Effect of Live and Fragmented Saccharomyces cerevisiae in the Feed of Pigs Challenged with Mycoplasma hyopneumoniae.

Currently, the responsible use of antimicrobials in pigs has allowed the continuous development of alternatives to these antimicrobials. In this study, we describe the impact of treatments with two probiotics, one based on live Saccharomyces cerevisiae (S. cerevisiae) and another based on fragmented S. cerevisiae (beta-glucans), that were administered to piglets at birth and at prechallenge with Mycoplasma hyopneumoniae. Thirty-two pigs were divided into four groups of eight animals each. The animals had free access to water and food. The groups were as follows: Group A, untreated negative control; Group B, inoculated by nebulization with M. hyopneumoniae positive control; Group C, first treated with disintegrated S. cerevisiae (disintegrated Sc) and inoculated by nebulization with M. hyopneumoniae; and Group D, treated with live S. cerevisiae yeast (live Sc) and inoculated by nebulization with M. hyopneumoniae. In a previous study, we found that on Days 1 and 21 of blood sampling, nine proinflammatory cytokines were secreted, and an increase in their secretion occurred for only five of them: TNF-α, INF-α, INF-γ, IL-10, and IL-12 p40. The results of the clinical evolution, the degree of pneumonic lesions, and the productive parameters of treated Groups C and D suggest that S. cerevisiae has an immunomodulatory effect in chronic proliferative M. hyopneumoniae pneumonia characterized by delayed hypersensitivity, which depends on the alteration or modulation of the respiratory immune response. The data presented in this study showed that S. cerevisiae contributed to the innate resistance of infected pigs.

Critical appraisal of the Colombian clinical practice guide for the prevention, diagnosis and treatment of suicidal ideation and/or behaviour (adoption).

INTRODUCTION: Suicide is a complex, global public health problem. The Colombian clinical practice guideline provides relevant input for its prevention, diagnosis and treatment. The objective was to evaluate the methodological quality, credibility and applicability of the Colombian clinical practice guideline for suicidal behaviour. METHODS: An academic group of 12 evaluators was established to assess the guide and its recommendations in a standardised way, using the AGREE-II and AGREE-REX instruments. The evaluations were given in the range of 0.0-1.0 with 0.7 as a cut-off point for appropriate quality. RESULTS: The global assessment of the AGREE-II was greater than 0.7 in the dimensions: "scope and objective" (0.86), "clarity of presentation" (0.89), "applicability" (0.73) and "editorial independence" (0.89). The lowest scores were for "participation of those involved" (0.67) and "rigour in preparation" (0.69). With the AGREE-REX, the results in all dimensions were below 0.70, which indicates lower quality and suitability for use. CONCLUSIONS: The adoption process of the Colombian guideline for suicidal behaviour was a rigorous methodological process, while the practice recommendations were valued as of low applicability due to low support in local evidence. It is necessary to strengthen the generation and synthesis of evidence at the national level to give greater support and applicability to the practice recommendations.

Familial LCAT Deficiency and Low HDL-C Levels: In silico Characterization of Two Rare LCAT Missense Mutations.

Mutations in the lecithin-cholesterol acyltransferase (LCAT) gene, which catalyzes the esterification of cholesterol, result in two types of autosomal recessive disorders: Familial LCAT deficiency (FLD) and Fish Eye Disease (FED). While both phenotypes are characterized by corneal opacities and different forms of dyslipidemia, such as low levels of high-density lipoprotein-cholesterol (HDL-C), FLD exhibits more severe clinical manifestations like splenomegaly, anemia, and renal failure. We describe the first clinically and genetically confirmed case of FLD in Colombia which corresponds to a 46-year-old woman with corneal opacity, hypothyroidism, and dyslipidemia, who does not have any manifestations of renal failure, with two pathogenic heterozygous missense variants in the LCAT gene: LCAT (NM_000229.2):c.803G>A (p.Arg268His) and LCAT (NM_000229.2):c.368G>C (p.Arg123Pro). In silico analysis of the mutations predicted the physicochemical properties of the mutated protein, causing instability and potentially decreased LCAT function. These compound mutations highlight the clinical heterogeneity of the phenotypes associated with LCAT gene mutations.

Development of undergraduate students' diagnostic accuracy for the classification of molar incisor hypomineralization.

INTRODUCTION: One of the major difficulties with respect to molar incisor hypomineralization (MIH) is its classification and differentiation from other enamel development defects (EDDs). The aim of this study was to evaluate diagnostic accuracy in dental students to classify MIH as well as its differentiation from other EDDs by combining conventional theoretical classes and e-learning-assisted pre-clinical practices. METHODS: In this one-group pre-test and post-test study, 59 second-year students assessed 115 validated photographs using the MIH Index on the Moodle learning platform. This index assesses the clinical features and extent of MIH, differentiating it from other EDDs. Students received automatic feedback after the pre-test. Two weeks later, students re-evaluated the same photographs. Both pairwise accuracy and overall diagnostic accuracy were estimated and compared for pre- and post-testing, with the area under the curve AUC, along with 95% confidence intervals (95% CI). RESULTS: The lowest diagnostic accuracy was for the ability to discriminate between white or cream-coloured demarcated opacities and hypomineralization-type defect that is not MIH. The overall pre-test accuracy was AUC = 0.83 and increased significantly post-test to AUC = 0.99 (p < .001). The overall accuracy to discriminate the extent of the lesion also increased significantly post-test (p < .001). CONCLUSION: Diagnostic skills to classify MIH can be developed by combining conventional theoretical classes and e-learning-assisted pre-clinical practices.

"La Perla Del Mar": A Case Report on Subcutaneous Penile Implants.

The purpose of this report is to alert and inform the medical community about the presence and practice of subcutaneous penile implants (SPIs), which are used with the intent of increasing sexual pleasure. This case aspires to deflect plausible misconceptions in the specific populations who use the SPIs. This case study was performed in January 2023 at a tertiary care center in Miami, Florida. A 61-year-old Cuban male admitted for a routine hernia repair with an incidental finding of a benign SPI was interviewed and examined; an extended collection of historical information regarding the patient's penile implant was ascertained. The patient stated that there was a tradition among the men and adolescent individuals living along coastal cities/towns of Cuba such as Havana and Matanzas who would elect to have pieces of stones or gems or any solid objects shaped and molded into round objects that are used for the intent of increasing sexual pleasure. The patient referred to the implant as "La Perla Del Mar," which translates directly into "Pearl of the Sea." Upon visualization of the nodule on examination, a differential diagnosis may include infection (such as syphilis), granulomas, sarcoidosis, dermatofibroma, epithelial inclusion cyst, or malignancy. However, an appropriate workup informed us about the penile implant. Clinicians should employ caution in investigating a penile nodule by taking a detailed social and sexual history and physical exam from the patient if possible. This case and the literature review cited to bolster the notion of a lack of chronic symptoms due to the inserted objects. Several provocations for the implantation of an artificial penile nodule, in this case, maybe extrapolated, such as the desire for a prospective partner's pleasure/displeasure, group identification, or masculine embodiment. The main takeaways from this case report are the considerations that should be taken in the older Caribbean population for patients with the "Perla Del Mar" implantation and bolstering the notion of complete sexual education for clinicians regarding specific populations to enhance patient care.

Evaluation of roasting and storage conditions as a strategy to improve the sensory characteristics and shelf life of coffee.

Coffee is one of the most consumed products worldwide. Among the varieties of this product, specialty coffee is a type of coffee that has been growing in the world market. This paper aims to assess the effects that the conditions derived from coffee roasting at different altitude levels have on the quality of the product. It was discovered that processing coffee at a higher altitude level yielded a smaller increase in bitterness. This led to a better Specialty Coffee Association (SCA) score in cupping and, consequently, to better preservation of the coffee quality. The storage time affected the aroma by associating roaster aromas with older coffees. Although the assessed origins had the same NIR spectra, differences in peak intensity lead to variations in the flavor and aroma of the coffee. Furthermore, although green beans prolong quality allowing a SCA score of 84.73 ± 2.81 after 4 months of storage, roasted coffee at higher altitudes could also maintain the quality between production and consumption (SCA score of 80.22 ± 0.91 after 2 months). Finally, this research found that the instrumental equipment helped to find minor changes in the sensorial profile, and with these changes correlated with the sensorial panel, the best conditions to preserve coffee quality were found.

Paciente con diagnóstico de Wiskott Aldrich y presencia de una nueva mutación

RESUMEN Introducción: El síndrome de Wiskott-Aldrich, es una inmunodeficiencia primaria, poco frecuente heredada de forma recesiva ligado al cromosoma X. Está asociado a fenotipos clínicos variables que se correlacionan con el tipo de mutación presente en la proteína del síndrome de Wiskott-Aldrich. Objetivo: Examinar el caso de un paciente con diagnóstico de Wiskott Aldrich y presencia de una mutación no descrita anteriormente. Presentación del caso: Paciente masculino cuya sintomatología se inició a los tres meses de edad, con infecciones respiratorias recurrentes, lesiones purpúricas hemorrágicas tipo equimosis, eccema y plaquetopenia. El diagnóstico se confirmó al año de inicio de los síntomas con la detección de una mutación no descrita anteriormente, ubicada en el codón 88 de la proteína del síndrome de Wiskott-Aldrich (p. Y88X; c.264C > G), asociada a una variante clásica. Conclusiones: La identificación temprana, diagnóstico y estratificación del fenotipo, es esencial para reducir los eventos desfavorables y complicaciones de la afección. El estudio genético es el medio de confirmación diagnóstica definitivo para el síndrome, lo que permite aplicar el protocolo terapéutico más adecuado para este tipo de inmunodeficiencia.

ABSTRACT Introduction: Wiskott Aldrich syndrome is a primary immunodeficiency, rarely inherited in a recessive way and linked to the X chromosome. It is associated with variable clinical phenotypes that correlate with the type of mutation present in the Wiskott Aldrich syndrome protein. Objective: Examine the case of a patient diagnosed with Wiskott Aldrich and presence of a mutation not described above. Case presentation: Male patient whose symptoms began at three months of age, with recurrent respiratory infections, purpuric hemorrhagic lesions such as ecchymosis, eczema and platelettopenia. The diagnosis was confirmed one year of after the symptoms onset with the detection of a mutation not previously described, located in codon 88 of the Wiskott Aldrich syndrome protein (p. Y88X; c.264C>G), associated with a classical variant. Conclusions: Early identification, diagnosis and stratification of the phenotype is essential to reduce unfavorable events and complications of the condition. The genetic study is the mean of definitive diagnostic confirmation for the syndrome, which allows to apply the most appropriate therapeutic protocol for this type of immunodeficiency.

Developing diagnostic skills from preclinical dental education: Caries detection and assessment using e-learning assisted practice.

PURPOSE: To evaluate the feasibility of developing visual diagnostic skills for detecting and assessing dental caries using e-learning assisted practice in preclinical dental education. METHODS: A one-group before and after the study was conducted. After a theoretical lesson on cariology, 53 inexperienced second-year preclinical students assessed 78 clinical photographs using the Nyvad criteria; they received automated feedback upon completion of the test. After a week, all students reassessed the same set of photographs, which were randomly reordered. Differential diagnostic accuracy was analyzed category-pairwise, and overall accuracy measures were based on the receiver operator curve. Diagnostic accuracy in both attempts was evaluated and compared through estimation and pooling of individual student accuracies. RESULTS: Pooled category-pairwise accuracy was lower for discriminating Sound surface from Non-cavitated-active caries, and for discriminating inactive caries (surface discontinuity) from intact surface inactive caries and Cavitated-active caries. Pooled overall accuracy, after the theoretical lesson, was 0.79 (95% confidence interval [CI] 0.77-0.81), and it increased to 0.99 (95% CI 0.98-0.99) after feedback. Between-student variability in accuracy was reduced from I2  = 0.66 to 0.55. CONCLUSION: E-learning assisted practice is a feasible alternative to start developing visual diagnostic skills for detecting and assessing dental caries using the Nyvad criteria from preclinical dental education in cariology. However, further studies are required to evaluate its effectiveness in improving real-world practice knowledge and skills.

Desarrollo de un modelo de planeación financiera para una compañía de alimentos utilizando simulación Monte Carlo / Development of a financial planning model for the food's company using Monte Carlo simulation / Desenvolvimento de um modelo de planeamento financeiro para a empresa do ramo alimentar utilizando simulação Monte Carlo

RESUMEN El objetivo es desarrollar un modelo de planeación financiera que permita calcular las ganancias probables de una compañía de alimentos en Colombia, en un horizonte temporal de seis años. La metodología utilizada es el Valor Presente Neto de sus flujos de caja libre, calculados a partir de 38 variables de entrada y de proceso que recogen el aspecto macroeconómico, las políticas financieras y los estados contables. Se realizaron 10.000 iteraciones con la técnica de simulación Montecarlo. Los resultados de la simulación indican que sus ganancias probables están entre $278.293 millones y $449.934 millones con un nivel de confianza del 90%. El análisis de sensibilidad del plan financiero permite concluir que la compañía debe reformular sus políticas financieras relacionadas con la administración del capital de trabajo, dado que la cartera y principalmente los inventarios tienen una influencia negativa sobre el VPN, según los coeficientes de regresión. CLASIFICACIÓN JEL B41, C15

ABSTRACT The goal is to develop a financial planning model that allows calculating the probable profits of a food company in Colombia, in a time horizon of six years. The methodology used is the Net Present Value of its Free Cash Flow, calculated from 38 input and process variables that include the macroeconomic aspect, financial policies and financial statements. 10.000 iterations were carried out with the Montecarlo simulation technique. The simulation results indicate that its probable profits are between $278.293 million and y $449.934 million with a confidence level of 90%. The sensitivity analysis of the financial plan allows to conclude that the company should reformulate its financial policies related to the management of working capital, since the debt clients and mainly the inventories has a negative influence on the Net Present Value, according the regression coefficients. JEL CLASSIFICATION B41, C15

RESUMO O objectivo é desenvolver um modelo de planeamento financeiro que permita calcular os prováveis lucros de uma empresa alimentar na Colômbia, num horizonte temporal de seis anos. A metodologia utilizada é o Valor Presente Líquido dos seus fluxos de caixa livres, calculado a partir de 38 variáveis de entrada e de processo que recolhem o aspecto macroeconómico, as políticas financeiras e as declarações contabilísticas. Um total de 10.000 iterações foram realizadas utilizando a técnica de simulação de Monte Carlo. Os resultados da simulação indicam que os seus prováveis lucros se situam entre $278,293 milhões e $449,934 milhões com um nível de confiança de 90%. A análise de sensibilidade do plano financeiro permite concluir que a empresa deve reformular as suas políticas financeiras relacionadas com a gestão do capital de exploração, uma vez que a carteira e principalmente os inventários têm uma influência negativa no VPL, de acordo com os coeficientes de regressão. CLASSIFICAÇÃO JEL B4I, CI5

World-Class Managers: a Pilot Tuning Project-based on Generic Competences.

INTRODUCTION: This research evaluates the generic competences of the managers that belong to the 20 World Class Sectors, according to the Productive Transformation Program in Colombia. METHOD: A survey applied to 280 managers seeks to evaluate the 27 generic competences of the Tuning Project, using descriptive statistics and exploratory factor analysis to measure three dimensions: motivation/commitment, self-efficacy and the competence's origin. RESULTS: The most necessary skills to boost the positioning of these companies in international markets are the weakest. The findings' relevance indicates that the managers' commitment and motivation is greater than the effectiveness in their performance; also, the findings emphasize the family education as one of the main sources of their competences.

INTRODUCCIÓN: Esta investigación evalúa las competencias genéricas de los gerentes que pertenecen a los 16 Sectores de Talla Mundial, según el Programa de Transformación Productiva en Colombia. MÉTODO: Una encuesta aplicada a 280 gerentes busca evaluar las 27 competencias del Proyecto Tuning, a través de técnicas de estadística descriptiva y análisis factorial exploratorio, para medir tres dimensiones: Motivación/compromiso, Auto-eficacia y el Origen de la competencia. RESULTADOS: Las competencias más necesarias para potencializar el posicionamiento de estas empresas en los mercados internacionales, son las más débiles. La relevancia de los hallazgos indica que es superior el compromiso y la motivación de los gerentes que la eficacia en su desempeño y se destaca, además, la formación familiar como una de las principales fuentes de sus competencias.

Apoptosis: Activation and Inhibition in Health and Disease.

There are many types of cell death, each involving multiple and complex molecular events. Cell death can occur accidentally when exposed to extreme physical, chemical, or mechanical conditions, or it can also be regulated, which involves a genetically coded complex machinery to carry out the process. Apoptosis is an example of the latter. Apoptotic cell death can be triggered through different intracellular signalling pathways that lead to morphological changes and eventually cell death. This is a normal and biological process carried out during maturation, remodelling, growth, and development in tissues. To maintain tissue homeostasis, regulatory, and inhibitory mechanisms must control apoptosis. Paradoxically, these same pathways are utilized during infection by distinct intracellular microorganisms to evade recognition by the immune system and therefore survive, reproduce and develop. In cancer, neoplastic cells inhibit apoptosis, thus allowing their survival and increasing their capability to invade different tissues and organs. The purpose of this work is to review the generalities of the molecular mechanisms and signalling pathways involved in apoptosis induction and inhibition. Additionally, we compile the current evidence of apoptosis modulation during cancer and Leishmania infection as a model of apoptosis regulation by an intracellular microorganism.

Análisis prospectivo de las competencias genéricas Tuning-Alfa en la ciudad de Medellín al 2032 / Prospective analysis of the generic Tuning-Alfa competences in the city of Medellin by the year 2032

Resumen Al establecer el carácter estratégico de las competencias genéricas Tuning en los procesos formativos de los administradores al 2032 en la ciudad de Medellín, se evidencian que, la competencia surge con sentido ontológico, evoluciona a lo praxeológico y posteriormente integra los dos sentidos. Se confirma que en la administración se privilegian procesos profesionalizantes, se requiere el dominio de un segundo idioma, se requiere compromiso con el medio sociocultural y se espera el desarrollo de la capacidad de aplicar los conocimientos en la práctica; se considera que la formación se orienta para desarrollar la capacidad creativa; y se evidencia una relevante indiferencia con respecto a la formación ética y de responsabilidad social.

Abstract When establishing the strategic nature of the generic Tuning competences in the training processes of managers by the year 2032 in the city of Medellin, it is made evident that the competence emerges with an ontological sense, it evolves to the praxeological approach, and then, it integrates the two senses. In management, it is confirmed that professionalizing processes are privileged, the mastery of a foreign language is required, a commitment to the sociocultural environment is required, and the development of the ability to apply knowledge in practice is expected. It is considered that training is oriented to develop the creative ability; and a relevant indifference with respect to the ethical training and social responsibility is made evident.

TRIM28 regulates the nuclear accumulation and toxicity of both alpha-synuclein and tau.

Several neurodegenerative diseases are driven by the toxic gain-of-function of specific proteins within the brain. Elevated levels of alpha-synuclein (α-Syn) appear to drive neurotoxicity in Parkinson's disease (PD); neuronal accumulation of tau is a hallmark of Alzheimer's disease (AD); and their increased levels cause neurodegeneration in humans and model organisms. Despite the clinical differences between AD and PD, several lines of evidence suggest that α-Syn and tau overlap pathologically. The connections between α-Syn and tau led us to ask whether these proteins might be regulated through a shared pathway. We therefore screened for genes that affect post-translational levels of α-Syn and tau. We found that TRIM28 regulates α-Syn and tau levels and that its reduction rescues toxicity in animal models of tau- and α-Syn-mediated degeneration. TRIM28 stabilizes and promotes the nuclear accumulation and toxicity of both proteins. Intersecting screens across comorbid proteinopathies thus reveal shared mechanisms and therapeutic entry points.

Reduction of Nuak1 Decreases Tau and Reverses Phenotypes in a Tauopathy Mouse Model.

Many neurodegenerative proteinopathies share a common pathogenic mechanism: the abnormal accumulation of disease-related proteins. As growing evidence indicates that reducing the steady-state levels of disease-causing proteins mitigates neurodegeneration in animal models, we developed a strategy to screen for genes that decrease the levels of tau, whose accumulation contributes to the pathology of both Alzheimer disease (AD) and progressive supranuclear palsy (PSP). Integrating parallel cell-based and Drosophila genetic screens, we discovered that tau levels are regulated by Nuak1, an AMPK-related kinase. Nuak1 stabilizes tau by phosphorylation specifically at Ser356. Inhibition of Nuak1 in fruit flies suppressed neurodegeneration in tau-expressing Drosophila, and Nuak1 haploinsufficiency rescued the phenotypes of a tauopathy mouse model. These results demonstrate that decreasing total tau levels is a valid strategy for mitigating tau-related neurodegeneration and reveal Nuak1 to be a novel therapeutic entry point for tauopathies.

Ataxin-1 oligomers induce local spread of pathology and decreasing them by passive immunization slows Spinocerebellar ataxia type 1 phenotypes.

Previously, we reported that ATXN1 oligomers are the primary drivers of toxicity in Spinocerebellar ataxia type 1 (SCA1; Lasagna-Reeves et al., 2015). Here we report that polyQ ATXN1 oligomers can propagate locally in vivo in mice predisposed to SCA1 following intracerebral oligomeric tissue inoculation. Our data also show that targeting these oligomers with passive immunotherapy leads to some improvement in motor coordination in SCA1 mice and to a modest increase in their life span. These findings provide evidence that oligomer propagation is regionally limited in SCA1 and that immunotherapy targeting extracellular oligomers can mildly modify disease phenotypes.

[Teaching the legal aspects of medical practice to medical students in Puerto Rico]. / La enseñanza de los aspectos legales de la práctica médica a los estudiantes de medicina en Puerto Rico.

Challenges and changes facing modern medicine make it imperative that physicians acquire knowledge of the legal and regulatory framework of medical practice. Despite the importance of this issue, the curriculum in most medical schools do not include courses that offer medical students the necessary information about their legal duties to practice medicine. The trend should be to offer such courses in medical schools and medical residency programs.

La enseñanza de la cariología en la Facultad de Odontología de la Universidad CES, Medellín, Colombia / Teaching of Cariology at the College of Dentistry, Universidad CES, Medellin, Colombia

El propósito del presente artículo es disertar sobre el problema de la formación del estudiante de odontología, la cual debería ser integral-integradora, orientada a crear un concepto unificado en la mente del futuro profesional, donde todas las enfermedades que tienen origen en relación con la bio-película dental puedan ser analizadas y comprendidas como distintas manifestaciones en cuya etiología existen factores comunes que permiten definirlas como enfermedades multifactoriales, complejas, con un importante componente social. En este artículo se presenta la experiencia de más de treinta años, de la Universidad CES, en la enseñanza de las enfermedades de origen dento-bacteriano, caries dental y enfermedades del periodonto, haciendo un comparativo con las propuestas de la enseñanza de la cariología por competencias desarrollada en la comunidad europea y que se ha propuesto en Colombia.

The purpose of this article is to discuss in detail the problems related to teaching dental students, in a holistic manner oriented at developing a unified concept of diseases of dento-bacterial origin in order to properly analyze and understand dental caries and periodontal diseases, both sharing etiological factors which allow clinicians and researchers to define them as a complex, multifactorial disease with a very strong social component. In this article, the authors present thirty years of experience at the College of Dentistry, Universidad CES, Medellin, teaching dental caries and periodontal diseases in a comprehensive manner, comparing their methodology with the model proposed by the European Community and the ACFF (Alliance for a caries free future) in Colombia, based on the development of competences.

The role of health systems and policy in producing behavior and social change to enhance child survival and development in low- and middle-income countries: an examination of the evidence.

Evidence-based behavior change interventions addressing health systems must be identified and disseminated to improve child health outcomes. Studies of the efficacy of such interventions were identified from systematic searches of the published literature. Two hundred twenty-nine of the initially identified references were judged to be relevant and were further reviewed for the quality and strength of the evidence. Studies were eligible if an intervention addressed policy or health systems interventions, measured relevant behavioral or health outcomes (e.g., nutrition, childhood immunization, malaria prevention and treatment), used at least a moderate quality research design, and were implemented in low- or middle-income countries. Policy or systems interventions able to produce behavior change reviewed included media (e.g., mass media, social media), community mobilization, educational programs (for caregivers, communities, or providers), social marketing, opinion leadership, economic incentives (for both caregiver and provider), health systems strengthening/policy/legislation, and others. Recommendations for policy, practice, and research are given based on fairly strong data across the areas of health service delivery, health workforce, health financing, governance and leadership, and research.