Incidência de sífilis no estado do Rio de Janeiro e nomunicípio de Seropédica nos anos de 2010 a 2022 / Incidence of syphilis in the state of Rio de Janeiro andmunicipality of Seropédica in the years 2010 to 2022

Sífilis é uma infecção sexualmente transmissível (IST) que sinaliza a necessidade de efetivas políticas públicas devido ao aumento de casos na última década. Dessa forma, o objetivo do trabalho é descrever a incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica. Métodos: foi realizado um estudo descritivo, com abordagem quantitativa. A coleta dos dados foi realizada por meio do Sistema de Informação de Agravos de Notificação (Sinan), referentes ao município de Seropédica e ao estado do Rio de Janeiro, no período de 2010 a 2022. Resultados: foram identificados 105.138, 79.609 e 42.819 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no estado do Rio de Janeiro e 187, 140 e 79 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no município de Seropédica. Foi observado uma incidência maior para sífilis adquirida entre homens em comparação com mulheres tanto no estado do Rio de Janeiro (62.719 versus 42.346) quanto no município de Seropédica (110 versus 77). Houve um aumento nas taxas de incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica ao longo dos anos. Conclusão: a sífilis segue sendo uma doença com alta incidência no território do Rio de Janeiro. Nesse sentido, é importante elaborar estratégias em saúde pública mais efetivas às pessoas acometidas por tal infecção.

Syphilis is a sexually transmitted infection (STI) that signals the need for effective public policies due to the increase in cases in the last decade. Thus, the aim of this study is to describe the incidence of syphilis in the state of Rio de Janeiro and in the municipality of Seropédica. Methods: a descriptive study with a quantitative approach was carried out. Data collection was performed through the Sistema de Informação de Agravos de Notificação (Sinan), referring to the municipality of Seropédica and the state of Rio de Janeiro, from 2010 to 2022. Results: overall, 105.138, 79.609 and 42.819 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the state of Rio de Janeiro, and 187, 140, and 79 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the municipality of Seropédica. A higher incidence of acquired syphilis was observed among men compared to women both in the state of Rio de Janeiro (62.719 versus 42.346) and in the municipality of Seropédica (110 versus 77). There has been an increase in the incidence rates of syphilis in the state of Rio de Janeiro and the municipality of Seropédica over the years. Conclusion: syphilis continues to be a disease with a high incidence in the territory of Rio de Janeiro. In this sense, it is important to develop more effective public health strategies for people affected by this infection.

Epinephrine and norepinephrine regulate the expression of virulence factors in Gallibacterium anatis.

Gallibacterium anatis is a member of the Pasteurellaceae family and is an opportunistic pathogen that causes gallibacteriosis in chickens. Stress plays a relevant role in promoting the development of pathogenicity in G. anatis. Epinephrine (E) and norepinephrine (NE) are relevant to stress; however, their effects on G. anatis have not been elucidated. In this work, we evaluated the effects of E and NE on the growth, biofilm formation, expression of adhesins, and proteases of two G. anatis strains, namely, the hemolytic 12656-12 and the nonhemolytic F149T biovars. E (10 µM/mL) and NE (30 and 50 µM/mL) increased the growth of G. anatis 12656-12 by 20 % and 25 %, respectively. E did not affect the growth of F149T, whereas 40 µM/mL NE decreased bacterial growth by 25 %. E and NE at a dose of 30-50 µM/mL upregulated five fibrinogen adhesins in the 12565-12 strain, whereas no effect was observed in the F149T strain. NE increased proteolytic activity in both strains, whereas E diminished proteolytic activity in the 12656-12 strain. E and NE reduced biofilm formation (30 %) and increased Congo red binding (15 %) in both strains. QseBC is the E and NE two-component detection system most common in bacteria. The qseC gene, which is the E and NE receptor in bacteria, was identified in the genomic DNA of the 12565-12 and F149TG. anatis strains via PCR amplification. Our results suggest that QseC can detect host changes in E and NE concentrations and that catecholamines can modulate the expression of several virulence factors in G. anatis.

Interim Effectiveness Estimates of 2024 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Hospitalization - REVELAC-i Network, Five South American Countries, March-July 2024.

To reduce influenza-associated morbidity and mortality, countries in South America recommend annual influenza vaccination for persons at high risk for severe influenza illness, including young children, persons with preexisting health conditions, and older adults. Interim estimates of influenza vaccine effectiveness (VE) from Southern Hemisphere countries can provide early information about the protective effects of vaccination and help guide Northern Hemisphere countries in advance of their season. Using data from a multicountry network, investigators estimated interim VE against influenza-associated severe acute respiratory illness (SARI) hospitalization using a test-negative case-control design. During March 13-July 19, 2024, Argentina, Brazil, Chile, Paraguay, and Uruguay identified 11,751 influenza-associated SARI cases; on average, 21.3% of patients were vaccinated against influenza, and the adjusted VE against hospitalization was 34.5%. The adjusted VE against the predominating subtype A(H3N2) was 36.5% and against A(H1N1)pdm09 was 37.1%. These interim VE estimates suggest that although the proportion of hospitalized patients who were vaccinated was modest, vaccination with the Southern Hemisphere influenza vaccine significantly lowered the risk for hospitalization. Northern Hemisphere countries should, therefore, anticipate the need for robust influenza vaccination campaigns and early antiviral treatment to achieve optimal protection against influenza-associated complications.

Gut Microbiota Disruption in Hematologic Cancer Therapy: Molecular Insights and Implications for Treatment Efficacy.

Hematologic malignancies (HMs), including leukemia, lymphoma, and multiple myeloma, involve the uncontrolled proliferation of abnormal blood cells, posing significant clinical challenges due to their heterogeneity and varied treatment responses. Despite recent advancements in therapies that have improved survival rates, particularly in chronic lymphocytic leukemia and acute lymphoblastic leukemia, treatments like chemotherapy and stem cell transplantation often disrupt gut microbiota, which can negatively impact treatment outcomes and increase infection risks. This review explores the complex, bidirectional interactions between gut microbiota and cancer treatments in patients with HMs. Gut microbiota can influence drug metabolism through mechanisms such as the production of enzymes like bacterial ß-glucuronidases, which can alter drug efficacy and toxicity. Moreover, microbial metabolites like short-chain fatty acids can modulate the host immune response, enhancing treatment effectiveness. However, therapy often reduces the diversity of beneficial bacteria, such as Bifidobacterium and Faecalibacterium, while increasing pathogenic bacteria like Enterococcus and Escherichia coli. These findings highlight the critical need to preserve microbiota diversity during treatment. Future research should focus on personalized microbiome-based therapies, including probiotics, prebiotics, and fecal microbiota transplantation, to improve outcomes and quality of life for patients with hematologic malignancies.

Unveiling inflammatory biomarkers in multibacillary leprosy: the role of lymphocyte-platelet ratio in predicting leprosy reactions.

Leprosy is a neglected contagious disease that causes physical disability and episodes of inflammation, called leprosy reactions. There are currently no consolidated laboratory markers that can predict or confirm the diagnosis of leprosy reactions, negatively impacting the progression of the disease. The aim of this study was to analyze the behavior of inflammatory biomarkers in a population of patients with multibacillary leprosy. This prospective study in a northeastern capital involved 67 new cases of multibacillary leprosy, assessing inflammatory biomarkers at diagnosis. Histopathology, qPCR, slit skin smear microscopy, and laboratory tests, including CRP-albumin, neutrophil-lymphocyte, lymphocyte-monocyte, platelet-lymphocyte ratios, and systemic immune-inflammation index, were conducted. Statistical analysis utilized Stata version 16.0®, employing Chi-square, Kruskal-Wallis, and Poisson regression (5% significance). The population, mainly young brown men with low socioeconomic status, borderline leprosy, and and degree of physical disability one, saw 19.4% experiencing leprosy reactions. Standard multibacillary multidrug therapy was administered to all. Ratios and index values exceeding medians were prevalent (46.3-47.8%). Assessing biological markers against leprosy reactions revealed a positive relation between reactions and lymphocyte-platelet ratio (p = 0.05) and a positive trend with the systemic immune-inflammation index (p = 0.06). Patients with reactions were 1.3 times more likely to exhibit an elevated lymphocyte-platelet ratio. The lymphocyte-platelet ratio emerged as a potential indicator for recognizing leprosy reactions. Further research is essential to validate these findings, aiming for earlier detection of leprosy reactions.

Composite endpoints in COVID-19 randomized controlled trials: a systematic review.

BACKGROUND/AIMS: This study aimed to determine the prevalence of ordinal, binary, and numerical composite endpoints among coronavirus disease 2019 trials and the potential bias attributable to their use. METHODS: We systematically reviewed the Cochrane COVID-19 Study Register to assess the prevalence, characteristics, and bias associated with using composite endpoints in coronavirus disease 2019 randomized clinical trials. We compared the effect measure (relative risk) of composite outcomes and that of its most critical component (i.e. death) by estimating the Bias Attributable to Composite Outcomes index [ln(relative risk for the composite outcome)/ln(relative risk for death)]. RESULTS: Composite endpoints accounted for 152 out of 417 primary endpoints in coronavirus disease 2019 randomized trials, being more frequent among studies published in high-impact journals. Ordinal endpoints were the most common (54% of all composites), followed by binary or time-to-event (34%), numerical (11%), and hierarchical (1%). Composites predominated among trials enrolling patients with severe disease when compared to trials with a mild or moderate case mix (odds ratio = 1.72). Adaptations of the seven-point World Health Organization scale occurred in 40% of the ordinal primary endpoints, which frequently underwent dichotomization for the statistical analyses. Mortality accounted for a median of 24% (interquartile range: 6%-48%) of all events when included in the composite. The median point estimate of the Bias Attributable to Composite Outcomes index was 0.3 (interquartile range: -0.1 to 0.7), being significantly lower than 1 in 5 of 24 comparisons. DISCUSSION: Composite endpoints were used in a significant proportion of coronavirus disease 2019 trials, especially those involving severely ill patients. This is likely due to the higher anticipated rates of competing events, such as death, in such studies. Ordinal composites were common but often not fully appreciated, reducing the potential gains in information and statistical efficiency. For studies with binary composites, death was the most frequent component, and, unexpectedly, composite outcome estimates were often closer to the null when compared to those for mortality death. Numerical composites were less common, and only two trials used hierarchical endpoints. These newer approaches may offer advantages over traditional binary and ordinal composites; however, their potential benefits warrant further scrutiny. CONCLUSION: Composite endpoints accounted for more than a third of coronavirus disease 2019 trials' primary endpoints; their use was more common among studies that included patients with severe disease and their point effect estimates tended to underestimate those for mortality.

A new neuropsychological tool for simultaneous reading and executive functions assessment: initial psychometric properties.

Introduction: The development of reading and complex executive functions is fundamental for achieving social, academic, and professional success. So far, there is no single neuropsychological instrument that comprehensively assesses the domains of inhibitory control, cognitive flexibility, working memory, and reading comprehension. To assess executive functions related to reading, the "Assessment of Reading and Executive Functions" (AREF) was developed. In this study, we show initial evidence of validity and reliability for four subtests - Graphophonological-Semantic Flexibility, Inhibitory Control, Flexibility, and Working Memory. Methods: A total of 93 students from 4th to 9th grade, aged 8-14, in public (n = 61) and private (n = 32) schools were evaluated. Tasks from the AREF instrument, as well as measures of reading comprehension, inhibitory control, cognitive flexibility, working memory, and intelligence, were administered. Correlations between AREF scores and the other measures were performed to assess external construct validity. Performance differences between school groups on AREF subtests were analyzed using ANOVA, t-test, and Mann-Whitney tests, and the internal consistency of the instrument's tasks was evaluated using Cronbach's alpha coefficient. Results: The scores of the AREF subtests demonstrated significant positive correlations with reading measures (ranging from 0.339 to 0.367) and executive functions (ranging from 0.209 to 0.396). Significant differences were found in the performance of some AREF tasks when comparing individuals from public and private schools, as well as between 4th and 5th graders compared to students in higher grades. The internal consistency of the tasks was low for Graphophonological-Semantic Flexibility (Cronbach's α = 0.566), moderate for Inhibitory Control and Flexibility (Cronbach's α = 0.768), and high for Working Memory (Cronbach's α = 0.881). Discussion: The results provide initial evidence of construct validity and reliability for the AREF subtests. It is expected that this new neuropsychological test will contribute to the assessment of reading skills and executive functions, assisting in guiding clinical and educational interventions for individuals with and without neurodevelopmental disorders.

Virtual simulation for teaching cardiology in nursing: a scoping review protocol.

INTRODUCTION: Virtual simulation (VS) can be an effective learning strategy in the context of nursing education on cardiovascular disease; however, its use in teaching cardiology in nursing is less studied. The objective of this scoping review is to map the use of VS for teaching cardiology in nursing. METHODS AND ANALYSIS: This scoping review will be conducted according to the Joanna Briggs Institute methods, and the results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Eight databases will be searched: MEDLINE (NCBI/PubMed), Cumulative Index to Nursing and Allied Health Literature, Web of Science, Latin American and Caribbean Literature in Health Sciences, Spanish Bibliographic Index of Health Sciences, Database of Nursing, EMBASE and Google Scholar from inception to 31 July 2024. This study will include any existing peer-reviewed literature and grey literature. There will be no time or language restrictions. Two reviewers will screen and select the articles independently, and when there are differences, they will be resolved with a third opinion. When appropriate, broad themes and categories derived from the review questions will be accompanied by other illustrative formats (eg, tables or graphs, word clouds and infographics). ETHICS AND DISSEMINATION: This research project does not require ethical committee approval. The study is part of a cooperative research project between researchers from the Federal University of Piauí, Northeast of Brazil, and Queen's University, Ontario, Canada, to develop and seek evidence of content validity of a VS game about valvular heart disease. The protocol and review will be published in peer-reviewed journals. REGISTRATION DETAILS: Open Science Framework (https://doi.org/10.17605/OSF.IO/S3UMH).

BvgR is important for virulence-related phenotypes in Bordetella bronchiseptica.

Bordetella bronchiseptica is a pathogenic bacterium that causes respiratory infections in mammals. Adhesins, toxins, and secretion systems necessary for infection are regulated by the two-component system BvgAS. When the BvgAS system is inactive, there is no transcription of virulence-activated genes, and virulence-repressed genes (vrg) are expressed. The regulation of some vrgs in B. bronchiseptica is dependent upon the virulence-activated gene bvgR. Although having a regulatory role, no DNA-binding domain is described for BvgR. Instead, it contains an EAL domain, usually found in cyclic-di-GMP (c-di-GMP)-specific phosphodiesterases. c-di-GMP is a bacterial second messenger that regulates multiple phenotypes in bacteria, including B. bronchiseptica. The current study aimed to deepen our knowledge about BvgR. We employed RNA-seq analysis to define the BvgR regulon, and then we investigated the phenotypes in which BvgR regulation might be involved such as biofilm formation, cytotoxicity, and virulence. Our result revealed that BvgR inhibits biofilm formation and flagellin expression in virulent phase. Although BvgR has long been considered a repressor protein, our results show that it also upregulates almost 100 genes. This regulation is likely indirect, as BvgR lacks a DNA-binding domain. Notably, among the upregulated genes, we identified 15 associated with the type three secretion system. Consistent with these findings, a B. bronchiseptica strain deficient in bvgR was less cytotoxic than the wild-type strain, elicited a milder immune response, and was less able to persist in the lower respiratory tract of mice.IMPORTANCEBordetella bronchiseptica is a harmful bacterium responsible for respiratory infections in mammals. Its ability to cause disease is tightly regulated by a system called BvgAS. In this study, we focused on understanding the role of a specific gene called bvgR in regulating B. bronchiseptica's virulence factors. Our findings revealed that BvgR, previously thought to primarily repress gene expression, actually plays a complex role in both activating and inhibiting various genes involved in bacterial virulence. This newfound understanding sheds light on the intricate mechanisms underlying B. bronchiseptica's ability to cause infections, providing valuable insights for developing strategies to combat these infections in humans and animals.

Physical exercise in Chilean breast cancer survivors: Qualitative study of barriers, facilitators and preferences. / Actividad física en chilenas sobrevivientes de cáncer de mama: estudio cualitativo de barreras, facilitadores y preferencias.

Introduction: Breast cancer survivors often experience pre and post-treatment physical and psychological symptoms, negatively affecting their quality of life. Regular physical exercise is associated with better quality of life and lower recurrence of cancer, and therefore all oncological patients are recommended to practice it in a regular basis. Despite this, breast cancer survivors have low adherence to physical exercise. The purpose of this study is to identify barriers, facilitators and preferences of Chilean breast cancer survivors to practice physical exercise. Methods: Phenomenological qualitative study of 12 in-depth interviews with adjuvant radiation therapy concluded at least three months ago. Results: Breast cancer survivors ignored the benefits of physical exercise during and after treatment. The barriers were physical symptoms, psychological barriers, sociocultural barriers, health system barriers, disinformation and sedentary lifestyle. Facilitators were coping with physical symoptoms, psychological issues, having information and active lifestyle. The preferences were painless and familiar exercises. Preferred exercise was walking. Conclusions: Breast cancer survivors may adhere to physical exercise despite barriers when certain facilitators are present, which may be promoted by the health team when reporting the benefits of the physical exercise, prescribing personalized, safe and painless physical exercise and educating both patient and her family about the role of the physical exercise in cancer recovering process.

Introducción: Las sobrevivientes de cáncer de mama suelen ver afectada negativamente su calidad de vida por síntomas físicos y psicológicos pre y post tratamiento. La práctica regular de ejercicio físico se asocia a mejor calidad de vida y menor recurrencia del cáncer, por esto es recomendado a todos los pacientes oncológicos. Sin embargo, existe baja adherencia a este. El propósito de este artículo es identificar barreras, facilitadores y preferencias de sobrevivientes de cáncer de mama chilenas para realizar ejercicio físico. Métodos: Estudio cualitativo fenomenológico, basado en entrevistas en profundidad a 12 sobrevivientes de cáncer de mama que terminaron la radioterapia adyuvante hace tres o más meses. Resultados: Las sobrevivientes de cáncer de mama desconocían la importancia del ejercicio físico durante y después del tratamiento. Las barreras identificadas fueron síntomas físicos, barreras psicológicas, socioculturales, del sistema de salud; desinformación y sedentarismo. Los facilitadores fueron físicos, psicológicos, contar con información y práctica de ejercicio físico antes del diagnóstico. Las preferencias fueron ejercicios indoloros y familiares. El ejercicio preferido fue caminar. Conclusiones: Es posible que las sobrevivientes de cáncer de mama adhieran al ejercicio físico, a pesar de las barreras cuando hay ciertos facilitadores presentes. Estos pueden ser generados por el equipo médico al informar los beneficios del ejercicio físico, prescribir ejercicio físico personalizado, seguro e indoloro y educar a la paciente y a su familia sobre el rol del ejercicio físico en la recuperación de sobrevivientes de cáncer de mama.

Catalyzing Change: Assessing Inner Setting Context of Cervical Cancer Prevention Efforts in Loreto, Peru, Prior to Transition from VIA to HPV Screen-and-Treat.

Background: The objective of this study was to understand health care providers' perspectives regarding the facilitators of and barriers to the success of the former Pap and VIA-based cervical cancer program in Iquitos, Peru, using the Consolidated Framework for Implementation Research (CFIR) to inform the transition to the HPV screen-and-treat intervention. By exploring the pre-implementation organizational context, or inner setting, through the opinions of those who would implement the HPV-based intervention at the patient care level, this research lays the foundation to assess readiness before implementation and understand what's necessary to design contextually appropriate and sustainable interventions in LMIC settings. Methods: We conducted 19 semi-structured interviews with health professionals (12 nurse-midwives, 4 doctors, and 3 laboratory technicians) who administered the former Pap- and VIA-based cervical cancer EDT program. Results: Providers identified information gaps between the primary level of care, where cervical cancer screening occurs, and the hospital level of care, where diagnosis and treatment occurs. These gaps, which were caused in part by fragmented, antiquated, and overlapping data systems, resulted in the loss of patients between levels of care. Participants also noted a lack of trained personnel and basic materials. Some providers found their way around these gaps by facilitating informal information exchanges among providers to ensure women were not lost to follow-up. Conclusions: PPC relied on these findings and other data from INSPIRE Phase 1 to implement a HPV-based screen-and-treat program that dramatically increased screening and treatment; however, challenges remain regarding resources and sustainability related to HPV technology.

Hydrogen-designed spin-states of 2D silicon carbide and graphene nanostructures.

Identifying and manipulating spin in two-dimensional materials is of great interest in advancing quantum information and sensing technologies, as well as in the development of spintronic devices. Here, we investigate the influence of hydrogen adsorption on the electronic and magnetic properties of graphene-like triangulenes. We have constructed triangulenes from SiC monolayers, which have been successfully synthesized very recently, extending our investigation to include graphene triangulenes. This advancement in the synthesis of SiC monolayers allows us to investigate deeper into the unique properties of SiC-based triangulenes and compare them with their graphene counterparts. The addition of hydrogen has been found to induce a magnetic moment in the SiC monolayer, with a more localized spin density when H is adsorbed in the C sites while spreading through the lattice when adsorbed on the Si sites. In triangular flakes, the ground spin state changes with the adsorption site: decreasing multiplicity on edge-defined sublattices and increasing it on the opposite sublattice. These findings suggest hydrogen adsorption as a tool for tuning spin-state properties in SiC and graphene nanostructures, with potential applications in spintronics and spin quantum dot devices.

Analysis of Velocity, Power and Skin Temperature in Paralympic Powerlifting Athletes with Fixed and Variable Resistance.

Variable resistance training has been widely used in athletic preparation. OBJECTIVES: To analyze the use of currents (VRT) and the traditional method (TRAD) on speed, power and temperature in a training session. METHODS: Fourteen paralympic powerlifting (PP) athletes took part over three weeks. In week 1, familiarization and 1RM tests took place, and, in weeks 2 and 3, pre- and post-training took place, where the propulsive mean velocity and power and temperatures were assessed before and after, at 24 h and 48 h. RESULTS: There was a difference in the sternal pectoral temperatures before and after VRT (p = 0.040) and at 48 h for TRAD and VRT (p = 0.018); in the clavicular pectoralis before and after VRT and TRAD (p = 0.003); in the anterior deltoid after and at 48 h for TRAD and VRT (p = 0.026 and p = 0.017); and in the triceps after and at 24 h and 48 h between TRAD and VRT (p = 0.005). In the training series, the MPV was significant in TRAD between Set1 and Set5 (p = 0.003), in training (VRT) between Set1 and Set5 (p = 0.001) and in Set5 between the methods (p = 0.047). For power, there was a difference between Set1 and 5 in TRAD (p = 0.016) and VRT (p = 0.002). CONCLUSION: We conclude that training with currents (VRT) promoted greater muscle fatigue when compared to traditional training.

Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery - a prospective cohort study.

Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32-64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien-Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68-12.76) and any complication (31.6%, 30.09-33.07). POMR stood at 1.9% (1.48-2.37), with elective and emergency surgery mortalities at 0.7% (0.40-1.23) and 3% (2.3-3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low-risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017.

Synthesis of 6-bromo-7-arylaminoisoquinoline-5,8-quinones and its effects on Piscirickettsia salmonis infection in vitro.

Among the most important aquaculture resources for our country, salmon and trout stand out. Their production has increased significantly in recent decades, making them two of the most valuable resources in economic terms. However, high aquaculture production has allowed many pathogens to proliferate, causing infectious diseases and significant production losses. Piscirickettsia salmonis is a gram-negative, facultative intracellular bacterium that is responsible for causing severe disease in a variety of salmonid fish species. Despite the significant impact of P. salmonis on aquaculture, effective treatments for this disease remain limited. Current prevention and control strategies often include antibiotics and vaccines. However, these treatments have shown varying degrees of efficacy. A promising approach involves synthesizing bioactive analog compounds with antibacterial properties. Quinones, secondary metabolites that are abundant in nature, have become a focal point of interest due to their diverse physiological activities, including antibiotic, insecticidal, antifungal, and anticancer properties. In this study, it is shown the synthesis of series 6-bromo-7-arylaminoisoquinoline-5,8-quinones, the characterization of these compounds using classical spectroscopic methods such as one-dimensional nuclear magnetic resonance (NMR), FT-IR (infrared), mass spectrometry, and the biological activity against Piscirickettsia salmonis. The brominated derivative compounds showed no cytotoxicity at any concentration evaluated. Furthermore, the infectivity of P. salmonis after treatment with the analog compounds indicated that derivatives methyl 6-bromo-7-((4-methoxyphenyl)amino)-1,3-dimethy-5,8-dioxo-5,8-dihydroisoquinoline-4-carboxylate (4b) and methyl 7-((4'-amino-[1,1'-biphenyl]-4-yl)amino)-6-bromo-1,3-dimethy-5,8-dioxo-5,8-dihydroisoquinoline-4-carboxylate (4g) reduced the bacterial load at 25 µg/mL concentration.

Predictability and functional impact of lateral acromioplasty using preoperative 2D planning on the correction of the critical shoulder angle (CSA) in patients with rotator cuff repair.

Background: Rotator cuff tears are highly prevalent, and their association with critical shoulder angle (CSA) has been reported. There is controversy regarding whether the morphology of the acromion influences its incidence, as well as whether acromioplasty would impact the results of a rotator cuff repair. Lateral acromioplasty does not play a decompressive role; rather, it aims to correct the deltoid vector. According to some publications, this would achieve less loading on the repaired rotator cuff, a lower retear rate, and better function. CSA correction with lateral acromioplasty can be planned with radiography (2-dimensional [2D]), but its predictability has not been fully studied. The primary objective of this study is to evaluate the predictability of 2D planning with radiography in CSA correction in patients with rotator cuff repair. The secondary objective is to analyze the association between the correction of the CSA and the functional outcomes. Methods: This single-center, prospective, observational, analytical study included candidates for arthroscopic repair of a rotator cuff tear with a CSA > 35°. Lateral acromioplasty was performed as planned with preoperative radiography (2D) to achieve a CSA of 35°. The degrees to be corrected were calculated. CSA was recalculated with a postoperative radiography; and the error in the planned grades to be corrected was calculated. At the end of follow-up, Visual Analog Scale, Subjective Shoulder Value (SSV), and Quick-Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scores were evaluated. Results: Forty one cases were included, 43.9% were men, and the mean age was 55.5 ± 8.6 years. The mean preoperative and postoperative CSA were 39.6° ± 1.9° and 35.7° ± 2.3°, respectively; 41.5% achieved a postoperative CSA ≤ 35°. The mean CSA planned correction error was 45.7 ± 28.8%. At the end of the follow-up, 33 (78.6%) had a functional evaluation, with an average follow-up of 41 ± 6.8 months. The mean Visual Analog Scale, Quick-DASH, and SSV were 0.9 ± 1.6, 5.3 ± 7.5, and 92.7 ± 10.6, respectively. There was a significant difference in Quick-DASH (P = .01) and SSV (P = .02) according to whether a postoperative CSA ≤ 35° was achieved. Conclusion: In lateral acromioplasty, planning of CSA correction with radiography (2D) is imprecise. Reaching a CSA ≤ 35° positively influences functional results.

The Global Rise of ESBL-Producing Escherichia coli in the Livestock Sector: A Five-Year Overview.

ß-lactam antibiotics are a key element in the treatment of bacterial infections. However, the excessive use of these antibiotics has contributed to the emergence of ß-lactam-resistant enterobacteria, including Escherichia coli. One of the main challenges facing the public health sector is antibacterial resistance (ABR), mainly due to limited options in its pharmacological treatment. Currently, extended-spectrum ß-lactamases (ESBLs) present an alarming situation, as there is an increase in morbidity and mortality rates, prolonged hospital stays, and increased costs for sanitary supplies, which involve not only humans but also the environment and animals, especially animals destined for food production. This review presents an analysis of the prevalence of ESBL-producing E. coli and its distribution in different animal sources throughout the world, providing an understanding of the association with resistance and virulence genes, as well as perceiving the population structure of E. coli.

The Anatomy, Histology, and Function of the Major Pelvic Ganglion.

This review provides a comprehensive analysis of the pelvic plexus and its regulation across various mammalian species, including rats, cats, dogs, and pigs. The pelvic and hypogastric nerves play crucial roles in regulating pelvic functions such as micturition, defecation, and erection. The anatomical organization of these nerves varies, forming either well-defined ganglia or complex plexuses. Despite these variations, the neurons within these structures are consistently regulated by key neurotransmitters, norepinephrine and acetylcholine. These neurons also possess receptors for testosterone and prolactin, particularly in rats, indicating the significant role of these hormones in neuronal function and development. Moreover, neuropeptides such as vasoactive intestinal peptide (VIP), substance P, neuropeptide Y (NPY), somatostatin (SOM), galanin (GAL), and calcitonin gene-related peptide (CGRP) are co-released with neurotransmitters to modulate pelvic functions. This review highlights the complex interplay between neurotransmitters, neuropeptides, and hormones in regulating pelvic physiology and emphasizes the importance of hormonal regulation in maintaining the functionality and health of the pelvic plexus across different species.

Symbolic information approach applied to human intracranial data to characterize and distinguish different congnitive processes.

How the human brain processes information during different cognitive tasks is one of the greatest questions in contemporary neuroscience. Understanding the statistical properties of brain signals during specific activities is one promising way to address this question. Here we analyze freely available data from implanted electrocorticography (ECoG) in five human subjects during two different cognitive tasks in the light of information theory quantifiers ideas. We employ a symbolic information approach to determine the probability distribution function associated with the time series from different cortical areas. Then we utilize these probabilities to calculate the associated Shannon entropy and a statistical complexity measure based on the disequilibrium between the actual time series and one with a uniform probability distribution function. We show that an Euclidian distance in the complexity-entropy plane and an asymmetry index for complexity are useful for comparing the two conditions. We show that our method can distinguish visual search epochs from blank screen intervals in different electrodes and patients. By using a multiscale approach and embedding time delays to downsample the data, we find important timescales in which the relevant information is being processed. We also determine cortical regions and time intervals along the 2-s-long trials that present more pronounced differences between the two cognitive tasks. Finally, we show that the method is useful to distinguish cognitive processes using brain activity on a trial-by-trial basis.