3-Acetylpyridine-induced ataxic-like motor impairments are associated with plastic changes in the Purkinje cells of the rat cerebellum.

Ataxias are characterized by aberrant movement patterns closely related to cerebellar dysfunction. Purkinje cell axons are the sole outputs from the cerebellar cortex, and dysfunctional activity of Purkinje cells has been associated with ataxic movements. However, the synaptic characteristics of Purkinje cells in cases of ataxia are not yet well understood. The nicotinamide antagonist 3-acethylpyridine (3-AP) selectively destroys inferior olivary nucleus neurons so it is widely used to induce cerebellar ataxia. Five days after 3-AP treatment (65mg/kg) in adult male Sprague-Dawley rats, motor incoordination was revealed through BBB and Rotarod testing. In addition, in Purkinje cells from lobules V-VII of the cerebellar vermis studied by the Golgi method, the density of dendritic spines decreased, especially the thin and mushroom types. Western blot analysis showed a decrease in AMPA and PSD-95 content with an increase of the α-catenin protein, while GAD-67 and synaptophysin were unchanged. Findings suggest a limited capacity of Purkinje cells to acquire and consolidate afferent excitatory inputs and an aberrant, rigid profile in the movement-related output patterns of Purkinje neurons that likely contributes to the motor-related impairments characteristic of cerebellar ataxias.

Ortoqueratología vs ortoqueratología combinada con atropina para el control de miopía en niños: revisión sistemática / Orthokeratology vs. orthokeratology combined with atropine for the control of myopia in children: Systematic review

El propósito de esta investigación es determinar la eficacia de la ortoqueratología (OK) en comparación con la ortoqueratología combinada con atropina (AOK) para el control de la miopía en niños. Se realizó una revisión sistemática que incluyó revisiones sistemáticas con metaanálisis, además de ensayos clínicos aleatorizados y controlados, en las bases de datos PubMed, Web of Science, Scopus, Cochrane Library, ProQuest, Taylor & Francis, Science Direct, y de una búsqueda manual de las revistas Q1-Q4 del Scimago Journal & Country Rank, publicadas en últimos 5 años en idioma inglés y español. Se tomaron en cuenta 18 estudios que cumplieron con los criterios de elegibilidad. Los artículos seleccionados incluyeron 6.866 pacientes para el análisis, en donde se encontró mayor eficacia de la AOK al 0,01% debido a su capacidad de reducir la progresión de miopía y alargamiento axial. En nuestra investigación se determinó que podría existir un efecto aditivo en la combinación de atropina al 0,01% con OK en un periodo de 1 a 2 años de tratamiento en pacientes con miopía leve, sin embargo, se deben realizar más estudios multiétnicos, en donde se considere una correcta evaluación de la progresión de miopía, factores genéticos y ambientales que puedan influir en los resultados (AU)

The purpose of this investigation is to determine the efficacy of orthokeratology (OK) compared to orthokeratology combined with atropine (AOK) for the control of myopia in children. A systematic review that included systematic reviews with meta-analyses, as well as randomized and controlled clinical trials, was carried out in the PubMed, Web of Science, Scopus, Cochrane Library, ProQuest, Taylor & Francis, Science Direct databases, as well as a manual search of the Q1-Q4 journals of the Scimago Journal & Country Rank, published in the last 5 years in English and Spanish. Eighteen studies that met the eligibility criteria were considered. The articles selected included 6866 patients for analysis, where orthokeratology combined with 0.01% atropine was found to be more effective due to its ability to reduce the progression of myopia and axial elongation. In our investigation, it was determined that there could be an additive effect in the combination of 0.01% atropine with orthokeratology in a period of 1–2 years of treatment in patients with mild myopia; however, more multiethnic studies should be carried out, in where a correct evaluation of the progression of myopia, genetic and environmental factors that may influence the results is considered (AU)

Equity, Diversity and Inclusion (EDI) in Organ Transplantation: An ESOT Survey About EDI Within ESOT as an Organization and its Educational Activities, and Transplantation Research and Science.

The European Society of Organ Transplantation (ESOT) strives to promote equity, diversity, and inclusion (EDI) across all its activities. We surveyed the transplant community's experiences and perspectives regarding EDI within ESOT as an organization and its educational activities, and research in general. A total of 299 respondents completed the questionnaire. About half agreed that ESOT's Executive Committee, Council, and Sections/Committees are diverse and inclusive (51%) and that ESOT promotes EDI in its live and digital educational activities (54%). Forty percent of respondents agreed that scientific and clinical trials in the field of transplantation are diverse and inclusive. Despite the wide distribution of the survey, most of the respondents self-identified as White and were either physician or surgeon. However, the results contribute a unique insight into the experiences and perspectives of the transplantation community regarding EDI. Whilst ESOT is committed to the principles of EDI, perceptions and the high number of proposals show the apparent need to prioritize efforts to embed EDI across ESOT and transplantation science. These data should constitute a starting point for change and provide guidance for future efforts to promote EDI within the transplantation community.

Orthokeratology vs. orthokeratology combined with atropine for the control of myopia in children: systematic review.

The purpose of this investigation is to determine the efficacy of orthokeratology (OK) compared to orthokeratology combined with atropine (AOK) for the control of myopia in children. A systematic review that included systematic reviews with meta-analyses, as well as randomized and controlled clinical trials, was carried out in the PubMed, Web of Science, Scopus, Cochrane Library, ProQuest, Taylor & Francis, Science Direct databases, as well as a manual search. Of the Q1-Q4 journals of the Scimago Journal & Country Rank, published in the last 5 years in English and Spanish. Eighteen studies that met the eligibility criteria were considered. The articles selected included 6,866 patients for analysis, where orthokeratology combined with 0.01% atropine was found to be more effective due to its ability to reduce the progression of myopia and axial elongation. In our investigation, it was determined that there could be an additive effect in the combination of 0.01% atropine with orthokeratology in a period of 1-2 years of treatment in patients with mild myopia; however, more multiethnic studies should be carried out, in where a correct evaluation of the progression of myopia, genetic and environmental factors that may influence the results is considered.

Tratamiento farmacológico para sedación consciente en la consulta dental: revisión sistemática / Pharmacological treatment for conscious sedation in the dental office: systematic review

Introducción: La sedación consciente es una técnica no solo aplicada para pacientes pediátricos sino también para adultos y esto es determinado por fobia, ansiedad, discapacidad, estrés por la consulta odontológica y los diferentes tratamientos dentales. Material y métodos: Se utilizaron diversas bases de datos como los son PubMed, Scopus, Cochrane, para incluir la totalidad de investigaciones clínicas que se publicaron en el área de mala conducta en consulta dental y el tratamiento mediante sedación consciente con sus diferentes fármacos aplicados. Resultados: En referencia de los diferentes artículos obtenidos en la búsqueda sistemática referida a estudios clínicos, experimentales, enfocados a sedación consciente en la consulta odontológica, y mediante la revisión de artículos se ha obtenido diez artículos en los cuales se utilizaron diferentes fármacos para realizar la sedación consciente. Conclusiones: La vía de administración medicamentosa más aceptada para realizar la sedación consciente es la vía oral, existen un sin número de combinaciones farmacológicas para poder realizar la misma. (AU)

Introduction: Conscious sedation is a technique not only applied to pediatric patients but also to adults and thisis determined by phobia, anxiety, disability, stress due to dental consultation and different dental treatments. Material and methods: Various data bases were used, such as PubMed, Scopus, Cochrane, to include all the clinical investigations that were published in the area of misconduct in dental practice and treatment by conscious sedation with its different drugs applied. Results: In reference to the different articles obtained in the systematic search referred to clinical, experimental studies, focused on conscious sedation in the dental consultation, and through the review of articles, ten articles have been obtained in which different drugs were used to perform conscious sedation. Conclusions: The most accepted route of drug administration to carry out conscious sedation is the oral route, there are a number of pharmacological combinations to be able to carry it out. (AU

Early Childhood Predictors for Dental Caries: A Machine Learning Approach.

We aimed to develop and validate caries prognosis models in primary and permanent teeth after 2 and 10 y of follow-up through a machine learning (ML) approach, using predictors collected in early childhood. Data from a 10-y prospective cohort study conducted in southern Brazil were analyzed. Children aged 1 to 5 y were first examined in 2010 and reassessed in 2012 and 2020 regarding caries development. Dental caries was assessed using the Caries Detection and Assessment System (ICDAS) criteria. Demographic, socioeconomic, psychosocial, behavioral, and clinical factors were collected. ML algorithms decision tree, random forest, and extreme gradient boosting (XGBoost) were employed, along with logistic regression. The discrimination and calibration of models were verified in independent sets. From 639 children included at the baseline, we reassessed 467 (73.3%) and 428 (66.9%) children in 2012 and 2020, respectively. For all models, the area under receiver operating characteristic curve (AUC) at training and testing was above 0.70 for predicting caries in primary teeth after 2-y follow-up, with caries severity at the baseline being the strongest predictor. After 10 y, the SHAP algorithm based on XGBoost achieved an AUC higher than 0.70 in the testing set and indicated caries experience, nonuse of fluoridated toothpaste, parent education, higher frequency of sugar consumption, low frequency of visits to the relatives, and poor parents' perception of their children's oral health as top predictors for caries in permanent teeth. In conclusion, the implementation of ML shows potential for determining caries development in both primary and permanent teeth using easy-to-collect predictors in early childhood.

Effect of three feeding levels on the pathogenesis and establishment of Haemonchus contortus in parasite-naïve Pelibuey hair sheep lambs during their first infection.

This study evaluated the effect of three feeding levels on the pathogenesis and establishment of H. contortus upon the first infection of parasite-naïve Pelibuey hair sheep lambs. Forty-two 6-month-old hair sheep lambs (24 ± 4 kg) raised parasite free from birth were used. The lambs were assigned to 3 groups (n = 14), and each was fed a diet designed for different daily weight gain (DWG): 75 g/d (Diet 1), 125 g/d (Diet 2) and 200 g/d (Diet 3). After four weeks of diet adaptation, 10 lambs/group were infected with 450 L3H. contortus/kg BW (infected), and 4 lambs/group were kept parasite-free (NInf). DWG, hematocrit (Ht), hemoglobin (Hb), peripheral eosinophils (EOS), IgG concentration against H. contortus, and eggs per gram (EPG) of feces were measured in each lamb from day 14 before infection until day 29 postinfection (PI). On day 29 PI, the lambs were slaughtered to determine the total number of adult parasites (TAW), the length of the female worms, and the number of eggs in utero (EIU). Each group reached the expected DWG (P = 0.001), and there was no effect of infection or the diet × infection interaction. Ht was lower in infected lambs than in NInf lambs, and this difference was significant for animals on Diets 1 and 2 (P = 0.044). From day 14 PI onward, Hb was lower in the infected lambs than in the NInf lambs (P = 0.001). Furthermore, compared with NInf lambs, the infected lambs had higher EOS from day 7 PI and higher IgG from day 14 PI. Neither EOS nor IgG were affected by diet. Lambs on Diet 3 had lower EPG during patency than those fed Diets 1 or 2 (days 25 and 28 PI; P = 0.002). Furthermore, lambs fed Diet 3 had lower TAW (Diet 1 vs 3 P = 0.037; Diet 2 vs 3 P = 0.049) and EIU (P = 0.004) than lambs fed Diet 1 or 2. Lambs were resilient to infection regardless of diet. Although EOS and IgG were higher in all infected animals than in Ninf animals, EPG, TAW and EIU decreased only in lambs fed Diet 3. Thus, a diet targeting a DWG of 200 g/d can significantly limit the establishment of H. contortus in Pelibuey lambs infected for the first time.

Dientes supernumerarios: reporte de un caso / Supernumerary teeth: report of a case

Los dientes supernumerarios son unidades dentales que numéricamente exceden la cantidad de dientes normal, un fenómeno también conocida como hiperdontia, los dientes supernumerarios más comunes son mesiodens, que ocurren entre los incisivos centrales. El presente artículo tiene como objetivo describir un reporte de caso de una paciente de género femenino, de 21 años de edad, que presenta 13 dientes incluidos, de los cuales 6 son supernumerarios, los mismos que fueron extraídos en dos tiempos quirúrgicos. (AU)

Supernumerary teeth are dental units that numerically exceed the normal number of teeth, a phenomenon also known as hiperdontia. The most common supernumerary teeth are mesiodens, which occur between the central incisors. This article aims to describe a case report of a female patient, 21 yearsold, who has 13 included teeth, of which 6 are supernumerary, thesameones that were extracted in two surgical times. (AU)

Impact of Dietary Condensed Tannins and Haemonchus contortus Infection in Growing Sheep: Effects on Nutrient Intake, Digestibility, and the Retention of Energy and Nitrogen.

PURPOSE: A controlled study evaluated the effect of condensed tannins (CT) from Gymnopodium floribundum leaf meal (GF), infection with Haemonchus contortus (I) and their interaction, on feed intake, diet digestibility and retention of N (NR) and energy (ER) in hair sheep lambs. METHODS: Thirty-six, worm-free hair sheep lambs (14.9 ± 1.56 kg body weight) were housed in metabolic cages. Eighteen animals were infected with 6000 H. contortus L3, while other 18 lambs were kept non-infected. On day 28th post-infection (PI), infected lambs were assigned to three diet groups: a diet without GF (I-NONGF), a diet with GF (I + GF) and a diet with GF + polyethylene glycol (PEG) (I + GF + PEG). Non-infected (NI) lambs were assigned to similar diet groups: NI-NONGF, NI + GF and NI + GF + PEG. The packed cell volume (% PCV), ante-mortem faecal egg counts and post-mortem worm burdens were also evaluated. RESULTS: Infection did not affect digestibility, NR and ER. Meanwhile, CT intake from the GF diet reduced the digestibility of dry matter, organic matter and crude protein, as well as NR, compared to lambs consuming the NONGF and GF + PEG diets (P < 0.05). Although, the digestible energy was similar between lambs consuming NONGF and GF + PEG diets, the ER was higher for lambs consuming the control NONGF diet. Diets did not affect the PCV, or the ante-mortem and post-mortem parasitological variables. CONCLUSION: The costs on N and energy metabolism were mainly associated with the CT content of the GF diet, but other features of the diet such as the high lignin content, seemed to affect animals consuming GF meal. Meanwhile, the H. contortus infection had a non-significant impact.

Association of leptin receptor expression in placenta and peripheral blood mononuclear cell with maternal weight in birth outcomes.

INTRODUCTION: The pregnancy period represents the most intense period of growth and development. Pre-pregnancy weight influences weight gain during pregnancy. Leptin is a hormone mainly derived from white adipose tissue, during pregnancy leptin is also produced by the placenta. It has been suggested that the effects of placental leptin on the mother may contribute to endocrine-mediated alterations in energy balance; a dysregulation in leptin levels or its receptors may lead to poor birth outcomes. Therefore, the main goal of the present study was to analyze the differences in birth outcomes by maternal weight with the expression level of leptin receptor in maternal peripheral blood mononuclear cell (PBMC) and placental tissue. METHODS: Women with full-term gestation and its offspring were enrolled. Total RNA from maternal PBMC and placenta was obtained to perform the analysis of expression of the leptin receptor (LEPR) gene trough real-time PCR technique. Data were analyzed using one-way ANOVA or Mann-Whitney u test when applicable. Pearson correlation coefficient was used to determine the relationship between continuous variables (Stata v.13); p ≤ 0.05 was considered statistically significant. RESULTS: No statistically significant differences were found between LEPR expression level and the BMI studied groups in maternal PBMC and placental tissue. Interaction between gestational weight gain (GWG) and LEPR in maternal PBMC explain in a 32% the variability of the newborn weight. CONCLUSIONS: LEPR expression level in maternal PBMC correlates with newborn measurements independent from sex. GWG can affect fetal development by increasing fetal birth weight.

Local negative permittivity and topological phase transition in polar skyrmions.

Topological solitons such as magnetic skyrmions have drawn attention as stable quasi-particle-like objects. The recent discovery of polar vortices and skyrmions in ferroelectric oxide superlattices has opened up new vistas to explore topology, emergent phenomena and approaches for manipulating such features with electric fields. Using macroscopic dielectric measurements, coupled with direct scanning convergent beam electron diffraction imaging on the atomic scale, theoretical phase-field simulations and second-principles calculations, we demonstrate that polar skyrmions in (PbTiO3)n/(SrTiO3)n superlattices are distinguished by a sheath of negative permittivity at the periphery of each skyrmion. This enhances the effective dielectric permittivity compared with the individual SrTiO3 and PbTiO3 layers. Moreover, the response of these topologically protected structures to electric field and temperature shows a reversible phase transition from the skyrmion state to a trivial uniform ferroelectric state, accompanied by large tunability of the dielectric permittivity. Pulsed switching measurements show a time-dependent evolution and recovery of the skyrmion state (and macroscopic dielectric response). The interrelationship between topological and dielectric properties presents an opportunity to simultaneously manipulate both by a single, and easily controlled, stimulus, the applied electric field.

Sedación consciente, inhalatoria y farmacológica, su efectividad en la reconducción de la conducta del paciente pediátrico en la consulta dental: estudio observacional de corte transversal / Conscious inhalation and pharmacological sedation, its effectiveness in the reconduction of the behavior of the pediatric patient in the dental office: cross-sectional observational study

OBJETIVO: El objetivo del estudio fue evaluar si la sedación consciente reconduce o no la conducta del paciente pediátrico, en la consulta dental. METODOLOGÍA: La muestra del estudio clínico se obtuvo de sesenta y cinco pacientes que no permiten el tratamiento dental en la consulta odontológica,con edades comprendidas entre los 4 y 9 nueve años de edad. RESULTADOS: De los 65 pacientes que representa el 100% de la muestra, se obtuvo que el 86,15% pudo reconducir la conducta después de la sedación consciente. Sin embargo, en el 13,85% el comportamiento después de la sedación consciente no se pudo reconducir. CONCLUSIÓN: La sedación conscientepuede ayudar a reducir la fobia, estrés que los pacientes pediátricos presentes en la consulta dental. Asimismo, nos permiten llevar a cabo el tratamiento previsto, además de ayudar a reconducir la conducta del paciente

INTRODUCTION: The objective of the study was to evaluate whether conscious sedation redirected or not the behavior of the pediatric patient, in the dental office. MATERIALS AND METHODS: The clinical study sample was obtained from sixty-five patients who do not allow treatment in the dental office, aged between 4 and 9 years. RESULTS: Of the 65 patients representing 100% of the sample, it was obtained that 86.15% was able to redirect the behavior after conscious sedation. However, in 13.85% the behavior after conscious sedation could not be redirected. CONCLUSION: Conscious sedation can help reduce phobia, stress that pediatric patients present in the dental office. They also allow us to carry out the planned treatment, in addition to helping to redirect the patient's behavior

Infección por SARS-CoV-2 y enfermedad por coronavirus-2019 en pediatría / SARS-CoV-2 infection and corona virus disease 2019 in pediatrics

Resumen La infección por SARS-CoV-2 (y la enfermedad causada por este virus: COVID-19), es de menor frecuencia y gravedad en pediatría. La naturaleza de esto sigue siendo motivo de análisis. No obstante, los niños tienen la potencialidad de infectarse, enfermarse y de transmitir la infección a otras personas. Este artículo revisa lo conocido hasta el momento acerca de epidemiología, etiopatogenia, cuadro clínico, diagnóstico y tratamiento de COVID-19 en niños.

SARS-CoV-2 infection (and the disease it causes: COVID-19), is less frequent and milder in the pediatric population. The reasons behind this milder clinical expression are under investigation. Nevertheless, children are still susceptible to be infected, to develop symptoms and disease, and to transmit the virus. In this article, we review the information about COVID-19 in children, including epidemiology, etiopathogenesis, diagnostic approach, clinical outcomes and treatment.

[Recommendations of the Working Groups from the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) for the management of adult critically ill patients in the coronavirus disease (COVID-19)]. / Recomendaciones de «hacer¼ y «no hacer¼ en el tratamiento de los pacientes críticos ante la pandemia por coronavirus causante de COVID-19 de los Grupos de Trabajo de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC).

On March 11, 2020, the Director-General of the World Health Organization (WHO) declared the disease caused by SARS-CoV-2 (COVID-19) as a pandemic. The spread and evolution of the pandemic is overwhelming the healthcare systems of dozens of countries and has led to a myriad of opinion papers, contingency plans, case series and emerging trials. Covering all this literature is complex. Briefly and synthetically, in line with the previous recommendations of the Working Groups, the Spanish Society of Intensive, Critical Medicine and Coronary Units (SEMICYUC) has prepared this series of basic recommendations for patient care in the context of the pandemic.

Outcomes of an enhanced recovery after radical cystectomy program in a prospective multicenter study: compliance and key components for success.

OBJECTIVE: To investigate the effect of an Enhanced Recovery After Surgery (ERAS) program on complications and length of stay (LOS) after radical cystectomy (RC) and to assess if the number and type of components of ERAS play a key role on the decrease of surgical morbidity. MATERIALS AND METHODS: We analyzed the data of 277 patients prospectively recruited in 11 hospitals undergoing RC initially managed according to local practice (Group I) and later within an ERAS program (Group II). Two main outcomes were defined: 90-day complications rate and LOS. As secondary variables we studied 90-day mortality, 30-day readmission and transfusion rate. RESULTS: Patients in Group II had a higher use of ERAS measures (98.6%) than those in Group I (78.2%) (p < 0.05). Patients in Groups I and II experienced similar complications (70.5% vs. 66%, p = 0.42). LOS was not different between Groups I and II (12.5 and 14 days, respectively, p = 0.59). The risk of having any complication decreases for patients having more than 15 ERAS measures adopted [RR = 0.815; 95% confidence interval (CI) 0.667-0.996; p = 0.045]. Avoidance of transfusion and nasogastric tube, prevention of ileus, early ambulation and a fast uptake of a regular diet are independently associated with the absence of complications. CONCLUSIONS: Complications and LOS after RC were not modified by the introduction of an ERAS program. We hypothesize that at least 15 measures should be applied to maximize the benefit of ERAS.

Optimized germinated soybean/cornstarch extrudate and its in vitro fermentation with human inoculum.

The aim of this work was to optimise a soybean/cornstarch extrudate by adjusting a central composite design and to maximise a product with a high protein and resistant starch (RS) content by evaluating the indigestible fractions through in vitro colonic fermentation and production of short-chain fatty acids (SCFAs) with potential health benefits. According to the response surface analysis and RS maximisation results, an optimisation of the independent variables was obtained as follows: 32.5% feed moisture, 144 °C extrusion temperature and a proportion of 44% germinated soybean flour and 56% cornstarch. A product with a 2.11% expansion index, 6.25 N hardness, a glycaemic index of 49 and 12% resistant starch was obtained. The optimised extrudate showed a 36% indigestible fraction and high fermentability with respect to that of the lactulose control. Furthermore, the decrease in pH was inversely proportional to the production of SCFAs and the volume of gas generated. Acetic, propionic, and butyric acids were produced at a molar ratio of 62:27:11, while the highest SCFA concentrations were found 48 h after incubation. The RS of the optimised extruder was a viable substrate for in vitro colonic fermentation, suggesting that it is a good food source to produce SCFAs, which could exert an effect on the regulation of lipid and glucose metabolism.

Influence of germination time on the morphological, morphometric, structural, and physicochemical characteristics of Esmeralda and Perla barley starch.

The aim of this study was to analyzing the impact of germination time on the morphology, crystallinity, gelatinization and viscosity properties on the starch of Esmeralda and Perla barley variety. The two barley were germinated for 1 to 8 days, at 26 °C and 65% relative humidity. Micrographs showed the presence of pinholes and eroded surfaces. Starch in Esmeralda was hydrolyzed completely at 8 days of germination. Birefringence was reduced from day 4, losing molecular structuring of the crystalline area. Morphometric data: fractal dimension, area, perimeter, circularity, and roundness decreased significantly along germination time in both varieties. The entropy increased significantly, from 0.79 to 10.09 in Esmeralda and from 0.46 to 7.57 in Perla. Relative crystallinity decreased significantly in the Perla from 24.7% to 23.6%. Viscosity peaks were also significantly reduced, pasting temperature was constant in Esmeralda but in Perla was significantly reduced from 95.43 to 95.19 °C with germination, the gelatinization temperature increased significantly in the Esmeralda while in Perla it remained constant. Enthalpy decreased significantly to 75.8% and 37% in Esmeralda and Perla respectively. The study of germination impact on structural and physicochemical properties is important to identify the use of hydrolyzed starches in the food industry or others.

Observation of room-temperature polar skyrmions.

Complex topological configurations are fertile ground for exploring emergent phenomena and exotic phases in condensed-matter physics. For example, the recent discovery of polarization vortices and their associated complex-phase coexistence and response under applied electric fields in superlattices of (PbTiO3)n/(SrTiO3)n suggests the presence of a complex, multi-dimensional system capable of interesting physical responses, such as chirality, negative capacitance and large piezo-electric responses1-3. Here, by varying epitaxial constraints, we discover room-temperature polar-skyrmion bubbles in a lead titanate layer confined by strontium titanate layers, which are imaged by atomic-resolution scanning transmission electron microscopy. Phase-field modelling and second-principles calculations reveal that the polar-skyrmion bubbles have a skyrmion number of +1, and resonant soft-X-ray diffraction experiments show circular dichroism, confirming chirality. Such nanometre-scale polar-skyrmion bubbles are the electric analogues of magnetic skyrmions, and could contribute to the advancement of ferroelectrics towards functionalities incorporating emergent chirality and electrically controllable negative capacitance.