METHODS: A cohort of 369 pregnant women underwent a 75-g oral glucose tolerance test. Maternal variables, pharmacotherapy prescriptions and neonatal outcomes were analysed employing t-tests, χ2 tests, and logistic regression. A p < .05 was considered significant. RESULTS: Early GD increased the odds of neonatal hypoglycaemia [odds ratio (OR): 18.57, p = .013] and respiratory distress syndrome (OR: 4.75, p = .034). Nutritional therapy prescription by an accredited nutritionist was the most common treatment in women diagnosed after 24 weeks, but those with eGD required more frequently specialized nutritional consulting + metformin to achieve glycaemic control (p = .027). eGD was associated with a higher requirement of nutritional therapy prescription + metformin (OR: 2.26, 95% confidence interval: 1.25-4.09, p = .007) and with maternal hyperglycaemia during the post-partum period at 2 h of the oral glucose tolerance test (OR: 1.03, 95% confidence interval: 1.02-1.13, p = .024). CONCLUSION: Timely diagnosis and personalized treatment of GD are desirable because an earlier presentation is related to a higher risk of adverse neonatal and maternal outcomes.

Machine learning based detection of T-wave alternans in real ambulatory conditions.

BACKGROUND AND OBJECTIVE: T-wave alternans (TWA) is a fluctuation in the repolarization morphology of the ECG. It is associated with cardiac instability and sudden cardiac death risk. Diverse methods have been proposed for TWA analysis. However, TWA detection in ambulatory settings remains a challenge due to the absence of standardized evaluation metrics and detection thresholds. METHODS: In this work we use traditional TWA analysis signal processing-based methods for feature extraction, and two machine learning (ML) methods, namely, K-nearest-neighbor (KNN) and random forest (RF), for TWA detection, addressing hyper-parameter tuning and feature selection. The final goal is the detection in ambulatory recordings of short, non-sustained and sparse TWA events. RESULTS: We train ML methods to detect a wide variety of alternant voltage from 20 to 100 µV, i.e., ranging from non-visible micro-alternans to TWA of higher amplitudes, to recognize a wide range in concordance to risk stratification. In classification, RF outperforms significantly the recall in comparison with the signal processing methods, at the expense of a small lost in precision. Despite ambulatory detection stands for an imbalanced category context, the trained ML systems always outperform signal processing methods. CONCLUSIONS: We propose a comprehensive integration of multiple variables inspired by TWA signal processing methods to fed learning-based methods. ML models consistently outperform the best signal processing methods, yielding superior recall scores.

Psychosocial Impact of Infertility Diagnosis and Conformity to Gender Norms on the Quality of Life of Infertile Spanish Couples.

Epidemiological data show that human reproductive disorders are a common problem worldwide, affecting almost one in six people of reproductive age. As a result, infertility has been identified by the World Health Organization as a public health disease. Reproductive problems can take a heavy toll on the psychosocial well-being of couples suffering from infertility. This is especially true for women, who tend to be the ones who undergo the most treatment. The main objective of the present study is to find out whether a sex-based infertility diagnosis influences the quality of life of couples with infertility. Also, we aim to find out whether the degree of adherence to gender norms influences their quality of life. A cross-sectional study was conducted using the Fertility Quality of Life Questionnaire (FertiQoL) and the Conformity to Feminine and Masculine Norms Inventories in a sample of 219 infertile Spanish couples (438 participants). The results show that, in all cases, regardless of the degree of conformity to gender norms and whether the infertility diagnosis was of female or male origin, women have lower scores on the self-perceived quality of life. This suggests that being female is already a psychosocial risk factor when assessing the psychosocial consequences of infertility.

Antepartum Fetal Surveillance and Optimal Timing of Delivery in Diabetic Women: A Narrative Review.

Antepartum fetal surveillance (AFS) is essential for pregnant women with diabetes to mitigate the risk of stillbirth. However, there is still no universal consensus on the optimal testing method, testing frequency, and delivery timing. This review aims to comprehensively analyze the evidence concerning AFS and the most advantageous timing for delivery in both gestational and pregestational diabetes mellitus cases. This review's methodology involved an extensive literature search encompassing international diabetes guidelines and scientific databases, including PubMed, MEDLINE, Google Scholar, and Scopus. The review process meticulously identified and utilized pertinent articles for analysis. Within the scope of this review, a thorough examination revealed five prominent international guidelines predominantly addressing gestational diabetes. These guidelines discuss the utility and timing of fetal well-being assessments and recommendations for optimal pregnancy resolution timing. However, the scarcity of clinical trials directly focused on this subject led to a reliance on observational studies as the basis for most recommendations. Glucose control, maternal comorbidities, and the medical management received are crucial in making decisions regarding AFS and determining the appropriate delivery timing.

Family Involvement and at-Home Physical Therapy on Duchenne Muscular Dystrophy: A Randomized Controlled Trial.

BACKGROUND: Duchenne muscular dystrophy (DMD) is a genetic condition that causes muscle weakness and begins in early childhood. To treat its complications, the rehabilitation program includes physical therapy, mainly on the musculoskeletal and the respiratory complications that appear on the evolution of the disease. This study aims to explore the effects of physical therapy with or without an at-home program on motor function among children with DMD. METHODS: A randomized controlled trial was carried out for one year (one group with at-home and conventional physical therapy and another with conventional physical therapy). Motor function was measured using the Motor Function Measure (MFM) scale, the Vignos and Brooke scales, the Timed-up-and-Go test, and the six-minute walk distance test. RESULTS: Twenty-seven participants with DMD participated in this study. In the at-home and conventional physical therapy group, better motor function at the distal and global level was maintained, per the results of the MFM scale (P < 0.05). The rest of the variables did not achieve statistically significant changes. CONCLUSIONS: Our results suggest that complementing conventional treatment with at-home treatment in which the family is involved maintains better motor function, in participants with DMD.

Dysfunction of Drosophila mitochondrial carrier homolog (Mtch) alters apoptosis and disturbs development.

Mitochondrial carrier homologs 1 (MTCH1) and 2 (MTCH2) are orphan members of the mitochondrial transporter family SLC25. Human MTCH1 is also known as presenilin 1-associated protein, PSAP. MTCH2 is a receptor for tBid and is related to lipid metabolism. Both proteins have been recently described as protein insertases of the outer mitochondrial membrane. We have depleted Mtch in Drosophila and show here that mutant flies are unable to complete development, showing an excess of apoptosis during pupation; this observation was confirmed by RNAi in Schneider cells. These findings are contrary to what has been described in humans. We discuss the implications in view of recent reports concerning the function of these proteins.

The neuropeptidergic connectome of C. elegans.

Efforts are ongoing to map synaptic wiring diagrams, or connectomes, to understand the neural basis of brain function. However, chemical synapses represent only one type of functionally important neuronal connection; in particular, extrasynaptic, "wireless" signaling by neuropeptides is widespread and plays essential roles in all nervous systems. By integrating single-cell anatomical and gene-expression datasets with biochemical analysis of receptor-ligand interactions, we have generated a draft connectome of neuropeptide signaling in the C. elegans nervous system. This network is characterized by high connection density, extended signaling cascades, autocrine foci, and a decentralized topology, with a large, highly interconnected core containing three constituent communities sharing similar patterns of input connectivity. Intriguingly, several key network hubs are little-studied neurons that appear specialized for peptidergic neuromodulation. We anticipate that the C. elegans neuropeptidergic connectome will serve as a prototype to understand how networks of neuromodulatory signaling are organized.

Parásitos en un venado de cola blanca silvestre en Cajamarca, Perú

En el presente estudio se informa sobre los parásitos encontrados en un venado de cola blanca, Odocoileus virginianus peruvianus, capturado en el bosque seco del distrito de Paccha, provincia de Chota, departamento de Cajamarca. El Servicio Nacional Forestal y de Fauna Silvestre recuperó los parásitos de un espécimen macho adulto y las remitió al Centro de Investigación en Medicina Tropical de la Universidad Nacional de Cajamarca para la identificación taxonómica de helmintos y artrópodos, y análisis coproparasitológico. Se identificaron dos metacéstodos correspondientes a Cysticercus tenuicollis. En los análisis coproparasitológicos cualitativos se hallaron huevos de Nematodirus spp. en una carga de 10 por gramo de heces (h.p.g.) y 40 h.p.g. tipo Strongílidos que no pudieron diferenciarse por la baja carga en el coprocultivo. No se detectaron huevos de trematodos en la sedimentación. De ectoparásitos, se identificaron ocho garrapatas duras Rhipicephalus (Boophilus) microplus y cinco piojos chupadores Solenopotes binipilosus. Varios de los ejemplares fueron depositados en el Museo de Historia Natural de la Universidad Nacional Mayor de San Marcos, Lima. Los hallazgos representan el primer reporte formal de la garrapata común del ganado en esta subespecie de cérvido. Además, se registra por primera vez la presencia del piojo Solenopotes binipilosus en territorio peruano.

In the present study, findings regarding parasites discovered in a white-tailed deer, Odocoileus virginianus peruvianus, captured in the dry forest of the Paccha district, Chota province, Cajamarca department, are reported. The Servicio Nacional Forestal y de Fauna Silvestre recovered parasites from an adult male specimen and forwarded them to the Tropical Medicine Research Center at the Universidad Nacional de Cajamarca for taxonomic identification of helminths and arthropods, as well as coproparasitological analysis. Two metacestodes corresponding to Cysticercus tenuicollis were identified. Qualitative coproparasitological analyses revealed Nematodirus spp. eggs at a concentration of 10 eggs per gram of feces (EPG) and 40 EPG of Strongylid type that could not be differentiated due to low counts in the coproculture. No trematode eggs were detected in the sedimentation. Among ectoparasites, eight hard ticks Rhipicephalus (Boophilus) microplus and five sucking lice Solenopotes binipilosus were identified. Several specimens were deposited in the Museo de Historia Natural de la Universidad Nacional Mayor de San Marcos, Lima. These findings represent the first formal report of the common cattle tick in this subspecies of cervid. Additionally, the presence of the Solenopotes binipilosus louse in Peruvian territory is reported for the first time.

Evaluations of Anticancer Effects of Combinations of Cisplatin and Tirucallane-Type Triterpenes Isolated from Amphipterygium adstringens (Schltdl).

The cytotoxic activity of combinations of masticadienonic (AMD) or 3αOH-hydroxy-masticadienonic (3αOH-AMD) acids with cisplatin (CDDP) was evaluated against PC3 prostate and HCT116 colon cancer cell lines. Combinations A (half the IC50 value), B (IC50 value), and C (twice the IC50 value) were tested at a 1 : 1 ratio. All AMD plus CDDP combinations demonstrated increased cytotoxic effect, as determined by the sulforhodamine B test, in both cell types. The best combination was B, which showed 93 % and 91 % inhibition of the proliferation of PC3 and HCT116 cells, respectively. It also increased apoptosis in the PC3 cell lines, as evaluated by flow cytometry. However, in vivo tests showed no additional activity from the AMD plus CDDP combinations. These results showed that the increased cytotoxic activity of the combinations in vitro did not reflect in vivo tests. All combinations of 3αOH-AMD plus CDDP exerted antagonistic effects in both cell types.

Autolesiones y conducta suicida en niños y adolescentes. Lo que la pandemia nos ha desvelado / Self-injury and suicidal behavior in children and youth population: Learning from the pandemic

Introducción: Las conductas suicidas y las autolesiones están aumentando en niños y adolescentes. Las autolesiones no suicidas suponen un método disfuncional de regulación emocional. Es importante aprender a distinguirlas de las conductas suicidas. Material y métodos: Revisión narrativa de la situación actual sobre suicidio y autolesiones en España. Estudio descriptivo conductas suicidas en urgencias pediátricas. Resultados: En un estudio multicéntrico de la Sociedad Española de Urgencias Pediátricas (SEUP) se analizaron las consultas por salud mental (marzo-2019 a marzo-2020 y marzo-2020 a marzo-2021), encontrándose un aumento del 122% del diagnóstico «intoxicación no accidental por fármacos» y del 56% en «suicidio/intento de suicidio/ideación autolítica». En otro análisis prospectivo, se registraron 281 tentativas, siendo el perfil de paciente: sexo femenino (90,1%), 14,8 años, el 34,9% sin diagnóstico psiquiátrico previo, el 57,7% con conductas suicidas anteriormente. La presencia de trastornos psiquiátricos, en especial de depresión, y de intentos previos, son los factores de riesgo más implicados en la conducta suicida, aunque existen otros de índole diversa (familiares, personales o sociales). Los pediatras deben estar formados para atender consultas sobre suicidio, y adquirir habilidades para realizar una entrevista con actitud de apoyo y empatía. En España los planes de prevención de suicidio son heterogéneos y no existe un plan nacional de prevención del suicidio. Conclusiones: Se deben reforzar los recursos de atención primaria, hospitalaria y de salud mental de la población pediátrica. Los centros escolares y la formación en psiquiatría infantil y adolescente para médicos y enfermeras resultan cruciales en la prevención del suicidio en niños y adolescentes. (AU)

Introduction: Suicidal behavior and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviors. Methods: Narrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviors in pediatric emergencies. Results: Mental health consultations were analyzed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the Spanish Society of Pediatric Emergencies (SEUP), finding a 122% increase of the diagnosis of «non-accidental drug intoxication» and 56% of «suicide/suicide attempt/suicidal ideation». In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1%), 14.8 years old, 34.9% without previous psychiatric diagnosis; 57.7% with previous suicidal behavior. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behavior, although other factors are involved (family, personal or social). Pediatricians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. Conclusions: Primary, hospital and mental health care resources for pediatric population should be strengthened to prevent suicidal behaviors. Specific training for school staff, and child and adolescent psychiatry training for pediatricians and nurses are crucial in the prevention of suicide in children and adolescent population. (AU)

Self-injury and suicidal behavior in children and youth population: Learning from the pandemic.

INTRODUCTION: Suicidal behaviour and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviours. METHODS: Narrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviours in paediatric emergencies. RESULTS: Mental health consultations were analysed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the SEUP (Spanish Society of Pediatric Emergencies), finding a 122 % increase of the diagnosis of "non-accidental drug intoxication" and 56 % of "suicide/suicide attempt/suicidal ideation". In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1 %), 14.8 years old, 34.9 % without previous psychiatric diagnosis; 57.7% with previous suicidal behaviour. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behaviour, although other factors are involved (family, personal or social). Pediatricians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. CONCLUSIONS: Primary, hospital and mental health care resources for paediatric population should be strengthened to prevent suicidal behaviours. Specific training for school staff, and child and adolescent psychiatry training for paediatricians and nurses are crucial in the prevention of suicide in children and adolescent population.

Transcriptome analysis of aphids exposed to glandular trichomes in tomato reveals stress and starvation related responses.

Understanding the responses of insect herbivores to plant chemical defences is pivotal for the management of crops and pests. However, the mechanisms of interaction are not entirely understood. In this study, we compared the whole transcriptome gene expression of the aphid Macrosiphum euphorbiae grown on two different varieties of tomato that differ in their inducible chemical defences. We used two isogenic lines of tomato with a shared genetic background that only differ in the presence of type IV glandular trichomes and their associated acylsucrose excretions. This works also reports a de novo transcriptome of the aphid M. euphorbiae. Subsequently, we identified a unique and distinct gene expression profile for the first time corresponding to aphid´s exposure to type IV glandular trichomes and acylsugars. The analysis of the aphid transcriptome shows that tomato glandular trichomes and their associated secretions are highly efficient in triggering stress-related responses in the aphid, and demonstrating that their role in plant defence goes beyond the physical impediment of herbivore activity. Some of the differentially expressed genes were associated with carbohydrate, lipid and xenobiotic metabolisms, immune system, oxidative stress response and hormone biosynthesis pathways. Also, the observed responses are compatible with a starvation syndrome. The transcriptome analysis puts forward a wide range of genes involved in the synthesis and regulation of detoxification enzymes that reveal important underlying mechanisms in the interaction of the aphid with its host plant and provides a valuable genomic resource for future study of biological processes at the molecular level using this aphid.