Innovative teaching in infection prevention and control and infectious diseases education: testing and investigation of student perceptions.

PURPOSE: Many curricula promote frontal teaching approaches, potentially decreasing interaction and motivation - also within infection prevention & control and infectious diseases (IPC/ID). We aimed to investigate the implementation of three innovative teaching methods (ITM) within IPC/ID education: game-based learning (GBL), peer-teaching (PT) and misinformation detection (MID). METHODS: Multi-phase study involving third-year medical students was conducted. Phase-1 included a cross-sectional survey, assessing previous ITM-experience and interest to participate in phase-2, where the students were divided into teams. Each team prepared a video covering an IPC/ID-topic with deliberately placed misinformation, which had to be identified and corrected by the opposing team, followed by qualitative evaluation (phase-3). Finally, the MID-concept was incorporated into regular curricula in a non-competitive environment (phase-4) and evaluated within a cohort not involved in phases 1-3. RESULTS: 276 students responded to phase-1. 58% expressed interest in participating in phase-2. Roughly 59% [47-71%] CI-95% of respondents without previous PT-experience stated interest in PT, while the interest in GBL and MID was even higher. 19 students participated in phase-2. All topic MID-scores ranged between 6 and 8/10 points, except for emporiatrics (3/10). Post-hoc analysis revealed a positive student-perception of ITM, particularly GBL. Phase-4 received 103 responses with general positive evaluation. Major agreements existed on the usefulness of critical information evaluation for medical practice (82% [75-91%] CI-95%) and of MID during studies (69% [59-79%] CI-95%). CONCLUSION: our results hint at a relatively high interest in ITM and show MID applicability in regular IPC/ID curricula, which could be of advantage for the learning environment.

Reinforcing Protein Biochemistry: A Two-Week Experiment Studying Iron(III) Binding by the Transferrin Protein through Stoichiometric Determination, Stability Analysis, and Visualization of the Binding Site.

The two-week protein biochemistry experience described herein focuses on reinforcing key biochemical concepts and achieving significant learning domain accomplishments for students (Content Knowledge, Logical Mathematical Reasoning, Visualization, Information Literacy, and Knowledge Integration) and valuable teaching opportunities for instructors. The experience encompasses an exploration of the transport protein serum transferrin as an important regulator of Fe(III) biochemistry and incorporates techniques to assess protein-metal stoichiometry and protein stability and to perform molecular visualization. Students gain practical experience in utilizing spectrophotometric analysis for constructing stoichiometric curves, in performing urea-PAGE, and in applying the PyMOL program to evaluate metal coordination at a protein binding site and the associated protein structural change. The learning and teaching accomplishments provide valuable skills that can be extended into research and translated to other teaching formats.

Novel Biomarkers in Early Detection of Heart Failure: A Narrative Review.

Heart failure (HF) represents a significant global health challenge, characterized by a variety of symptoms resulting from cardiac dysfunction. This dysfunction often leads to systemic and pulmonary congestion. The pathophysiology of HF is complex, involving stimulation of the sympathetic nervous system, which is insufficiently balanced by the release of natriuretic peptide. This imbalance leads to progressive hypertrophy and dilatation of the heart's chambers, impairing its pumping efficiency and increasing the risk of arrhythmias and conduction disorders. The prevalence of HF is exceptionally high in industrialized nations and is expected to increase owing to an aging population and advancements in diagnostic methods. This study emphasizes the critical role of early diagnosis in reducing morbidity and mortality associated with HF, focusing specifically on the evolving importance of biomarkers in managing this condition. Biomarkers have played a key role in transforming the diagnosis and treatment of HF. Traditional biomarkers such as b-type natriuretic peptide and N-terminal pro-b-type natriuretic peptide have been widely adopted for their cost-effectiveness and ease of access. However, the rise of novel biomarkers such as growth differentiation factor 15 and adrenomedullin has shown promising results, offering superior sensitivity and specificity. These new biomarkers enhance diagnostic accuracy, risk stratification, and prognostic evaluation in HF patients. Despite these advancements, challenges remain, such as limited availability, high costs, and the need for further validation in diverse patient populations. Through a comprehensive literature review across databases such as PubMed, Google Scholar, and the Cochrane Library, this study compiles and analyzes data from 18 relevant studies, offering a detailed understanding of the current state of HF biomarkers. The study examines both traditional and emerging biomarkers such as galectin-3 and soluble suppression of tumorigenicity 2 in HF, exploring their clinical roles and impact on patient outcomes.

Positive modulation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors differentially alters spatial learning and memory in juvenile rats younger and older than three weeks.

Remarkable performance improvements occur at the end of the third postnatal week in rodents tested in various tasks that require navigation according to spatial context. While alterations in hippocampal function at least partially subserve this cognitive advancement, physiological explanations remain incomplete. Previously, we discovered that developmental modifications to hippocampal glutamatergic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors in juvenile rats was related to more mature spontaneous alternation behavior in a symmetrical Y-maze. Moreover, a positive allosteric modulator of AMPA receptors enabled immature rats to alternate at rates seen in older animals, suggesting an excitatory synaptic limitation to hippocampal maturation. We then validated the Barnes maze for juvenile rats in order to test the effects of positive AMPA receptor modulation on a goal-directed spatial memory task. Here we report the effects of the AMPA receptor modulator, CX614, on spatial learning and memory in the Barnes maze. Similar to our prior report, animals just over 3 weeks of age display substantial improvements in learning and memory performance parameters compared to animals just under 3 weeks of age. A moderate dose of CX614 enabled immature animals to move more directly to the goal location, but only after 1 day of training. This performance improvement was observed on the second day of training with drug delivery or during a memory probe trial performed without drug delivery after the second day of training. Higher doses created more search errors, especially in more mature animals. Overall, CX614 provided modest performance benefits for immature rats in a goal-directed spatial memory task.

Caldendrin Is a Repressor of PIEZO2 Channels and Touch Sensation in Mice.

The sense of touch is crucial for cognitive, emotional, and social development and relies on mechanically activated (MA) ion channels that transduce force into an electrical signal. Despite advances in the molecular characterization of these channels, the physiological factors that control their activity are poorly understood. Here, we used behavioral assays, electrophysiological recordings, and various mouse strains (males and females analyzed separately) to investigate the role of the calmodulin-like Ca2+ sensor, caldendrin, as a key regulator of MA channels and their roles in touch sensation. In mice lacking caldendrin (Cabp1 KO), heightened responses to tactile stimuli correlate with enlarged MA currents with lower mechanical thresholds in dorsal root ganglion neurons (DRGNs). The expression pattern of caldendrin in the DRG parallels that of the major MA channel required for touch sensation, PIEZO2. In transfected cells, caldendrin interacts with and inhibits the activity of PIEZO2 in a manner that requires an alternatively spliced sequence in the N-terminal domain of caldendrin. Moreover, targeted genetic deletion of caldendrin in Piezo2-expressing DRGNs phenocopies the tactile hypersensitivity of complete Cabp1 KO mice. We conclude that caldendrin is an endogenous repressor of PIEZO2 channels and their contributions to touch sensation in DRGNs.

Expiratory Muscle Activity Counteracts Positive End-Expiratory Pressure and Is Associated with Fentanyl Dose in Patients with Acute Respiratory Distress Syndrome.

Rationale: Hypoxemia during mechanical ventilation might be worsened by expiratory muscle activity, which reduces end-expiratory lung volume through lung collapse. A proposed mechanism of benefit of neuromuscular blockade in acute respiratory distress syndrome (ARDS) is the abolition of expiratory efforts. This may contribute to the restoration of lung volumes. The prevalence of this phenomenon, however, is unknown. Objectives: To investigate the incidence and amount of end-expiratory lung impedance (EELI) increase after the administration of neuromuscular blocking agents (NMBAs), clinical factors associated with this phenomenon, its impact on regional lung ventilation, and any association with changes in pleural pressure. Methods: We included mechanically ventilated patients with ARDS monitored with electrical impedance tomography (EIT) who received NMBAs in one of two centers. We measured changes in EELI, a surrogate for end-expiratory lung volume, before and after NMBA administration. In an additional 10 patients, we investigated the characteristic signatures of expiratory muscle activity depicted by EIT and esophageal catheters simultaneously. Clinical factors associated with EELI changes were assessed. Measurements and Main Results: We included 46 patients, half of whom showed an increase in EELI of >10% of the corresponding Vt (46.2%; IQR, 23.9-60.9%). The degree of EELI increase correlated positively with fentanyl dosage and negatively with changes in end-expiratory pleural pressures. This suggests that expiratory muscle activity might exert strong counter-effects against positive end-expiratory pressure that are possibly aggravated by fentanyl. Conclusions: Administration of NMBAs during EIT monitoring revealed activity of expiratory muscles in half of patients with ARDS. The resultant increase in EELI had a dose-response relationship with fentanyl dosage. This suggests a potential side effect of fentanyl during protective ventilation.

Influence of environmental enrichment on sexual behavior and the process of learning and memory in a rat model of autism with valproic acid.

Autism spectrum disorder (ASD) is a psychiatric disorder with severe behavioral consequences and no specific therapy. Its etiology is multifactorial, as it is caused by a complex interaction of genetic and environmental factors. In rats, prenatal exposure to the antiepileptic drug valproic acid (VPA) has been associated with an increased risk of autistic-like behaviors in offspring, including social behavior deficits, increased repetitive behaviors, and cognitive impairments. In addition, VPA-treated rats have shown altered sociosexual behaviors. However, the mechanisms underlying these alterations in reproductive processes in VPA-treated rats are not fully understood. Interestingly some abnormal behaviors in VPA autism models are improved by an enriched environment (EE). In the present study, we examined the effects of EE on memory performance and sexual behavior in male rats. We found that on postnatal day 90, EE reduced the time it took for both control and VPA-treated groups to find a hidden platform in the Morris water maze. On PND 100, prenatal exposure to VPA reduced total exploring time in object recognition tests. On PND 110, EE reduced mount and intromission latency and increased ejaculatory frequency in VPA-treated male rats. These results suggest that environmental stimuli significantly influence the onset of sexual behavior in VPA-treated male rats and that EE may be a potential tool for improving a variety of behavioral deficiencies in rodent models of autism.

Overview of Reptile Diversity from Bobaomby Complex, Northern Tip of Madagascar.

Many studies on reptiles have been conducted across Madagascar but some areas are poorly known in terms of the diversity of reptiles such as the Bobaomby Complex in the northern tip of Madagascar. In February and March 2018, we conducted a biodiversity survey within five sites. This biological survey is to collect scientific information for helping new protected creations. Three main methods were used including pitfall trap, visual and acoustic searching along the transect and refuge examination. In total, we recorded 42 species including 5 chameleons, 8 skinks, 11 geckos, 16 snakes and 2 blinds snake species. All recorded species are endemic to Madagascar except Hemidactylus frenatus, Ebenavia inunguis and Phelsuma abbotti. Rare species known only from a few specimens have been recorded in the Bobaomby Complex: Heteroliodon fohy, Pseudoxyrhopus ambreensis, and Madascincus arenicola. Thirteen species are classified as threatened on the IUCN Red List, of which three are Critically Endangered: Paracontias minimus, Madascincus arenicola, and Paroedura lohatsara; three are Endangered: Heteroliodon fohy, Lycodryas inopinae, and Phisalixella variabilis; and seven are Vulnerable: Brookesia ebenaui, Furcifer petteri, Blaesodactylus boivini, Uroplatus ebenaui, Uroplatus henkeli, Liophidium therezieni and Flexiseps ardouini. Our results reveal the importance of the Bobaomby Complex for conserving reptile diversity and highlight the need to protect it.

Sensitivity of CNN image analysis to multifaceted measurements of neurite growth.

Quantitative analysis of neurite growth and morphology is essential for understanding the determinants of neural development and regeneration, however, it is complicated by the labor-intensive process of measuring diverse parameters of neurite outgrowth. Consequently, automated approaches have been developed to study neurite morphology in a high-throughput and comprehensive manner. These approaches include computer-automated algorithms known as 'convolutional neural networks' (CNNs)-powerful models capable of learning complex tasks without the biases of hand-crafted models. Nevertheless, their complexity often relegates them to functioning as 'black boxes.' Therefore, research in the field of explainable AI is imperative to comprehend the relationship between CNN image analysis output and predefined morphological parameters of neurite growth in order to assess the applicability of these machine learning approaches. In this study, drawing inspiration from the field of automated feature selection, we investigate the correlation between quantified metrics of neurite morphology and the image analysis results from NeuriteNet-a CNN developed to analyze neurite growth. NeuriteNet accurately distinguishes images of neurite growth based on different treatment groups within two separate experimental systems. These systems differentiate between neurons cultured on different substrate conditions and neurons subjected to drug treatment inhibiting neurite outgrowth. By examining the model's function and patterns of activation underlying its classification decisions, we discover that NeuriteNet focuses on aspects of neuron morphology that represent quantifiable metrics distinguishing these groups. Additionally, it incorporates factors that are not encompassed by neuron morphology tracing analyses. NeuriteNet presents a novel tool ideally suited for screening morphological differences in heterogeneous neuron groups while also providing impetus for targeted follow-up studies.

Características clínicas del síndrome de takotsubo: una serie de casos / Clinical characteristics of takotsubo syndrome: a series of cases

Resumen Introducción: El síndrome de takotsubo (STT) es una entidad de reciente reconocimiento que asemeja un síndrome coronario agudo. Su epidemiologia ha sido estudiada en diversas poblaciones del mundo. El desencadenante más frecuente es un evento estresante emocional. Objetivo: Describir las características clínicas de una serie de casos con STT. Material y métodos: Se realizó un estudio descriptivo y retrospectivo. Se evaluaron las variables de edad, sexo, características clínicas, factores de riesgo cardiovascular, factores desencadenantes, biomarcadores, hallazgos electrocardiográficos, ecocardiográficos y angiográficos en los expedientes clínicos de un grupo de casos de pacientes con STT. Resultados: Se incluyeron 19 casos de STT. Fueron 16 mujeres y 3 hombres, promedio de edad 62 ± 14 años; el principal factor de riesgo cardiovascular fue el sedentarismo, en 13 casos. El desencadenante emocional estuvo presente en la mayoría de los casos. El síntoma más frecuente fue el dolor torácico, ocho casos presentaron datos de choque e insuficiencia cardiaca. La variante más común por ecocardiograma fue el balonamiento apical en un 79%, al igual que por ventriculografía. La complicación más común fue choque cardiogénico. Conclusiones: Las características clínicas de nuestra población son similares a las descritas previamente en la literatura. El STT es una miocardiopatía transitoria y reversible con buen pronóstico.

Abstract Introduction: takotsubo syndrome (TTS) is a recently recognized entity that resembles an acute coronary syndrome. Its epidemiology has been studied in various populations around the world. The most frequent trigger is an emotional stressful event. Objective: To describe the clinical characteristics of a series of cases with TTS. Material and methods: A descriptive and retrospective study was carried out. The variables of age, gender, clinical characteristics, cardiovascular risk factors, triggering factors, biomarkers, electrocardiographic, echocardiographic, and angiographic findings in the clinical records of a group of cases of patients with TTS were evaluated. Results: 19 cases of TTS were included. There were 16 women and 3 men, the average age was 62 ± 14 years; the main cardiovascular risk factor was sedentary lifestyle in 13 cases. The emotional trigger was present in most cases. The most frequent symptom was chest pain, eight cases presented data of shoCKP and heart failure. The most common variant by echocardiography was apical ballooning in 79%, as well as by ventriculography. The most common complication was cardiogenic shoCKP. Conclusions: The clinical characteristics of our population are like those previously described in the literature. TTS is a transient and reversible cardiomyopathy with a good prognosis.

Human-Gut Phages Harbor Sporulation Genes.

Spore-forming bacteria are prevalent in mammalian guts and have implications for host health and nutrition. The production of dormant spores is thought to play an important role in the colonization, persistence, and transmission of these bacteria. Spore formation also modifies interactions among microorganisms such as infection by phages. Recent studies suggest that phages may counter dormancy-mediated defense through the expression of phage-carried sporulation genes during infection, which can alter the transitions between active and inactive states. By mining genomes and gut-derived metagenomes, we identified sporulation genes that are preferentially carried by phages that infect spore-forming bacteria. These included genes involved in chromosome partitioning, DNA damage repair, and cell wall-associated functions. In addition, phages contained homologs of sporulation-specific transcription factors, notably spo0A, the master regulator of sporulation, which could allow phages to control the complex genetic network responsible for spore development. Our findings suggest that phages could influence the formation of bacterial spores with implications for the health of the human gut microbiome, as well as bacterial communities in other environments. IMPORTANCE Phages acquire bacterial genes and use them to alter host metabolism in ways that enhance phage fitness. To date, most auxiliary genes replace or modulate enzymes that are used by the host for nutrition or energy production. However, phage fitness is affected by all aspects of host physiology, including decisions that reduce the metabolic activity of the cell. Here, we focus on endosporulation, a complex and ancient form of dormancy found among the Bacillota that involves hundreds of genes. By coupling homology searches with host classification, we identified 31 phage-carried homologs of sporulation genes that are mostly limited to phages infecting spore-forming bacteria. Nearly one-third of the homologs recovered were regulatory genes, suggesting that phages may manipulate host genetic networks by tapping into their control elements. Our findings also suggest a mechanism by which phages can overcome the defensive strategy of dormancy, which may be involved in coevolutionary dynamics of spore-forming bacteria.

Clinical characteristics of takotsubo syndrome: a series of cases.

INTRODUCTION: takotsubo syndrome (TTS) is a recently recognized entity that resembles an acute coronary syndrome. Its epidemiology has been studied in various populations around the world. The most frequent trigger is an emotional stressful event. OBJECTIVE: To describe the clinical characteristics of a series of cases with TTS. MATERIAL AND METHODS: A descriptive and retrospective study was carried out. The variables of age, gender, clinical characteristics, cardiovascular risk factors, triggering factors, biomarkers, electrocardiographic, echocardiographic, and angiographic findings in the clinical records of a group of cases of patients with TTS were evaluated. RESULTS: 19 cases of TTS were included. There were 16 women and 3 men, the average age was 62 ± 14 years; the main cardiovascular risk factor was sedentary lifestyle in 13 cases. The emotional trigger was present in most cases. The most frequent symptom was chest pain, eight cases presented data of shoCKP and heart failure. The most common variant by echocardiography was apical ballooning in 79%, as well as by ventriculography. The most common complication was cardiogenic shoCKP. CONCLUSIONS: The clinical characteristics of our population are like those previously described in the literature. TTS is a transient and reversible cardiomyopathy with a good prognosis.

INTRODUCCIÓN: El síndrome de takotsubo (STT) es una entidad de reciente reconocimiento que asemeja un síndrome coronario agudo. Su epidemiologia ha sido estudiada en diversas poblaciones del mundo. El desencadenante más frecuente es un evento estresante emocional. OBJETIVO: Describir las características clínicas de una serie de casos con STT. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo y retrospectivo. Se evaluaron las variables de edad, sexo, características clínicas, factores de riesgo cardiovascular, factores desencadenantes, biomarcadores, hallazgos electrocardiográficos, ecocardiográficos y angiográficos en los expedientes clínicos de un grupo de casos de pacientes con STT. RESULTADOS: Se incluyeron 19 casos de STT. Fueron 16 mujeres y 3 hombres, promedio de edad 62 ± 14 años; el principal factor de riesgo cardiovascular fue el sedentarismo, en 13 casos. El desencadenante emocional estuvo presente en la mayoría de los casos. El síntoma más frecuente fue el dolor torácico, ocho casos presentaron datos de choque e insuficiencia cardiaca. La variante más común por ecocardiograma fue el balonamiento apical en un 79%, al igual que por ventriculografía. La complicación más común fue choque cardiogénico. CONCLUSIONES: Las características clínicas de nuestra población son similares a las descritas previamente en la literatura. El STT es una miocardiopatía transitoria y reversible con buen pronóstico.

High-fat diet-induced elevation of body weight set point in male mice.

OBJECTIVE: High-fat diets (HFD) are thought to disrupt energy homeostasis to drive overeating and obesity. However, weight loss resistance in individuals with obesity suggests that homeostasis is intact. This study aimed to reconcile this difference by systematically assessing body weight (BW) regulation under HFD. METHODS: Male C57BL/6 N mice were fed diets with varying fat and sugar in different durations and patterns. BW and food intake were monitored. RESULTS: BW gain was transiently accelerated by HFD (≥40%) prior to plateauing. The plateau was consistent regardless of starting age, HFD duration, or fat/sugar content. Reverting to a low-fat diet (LFD) caused transiently accelerated weight loss, which correlated with how heavy mice were before the diet relative to LFD-only controls. Chronic HFD attenuated the efficacy of single or repetitive dieting, revealing a defended BW higher than that of LFD-only controls. CONCLUSIONS: This study suggests that dietary fat modulates the BW set point immediately upon switching from LFD to HFD. Mice defend a new elevated set point by increasing caloric intake and efficiency. This response is consistent and controlled, suggesting that hedonic mechanisms contribute to rather than disrupt energy homeostasis. An elevated floor of the BW set point after chronic HFD could explain weight loss resistance in individuals with obesity.

Caldendrin represses neurite regeneration and growth in dorsal root ganglion neurons.

Caldendrin is a Ca2+ binding protein that interacts with multiple effectors, such as the Cav1 L-type Ca2+ channel, which play a prominent role in regulating the outgrowth of dendrites and axons (i.e., neurites) during development and in response to injury. Here, we investigated the role of caldendrin in Cav1-dependent pathways that impinge upon neurite growth in dorsal root ganglion neurons (DRGNs). By immunofluorescence, caldendrin was localized in medium- and large- diameter DRGNs. Compared to DRGNs cultured from WT mice, DRGNs of caldendrin knockout (KO) mice exhibited enhanced neurite regeneration and outgrowth. Strong depolarization, which normally represses neurite growth through activation of Cav1 channels, had no effect on neurite growth in DRGN cultures from female caldendrin KO mice. Remarkably, DRGNs from caldendrin KO males were no different from those of WT males in terms of depolarization-dependent neurite growth repression. We conclude that caldendrin opposes neurite regeneration and growth, and this involves coupling of Cav1 channels to growth-inhibitory pathways in DRGNs of females but not males.

Cartilage-inspired surface textures for improved tribological performance of orthopedic implants.

Joint replacements have become one of the most common orthopedic procedures due to the significant demands of retaining functional mobility. While these procedures are of great value to patients, there are some limitations. Durability is the most important limitation associated with joint replacement that needs to be addressed due to the increasing number of younger patients. Titanium is a commonly used implant material which has high biocompatibility, high strength-to-density ratio, and high corrosion resistance. However, current titanium implants have poor wear resistance which shortens their lifespan. In this study, microscale dimples with four different dimple shapes (circular, triangular, square, and star) of similar sizes to the pores found in natural articular cartilage were fabricated on titanium disks to improve implant lubrication and reduce wear. Biotribology tests were performed on dimpled and non-dimpled titanium disks in a condition similar to that inside of a patient's body. It was shown that dimpling the titanium disks optimized the lubricant film formation and decreased the wear rate significantly while also reducing the coefficient of friction (COF). The star-shaped dimples had the lowest COF and almost no detectable wear after 8 h of testing. To investigate whether dimpling increased bacterial colonization due to increased surface area, and to determine whether any increase could be limited by coating with antibacterial materials, bacterial colonization with Staphylococcus aureus was tested with non-dimpled and star-shaped dimpled titanium disks with and without coating with polydopamine (PDA), silver (Ag) nanoparticles (NPs), and PDA + Ag NPs. It was found that dimpling did not increase bacterial colonization, and that coating with PDA, Ag NPs, or PDA + Ag NPs did not decrease bacterial colonization. Nevertheless, we conclude that star-shaped dimpled titanium surfaces have potential utility as more durable orthopedic implants.

Pre-operative predictors of poor reduction in acetabular fractures submitted to surgical treatment.

INTRODUCTION: Acetabular fractures are among the most complex orthopedic injuries, and their treatment and understanding have evolved remarkably in the last 50 years. Several factors affect the reduction quality of the surgically treated displaced acetabular fractures. Thus, this study aimed to identify these factors by analyzing patients' data. PATIENTS AND METHODS: Retrospective data from fractures operated in one center over 8 years were analyzed. Patients with a mature skeleton who underwent open reduction and internal fixation and had a minimum follow-up period of 6 weeks were included. Non-displaced fractures were excluded from the study. Radiographic assessment of the reduction was performed before surgery and at follow-up using the method described by Borelli et al. The effects of age (<40 or >40 years), sex, initial displacement (< 20 mm or > 20 mm), time to surgery (<14 days or>14 days), fracture pattern (elementary or associated), number of associated fractures (< 3 or > 3), and associated pelvic injury were analyzed RESULTS: The study included 115 (83.9%) men and 22 (16.1%) women, with a mean age of 34.1 years (range 16-74 years). In the sixth week of follow-up, reductions were satisfactory in 96 (70.7%) patients and unsatisfactory in 41 (29.3%). The most prevalent patterns were the posterior wall (23.1%) and both column (15.7%). Linear regression showed that residual displacement was directly correlated with initial displacement (p = 0.027) but without association with reduction quality. Age, sex, and initial displacement had no effect on reduction quality, which is in contrast with longer time to surgery (p = 0.004), associated fracture pattern (p = 0.002), three or more associated fractures (p = 0.001), and presence of associated pelvic injury (p = 0.021). CONCLUSION: Attempting to shorten the time to operate the fractures can lead to better results for patients because the other factors associated with poor reduction are inherent the trauma and cannot be modified by the surgeon.

Genome-Resolved Metaproteomics Decodes the Microbial and Viral Contributions to Coupled Carbon and Nitrogen Cycling in River Sediments.

Rivers have a significant role in global carbon and nitrogen cycles, serving as a nexus for nutrient transport between terrestrial and marine ecosystems. Although rivers have a small global surface area, they contribute substantially to worldwide greenhouse gas emissions through microbially mediated processes within the river hyporheic zone. Despite this importance, research linking microbial and viral communities to specific biogeochemical reactions is still nascent in these sediment environments. To survey the metabolic potential and gene expression underpinning carbon and nitrogen biogeochemical cycling in river sediments, we collected an integrated data set of 33 metagenomes, metaproteomes, and paired metabolomes. We reconstructed over 500 microbial metagenome-assembled genomes (MAGs), which we dereplicated into 55 unique, nearly complete medium- and high-quality MAGs spanning 12 bacterial and archaeal phyla. We also reconstructed 2,482 viral genomic contigs, which were dereplicated into 111 viral MAGs (vMAGs) of >10 kb in size. As a result of integrating gene expression data with geochemical and metabolite data, we created a conceptual model that uncovered new roles for microorganisms in organic matter decomposition, carbon sequestration, nitrogen mineralization, nitrification, and denitrification. We show how these metabolic pathways, integrated through shared resource pools of ammonium, carbon dioxide, and inorganic nitrogen, could ultimately contribute to carbon dioxide and nitrous oxide fluxes from hyporheic sediments. Further, by linking viral MAGs to these active microbial hosts, we provide some of the first insights into viral modulation of river sediment carbon and nitrogen cycling. IMPORTANCE Here we created HUM-V (hyporheic uncultured microbial and viral), an annotated microbial and viral MAG catalog that captures strain and functional diversity encoded in these Columbia River sediment samples. Demonstrating its utility, this genomic inventory encompasses multiple representatives of dominant microbial and archaeal phyla reported in other river sediments and provides novel viral MAGs that can putatively infect these. Furthermore, we used HUM-V to recruit gene expression data to decipher the functional activities of these MAGs and reconstruct their active roles in Columbia River sediment biogeochemical cycling. Ultimately, we show the power of MAG-resolved multi-omics to uncover interactions and chemical handoffs in river sediments that shape an intertwined carbon and nitrogen metabolic network. The accessible microbial and viral MAGs in HUM-V will serve as a community resource to further advance more untargeted, activity-based measurements in these, and related, freshwater terrestrial-aquatic ecosystems.

Factores asociados al uso de métodos anticonceptivos en mujeres en edad fértil de 15 a 49 años según encuesta demográfica en Perú / Associated factors within the use of contraceptive methods in women of childbearing age between 15 to 49 years old according to a demographic survey in Peru

Introducción: Los métodos anticonceptivos son importantes herramientas para lograr una planificación familiar deseada. Objetivo: Determinar los factores asociados al uso de métodos anticonceptivos en mujeres en edad fértil de 15 a 49 años según ENDES 2018. Material y métodos: Estudio descriptivo, observacional, analítico y retrospectivo. Se analizó la muestra de la Encuesta Nacional Demográfica de Salud Familiar (ENDES), del año 2018 a mujeres peruanas entre 15 a 49 años que respondieron el módulo de métodos anticonceptivos. Resultados: Mayor prevalencia de usuarias de métodos anticonceptivos en el área urbana (RP=1,046, IC:1,037 ­ 1,054), según estado conyugal se evidencia un mayor uso en casadas o convivientes (RP=1,080 IC:1,071 ­ 1,090), en el nivel educativo se obtiene que mujeres con estudios superiores tiene mayor prevalencia de uso de anticonceptivos (RP= 1,021, IC:1,016 ­ 1,026) y, finalmente, la edad en la 1ª relación sexual menor a los 17 años tiene mayor prevalencia (RP = 1,017 IC:1,016 ­ 1,026). Conclusión: Existe asociación positiva entre residir en área urbana, edad de primera relación sexual menor a 17 años, ser casada o conviviente y tener grado de instrucción superior y el uso de métodos anticonceptivos.

Background: Contraceptive methods are an important tool to achieve the desired family planning.To determine the factors associated Objective:within the use of contraceptive methods in women of childbearing age between 15 to 49 years old according to the ENDES 2018. Material and methods: Descriptive, observational, analytical and retrospective study. The sample, of the National Demographic Survey of Family Health (ENDES) 2018, to Peruvian women between 15 to 49 years old who responded to the contraceptive methods module was analyzed. Results: There is a higher prevalence of women using contraceptive methods in the urban area (PR = 1,046, CI: 1,037 - 1,054), according the marital status there is a high use in married women of contraceptive use (PR = 1,080 CI: 1,071 - 1,090), in the educational level it's obtained that women with higher education have a higher prevalence of contraceptive use (PR = 1,021, CI: 1,016 - 1,026) and, finally, that the age in the first sex relationship before 17 years has a higher prevalence (PR = 1,017 CI: 1,016 - 1,026). Conclusion: There is a positive association between living in an urban area, age of first sexual intercourse less than 17 years, being married and having high educational level in the use of contraceptive methods.

Daily or Less Frequent Topical 1% Atropine Slows Defocus-Induced Myopia Progression in Contact Lens-Wearing Guinea Pigs.

Purpose: This study compared the efficacy of topical 1% atropine applied daily versus every 3 days for controlling myopia progression in guinea pigs. Methods: To induce myopia, pigmented guinea pigs (New Zealand strain, n = 38) wore monocular -10 D rigid gas-permeable (RGP) contact lenses, which were replaced after 3 weeks with -15 diopter (D) contact lenses. Animals were treated with 1% atropine either daily (Atr-QD; n = 12), or every 3 days (Atr-Q3D; n = 11), or with artificial tears (control group; n = 15). Spherical equivalent refractive error (SER) and axial length (AL) data, as well as retinal and choroidal thickness data were collected weekly. Results: Whereas mean (±SEM) interocular differences (treated - fellow) in both SER and AL at week 0 (baseline) were similar for all groups, significant differences between the atropine-treated and control groups were evident by week 6 (SER and AL, P < 0.001). The treated eyes of the control group showed relatively more axial elongation and myopia progression than both the Atr-QD and Atr-Q3D groups. Choroidal blood vessel area also decreased over time in the treated eyes of the control group, coupled with choroidal thinning overall, with these changes being attenuated by atropine. Retinal thickness showed a developmental decrease over the treatment period but was unaffected by atropine. Conclusions: For this defocus-induced guinea pig model of myopia, application of 1% topical atropine slows myopia progression, even when applied every 3 days. Translational Relevance: The results from this study suggest that the frequency of dosing for topical atropine may be reduced from the widely used daily dosing regimen without loss of myopia control efficacy.