Environmental sympatry through time: spatio-temporal distribution and conservation status of two sympatric anuran species (Leptodactylidae) in South America / Simpatría ambiental a través del tiempo: distribución espacio-temporal y estado de conservación de dos especies de anuros simpátricos (Leptodactylidae) en América del Sur

Abstract Introduction: Leptodactylus latinasus and Physalaemus cuqui are sympatric anuran species with similar environmental requirements and contrasting reproductive modes. Climatic configuration determines distribution patterns and promotes sympatry of environmental niches, but specificity/selectivity determines the success of reproductive modes. Species distribution models (SDM) are a valuable tool to predict spatio-temporal distributions based on the extrapolation of environmental predictors. Objectives: To determine the spatio-temporal distribution of environmental niches and assess whether the protected areas of the World Database of Protected Areas (WDPA) allow the conservation of these species in the current scenario and future. Methods: We applied different algorithms to predict the distribution and spatio-temporal overlap of environmental niches of L. latinasus and P. cuqui within South America in the last glacial maximum (LGM), middle-Holocene, current and future scenarios. We assess the conservation status of both species with the WDPA conservation units. Results: All applied algorithms showed high performance for both species (TSS = 0.87, AUC = 0.95). The L. latinasus predictions showed wide environmental niches from LGM to the current scenario (49 % stable niches, 37 % gained niches, and 13 % lost niches), suggesting historical fidelity to stable climatic-environmental regions. In the current-future transition, L. latinasus would increase the number of stable (70 %) and lost (20 %) niches, suggesting fidelity to lowland regions and a possible trend toward microendemism. P. cuqui loses environmental niches from the LGM to the current scenario (25 %) and in the current-future transition (63 %), increasing the environmental sympathy between both species; 31 % spatial overlap in the current scenario and 70 % in the future. Conclusion: Extreme drought events and rainfall variations, derived from climate change, suggest the loss of environmental niches for these species that are not currently threatened but are not adequately protected by conservation units. The loss of environmental niches increases spatial sympatry which represents a new challenge for anurans and the conservation of their populations.

Resumen Introducción: Leptodactylus latinasus y Physalaemus cuqui son especies de anuros simpátricos con requerimientos ambientales similares y modos reproductivos contrastantes. La configuración climática determina los patrones de distribución y promueve la simpatría de los nichos ambientales, pero la especificidad/selectividad determina el éxito de los modos reproductivos. Los modelos de distribución de especies (MDE) son una herramienta valiosa para predecir distribuciones espacio-temporales basadas en la extrapolación de predictores ambientales. Objetivos: Determinar la distribución espacio-temporal de los nichos ambientales y evaluar si las áreas protegidas de la base de Datos Mundial de Áreas Protegidas (DMAP) permiten la conservación de estas especies en el escenario actual y futuro. Métodos: Aplicamos diferentes algoritmos para predecir la distribución y superposición espacio-temporal de nichos ambientales de L. latinasus y P. cuqui dentro de América del Sur en el último máximo glacial (UGM), Holoceno medio, actual y futuro. Evaluamos el estado de conservación de ambas especies con las unidades de conservación de la DMAP. Resultados: Todos los algoritmos aplicados mostraron un alto rendimiento para ambas especies (TSS = 0.87, AUC = 0.95). Las predicciones de L. latinasus mostraron amplios nichos ambientales desde LGM hasta el escenario actual (49 % de nichos estables, 37 % de nichos ganados y 13 % de nichos perdidos), sugiriendo fidelidad histórica por regiones climático-ambientales estables. En la transición actual-futura L. latinasus incrementaría la cantidad de nichos estables (70 %) y perdidos (20 %), sugiriendo fidelidad por regiones de tierras bajas y la posible tendencia hacia el microendemismo. P. cuqui pierde nichos ambientales desde el LGM al escenario actual (25 %) y en la transición actual-futura (63 %), incrementando la simpatría ambiental entre ambas especies; 31 % de superposición espacial en el escenario actual y 70 % en el futuro. Conclusión: Los eventos de sequía extrema y las variaciones de precipitaciones, derivados del cambio climático, sugieren la pérdida de nichos ambientales para estas especies, actualmente no se encuentran amenazadas, pero no están adecuadamente protegidas por las unidades de conservación. La pérdida de nichos ambientales aumenta la simpatría espacial que representa un nuevo desafío para estos anuros y la conservación de sus poblaciones.

Propiedades psicométricas de la Escala Dispvac: evidencia de la validez de contenido interna, externa y fiabilidad / Psychometric properties of Dispvac Scale: evidence of its content, internal validity, external validity, and reliability

Resumen Introducción: una de las barreras al acceso a la vacunación contra las enfermedades infecciosas es la reticencia a la vacunación, la cual suele medirse o asociarse a una poca disposición para vacunarse, actitudes antivacunas o la probabilidad reportada de obtener una vacuna. Sin embargo, no existe un consenso en la forma en la cual este constructo es medido. Objetivo: el propósito de este artículo es identificar las propiedades psicométricas y la estructura factorial de la nueva Escala Dispvac en una muestra colombiana. Método: se realizó un diseño psicométrico para identificar las propiedades psicométricas de la escala con una muestra de 1131 participantes (masculino: 37.30%, femenino 61.90%, otro: 0.79%; media edad: 25.84, SD edad: 10.19), a través de un muestreo por conveniencia. Se realizó un análisis factorial exploratorio, un análisis factorial confirmatorio, un análisis de fiabilidad y la validez convergente. Resultados: se sugieren dos factores: actitudes cognitivas hacia la vacunación y legitimidad percibida de las autoridades al requerir la vacunación que comprende la prueba. La prueba Dispvac se correlaciona de manera negativa con la Escala VAX. Conclusiones: los dos factores que comprenden la Escala Dispvac sugieren que la intención a vacunarse implica también creencias sobre la autoridad/instituciones en vacunación.

Abstract Introduction: One of the main barriers to access to vaccination against infectious diseases is vaccine hesitancy, which is usually measured or associated to a low disposition to receive vaccination, anti-vaccine attitudes or the reported probability to receive a vaccine. However, there is no consensus in the way this construct is measured. Objective: The objective of this study it to identify the psychometric properties and the factorial structure of the Scale Dispvac in a Colombian sample. Method: To this goal, a psychometric design was made to identify the psychometric properties of the new scale making use of 1131 participants (male: 37.30%, female: 61.90%, other: 0.79%; age mean: 25.84, age SD: 10.19), through a convenience sampling. We conducted an exploratory factorial analysis, a confirmatory factorial analysis, a reliability analysis, and the convergent validity. Results: Two factors are suggested: Cognitive attitudes towards vaccination and perceived legitimacy of authorities to require vaccination. The Dispvac Scale is negatively correlated with the VAX Scale. Conclusions: The mentioned factors suggest that intention to vaccinate also implies beliefs on the authority in vaccination.

Insulin reference intervals in Brazilian adolescents by direct and indirect approaches: validation of a data mining method from laboratory data

Abstract Objective To determine reference intervals (RI) for fasting blood insulin (FBI) in Brazilian adolescents, 12 to 17 years old, by direct and indirect approaches, and to validate indirectly determined RI. Methods Two databases were used for RI determination. Database 1 (DB1), used to obtain RI through a posteriori direct method, consisted of prospectively selected healthy individuals. Database 2 (DB2) was retrospectively mined from an outpatient laboratory information system (LIS) used for the indirect method (Bhattacharya method). Results From DB1, 29345 individuals were enrolled (57.65 % female) and seven age ranges and sex partitions were statistically determined according to mean FBI values: females: 12 and 13 years-old, 14 years-old, 15 years-old, 16 and 17 years-old; and males: 12, 13 and 14 years-old, 15 years-old, 16 and 17 years-old. From DB2, 5465 adolescents (67.5 % female) were selected and grouped according to DB1 partitions. The mean FBI level was significantly higher in DB2, on all groups. The RI upper limit (URL) determined by Bhattacharya method was slightly lower than the 90 % CI URL directly obtained on DB1, except for group female 12 and 13 years old. High agreement rates for diagnosing elevated FBI in all groups on DB1 validated indirect RI presented. Conclusion The present study demonstrates that Bhattacharya indirect method to determine FBI RI in adolescents can overcome some of the difficulties and challenges of the direct approach.

The influence of dental bleaching on patient's quality of life: A multistudy analysis of aesthetic and psychosocial outcomes.

OBJECTIVES: To assess the Quality of Life (QoL) of participants treated with dental bleaching using different techniques by administering two questionnaires Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), as well as the bleaching efficacy and tooth sensitivity (TS). MATERIALS AND METHODS: Secondary results for nine randomized clinical trials were included, involving 489 participants who underwent bleaching procedures. The questionnaires were applied at baseline and 30-day post-bleaching. Bleaching efficacy (ΔSGU/ΔEab) and TS were also evaluated (VAS/NRS). The effect of bleaching on aesthetic self-perception was evaluated using the Paired t-test. The Kruskal-Wallis test assessed variations by technique. Also, the correlations between questionnaires and outcomes was evaluated (α = 0.05). RESULTS: After the bleaching treatment, both questionnaire revealed significant differences compared to the baseline, regardless of the factor evaluated (p < 0.05), except for Physical pain in OHIP-14 (p = 0.53). No correlation was found between OHIP-14 and bleaching efficacy (p < 0.008). A significant correlation was found between bleaching efficacy and dental self-confidence, indicating that dental self-confidence increased as the number of SGU (ΔSGU) increased, while social impact (ΔEab) and aesthetic concern (ΔSGU) decreased. Additionally, a significant correlation was observed between TS and OHIP-14 (Physical pain). For PIDAC, both dental self-confidence and psychological impact were correlated with TS in the VAS. CONCLUSION: Subjects who underwent dental bleaching treatment improved their self-perception and dental self-confidence. Dental bleaching, besides enhancing the patient's smile, also improves their self-esteem. CLINICAL RELEVANCE: Dental bleaching, besides improving the patient's smile, also enhances their self-esteem.

Survival and Risk Factors Associated with Mortality in Patients with Sleep Apnoea in Colombia: A Retrospective Cohort Study.

Background: Survival in patients with sleep apnoea (SA) can be reduced by variables such as age, sex, and comorbidities. However, survival data in patients with SA in Colombia remains scarce. Methods: This is a retrospective cohort study of patients diagnosed with SA between 2005 and 2022. Five-year survival was assessed using the Kaplan-Meier method, and survival curves were stratified by age, sex, and cardiovascular disease. Risk factors associated with survival were evaluated using Hazard Ratio (HR) by adjusting for confounding variables with a Cox regression model. A minimum sample size of 1537 patients were estimated to be necessary to estimate a survival incidence rate with a 5% precision. Results: The five-year survival rate in the general population was 94.6%, with lower survival in patients over 65 years (88.5% vs 97.9%; p < 0.001) and in patients with cardiovascular disease (89% vs 95.2%; p < 0.001) compared to the control group. In the Cox regression, age showed an HR of 1.05 (95% CI: 1.02-1.07; p < 0.001). Male sex had an HR of 2.31 (95% CI: 1.25-4.25; p = 0.007), congestive heart failure an HR of 4.00 (95% CI: 2.31-6.94; p < 0.001), chronic obstructive pulmonary disease (COPD) an HR of 1.75 (95% CI: 1.04-2.96; p = 0.035), chronic kidney disease (CKD) an HR of 2.23 (95% CI: 1.31-3.78; p = 0.003), and metastatic cancer an HR of 4.96 (95% CI: 1.95-12.60; p = 0.001). Conclusion: The study showed a high five-year survival rate in patients with SA. The risk factors associated with decreased overall five-year survival were age, male sex, cardiovascular disease, COPD, CKD, and metastatic cancer.

[Social factors and entry to the waiting list for kidney transplantation]. / Factores sociales e ingreso a lista de espera para trasplante renal.

INTRODUCTION: Kidney transplant continues to be the best treatment option for patients with end-stage chronic renal failure. The shortage of organs and long waiting times mean that many patients arrive at the transplant with a significant level of deterioration. The objective was to analyze the relationship between socioeconomic variables and knowledge about pre-emptive kidney transplant in the pre-transplant consultation. METHODS: Cross-sectional study. A group of patients over 18 years' old who began pre-transplant evaluation was analyzed. Socioeconomic variables were evaluated and a brief survey on nephrological follow-up and information on kidney transplant prior to dialysis (preemptive) was carried out. RESULTS: A total of 164 patients with (mean ± SD) 57 ± 14 years were evaluated. A 56% (n = 92) had a predialysis nephrological follow-up of 33 ± 66 months, with 41% (n = 68) of more than one year. The time on dialysis before the pre-transplant consultation averaged 20 ± 23 months. Seventy-two % (n = 118) did not have information on pre-emptive kidney transplantation. Patients with predialysis nephrological follow-up were more likely to have information about pre-emptive kidney transplantation (OR 2.94; IC 1.30-6.63; p 0.009). DISCUSSION: Referral to the transplant center is postponed by increasing the time on dialysis. Most patients are not aware of pre-emptive kidney transplantation. These findings point out the need to implement policies to improve patient education, access to information, and timely referral to transplant centers.

Introducción: El trasplante renal continúa siendo la mejor opción de tratamiento para los pacientes con insuficiencia renal crónica terminal. La escasez de órganos y los largos tiempos de espera hacen que muchos pacientes lleguen al trasplante con un importante nivel de deterioro. El objetivo es analizar la relación entre variables socioeconómicas y el conocimiento sobre el trasplante renal preemptive en la consulta pretrasplante. Métodos: Estudio de corte transversal. Se analizó un grupo de pacientes mayores de 18 años que inició evaluación pre-trasplante renal en el período comprendido entre agosto 2021 y junio 2023. Se evaluaron variables socioeconómicas y se realizó una breve encuesta sobre seguimiento nefrológico e información sobre trasplante renal previo a diálisis (preemptive). Resultados: Se evaluaron 164 pacientes con (media ± DS) 57 ± 14 años. El 56 % (n = 92) tuvo seguimiento nefrológico prediálisis de 33 ± 66 meses, siendo superior a un año en el 41 % (n = 68). El tiempo en diálisis previo a la consulta pre-trasplante promedió los 20 ± 23 meses. No tenía información sobre trasplante renal previo a la diálisis el 72% (n = 118). Los pacientes con seguimiento nefrológico prediálisis tuvieron más probabilidad de tener información sobre el trasplante renal preemptive (OR 2.94; IC 1.30-6.63; p 0.009) Discusión: La derivación al centro de trasplante se posterga, aumentando el tiempo en diálisis. La mayoría de los pacientes no tienen conocimiento del trasplante renal preemptive. Estos hallazgos señalan la necesidad de implementar políticas de mejora en la educación del paciente, acceso a la información y derivación oportuna a los centros de implante.

Acute kidney injury and mortality in patients with critical COVID-19 in Mexico: case-control study.

OBJECTIVE: We aimed to test the association between acute kidney injury (AKI) and mortality in critically ill patients with Coronavirus disease 2019 (COVID-19). METHOD: We conducted a single-center case-control study at the intensive care unit (ICU) of a second-level hospital in Mexico. We included 100 patients with critical COVID-19 from January to December 2021, and collected demographic characteristics, comorbidities, APACHE II, SOFA, NEWS2, and CO-RADS scores at admission, incidence of intrahospital complications, length of hospital and ICU stay, and duration of mechanical ventilation, among others. RESULTS: The median survival of deceased patients was 20 days. After multivariable logistic regression, the following variables were significantly associated to mortality: AKI (adjusted odds ratio [AOR] 6.64, 95% confidence intervals [CI] = 2.1-20.6, p = 0.001), age > 55 years (AOR 5.3, 95% CI = 1.5-18.1, p = 0.007), and arrhythmias (AOR 5.15, 95% CI = 1.3-19.2, p = 0.015). Median survival was shorter in patients with AKI (15 vs. 22 days, p = 0.043), as well as in patients with overweight/obesity (15 vs. 25 days, p = 0.026). CONCLUSION: Our findings show that the development of AKI was the main risk factor associated with mortality in critical COVID-19 patients, while other factors such as older age and cardiac arrhythmias were also associated with this outcome. The management of patients with COVID-19 should include renal function screening and staging on admission to the Emergency Department.

OBJETIVO: Probar la asociación entre lesión renal aguda y mortalidad en pacientes con COVID-19 grave. MÉTODO: Realizamos un estudio de casos y controles unicéntrico en la unidad de cuidados intensivos (UCI) de un hospital de segundo nivel en México. Incluimos 100 pacientes con COVID-19 grave de enero a diciembre 2021, recolectando características demográficas, comorbilidad, APACHE II, SOFA, NEWS2 y CO-RADS al ingreso, incidencia de complicaciones intrahospitalarias, duración de la estancia hospitalaria y en la UCI, duración de ventilación mecánica, etc. RESULTADOS: La mediana de supervivencia de los pacientes que fallecieron fue de 20 días. Al realizar el análisis de regresión logística multivariable, las siguientes variables se asociaron significativamente con la mortalidad: lesión renal aguda (odds ratio ajustada [ORa]: 6.64; intervalo de confianza del 95% [IC95%]: 2.1-20.6; p = 0.001), edad > 55 años (ORa: 5.3; IC95%: 1.5-18.1; p = 0.007) y arritmias (ORa: 5.15; IC95%: 1.3-19.2; p = 0.015). La supervivencia fue menor en pacientes con lesión renal aguda (15 vs. 22 días; p = 0,043), así como en pacientes con sobrepeso u obesidad (15 vs. 25 días; p = 0.026). CONCLUSIONES: Nuestros resultados muestran que el desarrollo de lesión renal aguda es el principal factor de riesgo asociado a mortalidad en pacientes con COVID-19 grave, mientras que otros factores, como la edad > 55 años y la presencia de arritmias cardiacas, también se asocian a mortalidad por COVID-19. El manejo de pacientes con COVID-19 debe incluir el tamizaje y la estadificación de la función renal al ingreso a urgencias.

Analysis of two reperfusion techniques in uterine transplantation in an experimental model.

INTRODUCTION: Uterine transplantation was developed for the treatment of absolute uterine factor infertility. As it is a new modality of transplantation, there is still room for technical improvement. A factor that impacts graft survival in organ transplantation is the warm ischemia time. In uterine transplantation specifically, at least two vascular anastomoses are performed on each side of the uterus, and the graft revascularization takes place when the vascular clamps of the arteries and veins are released on both sides simultaneously. For this reason, the warm ischemia time in uterine transplant is expected to be considerably long. The purpose of this study was to compare the sequential technique of uterine graft revascularization, which aims to reduce the warm ischemia time of the procedure, with the simultaneous revascularization technique. MATERIAL AND METHODS: For the procedure, the uterine auto-transplantation technique was performed using 10 non-pregnant adult ewes weighing about 45 kg, divided into two groups: simultaneous revascularization group (5 animals) and sequential revascularization group (5 animals). To evaluate the groups, we analyzed the procedure and warm ischemia times, graft macroscopy, hemodynamic, laboratory, and histological parameters of the uterus. RESULTS: The sequential revascularization technique group had similar surgical procedure times, and the warm ischemia time was significantly shorter with medians of 32 min in the sequential group versus 72 min in the simultaneous group (p < 0.008). The graft macroscopy and hemodynamic, laboratory, and histological parameters evaluated were similar between the groups. CONCLUSIONS: The sequential revascularization technique proved to reduce the warm ischemia time in the sheep uterine auto-transplantation model without compromising graft viability.

Diversity of Marek's Disease Virus Strains in Infections in Backyard and Ornamental Birds.

Marek's disease is caused by Mardivirus gallidalpha2, commonly known as Marek's disease virus (MDV). This pathogen infects various bird species resulting in a range of clinical manifestations. The meq gene, which is crucial for oncogenesis, has been extensively studied, but molecular investigations of MDV in noncommercial South American birds are limited. This study detected MDV in backyard and ornamental birds from Brazil and Peru and characterized the meq gene. MDV was confirmed in all seven outbreaks examined. Three isoforms of meq (S-meq, meq, and L-meq) and two to seven proline repeat regions (PRRs) were detected among the sequenced strains. At the amino acid level, genetic profiles with low and high virulence potential were identified. Phylogenetic analysis grouped the sequences into three distinct clusters. Selection pressure analysis revealed 18 and 15 codons under positive and negative selection, respectively. The results demonstrate significant MDV diversity in the studied birds, with both high and low virulence potentials. This study highlights the importance of monitoring and characterizing circulating MDV in backyard and ornamental birds, as they can act as reservoirs for future epidemiological outbreaks.

[Hypertrophic cardiomyopathy with mid-ventricular phenotype and filamin C mutation, an uncommon case report]. / Cardiomiopatía hipertrófica variante medio apical con mutación de la filamina C, una variante poco común. Reporte de caso.

Hypertrophic cardiomyopathy has a different presentation spectrum, including left ventricular outflow tract obstruction. The most common phenotype is the asymmetric septal variant, with the mid-apical variant being rare. On the other hand, there are specific mutations associated with hypertrophic cardiomyopathy, with the Filamin C variant being an unusual condition in these patients. Therefore, we present the case of a 23-year-old male patient with a diagnosis of hypertrophic cardiomyopathy in whom a Filamin C variant was documented. Given the inadequate response and persistence of symptoms to medical management, a myectomy procedure was performed with a transapical approach, with subsequent improvement in clinical symptoms and outflow tract obstruction. This case illustrates a rare variant with a surgical approach different from the conventional transaortic approach, with marked improvement in symptoms.

Variables Associated With In-Hospital Lethality in COVID-19: A Prospective Cohort Study From Colombia.

INTRODUCTION: The emergence of COVID-19 represents the most significant health crisis in recent history. Incidence and mortality rates depend on several factors. Many studies have focused on investigating which characteristics could be strongly related to higher mortality and lethality. OBJECTIVE: This study aims to analyze the variables associated with in-hospital mortality among patients admitted in a reference northeastern region of a Colombian institution. METHODS: An ambidirectional cohort, single-center study was carried out in a reference hospital in northeastern Colombia. All patients admitted to the Fundación Oftalmológica de Santander (FOSCAL) between March 2020 and September 2021, with COVID-19 real-time polymerase chain reaction (PCR) positive test, were included. RESULTS: A total of 3,028 patients were included, of whom 2,034 (67.8%) survived and 994 (32.8%) died during their hospital stay; 48.8% (1,479) of the patients were female. The most common comorbidities were hypertension (1,236 patients, 40.8%), obesity (body mass index (BMI) ≥ 30; 656 patients, 21.6%), and diabetes (618 patients, 20.4%). The average age of the surviving patients was 52.2 years, while for the deceased patients, it was 70.3 years. The variables that showed significant association with in-hospital mortality were as follows: male sex ≥ 45 years, dyspnea, oxygen saturation (SatO2) < 85%, hypertension, chronic kidney disease (CKD), and a Charlson Comorbidity Index (CCI) score of >1. CONCLUSIONS: Male sex, age ≥ 45 years, dyspnea, SatO2 < 85%, hypertension, CKD, and a CCI score of >1 were associated with a higher risk of in-hospital mortality in COVID-19-infected patients.

A Multidisciplinary Approach to the Classification and Management of Intestinal Failure: Knowledge in Progress.

Intestinal failure (IF) is a debilitating condition characterized by the insufficient function of the gastrointestinal tract to absorb nutrients and fluids essential for life. This review consolidates recent advancements and challenges in managing IF among adult and pediatric populations, highlighting differences in etiology, management, and outcomes. Over the recent years, significant strides have been made in the nutritional and medical management of IF, significantly reducing mortality rates and improving the quality of life for patients. Key advancements include the development and availability of glucagon-like peptide-2 (GLP-2) analogs, improved formulations of parenteral nutrition, and the establishment of specialized interdisciplinary centers. Short bowel syndrome (SBS) remains the predominant cause of IF globally. The pediatric segment is increasingly surviving into adulthood, presenting unique long-term management challenges that differ from adult-onset IF. These include the need for tailored nutritional support, management of IF-associated liver disease, and addressing growth and neurodevelopmental outcomes. The therapeutic landscape for IF continues to evolve with the development of new treatment modalities and better understanding of the condition's pathophysiology. However, disparities in treatment outcomes between children and adults suggest the need for age-specific management strategies. This review underscores the importance of a nuanced approach to IF, incorporating advancements in medical science with a deep understanding of the distinct needs.

Sirtuin Expression in Insulin-Sensitive Tissues of Rats with Impaired Glucose Tolerance is not Affected by Resistance Training or Zinc Supplementation.

While physical activity and zinc supplementation have shown benefits in diabetes management, little is known about their effect on less severe glucose homeostasis disorders, such as impaired glucose tolerance. On the other hand, sirtuins have an important role in glucose metabolism and insulin sensitivity, but to date, there is no information about the impact of zinc supplementation or physical activity on their regulation in individuals with impaired glucose homeostasis. The aim of this study was to assess the effect of supplemental zinc, muscle-resistance training, and their combination on the expression of selected sirtuins in insulin-sensitive tissues of rats with impaired glucose tolerance. Thirty male Wistar rats with impaired glucose tolerance were fed a high-fat diet for 12 weeks while subjected to zinc supplementation, resistance training, both, or none. Morphometric and metabolic evaluations were performed at the end of the experimental period, and gene expression of sirtuins 1, 2, 4, and 7 was assessed in liver, gastrocnemius muscle, and white adipose tissue. Results showed that zinc supplementation and/or resistance training did not improve metabolic parameters of rats with impaired glucose tolerance, nor did they affect the expression of selected sirtuins in any of the tissues evaluated. However, the expression of some sirtuins was associated with metabolic parameters in a tissue-specific manner. Additional studies are needed to evaluate whether zinc supplementation and/or resistance training can improve metabolic status or modulate sirtuins expression in advanced stages of impaired glucose homeostasis.

Unveiling the mystery of the female heart's rhythm: a look into gender inequalities in electrophysiology.

This review explores gender disparities in cardiac electrophysiology, highlighting differences in the electrical activity of the heart between men and women. It emphasizes the importance of understanding these variances for correct diagnosis and effective treatment of cardiac arrhythmias. Women show distinct cardiac characteristics influenced by sex hormones, affecting their susceptibility to various arrhythmias. The manuscript covers the classification, mechanisms, and management of arrhythmias in women, considering factors such as pregnancy and menopause. By addressing these gender-specific nuances, it aims to improve healthcare practices and outcomes for female patients with cardiac rhythm disorders.

Esta revisión explora las disparidades de género en la electrofisiología cardiaca, destacando las diferencias en la actividad eléctrica del corazón entre hombres y mujeres. Se enfatiza la importancia de comprender estas variaciones para un diagnóstico correcto y un tratamiento efectivo de las arritmias cardiacas. Las mujeres muestran características cardiacas distintas influenciadas por las hormonas sexuales, lo que afecta su susceptibilidad a diversas arritmias. La revisión abarca la clasificación, los mecanismos y el manejo de las arritmias en las mujeres, considerando factores como el embarazo y la menopausia. Al abordar estos matices específicos de género, el objetivo es mejorar las prácticas de atención médica y los resultados para las pacientes de sexo femenino con trastornos del ritmo cardiaco.

Impact of hydrophobic and hydrophilic surface properties on Pseudomonas aeruginosa adhesion in materials used in mineral water wells.

Microbiologically contaminated water is a significant source of infections in humans and animals, with Pseudomonas aeruginosa (PSA) being particularly concerning due to its ability to thrive in water environments and its resistance to many disinfectants. Therefore, this study investigates the adhesion potential of PSA strains on various materials used in mineral water extraction wells, focusing on hydrophobic and hydrophilic properties. Mineral water samples were collected from three wells (P-01, P-07, and P-08) within the Guarani Aquifer System and Fractured Aquifer System (SAF) in Brazil. The physicochemical properties of the water, including concentrations of Sr (strontium), Fe (iron), Si (silicon), SO42- (sulfate ions), Cl- (chloride ions), and ORP (oxidation-reduction potential), were analyzed. Results indicated higher PSA adhesion on hydrophobic materials, particularly high-density polyethylene (HDPE) and geomechanically plasticized polyvinyl chloride (PVC). Multiple correlation analyses revealed positive correlations between PSA adhesion on hydrophilic materials and Sr, Fe, Si, SO42-, and Cl- concentrations. Conversely, ORP negatively correlated with bacterial adhesion on PVC surfaces, suggesting higher ORP values reduced PSA attachment. These findings highlight the importance of water composition and material properties in influencing bacterial adhesion and potential biofilm formation in mineral water extraction systems.

Effect of Tele-ICU on Clinical Outcomes of Critically Ill Patients: The TELESCOPE Randomized Clinical Trial.

Importance: Despite its implementation in several countries, there has not been a randomized clinical trial to assess whether telemedicine in intensive care units (ICUs) could improve clinical outcomes of critically ill patients. Objective: To determine whether an intervention comprising daily multidisciplinary rounds and monthly audit and feedback meetings performed by a remote board-certified intensivist reduces ICU length of stay (LOS) compared with usual care. Design, Setting, and Participants: A parallel cluster randomized clinical trial with a baseline period in 30 general ICUs in Brazil in which daily multidisciplinary rounds performed by board-certified intensivists were not routinely available. All consecutive adult patients (aged ≥18 years) admitted to the participating ICUs, excluding those admitted due to justice-related issues, were enrolled between June 1, 2019, and April 7, 2021, with last follow-up on July 6, 2021. Intervention: Remote daily multidisciplinary rounds led by a board-certified intensivist through telemedicine, monthly audit and feedback meetings for discussion of ICU performance indicators, and provision of evidence-based clinical protocols. Main Outcomes and Measures: The primary outcome was ICU LOS at the patient level. Secondary outcomes included ICU efficiency, in-hospital mortality, incidence of central line-associated bloodstream infections, ventilator-associated events, catheter-associated urinary tract infections, ventilator-free days at 28 days, patient-days receiving oral or enteral feeding, patient-days under light sedation, and rate of patients with oxygen saturation values under that of normoxemia, assessed using generalized linear mixed models. Results: Among 17 024 patients (1794 in the baseline period and 15 230 in the intervention period), the mean (SD) age was 61 (18) years, 44.7% were female, the median (IQR) Sequential Organ Failure Assessment score was 6 (2-9), and 45.5% were invasively mechanically ventilated at admission. The median (IQR) time under intervention was 20 (16-21) months. Mean (SD) ICU LOS, adjusted for baseline assessment, did not differ significantly between the tele-critical care and usual care groups (8.1 [10.0] and 7.1 [9.0] days; percentage change, 8.2% [95% CI, -5.4% to 23.8%]; P = .24). Results were similar in sensitivity analyses and prespecified subgroups. There were no statistically significant differences in any other secondary or exploratory outcomes. Conclusions and Relevance: Daily multidisciplinary rounds conducted by a board-certified intensivist through telemedicine did not reduce ICU LOS in critically ill adult patients. Trial Registration: ClinicalTrials.gov Identifier: NCT03920501.

Clinical Features of Typically Developing Children With and Without Prenatal Alcohol Exposure.

OBJECTIVE: To determine if prenatal alcohol exposure (PAE) affected physical and cognitive/behavioral outcomes in apparently typically developing, first-grade children. STUDY DESIGN: Three groups were compared: children with fetal alcohol spectrum disorders (FASD); children with PAE without FASD; and children without PAE. RESULTS: The three groups were significantly different on most physical traits and fewer neurodevelopmental traits. Two-group comparisons of exposed and unexposed, non-FASD groups were statistically different on: height, weight, head circumference (OFC), body mass index (BMI), and palpebral fissure length (PFL). Neurobehavioral outcomes were significant in three-group, but not two-group, comparisons. Few sex differences were observed; however, sex ratios indicated fewer male offspring in first grade among women who consumed 6+ drinks per occasion during pregnancy. For weight, OFC, BMI, age, rural residence, and drinking measures, mothers of exposed children without FASD were intermediaries between, and significantly different from, the other maternal groups. Adjusted for socioeconomic covariates, multivariate analysis of covariance (MANCOVA), three-group comparisons were significantly different for cognitive/behavioral variables (p<.001); however, two-group neurobehavior comparisons for children without FASD were not significant (p>.05). Physical trait MANCOVA comparisons of the non-FASD groups were significant only for weight (p<.004) when tested univariately and through stepdown analysis. Socioeconomic-adjusted trend plots were in the expected direction for nonverbal IQ, problem behaviors, attention, height, weight, OFC, vermilion, PFL, and total dysmorphology score. CONCLUSIONS: Even when meeting developmental norms, children with PAE exhibited trends of poorer growth and cognitive/behavioral traits than children without PAE. These findings support the notion that abstinence during pregnancy is best.

Multidrug Resistance Reversed by Maleimide Interactions. A Biological and Synthetic Overview for an Emerging Field.

Multidrug Resistance (MDR) can be considered one of the most frightening adaptation types in bacteria, fungi, protozoa, and eukaryotic cells. It allows the organisms to survive the attack of many drugs used in the daily basis. This force the development of new and more complex, highly specific drugs to fight diseases. Given the high usage of medicaments, poor variation in active chemical cores, and self-medication, the appearance of MDR is more frequent each time, and has been established as a serious medical and social problem. Over the years it has been possible the identification of several genes and proteins responsible for MDR and with that the development of blockers of them to reach MDR reversion and try to avoid a global problem. These mechanisms also have been observed in cancer cells, and several calcium channel blockers have been successful in MDR reversion, and the maleimide can be found included in them. In this review we explore the history, mechanisms, reversion efforts, and we specifically focused on the maleimide synthesis as MDR-reversers in co-administration, as well as their biological applications in a urge to expand the available information and explore a very plausible MDR reversion source.

Morphological study for Accipitrid birds (Accipitridforms, Accipitridae) in Iraq; part two.

A part two of Accipitridae Family members that belong to three genera: Circus, Gyps, and Neophron were documented as morphometrics, distribution ranges, and conservation status were reviewed and comprehensively discussed. A total of 29 voucher specimens belong to six species which are conserved in the "Iraq Natural History Research Center and Museum INHM" as follow: Marsh Harrier Circus aeruginosus (Linnaeus, 1758), Hen Harrier Circus cyaneus (Linnaeus, 1766), Montagus Harrier Circus pygargus (Linnaeus, 1758), Pallid Harrier Circus macrourus (Gmelin, 1770), Egyptian vulture Neophron percnopterus (Linnaeus, 1758), and Griffon vulture Gyps fulfus (Hablitz, 1783). The results revealed significant criteria about near threatened NT species IUCN and Birdlife International listed as Pallid Harrier Circus macrourus, and Endangered (EN) species as Egyptian vulture Neophron percnopterus globally decreasing population trend.

The ethanolic extract of Gomphrena celosioides is not carcinogenic and has antigenotoxic effects and chemopreventive Properties.

Gomphrena celosioides, popularly known as perpétua, perpétua brava, bachelor´s button and prostate globe amarahth, is used for the treatment of urinary tract disorders, kidney stones, for skin diseases, infectious diseases, gastrointestinal and respiratory conditions. Rich in phenolic acids and flavonoids, this plant has therefore a potential for use in cancer prevention. Given the above, the present research aimed to evaluate the carcinogenic effect of the ethanolic extract of G. celosioides (EEGc) in an alternative model of Drosophila melanogaster and the genotoxic and antigenotoxic effects in Swiss mice. The larval survival test and the detection of epithelial tumor clones were performed in D. melanogaster. The tested EEGc concentrations were 0.96, 1.92, 3.85 and 7.70 mg/mL. In Swiss mice, the genotoxicity and antigenotoxicity of doses of 100, 1,000 and 2,000 mg/Kg were evaluated. The results showed that EEGc at a concentration of 7.70 mg/mL reduced (p<0.05) larval survival. However, EEGc was not carcinogenic, and the lowest concentration (0.96 mg/mL) prevented (p<0.05) the basal occurrence of epithelial tumors. In mice, EEGc at the highest dose (2,000mg/Kg) increased the frequency of genomic lesions (p<0.05). Yet, none of the doses caused chromosomal lesions (p>0.05). When associated with cyclophosphamide, EEGc was antigenotoxic (p<0.05). The percentages of reduction of genomic damage ranged from 33.39 to 63.23% and of chromosomal damage from 20.00 to 77.19%. In view of the above, it is suggested that EEGc is not carcinogenic, has an antigenotoxic effect and chemopreventive properties.