Título del artículo:

Isolated Escherichia coli resistance genes in broiler chicken

Poultry production due to consumer demand has increased annually, which leads to the use of additives such as antibiotics to favor rearing conditions, this increases the deficiency in the composition of production animals\' intestinal microbiota and can generate microbiological and genetic changes; this microbiota can reach humans through food chain, generating a possible horizontal transfer of genes that encode resistance to antibiotics. The objective was to identify resistance profiles and the genes that encode it. Materials and methods: From 200 chickens, 35 strains of Escherichia coli with extended spectrum beta-lactamase resistance phenotype were isolated from healthy broilers, from production farms in Santander (Colombia). 83 % of the AmpC gene, 86 % of the blaCTXM gene, 54 % of the blaSHV gene and 57 % of the blaTEM gene were identified. Regarding the genes that code for resistance to quinolones, 94 % of the qnrB gene, 9 % of the qnrC gene and 0 % of the qnrA gene were identified. The coexistence of the genes that encode for resistance to antibiotics is a serious problem that requires vigilance, in view of this; control strategies must be generated to avoid the spread through the food chain, as well as strategies for the control of the use of antibiotics in the production.

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Revista Mexicana De Ciencias Pecuarias

Título del artículo:

Efficacy and Safety of Vagus Nerve Stimulation on Upper Limb Motor Recovery After Stroke. A Systematic Review and Meta-Analysis

Background: Upper limb motor impairment is one of the main complications of stroke, affecting quality of life both for the patient and their family. The aim of this systematic review was to summarize the scientific evidence on the safety and efficacy of Vagus Nerve Stimulation (VNS) on upper limb motor recovery after stroke. Methods: A systematic review and meta-analysis of studies that have evaluated the efficacy or safety of VNS in stroke patients was performed. The primary outcome was upper limb motor recovery. A search of articles published on MEDLINE, CENTRAL, EBSCO and LILACS up to December 2021 was performed, and a meta-analysis was developed to calculate the overall effects. Results: Eight studies evaluating VNS effects on motor function in stroke patients were included, of which 4 used implanted and 4 transcutaneous VNS. It was demonstrated that VNS, together with physical rehabilitation, increased upper limb motor function on average 7.06 points (95%CI 4.96; 9.16) as assessed by the Fugl-Meyer scale. Likewise, this improvement was significantly greater when compared to a control intervention (mean difference 2.48, 95%CI 0.98; 3.98). No deaths or serious adverse events related to the intervention were reported. The most frequent adverse events were dysphonia, dysphagia, nausea, skin redness, dysgeusia and pain related to device implantation. Conclusion: VNS, together with physical rehabilitation, improves upper limb motor function in stroke patients. Additionally, VNS is a safe intervention.

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Frontiers in Neurology

Título del artículo:

Ethnic Differences in the Prevalence of Hypertension in Colombia: Association With Education Level

BACKGROUND: A higher prevalence of hypertension is reported among Afro-descendants compared with other ethnic groups in high-income countries; however, there is a paucity of information in low- and medium-income countries. METHODS: We evaluated 3,745 adults from 3 ethnic groups (552 White, 2,746 Mestizos, 447 Afro-descendants) enrolled in the prospective population-based cohort study (PURE) - Colombia. We assessed associations between anthropometric, socioeconomic, behavioral factors, and hypertension. RESULTS: The overall prevalence of hypertension was 39.2% and was higher in Afro-descendants (46.3%) than in Mestizos (37.6%) and Whites (41.5%), differences that were due to the higher prevalence in Afro-descendant women. Hypertension was associated with older age, increased body mass index, waist circumference and waist-to-hip ratio, independent of ethnicity. Low education was associated with hypertension in all ethnic groups, and particularly in Afro-descendants, for whom it was the factor with the strongest association with prevalence. Notably, 70% of Afro-descendants had a low level of education, compared with 52% of Whites - 26% of Whites were university graduates while only 7% of Afro-descendants were. We did not find that education level alone had a mediator effect, suggesting that it is not a causal risk factor for hypertension but is an indicator of socioeconomic status, itself an important determinant of hypertension prevalence. CONCLUSIONS: We found that a higher prevalence of hypertension in Colombian Afro-descendants than other ethnic groups. This was principally associated with their lower mean educational level, an indicator of lower socioeconomic status.

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American Journal of Hypertension

Título del artículo:

Multilocus Sequence Typing helps understand the genetic diversity of Cryptosporidium hominis and Cryptosporidium parvum isolated from Colombian patients

Multilocus Sequence Typing has become a useful tool for the study of the genetic diversity and population structure of different organisms. In this study, a MLST approach with seven loci (CP47, MS5, MS9, MSC6-7, TP14, and gp60) was used to analyze the genetic diversity of Cryptosporidium hominis and Cryptosporidium parvum isolated from 28 Colombian patients. Five Cryptosporidium species were identified: C. hominis, C. parvum, Cryptosporidium felis, Cryptosporidium meleagridis, and Cryptosporidium suis. Unilocus gp60 analysis identified four allelic families for C. hominis (Ia, Ib, Id, and Ie) and two for C. parvum (IIa and IIc). There was polymorphic behavior of all markers evaluated for both C. hominis and C. parvum, particularly with the CP47, MS5, and gp60 markers. Phylogenetic analysis with consensus sequences (CS) of the markers showed a taxonomic agreement with the results obtained with the 18S rRNA and gp60 gene. Additionally, two monophyletic clades that clustered the species C. hominis and C. parvum were detected, with a higher number of subclades within the monophyletic groups compared to those with the gp60 gene. Thirteen MLG were identified for C. hominis and eight for C. parvum. Haplotypic and nucleotide diversity were detected, but only the latter was affected by the gp60 exclusion from the CS analysis. The gene fixation index showed an evolutionary closeness between the C. hominis samples and a less evolutionary closeness and greater sequence divergence in the C. parvum samples. Data obtained in this work support the implementation of MLST analysis in the study of the genetic diversity of Cryptosporidium, considering the more detailed information that it provides, which may explain some genetic events that with an unilocus approach could not be established. This is the first multilocus analysis of the intra-specific variability of Cryptosporidium from humans in South America.

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PLoS ONE

Título del artículo:

Effects of Polybrominated Diphenyl Ethers on Hormonal and Reproductive Health in E-Waste-Exposed Population: A Systematic Review

Electronic waste management is a global rising concern that is primarily being handled by informal recycling practices. These release a mix of potentially hazardous chemicals, which is an important public health concern. These chemicals include polybrominated diphenyl ethers (PBDEs), used as flame retardants in electronic parts, which are persistent in nature and show bioaccumulative characteristics. Although PBDEs are suspected endocrine disruptors, particularly targeting thyroid and reproductive hormone functions, the relationship of PBDEs with these health effects are not well established. We used the Navigation Guide methodology to conduct a systematic review of studies in populations exposed to e-waste to better understand the relationships of these persistent flame retardants with hormonal and reproductive health. We assessed nineteen studies that fit our pre-determined inclusion criteria for risk of bias, indirectness, inconsistency, imprecision, and other criteria that helped rate the overall evidence for its quality and strength of evidence. The studies suggest PBDEs may have an adverse effect on thyroid hormones, reproductive hormones, semen quality, and neonatal health. However, more research is required to establish a relationship of these effects in the e-waste-exposed population. We identified the limitations of the data available and made recommendations for future scientific work.

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International Journal of Environmental Research and Public Health

Título del artículo:

Return to sport and beyond following intramuscular tendon hamstring injury: A case report of an English Premier League football player

Background: Hamstring strain injuries are the most common type of injury in elite football and are associated with a high risk of reinjury, particularly those involving the intramuscular tendon (IMT). Limited information is available regarding the rehabilitation and return to sport (RTS) processes following such injuries. This case study describes the clinical presentation of an elite football player following IMT hamstring injury, their on- and off-pitch rehabilitation alongside performance monitoring throughout RTS and beyond. Case scenario: An elite football player suffered a grade 2c hamstring injury during an English Premier League (EPL) match. The player underwent early post-injury management, alongside progressive off-pitch physical preparation. The ‘control-chaos continuum’ was used as a framework for on-pitch rehabilitation to prepare the player for a return to full team training and competition. Objective and subjective markers of the player\'s response to progressive on- and off-pitch loading were monitored throughout RTS and beyond. Outcomes: The player returned to on-pitch rehabilitation after 11 days, to full team training having achieved weekly pre-injury chronic running load outputs after 35 days and played in the EPL 40 days post-injury. The player did not suffer reinjury for the rest of the EPL season. Conclusion: An understanding the unique structural and mechanical properties of the IMT, alongside expected RTS timeframes are important to inform rehabilitation and decision-making processes post-injury. Performance and frequent load-response monitoring throughout RTS and beyond, in conjunction with practitioner experience and effective communication are critical in facilitating effective RTS and reduce risk of reinjury following IMT injury.

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Physical Therapy in Sport

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Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine–Immune Therapeutic Mechanisms and Clinical Implications

Electroconvulsive therapy (ECT) is based on conducting an electrical current through the brain to stimulate it and trigger generalized convulsion activity with therapeutic ends. Due to the efficient use of ECT during the last years, interest in the molecular bases involved in its mechanism of action has increased. Therefore, different hypotheses have emerged. In this context, the goal of this review is to describe the neurobiological, endocrine, and immune mechanisms involved in ECT and to detail its clinical efficacy in different psychiatric pathologies. This is a narrative review in which an extensive literature search was performed on the Scopus, Embase, PubMed, ISI Web of Science, and Google Scholar databases from inception to February 2022. The terms “electroconvulsive therapy”, “neurobiological effects of electroconvulsive therapy”, “molecular mechanisms in electroconvulsive therapy”, and “psychiatric disorders” were among the keywords used in the search. The mechanisms of action of ECT include neurobiological function modifications and endocrine and immune changes that take place after ECT. Among these, the decrease in neural network hyperconnectivity, neuroinflammation reduction, neurogenesis promotion, modulation of different monoaminergic systems, and hypothalamus–hypophysis–adrenal and hypothalamus– hypophysis–thyroid axes normalization have been described. The majority of these elements are physiopathological components and therapeutic targets in different mental illnesses. Likewise, the use of ECT has recently expanded, with evidence of its use for other pathologies, such as Parkinson’s disease psychosis, malignant neuroleptic syndrome, post-traumatic stress disorder, and obsessive– compulsive disorder. In conclusion, there is sufficient evidence to support the efficacy of ECT in the treatment of different psychiatric disorders, potentially through immune, endocrine, and neurobiological systems.

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International Journal of Molecular Sciences

Título del artículo:

Immunomodulatory effect of a very-low-calorie ketogenic diet compared with bariatric surgery and a low-calorie diet in patients with excessive body weight

Background & aim: Inflammation and oxidative stress are the most probable mechanistic link between obesity and its co-diseases with cancer among them. The aim of this study was to evaluate whether the nutritional ketosis and weight loss induced by a very-low-calorie ketogenic diet (VLCKD) modulates the inflammatory and oxidative stress profile, compared with a standard, balanced hypocaloric diet (LCD) or bariatric surgery (BS) in patients with obesity. Methods: The study was performed in 79 patients with overweight or obesity and 32 normal-weight volunteers as the control group. Patients with obesity underwent a weight reduction therapy based on VLCKD, LCD or BS. The quantification of the circulating levels of a multiplexing test of cytokines and carcinogenesis/aging biomarkers, as well as of lipid peroxides and total antioxidant power, was carried out. Results: First, we observed that pro-inflammatory cytokines increase, while anti-inflammatory cytokines decrease under excessive body weight. Relevantly, when patients underwent weight loss strategies, it was shown that energy-restricted and surgical strategies of weight loss induced changes in circulating cytokine and lipid peroxides. This effect was more notable in patients following the VLCKD than the LCD or BS and it was observed mainly in the ketosis phase of the intervention. Particularly, IL-11, IL-12, IL-2, INF-γ, INF-β, Pentraxin-3 or MMP1 changed after VLCKD. Whereas, APRIL, TWEAK, osteocalcin and IL-28A increased after BS. Conclusion: As far as we know, this is the first study that evaluate the time-course of cytokines and oxidative stress markers after a VLCKD as compared with a standard LCD and BS. The observed results support the immunomodulatory effect of nutritional ketosis induced by a VLCKD synergistically with weight loss as a strategy to improve innate-immunity and to prevent infections and carcinogenesis in patients with obesity.

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Clinical Nutrition

Título del artículo:

Human ecological impacts on islands: Exemplified by a dwarf deer (Cervidae: Mazama sp.) on Pedro Gonzalez Island, Pearl Island Archipelago, Pacific Panama (6.2–5.6 kya)

The present study\'s primary goal is to apply analyses of stable isotopes and tooth micro- and mesowear to the question of dietary change among a mid-Holocene population of small brocket deer (Cervidae: Mazama) in response to anthropogenic alteration of the natural insular vegetation for approximately 450 calendar years (6060-5620 cal yr BP). The brocket deer remains were found in shell-bearing middens on Pedro González in the Pearl Island archipelago. This island is the third largest of many platform or continental islands in Pacific Panama that were periodically affected by rising post-glacial seas during Pleistocene warm periods and became hills in drowned plains during glacial periods, which were extensive on the Pacific side of the isthmus. Our study is based on pre-Columbian Mazama deer remains recovered from excavations in the ancient middens of Pedro González and on modern skeletons of Mazama deer belonging to three United States museum collections. For comparative purposes we added museum specimens of extant white-tailed deer (Odocoileus virginianus) of reduced size from the Florida Keys and Coiba Island (Pacific Panama). Our results show that the diets of 1) present-day white-tailed deer from Coiba and the Florida Keys and 2) the brocket deer (Mazama) still present on San José Island were browsers. On the other hand, as soon as Preceramic people arrived on Pedro Gonzalez ca 6000 cal yr BP, the local brocket deer\'s diet gradually included more and more abrasive plants in response to changes in vegetation cover related to increasing anthropogenic clearance for cultivation.

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Journal of Archaeological Science

Título del artículo:

Systematic review and meta-analysis of risk factors for Mesh infection following Abdominal Wall Hernia Repair Surgery

Background: Surgical Mesh Infection (SMI) after Abdominal Wall Hernia Repair (AWHR) represents a catastrophic complication. We performed a systematic review and meta-analysis to analyze the risk factors for SMI in the context of AWHR. Methods: PubMed, Embase, Scielo, and LILACS were searched without language or time restrictions from inception until June 2021. Articles evaluating the association between demographic, clinical, laboratory and surgical characteristics with SMI in AWHR were included. Results: 23 studies were evaluated, comprising a total of 118,790 patients (98% males; mean age 56.5 years) with a mesh infection pooled prevalence of 4%. Significant risk factors for SMI were type 2 diabetes mellitus, obesity, smoking history, steroids use, ASA III/IV, laparotomy vs laparoscopy, emergency surgery, duration of surgery and onlay mesh position vs sublay. The quality of evidence was regarded as very low–moderate. Conclusion: Several factors, highlighting sociodemographic characteristics, comorbidities, and the clinical scenario, may increase the risk of developing mesh infections in AWHR. The recognition and mitigation of these may significantly reduce mesh infection rates in this context.

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American Journal of Surgery

Título del artículo:

Individual Factors Associated with the Consumption of Illicit Substances: a Review of Reviews

Introduction: According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon. Methods: This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR. Results: Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders. Conclusions: The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.

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Revista Colombiana de Psiquiatria

Título del artículo:

Nanosensors in clinical development of CAR-T cell immunotherapy

Immunotherapy using CAR-T cells is a new technological paradigm for cancer treatment. To avoid severe side effects and tumor escape variants observed for conventional CAR-T cells approach, adaptor CAR technologies are under development, where intermediate target modules redirect immune cells against cancer. In this work, silicon nanowire field-effect transistors are used to develop target modules for an optimized CAR-T cell operation. Focusing on a library of seven variants of E5B9 peptide that is used as CAR targeting epitope, we performed multiplexed binding tests using nanosensor chips. These peptides had been immobilized onto the sensor to compare the transistor signals upon titration with anti-La 5B9 antibodies. The correlation of binding affinities and sensor sensitivities enabled a selection of candidates for the interaction between CAR and target modules. An extremely low detection limit was observed for the sensor, down to femtomolar concentration, outperforming the current assay of the same purpose. Finally, the CAR T-cells redirection capability of selected peptides in target modules was proven successful in an in-vitro cytotoxicity assay. Our results open the perspective for the nanosensors to go beyond the early diagnostics in clinical cancer research towards developing and monitoring immunotherapeutic treatment, where the quantitative analysis with the standard techniques is limited.

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Biosensors and Bioelectronics

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WORK-BASED ISOMETRIC EXERCISES EFFECT ON BLOOD PRESSURE: THE EEFIT STUDY

OBJECTIVE: To evaluate the effect of two workplace isometric exercise interventions on blood pressure in hypertensive adults. DESIGN AND METHOD: A randomized controlled multicenter clinical trial conducted in hypertensive (>130 mmHg systolic blood pressure (SBP)) 35 to 65 years old in work places in Colombia. Participants were assigned to either of two interventions: isometric handgrip dynamometer training at 30% of maximum strength (HGD) or wall squat (WS), or to a control group following standard recommendations. The interventions were performed at the participant\'s workplace and consisted of 4 sets of 2 minutes of sustained isometric contraction with 2 minutes\' rest between sets, 3 times per week for 12 weeks. SBP and diastolic blood pressure (DBP) were measured using an automatic device (Omron) with a standardized protocol before and after the 12-week intervention. RESULTS: Pre and post measurements were completed by 105 hypertensive participants: mean age of 45 years (SD 9.5), 63.8% of which were men. In the HGD group (n = 38) there were significant decreases in SBP [Pre: 141 mmHg (SD 7.8), Post: 127 mmHg (SD 9.1) (p < 0.001)], and in DBP [Pre: 87 mmHg (SD 5.8), Post: 82 mmHg (SD 9.5) (p < 0.001)]. There were also significant decreases in the WS-group (n = 35) in SBP [Pre: 139 mmHg (SD 7.5), Post: 126 mmHg (SD 12.4) (p < 0.001)], and in DBP [Pre: 86 mmHg (SD 5.2), Post 82 mmHg (SD 8.1) (p < 0.001)]. In the control group (n = 32), there were no significant changes in either in SBP [Pre: 140 mmHg (SD 8.4), Post: 137 mmHg (SD 12.9)], or DBP [Pre: 86 mmHg (SD 5.0), Post: 85 mmHg (SD 8.0) (p = 0.71)]. CONCLUSIONS: Both workplace isometric training interventions resulted in significant and clinically relevant reductions in blood pressure in subjects with high blood pressure. The combination of effectiveness, modest time commitment (42 minutes per week) and ease with which the interventions can be implemented in the workplace setting makes them both attractive and practical options with minimal barriers for participation. Furthermore, WS can be performed without any equipment.

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Journal of hypertension

Título del artículo:

Impact of an educational intervention on the self-care agency among Nursing students

Objective: to determine the impact of an educational intervention through Problem-Based Learning (PBL) and based on Orem’s Self-Care Theory on the self-care agency in Nursing students from two Colombian universities. Method: a multicentre quasi-experimental before-and-after study conducted on 2019. The population included the 56 students of the first Nursing semester from two Colombian universities. The “Hacia el cuidado de la vida” (“Towards Life Care”) intervention was conducted, with 12 two-hour sessions during 13 weeks on mental and spiritual self-care, healthy lifestyles, body self-care and social self-care through PBL. Sociodemographic and academic variables were measured, as well as consumer habits. The Self-Care Agency was measured at baseline (B) and at the last session (P) through the ASA-B scale (very low: 1-24, low: 25-48, good: 49-72 or very good: 73-96scores). Descriptive andbivariate statistics were applied. Results: forty (40) persons completed the study; 82.1% were female, with 18 years as median age. The overall score in the ASA-B scale was increased overall in a statistically significant way [B: X= 71.1 (SD= 0.73)andP: X= 75.6 (SD= 1.07); p< 0.001] and in 18-to-20-year old single women, with a score of 11 in knowledge test in first or second quartile, past history of using alcohol or energy drinks (p< 0.05). There was no variation in score in terms of affiliation to sport teams, student federations or religious groups. Conclusion: the educational intervention based on the self-care theory and PBL applied to students in their first Nursing semester improved their self-care agency.

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Metas de Enfermeria

Título del artículo:

Effect­of­corpus­luteum­irrigation­assessed­by­Doppler­ultrasound­on­the­gestation­percentage­of­embryo recipient­Holstein­cows

The luteal vasculature plays a critical role in corpus luteum (CL) function and provides important information on the physiology and pathophysiology of this structure. To quantify the blood flow of the luteal tissue, Doppler ultrasound is used to detect the flow of red blood cells through the blood vessels. The objective of the present study was to determine the degree of irrigation of the CL evaluated by Doppler ultrasound on the day (D0) of embryo transfer (ET) and 25 days post-transfer and its relationship with the percentage of early gestation in Holstein recipient cows. Thirty multiparous, non-lactating Holstein cows were used as in vitro embryo recipients. The blood supply rate of the CL and the percentage of gestation were evaluated. The corpora lutea were categorized into 1 (high), 2 (medium) and 3 (low) according to the degree of blood supply. The percentage of cows with these degrees of CL irrigation on the day of transfer were 50% (15/30), 23.3% (7/30) and 27.7% (8/30). On day 25 post-transfer they were 33.3% (10/30), 43.3% (13/30) and 23.3% (7/30), respectively. Additionally, the percentage of early gestation (25 days post-transfer) was evaluated for grades 1, 2 and 3 of CL blood supply, whose results were: 20% (6/30), 6.6% (2/30) and 0%, respectively. It was possible to conclude that the Holstein breed recipients classified in high degree of CL blood irrigation, presented better (P < 0.05) percentage of gestation of embryos of in vitro origin.

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Taurus

Título del artículo:

Exploring the Evolution of the Topics and Research Fields of Territorial Development from a Comprehensive Bibliometric Analysis

Countries with great deficiencies in development, research, and innovation are investing resources to advance in this aspect; meanwhile, it is necessary to advance in initiatives that promote local development, through the correct use and management of endogenous territorial capacities to achieve economic, social, and environmental development, and this is where the territorial development approach has intervened during the last decades. To obtain an understanding of the evolution of the research field on territorial development, a study of research topics and groups of research topics is implemented from subscription-based data sources (Scopus, Science direct, Ebsco, and Web of Science) and open access (Lens and Dimension platforms). Keyword co-occurrence techniques were implemented, and indicators of link strength and density-centrality of clusters were used to abstract patterns of change within the field of study. The evolution of the area, trends, and issues related to territorial development are identified in the different databases, mapping a discipline that still lacks comparative publications between research results at different scales.

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Sustainability (Switzerland)

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Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

Hernia repair is one of the most frequent interventions in surgery worldwide. The approach to abdominal wall and inguinal hernias remains a challenge due to emerging evidence on aspects such as timely diagnosis, use of innovative techniques or post-surgical care. However, pre-operative preparation is also a factor that substantially affects the absolute success rate of this type of condition. Time management between diagnosis and intervention, control of diseases that increase intra-abdominal pressure, weight and nutritional status, are some of the many elements to be considered in this type of patients before surgery. Considering that this condition carries high health care costs, especially in case of recurrence, has a risk of complications and affects the individual\'s functional capacity, the objective of this review is to synthesize evidence on the role of these factors on the short- and long-term outcome of inguinal hernia management, and to make suggestions on the general approach to this type of patients.

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Annals of Medicine and Surgery

Título del artículo:

Sensitivity and efficiency of RNA sample pooling for real-time quantitative polymerase chain reaction testing for SARS-CoV-2

Background: In spite of the worth of pool testing in public health, data on the sensitivity and efficiency of real-time quantitative polymerase chain reaction (RT-qPCR) pool testing for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in middle and low-income countries are limited. Methods: We mixed single specimens of extracted RNA positive for the SARS-CoV-2 envelope (E) gene by RT-qPCR with negative specimens, in pools of 4 (n=89), 8 (n=92), 16 (n=102), and 32 (n=105) specimens each. We estimated the average change in cycle threshold (Ct) for each pool size and added it to the Ct values of the first 1,350 tests in our lab, to obtain dilution-corrected Ct values. We estimated pool sensitivity as the proportion of samples with dilution-corrected Ct >40, and used it in simulations of the efficiency (tests used/true case detected) of binary split pool testing. Results: We tested 388 pools. Average Ct changes were 2.21, 2.51, 3.27, and 3.94 cycles, for pools of 4, 8, 16, and 32 specimens, respectively. Corresponding pool tests sensitivities were 91.1%, 89.6%, 85.8% and 82.5%. Pool testing was substantially more efficient than individual testing. For prevalence of 0.5% to 2.0%, the efficiency of pools of ≥8 specimens was 30% to 280% higher, and the number of people tested was 4.4 to 13.9 times higher than those of individual testing. Conclusions: Binary split pool testing substantially increases the number of people tested and the number of true cases detected per test used. This strategy is key to curtail the transmission of SARS-CoV-2, by increasing efficiency in the identification and isolation of symptomatic and asymptomatic infected individuals.

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Journal of Public Health and Emergency

Título del artículo:

The Anti-Coronavirus Therapies (ACT) Trials: Design, Baseline Characteristics, and Challenges

Background: Effective treatments for COVID-19 are urgently needed, but conducting randomized trials during the pandemic has been challenging. Methods: The Anti-Coronavirus Therapy (ACT) trials are parallel factorial international trials that aimed to enroll 3500 outpatients and 2500 inpatients with symptomatic COVID-19. The outpatient trial is evaluating colchicine vs usual care, and aspirin vs usual care. The primary outcome for the colchicine randomization is hospitalization or death, and for the aspirin randomization, it is major thrombosis, hospitalization, or death. The inpatient trial is evaluating colchicine vs usual care, and the combination of rivaroxaban 2.5 mg twice daily and aspirin 100 mg once daily vs usual care. The primary outcome for the colchicine randomization is need for high-flow oxygen, need for mechanical ventilation, or death, and for the rivaroxaban plus aspirin randomization, it is major thrombotic events, need for high-flow oxygen, need for mechanical ventilation, or death. Results: At the completion of enrollment on February 10, 2022, the outpatient trial had enrolled 3917 patients, and the inpatient trial had enrolled 2611 patients. Challenges encountered included lack of preliminary data about the interventions under evaluation, uncertainties related to the expected event rates, delays in regulatory and ethics approvals, and in obtaining study interventions, as well as the changing pattern of the COVID-19 pandemic. Conclusions: The ACT trials will determine the efficacy of anti-inflammatory therapy with colchicine, and antithrombotic therapy with aspirin given alone or in combination with rivaroxaban, across the spectrum of mild, moderate, and severe COVID-19. Lessons learned from the conduct of these trials will inform planning of future trials.

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CJC Open

Título del artículo:

IDH–wild-type glioblastoma cell density and infiltration distribution influence on supramarginal resection and its impact on overall survival: a mathematical model

OBJECTIVE Recent studies have proposed resection of the T2 FLAIR hyperintensity beyond the T1 contrast enhancement (supramarginal resection [SMR]) for IDH–wild-type glioblastoma (GBM) to further improve patients’ overall survival (OS). GBMs have significant variability in tumor cell density, distribution, and infiltration. Advanced mathematical models based on patient-specific radiographic features have provided new insights into GBM growth kinetics on two important parameters of tumor aggressiveness: proliferation rate (ρ) and diffusion rate (D). The aim of this study was to investigate OS of patients with IDH–wild-type GBM who underwent SMR based on a mathematical model of cell distribution and infiltration profile (tumor invasiveness profile). METHODS Volumetric measurements were obtained from the selected regions of interest from pre- and postoperative MRI studies of included patients. The tumor invasiveness profile (proliferation/diffusion [ρ/D] ratio) was calculated using the following formula: ρ/D ratio = (4π/3)2/3 × (6.106/[VT21/3 − VT11/3])2, where VT2 and VT1 are the preoperative FLAIR and contrast-enhancing volumes, respectively. Patients were split into subgroups based on their tumor invasiveness profiles. In this analysis, tumors were classified as nodular, moderately diffuse, or highly diffuse. RESULTS A total of 101 patients were included. Tumors were classified as nodular (n = 34), moderately diffuse (n = 34), and highly diffuse (n = 33). On multivariate analysis, increasing SMR had a significant positive correlation with OS for moderately and highly diffuse tumors (HR 0.99, 95% CI 0.98–0.99; p = 0.02; and HR 0.98, 95% CI 0.96–0.99; p = 0.04, respectively). On threshold analysis, OS benefit was seen with SMR from 10% to 29%, 10% to 59%, and 30% to 90%, for nodular, moderately diffuse, and highly diffuse, respectively. CONCLUSIONS The impact of SMR on OS for patients with IDH–wild-type GBM is influenced by the degree of tumor invasiveness. The authors’ results show that increasing SMR is associated with increased OS in patients with moderate and highly diffuse IDH–wild-type GBMs. When grouping SMR into 10% intervals, this benefit was seen for all tumor subgroups, although for nodular tumors, the maximum beneficial SMR percentage was considerably lower than in moderate and highly diffuse tumors.

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Journal of Neurosurgery

Título del artículo:

“Candy shaped vertebrae” as a form of presentation of spinal deformities in a patient with Cleidocranial syndrome

Cleidocranial Dysplasia (CCD) or Cleidocranial dysostosis is a very rare, under-diagnosed pathology caused by a variable degree of expression of a dominant gene. It is characterized by skeletal malformations, which can be expressed in different clinical and imagenologic findings, with a classic triad; late closure of cranial sutures, hypoplasia or aplasia of clavicles and dental abnormalities. We present a case of a 46 years old male, with no previous medical history, who presented to emergency department with a 4-month dorso-lumbar axial pain with no other symptoms. Imaging studies and clinical findings revealed characteristics compatible with CCD, with an unusual malformation of the vertebral bodies “candy shaped vertebrae”.

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Interdisciplinary Neurosurgery: Advanced Techniques and Case Management

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Prevalence of ABCB1 3435C>T polymorphism in the Cuban population

Objectives: ABCB1 gene polymorphisms can modify P-glycoprotein function with clinical consequences. Methods: The 3435C>T polymorphism prevalence was analyzed using oligonucleotide probes and next-generation sequencing in 421 unrelated healthy individuals living in Cuba. Data were stratified by gender, ethnic background and residence. The genotype and allelic frequencies were determined. Results: The genotype distribution met the Hardy-Weinberg equilibrium assumption. The allelic frequency was 63.5% for the 3435C variant. The genotype frequencies were 41.1% for CC, 44.9% for CT and 14.0% for TT. The allele and genotype distributions differed between individuals living in La Habana and Santiago de Cuba (p<0.05) when ethnic background was analyzed. The allelic distribution was similar among Admixed and Black subjects, and they differed from Caucasians. The CC genotype was equally distributed among Admixed and Black subjects, and they differed from Caucasians. The TT genotype frequency differed between Caucasians and Admixed. The CT genotype was distributed differently among the three groups. Similar distribution was obtained in Brazilians, whereas some similarities were observed in African, Spanish and Chinese populations, consistent with the mixed Cuban ethnic origin. Conclusions: This is the first report on allele and genotype frequencies of the 3435C>T polymorphism in Cuba, which may support personalized medicine programs.

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Drug Metabolism and Personalized Therapy

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Cardiovascular Risk Factors in Colombian Penitentiary Staff: An Interdisciplinary View of a High-Risk Occupation

Introduction: Cardiovascular risk factors have been measured under different conditions, there is some missing information related to specific occupations, such as penitentiary staff which due to their characteristics could have an increased cardiovascular risk. Objective: To determine cardiovascular risk factors on military staff from penitentiary institutions in Santander—Colombia. Methods: Cross-sectional study conducted with 182 workers. Anthropometric parameters, blood pressure, serum lipid profile, and glucose levels were measured. Univariate and bivariate analyses were carried out to establish differences between individuals. Results: Anthropometric and biochemical measures showed that 71.3% participants were overweight or obese, 29.4% presented high blood pressure with increased levels of total cholesterol (27.5%), triglycerides (40.7%), glucose (9.3%), and 84.1% presented low levels of HDL cholesterol. Bivariate analysis found a negative correlation between BMI and HDL cholesterol (p <.05) and a positive correlation between BMI with triglycerides (p <.01), systolic and diastolic blood pressure (DBP) (p <.01). Conclusion: The studied military population presented increased levels of cardiovascular risk in comparison with a similar group in age, gender of nonmilitary individuals. However, it is important to carry out comparative studies between military staff in order to determine the prevalence and other risk predicting factors present in this specific population.

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Hispanic Health Care International

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Factors Associated with the Consumption of Illicit Drugs: a Review of Reviews

The aim of this study was to identify the factors associated with the consumption of illicit drugs with stronger evidence in the personal, interpersonal, and contextual domains. For this reason, a review of reviews was carried out using international quality guidelines such as PRISMA and AMSTAR, searching in six databases and yielding 7782 articles in the initial search. In the end, 45 quantitative and qualitative reviews were included. Evidence of personal, interpersonal, and contextual factors was found that could be useful for the investigation of the most specific factors according to particular settings. Ecological approaches can be meaningful as integrative frameworks for this evidence.

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International Journal of Mental Health and Addiction

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Exploring empathy in first-semester nursing students using the empathy quotient (EQ)

Introduction: Empathy either considered as a dimension or a competence is crucial for the development of our social species, particularly in a situation as special as the care of others. Objectives: To determine the quotient of empathy of the first semester students of nursing at the Universidad Cooperativa de Colombia hosts Bucaramanga and its relations with the variables sex, age, social condition and city of origin. Materials and Methods: We analyzed the quotient of empathy using the EQ test Baron-Cohen and Wheelwright in all students in the first semester (N: 100). The relationship with the variables sex, age, social stratum and origin were determined by t test and F test, as well as ANOVA and Kruskal-Wallis test. Results: No statistical differences were found between the quotients of empathy of the sexes, age, social condition or city of origin, but variations in the distribution of the data were observed. Was determined a negative relationship between age and social condition with the quotients of empathy. Conclusions: The mean of the quotient of empathy of the population of nursing students from first semester was of 40,3 locating it in a middle position, the study group was quite heterogeneous, with a development low to medium of empathy. Strategies are necessary throughout his professional career for the development of empathy in this population of students since the vast majority will get your professional degree before reaching the brain maturity.

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Revista Cuidarte