From Data to Decisions: How AI Is Revolutionizing Clinical Prediction Models in Plastic Surgery.

SUMMARY: The impact of clinical prediction models within Artificial Intelligence (AI) and machine learning (ML) is significant. With its ability to analyze vast amounts of data and identify complex patterns, machine learning has the potential to improve and implement evidence-based plastic, reconstructive, and hand surgery. Among others, it is capable of predicting the diagnosis, prognosis, and outcomes of individual patients. This modeling aids daily clinical decision making, most commonly at the moment, as decision-support.Therefore, the purpose of this paper is to provide a practice guideline to plastic surgeons implementing AI in clinical decision-making or setting up AI research to develop clinical prediction models using the 7-step approach and the ABCD validation steps of Steyerberg et al. Secondly, we describe two important protocols which are in the development stage for AI research: 1) the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) checklist, and 2) The PROBAST checklist to access potential biases.

Mechanisms of Action of Fruit and Vegetable Phytochemicals in Colorectal Cancer Prevention.

Colorectal cancer (CRC) is the third most common cancer worldwide and its incidence is expected to increase by almost 80% by 2030. CRC apparition is related to poor diet, mainly due to low consumption of phytochemicals present in fruits and vegetables. Hence, this paper reviews the most promising phytochemicals in the literature, presenting scientific evidence regarding potential CRC chemopreventive effects. Moreover, this paper reveals the structure and action of CRC mechanisms that these phytochemicals are involved in. The review reveals that vegetables rich in phytochemicals such as carrots and green leafy vegetables, as well as some fruits such as pineapple, citrus fruits, papaya, mango, and Cape gooseberry, that have antioxidant, anti-inflammatory, and chemopreventive properties can promote a healthy colonic environment. Fruits and vegetables in the daily diet promote antitumor mechanisms by regulating cell signaling and/or proliferation pathways. Hence, daily consumption of these plant products is recommended to reduce the risk of CRC.

Bacterial Nanocellulose from Komagataeibacter Medellinensis in Fique Juice for Activated Carbons Production and Its Application for Supercapacitor Electrodes.

This paper presents the results obtained from the chemical activation of bacterial nanocellulose (BCN) using fique juice as a culture medium. BNC activation (BNCA) was carried out with H3PO4 and KOH at activation temperatures between 500 °C to 800 °C. The materials obtained were characterized morphologically, physicochemically, superficially, and electrochemically, using scanning electron microscopy, X-ray photoelectron spectroscopy (XPS), the physisorption of gases N2 and CO2 at 77 K and 273 K, respectively, cyclic voltammetry, chronopotentiometry, and electrochemical impedance spectroscopy (EIS). The samples activated with H3PO4 presented specific surface areas (SBET) around 780 m2 g-1, while those activated with KOH values presented specific surface areas between 680 and 893 m2 g-1. The XPS analysis showed that the PXPS percentage on the surface after H3PO4 activation was 11 wt%. The energy storage capacitance values ranged between 97.5 F g-1 and 220 F g-1 by EIS in 1 M H2SO4. The samples with the best electrochemical performance were activated with KOH at 700 °C and 800 °C, mainly due to the high SBET available and the accessibility of the microporosity. The capacitance of BNCAs was mainly improved by electrostatic effects due to the SBET rather than that of pseudocapacitive ones due to the presence of phosphorus heteroatoms.

Respuesta biológica en las pacientes con cáncer de mama tratadas con radioterapia intraoperatoria / Biological response in breast cancer patients using intraoperative radiotherapy

Introducción: el tratamiento conservador de la mama junto con la radioterapia es de elección en las pacientes con cáncer de mama precoz. Gracias a un mayor conocimiento de la radiobiología tumoral, la tendencia actual consiste en utilizar técnicas de irradiación parcial acelerada, entre las que destaca la radioterapia intraoperatoria (RIO). Métodos: estudio prospectivo multicéntrico dividido en 2 grupos comparativos con casos consecutivos de las pacientes a que han recibido una cirugía conservadora por cáncer de mama asociada o no a RIO. Se valora la relación de esta terapia con los valores de las proteínas involucradas en la respuesta biológica (IL6, IL8, CXCL10, IL1β y TNF- α) en muestras de suero preoperatorio y a las 24 h desde la cirugía, y de drenaje quirúrgico a las 6 y 24 h desde la cirugía. Resultados: se ha objetivado en las pacientes tratadas con RIO una disminución significativa de IL6 e IL8, así como un aumento de CXCL10 favorable para la lucha contra la progresión del tumor (p valor < 0,05). Las alteraciones del sistema inmunológico se manifiestan tanto en suero como en débito del drenaje quirúrgico a las 6 y 24 h desde la cirugía. Conclusiones: la RIO modifica la respuesta biológica en las pacientes con cáncer de mama. A pesar de que se deben desarrollar más líneas de investigación, la comprensión de los mecanismos de desarrollo del tumor, abre una nueva etapa en el desarrollo de tratamientos perioperatorios dirigidos a dianas concretas que compensen las consecuencias dañinas de la cirugía. (AU)

Introduction: Breast conserving surgery with radiotherapy is the treatment of choice in patients with early breast cancer. Due to a better understanding of tumour radiobiology, the current trend is to use accelerated partial irradiation techniques, among which intraoperative radiotherapy (RIO) stands out. Methods: Prospective multicentre study divided into two comparative groups with consecutive cases of patients who have undergone conservative surgery for breast cancer associated or not with RIO. The relation of this therapy with the values of proteins involved in the biological response (IL6, IL8, CXCL10, IL1β y TNF- α) is assessed in serum samples preoperative and 24 hours after surgery, and surgical drainage samples at 6 and 24 hours after surgery. Results: A significant decrease in IL6 and IL8, as well as an increase in CXCL10 favourable for the fight against tumour progression (p-value < 0.05) was observed in patients treated with RIO. Immune system alterations are manifested in both serum and surgical drainage debit at 6 and 24 hours after surgery. Conclusions: RIO modifies the biological response in breast cancer patients. Although more lines of research need to be developed, the understanding of the mechanisms of tumour development opens a new stage in the development of perioperative treatments directed at specific targets that compensate for the harmful consequences of surgery. (AU)

Development of Genistein Drug Delivery Systems Based on Bacterial Nanocellulose for Potential Colorectal Cancer Chemoprevention: Effect of Nanocellulose Surface Modification on Genistein Adsorption.

Genistein is an isoflavone with antioxidant, anti-inflammatory, and anticancer properties. That said, its use in the industry is limited by its low solubility in aqueous systems. In this work, bacterial nanocellulose (BNC) and BNC modified with cetyltrimethylammonium (BNC-CTAB) were evaluated as genistein-encapsulating materials for their controlled release in cancer chemoprevention. Thin films were obtained and characterized by contact angle, AFM, TEM, UV-Vis spectroscopy FTIR, and TGA techniques to verify surface modification and genistein encapsulation. The results show a decrease in hydrophilization degree and an increase in diameter after BNC modification. Furthermore, the affinity of genistein with the encapsulating materials was determined in the context of monolayer and multilayer isotherms, thermodynamic parameters and adsorption kinetics. Spontaneous, endothermic and reversible adsorption processes were found for BNC-GEN and BNC-CTAB-GEN. After two hours, the maximum adsorption capacity corresponded to 4.59 mg GEN∙g-1 BNC and 6.10 mg GEN∙g-1 BNC-CTAB; the latter was a more stable system. Additionally, in vitro release assays performed with simulated gastrointestinal fluids indicated controlled and continuous desorption in gastric and colon fluids, with a release of around 5% and 85%, respectively, for either system. Finally, the IC50 tests made it possible to determine the amounts of films required to achieve therapeutic concentrations for SW480 and SW620 cell lines.

Atributos afectivos y cognitivos hacia la fauna silvestre y su relación con factores sociodemográficos en población rural / Affective and cognitive attributes to wildlife and its relationship with sociodemographic factors in the rural population

RESUMEN Las posibles asociaciones entre factores sociodemográficos y el grado de conciencia ambiental, expresado en términos de un subconjunto de atributos afectivos y cognitivos, puede determinar la incidencia de programas de educación ambiental en zonas rurales, sobre la percepción frente a diversas problemáticas ambientales, de carácter local, así como la postura adoptada hacia la conservación de la fauna silvestre. En la zona de estudio, se observaron afectaciones al entorno, cacería ilegal, minería, deforestación, quemas y contaminación por residuos. Por lo anterior, fue importante conocer el nivel de conciencia ambiental de las personas involucradas. Además, este tipo de estudio es muy importante en el país, ya que contribuye en las investigaciones sobre el nivel de conciencia ambiental, por lo que es relevante indagar sobre este aspecto. Se tomó una muestra de 152 habitantes, pertenecientes a las 15 comunidades del área de influencia del trasvase Manso - Caldas, Colombia, a las que se les aplicaron encuestas cara a cara. Para el análisis estadístico, se recurrió a las pruebas de independencia y al análisis de correspondencias múltiples. Dentro de los atributos afectivos, se pudo identificar asociación entre la tenencia de tierra, la permanencia en la zona y el pertenecer a diferentes organizaciones de índole asociativo, con un incremento en el indicador utilizado, para evidenciar la conciencia ambiental. El estudio realizado expone el tratamiento de información empírica, que da cuenta de los avances alcanzados en programas de educación ambiental, ejecutados entre pobladores de zonas rurales, así como su relación con ciertos comportamientos proambientales.

ABSTRACT The possible associations between sociodemographic factors and the degree of environmental awareness, expressed in terms of a subset of affective and cognitive attributes, can determine the incidence of environmental education programs in rural areas on the perception of various environmental problems of a local nature, as well as the position adopted towards the conservation of wild fauna. In the study area, effects on the environment, illegal hunting, mining, deforestation, burning and contamination by residues were observed. Therefore, it was important to know the level of environmental awareness of the people involved in these programs. In addition, this type of study is very important in the country since it contributes to research on the level of environmental awareness, so it is relevant to inquire about this aspect. A sample of 152 inhabitants was taken from the 15 communities in the Manso transfer area, Caldas-Colombia, to which face-to-face surveys were applied. For statistical analysis, independence tests and Multiple Correspondence Analysis were used. Within the affective attributes, it was possible to identify an association between land ownership, permanence in the area and belonging to different organizations of an associative nature with an increase in the indicator used to demonstrate environmental awareness. The study carried out exposes the treatment of empirical information that accounts for the progress made in Environmental Education programs carried out among residents of rural areas, as well as its relationship with certain pro-environmental behaviors.

Prevalence and Determinants of Underweight, Overweight, and Obesity: A Cross-Sectional Study of Sociodemographic, Dietary, and Lifestyle Factors Among Adolescent Girls in Jutiapa, Guatemala.

BACKGROUND: As the incidence of overweight continues to increase among children and adolescents in Guatemala, underweight remains a prominent health problem. However, the prevalence of overweight or underweight and associated risk factors has not been investigated among adolescent girls. OBJECTIVE: To determine the prevalence of underweight and overweight/obesity and associated sociodemographic, dietary, and lifestyle factors among adolescent girls in Jutiapa, Guatemala. METHODS: A cross-sectional study of a subsample of 392 girls aged 12 to 17 years from an agriculture-nutrition trial was conducted. Anthropometric data were obtained using standard methods. Sociodemographic, dietary, and lifestyle data were collected using a structured questionnaire. Multivariable logistic regression was conducted using underweight (body mass index [BMI] for age < 5th percentile) and overweight/obesity (BMI for age ≥ 85th percentile) as outcome variables. RESULTS: The prevalence of underweight and overweight/obesity was 9.9% and 15.6%, respectively. Age (15-17 years), high waist circumference, high blood pressure, father being a farmer, large family (> 5 persons), hours spent watching TV, and high red meat consumption were significantly associated with underweight. Whereas being in school, high waist circumference, high blood pressure, overweight/obese mother, unemployed father, watching TV for more than 2 hours, having soft drinks at home, and meeting fruit recommendations were significantly associated with overweight/obesity. CONCLUSIONS: Our findings highlight the importance of concurrently addressing underweight and overweight/obesity among adolescent girls in rural Guatemala. Studies in various parts of the country are needed to confirm the results of the present study and for appropriate strategies to be implemented to reduce both underweight and overweight.

Understanding the causes and consequences of variability in infant ERP editing practices.

The current study examined the effects of variability on infant event-related potential (ERP) data editing methods. A widespread approach for analyzing infant ERPs is through a trial-by-trial editing process. Researchers identify electroencephalogram (EEG) channels containing artifacts and reject trials that are judged to contain excessive noise. This process can be performed manually by experienced researchers, partially automated by specialized software, or completely automated using an artifact-detection algorithm. Here, we compared the editing process from four different editors-three human experts and an automated algorithm-on the final ERP from an existing infant EEG dataset. Findings reveal that agreement between editors was low, for both the numbers of included trials and of interpolated channels. Critically, variability resulted in differences in the final ERP morphology and in the statistical results of the target ERP that each editor obtained. We also analyzed sources of disagreement by estimating the EEG characteristics that each human editor considered for accepting an ERP trial. In sum, our study reveals significant variability in ERP data editing pipelines, which has important consequences for the final ERP results. These findings represent an important step toward developing best practices for ERP editing methods in infancy research.

Sperm DNA fragmentation and male age: results of in vitro fertilization treatments.

OBJECTIVE: This study aimed to assess the effects of sperm DNA fragmentation in parents belonging to different age groups. The couples included in the study comprised normozoospermic men and infertile women undergoing conventional IVF. METHODS: The results obtained from 163 conventional IVF cycles were analyzed retrospectively. The couples enrolled in the study included women aged between 30 and 37 years. Sperm DNA fragmentation was studied using the TUNEL assay. The patients were split into four groups based on male age and sperm DNA fragmentation, as follows: Group 1: ≤39 years and TUNEL assay ≤20%; Group 2: ≤39 years and TUNEL assay >20%; Group 3: ≥40 years and TUNEL assay ≤20%; and Group 4: ≥40 years and TUNEL assay >20%. RESULTS: No significant differences were found in semen parameters or fertilization rates between groups. Groups with <20% sperm DNA fragmentation showed significant differences in other parameters, including higher blastocyst formation rate (Group 1: 63% and Group 3: 60% vs. Group 2: 43% and Group 4: 41%, p<0.05) and higher expanded blastocyst formation rate (Group 1: 42% and Group 3: 40% vs. Group 2: 21% and Group 4: 18%, p<0.05). Miscarriage rate was significantly higher in Group 4 (42% and 46% vs. 5%, 25% and 5% in Groups 1, 2 and 3, respectively, p<0.05). CONCLUSIONS: Our results showed lower blastocyst formation rates from IVF when males had high levels of sperm DNA fragmentation. Higher miscarriage rates were also observed in couples with males aged 40+ years. These results reinforce the need to inform couples with male partners aged 40+ years about the potential risks inherent to fertility treatment.

Recent Advances in Polymer Nanomaterials for Drug Delivery of Adjuvants in Colorectal Cancer Treatment: A Scientific-Technological Analysis and Review.

Colorectal cancer (CRC) is the type with the second highest morbidity. Recently, a great number of bioactive compounds and encapsulation techniques have been developed. Thus, this paper aims to review the drug delivery strategies for chemotherapy adjuvant treatments for CRC, including an initial scientific-technological analysis of the papers and patents related to cancer, CRC, and adjuvant treatments. For 2018, a total of 167,366 cancer-related papers and 306,240 patents were found. Adjuvant treatments represented 39.3% of the total CRC patents, indicating the importance of adjuvants in the prognosis of patients. Chemotherapy adjuvants can be divided into two groups, natural and synthetic (5-fluorouracil and derivatives). Both groups can be encapsulated using polymers. Polymer-based drug delivery systems can be classified according to polymer nature. From those, anionic polymers have garnered the most attention, because they are pH responsive. The use of polymers tailors the desorption profile, improving drug bioavailability and enhancing the local treatment of CRC via oral administration. Finally, it can be concluded that antioxidants are emerging compounds that can complement today's chemotherapy treatments. In the long term, encapsulated antioxidants will replace synthetic drugs and will play an important role in curing CRC.

Hierarchical Approach to Classify Food Scenes in Egocentric Photo-Streams.

Recent studies have shown that the environment where people eat can affect their nutritional behavior [1]. In this paper, we provide automatic tools for personalized analysis of a person's health habits by the examination of daily recorded egocentric photo-streams. Specifically, we propose a new automatic approach for the classification of food-related environments, that is able to classify up to 15 such scenes. In this way, people can monitor the context around their food intake in order to get an objective insight into their daily eating routine. We propose a model that classifies food-related scenes organized in a semantic hierarchy. Additionally, we present and make available a new egocentric dataset composed of more than 33 000 images recorded by a wearable camera, over which our proposed model has been tested. Our approach obtains an accuracy and F-score of 56% and 65%, respectively, clearly outperforming the baseline methods.

Bypass duodeno ileal con anastomsosis única (SADI) totalmente robótico / Full robotic single anastomosis duodeno-ileal bypass (SADI)

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Spinal anesthesia in a patient with Charcot-Marie-Tooth disease undergoing orthopedic surgery: case report / Anestesia raquídea en un paciente con enfermedad de Charcot-Marie-Tooth sometido a cirugía ortopédica: reporte de caso

Abstract Introduction: It is uncommon to come across patients with neuromuscular diseases in the daily practice of anesthesia, given the low prevalence of those conditions. Charcot-Marie-Tooth (CMT) disease is the most frequently, caused by an inherited abnormal myelin structure pattern. In view of the low prevalence of this condition (1:25,000), there is little information, derived mostly from case reports, about the use of neuroaxial anesthesia in these patients. Case presentation: Description of a patient with underlying CMT disease compromising lower limb mobility, who comes to the emergency service due to lower limb pain. After being diagnosed with an acetabular fracture, the patient underwent orthopedic surgery under spinal anesthesia, selected based on patient comorbidities, and the immediate postoperative follow-up. Results: The anesthetic and surgical procedures proceeded uneventfully and no neuropathic worsening was observed during the next 24 hours. Conclusion: Uneventful neuroaxial anesthesia is reported in a patient with neuromuscular disease. The case contributes to show the benefits and safety of this form of anesthesia when compared with other options.

Resumen Introducción: En la práctica anestésica diaria es raro enfrentarse a pacientes con patologías neuromusculares, dada la poca pre-valencia de dichas patologías. La más frecuente de ellas es la enfermedad de Charcot-Marie-Tooth, en la cual se hereda un patrón alterado en la estructura de la mielina. Debido a la baja prevalencia de esta patología (1:25000), el uso de anestesia neuroaxial en dichos pacientes no cuenta con mucha información, y mucha de ella proviene de reportes de casos. Presentación del caso: Se describe el caso de un paciente con enfermedad de Charcot-Marie-Tooth, de base, con compromiso de la movilidad en miembros inferiores, y quien asiste a urgencias por dolor en miembro inferior. Tras ser diagnosticado con fractura de acetábulo, fue sometido a cirugía ortopédica bajo anestesia raquídea, indicada a la luz de sus comorbilidades, y el posterior seguimiento inmediato. Resultados: Se realiza el procedimiento anestésico y quirúrgico sin complicaciones, y no se presenta empeoramiento de la neuropatía en las 24 horas posteriores. Conclusiones: Se reporta un caso de anestesia neuroaxial en paciente con enfermedad neuromuscular sin incidencias, que ayuda así a ir mostrando los beneficios de la mencionada anestesia y su seguridad frente a otras opciones.

Sensitivity to structure in action sequences: An infant event-related potential study.

Infants are sensitive to structure and patterns within continuous streams of sensory input. This sensitivity relies on statistical learning, the ability to detect predictable regularities in spatial and temporal sequences. Recent evidence has shown that infants can detect statistical regularities in action sequences they observe, but little is known about the neural process that give rise to this ability. In the current experiment, we combined electroencephalography (EEG) with eye-tracking to identify electrophysiological markers that indicate whether 8-11-month-old infants detect violations to learned regularities in action sequences, and to relate these markers to behavioral measures of anticipation during learning. In a learning phase, infants observed an actor performing a sequence featuring two deterministic pairs embedded within an otherwise random sequence. Thus, the first action of each pair was predictive of what would occur next. One of the pairs caused an action-effect, whereas the second did not. In a subsequent test phase, infants observed another sequence that included deviant pairs, violating the previously observed action pairs. Event-related potential (ERP) responses were analyzed and compared between the deviant and the original action pairs. Findings reveal that infants demonstrated a greater Negative central (Nc) ERP response to the deviant actions for the pair that caused the action-effect, which was consistent with their visual anticipations during the learning phase. Findings are discussed in terms of the neural and behavioral processes underlying perception and learning of structured action sequences.

RINITIS MEDICAMENTOSA: UN ESTUDIO OBSERVACIONAL

La rinitis medicamentosa es una enfermedad producida por el uso abusivo de descongestivos nasales. Objetivos: identificar las características demográficas del uso prolongado de descongestivos en nuestra población y la prevalencia de la rinitis medicamentosa. Materiales y Métodos: estudio retrospectivo, descriptivo, realizado por jóvenes alergistas de la ciudad de Córdoba. Resultados: se incluyeron 260 pacientes con diagnóstico de Rinitis Crónica, el 17%usaban descongestivos tópicos, el 13% lo utilizaban en forma prolongada y predominó en el sexo masculino. Conclusión: Se identificó un uso prolongado de descongestivos tópicos y alta prevalencia de rinitis medicamentosa.

Drug rhinitis is a disease caused by the abusive use of nasal decongestants. Objectives: to identify the demographic characteristics of the prolonged use of decongestants in our population and the prevalence of drug rhinitis. Materials and Methods: a retrospective, descriptive study carried out by young allergists from the city of Córdoba. Results: 260 patients with chronic rhinitis were included, 17% used topical decongestants, 13% used it on a prolonged basis and predominated in males. Conclusion: A prolonged use of topical decongestants and high prevalence of drug rhinitis was identified.

Valoración de la tolerancia y seguridad de 5 modelos de sedación durante la realización de la ecobroncoscopia / Tolerance and Safety of 5 Models of Sedation During Endobronchial Ultrasound

Introducción: La sedación durante la ecobroncoscopia es importante debido a la duración prolongada de esta exploración. Evaluamos distintos modelos de sedación y sus complicaciones. Método: Se realizó un estudio multicéntrico, prospectivo y observacional en el que recogieron distintas variables en 307 pacientes con distintos modelos de sedación: a) midazolam en bolo; b)propofol en perfusión; c) midazolam en bolo y propofol en perfusión; d) propofol en perfusión y remifentanilo en perfusión, y e) midazolam en bolo y fentanilo en bolo. Finalizada la prueba, los pacientes contestaron una encuesta de satisfacción. Resultados: Los pacientes por modelo de sedación fueron: A 24, B 37, C 107, D 62 y E 77. Las puntuaciones de las sensaciones percibidas de recuerdo, dolor, tos, disnea y exploración prolongada (0,65 ± 1,11; 0,3 ± 0,73; 0,46 ± 0,9; 0,29 ± 0,73; 0,59 ± 0,96) fueron menores frente a miedo y nerviosismo antes de la exploración (1,26 ± 1,37 y 1,5 ± 1,41). Los valores elevados de indiferencia ante la repetición (1,49 ± 1,3) y de sensación agradable de la prueba (1,23 ± 1,17), junto con cifras bajas la sensación de angustia (0,49 ± 0,85) e incomodidad de la exploración (0,62 ± 1,1), muestran que los distintos modelos de sedación fueron bien tolerados. El 46,6% de los pacientes no encontraron ningún momento malo y el 89,6% se repetiría la prueba. Los modelos E y C fueron los que menos complicaciones presentaron (12,9 y 31,7%) y, en todos los casos, se resolvieron con medidas terapéuticas sencillas. Conclusiones: Los modelos de sedación analizados fueron bien tolerados y la mayoría aceptarían la repetición de la ecobroncoscopia. Las complicaciones fueron escasas y sencillas de resolver

Introduction: Sedation during endobronchial ultrasound (EBUS) is essential due to the long duration of this procedure. We evaluated different models of sedation and their complications. Method: A multicenter, prospective, observational study of 307 patients undergoing EBUS was conducted. Patients were sedated with: a) midazolam bolus; b) propofol infusion; c) midazolam bolus and propofol infusion; d) propofol infusion and remifentanil infusión, or e)midazolam bolus and fentanyl bolus, and clinical variables were collected. Patients were asked to complete a satisfaction survey following the test. Results: Patients per sedation model were: A 24, B 37, C 107, D 62 and E 77. Scores for perceived sensations of recall, pain, cough, dyspnea and prolonged examination (0.65 ± 1.11; 0 3 ± 0.73, 0.46 ± 0.9, 0.29 ± 0.73, and 0.59 ± 0.96, respectively) were lower compared to fear and nervousness before the examination (1.26 ± 1.37 and 1.5 ± 1.41, respectively). High levels of indifference to repeating the procedure (1.49±1.3) and a reported pleasant feeling during the test (1.23±1.17), with low levels of anxiety (0.49 ± 0.85) and discomfort (0.62 ± 1.1), show that different models of sedation were well tolerated. Almost half the patients (46.6%) did not report any "worst momento" during the procedure, and 89.6% were willing to undergo a repeat test. The E and C models presented fewest complications (12.9 and 31.7%, respectively), and all were resolved with simple therapeutic measures. Conclusions: The models of sedation evaluated were well tolerated and most patients were willing to undergo repeat EBUS. Complications were few and easily resolved

Tolerance and Safety of 5 Models of Sedation During Endobronchial Ultrasound.

INTRODUCTION: Sedation during endobronchial ultrasound (EBUS) is essential due to the long duration of this procedure. We evaluated different models of sedation and their complications. METHOD: A multicenter, prospective, observational study of 307 patients undergoing EBUS was conducted. Patients were sedated with: a) midazolam bolus; b) propofol infusion; c) midazolam bolus and propofol infusion; d) propofol infusion and remifentanil infusión, or e) midazolam bolus and fentanyl bolus, and clinical variables were collected. Patients were asked to complete a satisfaction survey following the test. RESULTS: Patients per sedation model were: A 24, B 37, C 107, D 62 and E 77. Scores for perceived sensations of recall, pain, cough, dyspnea and prolonged examination (0.65±1.11; 0 3±0.73, 0.46±0.9, 0.29±0.73, and 0.59±0.96, respectively) were lower compared to fear and nervousness before the examination (1.26±1.37 and 1.5±1.41, respectively). High levels of indifference to repeating the procedure (1.49±1.3) and a reported pleasant feeling during the test (1.23±1.17), with low levels of anxiety (0.49±0.85) and discomfort (0.62±1.1), show that different models of sedation were well tolerated. Almost half the patients (46.6%) did not report any "worst moment" during the procedure, and 89.6% were willing to undergo a repeat test. The E and C models presented fewest complications (12.9 and 31.7%, respectively), and all were resolved with simple therapeutic measures. CONCLUSIONS: The models of sedation evaluated were well tolerated and most patients were willing to undergo repeat EBUS. Complications were few and easily resolved.

The Fixation Distance to the Stimulus Influences ERP Quality: An EEG and Eye Tracking N400 Study.

In a typical visual Event Related Potential (ERP) study, the stimulus is presented centrally on the screen. Normally an ERP response will be measured provided that the participant directs their gaze towards the stimulus. The aim of this study was to assess how the N400 component of an ERP was affected when the stimulus was presented in the foveal, parafoveal or peripheral vision of the participant's visual field. Utilizing stimuli that have previously produced an N400 response to action incongruities, the same stimuli sequences were presented at 0°, 4°, 8° and 12° of visual angle from a fixation location. In addition to the EEG data, eye tracking data were recorded to act as a fixation control method and to allow for eye artifact detection. The results show a significant N400 effect in the right parieto-temporal electrodes within the 0° visual angle condition. For the other conditions, the N400 effect was reduced (4°) or not present (8° and 12°). Our results suggest that the disappearance of the N400 effect with eccentricity is due to the fixation distance to the stimulus. However, variables like attentional allocation could have also had an impact on the results. This study highlights the importance of presenting a stimulus within the foveal vision of the participant in order to maximize ERP effects related to higher order cognitive processes.

Bronquiolitis obliterante en paciente tratado con D-penicilamina / Obliterating Bronchiolitis in a Patient Treated With D-Penicillamine

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