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INTRODUCTION: In the clinical medicine's immediate assistance unit, care is focused on outpatients with diseases that require early diagnosis, such as tuberculous adenitis (TA). The aim was to describe clinical features, complementary studies and procedures performed in patients with a diagnosis confirmed by bacteriology or pathological anatomy of TA. METHODS: Observational, descriptive, retrospective. PERIOD: 2017-2023. RESULTS: Fourty nine patients were included, with a median age of 31 years, 59% were female, 22% with comorbidities. 40% had localized lymphadenopathy, most of them cervical. HIV serology was positive in 3 cases (6.1%). Samples for bacteriology were submitted in 73%, with isolation of M. tuberculosis in 71%. Nodal fine needle aspiration (FNA) was performed in 79%, and in 48% the cytology results were suggestive of tuberculosis. Nodal biopsy was performed in 77%, with granulomatous adenitis as result in 62%. The term between admission and diagnosis ranged from a median of 40 days. Most treatments were started after the biopsy result, followed by culture, bacilloscopy, FNA, and GeneXpert. One patient died. DISCUSSION: TA predominates in the female sex in the studied group, coinciding with the local experience, the average age of presentation is 30 to 40 years, can affect any lymph node region, although the cervical location predominates, which coincides with the findings of this work. In our series, the diagnostic delay from the first consultation was shorter than reported in the literature.
Introducción: En el consultorio de atención inmediata de clínica se concentra la atención de pacientes ambulatorios con enfermedades que requieren diagnóstico precoz, como la adenitis tuberculosa (AT). El objetivo fue describir las características clínicas, estudios complementarios y procedimientos realizados a pacientes con diagnóstico confirmado por bacteriología o anatomía patológica de AT. Métodos: Estudio observacional, descriptivo, retrospectivo. Período: 2017-2023. Resultados: Se incluyeron 49 pacientes, con una mediana de edad de 31 años; 59% de sexo femenino, 22% con comorbilidades El 40% presentó adenopatías localizadas, la mayoría cervicales. La serología para HIV era positiva en 3 (6.1%). Al 73% se le ingresaron muestras para bacteriología, con aislamiento de M. tuberculosis en 71%. Al 79% se le realizó punción aspiración con aguja fina (PAAF) ganglionar; en el 48% los resultados de la citología fueron sugestivos de tuberculosis (TB). Al 77% se le realizó biopsia ganglionar, resultando en el 62% adenitis granulomatosa. Desde la primera consulta hasta el diagnóstico transcurrieron una mediana de 40 días. La mayoría de los tratamientos se iniciaron luego del resultado de la biopsia, seguido de cultivos, baciloscopia, PAAF y GeneXpert. Un paciente falleció. Discusión: La AT predominó en el sexo femenino en el grupo estudiado, coincidente con la experiencia local, la edad promedio de presentación fue 30 a 40 años. Puede afectar cualquier cadena ganglionar, aunque predomina la localización cervical, que coincide con los hallazgos de este trabajo. En nuestra serie, la demora diagnóstica desde la primera consulta fue menor a la referida en la bibliografía.
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Tuberculosis Ganglionar , Humanos , Femenino , Estudios Retrospectivos , Masculino , Adulto , Tuberculosis Ganglionar/diagnóstico , Tuberculosis Ganglionar/patología , Persona de Mediana Edad , Adulto Joven , Biopsia con Aguja Fina , Mycobacterium tuberculosis/aislamiento & purificación , Adolescente , AncianoRESUMEN
Background: In out-of-hospital cardiac arrest (OHCA) without ST-elevation, predictive markers that can identify those with a high risk of acute coronary syndrome are lacking. Methods: In this post hoc analysis of the Coronary Angiography after Cardiac Arrest (COACT) trial, the baseline, median, peak, and time-concentration curves of troponin-T (cTnT) (T-AUC) in OHCA patients without ST-elevation were studied. cTnT values were obtained at predefined time points at 0, 3, 6, 12, 24, 36, 28, and 72 hours after admission. All patients who died within the measurement period were not included. The primary outcome was the association between cTnT and 90-day survival. Secondary outcomes included the association of cTnT and acute thrombotic occlusions, acute unstable lesions, and left ventricular function. Results: In total, 352 patients were included in the analysis. The mean age was 64 ± 13 years (80.4% men). All cTnT measures were independent prognostic factors for mortality after adjustment for potential confounders age, sex, history of coronary artery disease, witnessed arrest, time to BLS, and time to return of spontaneous circulation (eg, for T-AUC: hazard ratio, 1.44; 95% CI, 1.06-1.94; P = .02; P value for all variables ≤.02). Median cTnT (odds ratio [OR], 1.58; 95% CI, 1.18-2.12; P = .002) and T-AUC (OR, 2.03; 95% CI, 1.25-3.29; P = .004) were independent predictors for acute unstable lesions. Median cTnT (OR, 1.62; 95% CI, 1.17-2.23; P = .003) and T-AUC (OR, 2.16; 95% CI, 1.27-3.68; P = .004) were independent predictors for acute thrombotic occlusions. CTnT values were not associated with the left ventricular function (eg, for T-AUC: OR, 2.01; 95% CI, 0.65-6.19; P = .22; P value for all variables ≥.14). Conclusion: In OHCA patients without ST-segment elevation, cTnT release during the first 72 hours after return of spontaneous circulation was associated with clinical outcomes.
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PURPOSE: Patients often refer to online materials when researching surgical procedures. This study compares the educational quality of online videos about tympanostomy tubes on two popular video platforms: YouTube and Facebook. This study provides clinicians with context about the content and quality of information patients may possess after watching online videos on tympanostomy tubes. MATERIALS AND METHODS: YouTube and Facebook were searched using key terms related to tympanostomy tubes. Videos were screened and scored in triplicate. DISCERN quality, content, production, and alternative medicine scores were assigned. Statistical analysis was conducted using GraphPad Prism. RESULTS: 76 YouTube and 86 Facebook videos were analyzed. DISCERN quality scores (mean = 1.8 vs. 1.4, P < .0001), content scores (mean = 1.7 vs. 1.0, P < .0001), and production scores (mean = 4.8 vs. 4.6, P = .0327) were significantly higher on YouTube compared to Facebook. 33 % of Facebook videos referenced alternative medicine, as compared with 0 % of YouTube videos (P < .0001). Physician/hospital-generated videos had significantly higher DISCERN and content scores than parent-, product-, and chiropractor-generated videos. Views did not correlate with DISCERN or content scores. CONCLUSION: YouTube is a better platform than Facebook for educational videos about tympanostomy tubes. YouTube videos had higher educational quality, more comprehensive content, and less alternative medicine. One third of Facebook videos advocated for alternative treatments. Importantly, videos on both platforms were of limited educational quality as demonstrated through low DISCERN reliability scores and coverage of few important content areas.
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Depression and anxiety disorders, prevalent neuropsychiatric conditions that frequently coexist, limit psychosocial functioning and, consequently, the individual's quality of life. Since the pharmacological treatment of these disorders has several limitations, the search for effective and secure antidepressant and anxiolytic compounds is welcome. Vitamin D has been shown to exhibit neuroprotective, antidepressant, and anxiolytic properties. Therefore, this study aimed to explore new molecular targets of calcitriol, the active form of vitamin D, through integrated bioinformatic analysis. Calcitriol targets were predicted in SwissTargetPrediction server (2019 version). The disease targets were collected by the GeneCards database searching the keywords "depression" and "anxiety". Gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analyze the intersections of targets. Network analyses were carried out using GeneMania server (2023 version) and Cytoscape (V. 3.9.1.) software. Molecular docking predicted the main targets of the network and Ligplot predicted the main intermolecular interactions. Our study showed that calcitriol may interact with multiple targets. The main targets found are the vitamin D receptor (VDR), histamine H3 receptor (H3R), endocannabinoid receptors 1 and 2 (CB1 and CB2), nuclear receptor NR1H3, patched-1 (PTCH1) protein, opioid receptor NOP, and phosphodiesterase enzymes PDE3A and PDE5A. Considering the role of these targets in the pathophysiology of depression and anxiety, our findings suggest novel putative mechanisms of action of vitamin D as well as new promising molecular targets whose role in these disorders deserves further investigation.
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Background X-linked Dystonia-Parkinsonism(XDP) is an adult-onset neurodegenerative disorder that results in the loss of striatal medium spiny neurons (MSNs). XDP is associated with disease-specific mutations in and around the TAF1 gene. This study highlights the utility of directly reprogrammed MSNs from fibroblasts of affected XDP individuals as a platform that captures cellular and epigenetic phenotypes associated with XDP-related neurodegeneration. In addition, the current study demonstrates the neuroprotective effect of SAK3 currently tested in other neurodegenerative diseases. Methods XDP fibroblasts from three independent patients as well as age- and sex-matched control fibroblasts were used to generate MSNs by direct neuronal reprogramming using miRNA-9/9*-124 and thetranscription factors CTIP2 , DLX1 -P2A- DLX2 , and MYT1L . Neuronal death, DNA damage, and mitochondrial health assays were carried out to assess the neurodegenerative state of directly reprogrammed MSNs from XDP patients (XDP-MSNs). RNA sequencing and ATAC sequencing were performed to infer changes in the transcriptomic and chromatin landscapesof XDP-MSNs compared to those of control MSNs (Ctrl-MSNs). Results Our results show that XDP patient fibroblasts can be successfully reprogrammed into MSNs and XDP-MSNs display several degenerative phenotypes, including neuronal death, DNA damage, and mitochondrial dysfunction, compared to Ctrl-MSNs reprogrammed from age- and sex-matched control individuals' fibroblasts. In addition, XDP-MSNs showed increased vulnerability to TNFα -toxicity compared to Ctrl-MSNs. To dissect the altered cellular state in XDP-MSNs, we conducted transcriptomic and chromatin accessibility analyses using RNA- and ATAC-seq. Our results indicate that pathways related to neuronal function, calcium signaling, and genes related to other neurodegenerative diseases are commonly altered in XDP-MSNs from multiple patients. Interestingly, we found that SAK3, a T-type calcium channel activator, that may have therapeutic values in other neurodegenerative disorders, protected XDP-MSNs from neuronal death. Notably, we found that SAK3-mediated alleviation of neurodegeneration in XDP-MSNs was accompanied by gene expression changes toward Ctrl-MSNs.
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This study addresses the challenge of low blood donation rates in developing countries by examining the effectiveness of a barrier-removal incentive-a one-day transportation voucher-to promote blood donation. Utilizing a longitudinal dataset of 23,750 donors from a Brazilian blood collection agency (BCA) collected between March 2018 and May 2020, we examine the short and long-term effects of this campaign on donation rates. Our results show that the incentive had a large positive influence on both donation attempts and successful donations on the day of the campaign. However, the short-term success of the intervention had an unintended consequence: the significant increase in prospective donors' waiting time at the BCA during the intervention day, which may help explain the negative impact on return rates in the 24-month follow-up. Despite these opposing outcomes, the net effect of the one-day blood donation incentive was still positive, offering valuable insights for BCAs aiming to enhance donor recruitment and retention strategies and emphasizing the need to balance immediate benefits with potential long-term impacts.
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Donantes de Sangre , Motivación , Humanos , Donantes de Sangre/psicología , Donantes de Sangre/estadística & datos numéricos , Masculino , Femenino , Adulto , Brasil , Persona de Mediana Edad , Estudios Longitudinales , Conducta SocialRESUMEN
We study the ordering dynamics of nonlinear voter models with multiple states, also providing a discussion of the two-state model. The rate with which an individual adopts an opinion scales as the qth power of the number of the individual's neighbors in that state. For q>1 the dynamics favor the opinion held by the most agents. The ordering to consensus is driven by deterministic drift, and noise plays only a minor role. For q<1 the dynamics favors minority opinions, and for multistate models the ordering proceeds through a noise-driven succession of metastable states. Unlike linear multistate systems, the nonlinear model cannot be reduced to an effective two-state model. We find that the average density of active interfaces in the model with multiple opinion states does not show a single exponential decay in time for q<1, again at variance with the linear model. This highlights the special character of the conventional (linear) voter model, in which deterministic drift is absent. As part of our analysis, we develop a pair approximation for the multistate model on graphs, valid for any positive real value of q, improving on previous approximations for nonlinear two-state voter models.
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During resolution of inflammation, specialized proresolving mediators (SPMs), including resolvins, are produced to restore tissue homeostasis. We hypothesized that there might be a dysregulation of SPMs pathways in pathological vascular remodeling and that resolvin D2 (RvD2) might prevent vascular remodeling and contractile and endothelial dysfunction in a model of obesity and hypertension. In aortic samples of patients with or without abdominal aortic aneurysms (AAA), we evaluated gene expression of enzymes involved in SPMs synthesis (ALOXs), SPMs receptors and pro-inflammatory genes. In an experimental model of aortic dilation induced by high fat diet (HFD, 60%, eighteen weeks) and angiotensin II (AngII) infusion (four weeks), we studied the effect of RvD2 administration in aorta and small mesenteric arteries structure and function and markers of inflammation. In human macrophages we evaluated the effects of AngII and RvD2 in macrophages function and SPMs profile. In patients, we found positive correlations between AAA and obesity, and between AAA and expression of ALOX15, RvD2 receptor GPR18, and pro-inflammatory genes. There was an inverse correlation between the expression of aortic ALOX15 and AAA growth rate. In the mice model, RvD2 partially prevented the HFD plus AngII-induced obesity and adipose tissue inflammation, hypertension, aortic and mesenteric arteries remodeling, hypercontratility and endothelial dysfunction, and the expression of vascular proinflammatory markers and cell apoptosis. In human macrophages, RvD2 prevented AngII-induced impaired efferocytosis and switched SPMs profile. RvD2 might represent a novel protective strategy in preventing vascular damage associated to hypertension and obesity likely through effects in vascular and immune cells.
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Ácidos Docosahexaenoicos , Hipertensión , Ratones Endogámicos C57BL , Obesidad , Remodelación Vascular , Animales , Masculino , Humanos , Ácidos Docosahexaenoicos/farmacología , Hipertensión/metabolismo , Hipertensión/tratamiento farmacológico , Obesidad/complicaciones , Obesidad/metabolismo , Remodelación Vascular/efectos de los fármacos , Ratones , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/metabolismo , Endotelio Vascular/patología , Dieta Alta en Grasa/efectos adversos , Angiotensina II , Aneurisma de la Aorta Abdominal/patología , Aneurisma de la Aorta Abdominal/metabolismo , Aneurisma de la Aorta Abdominal/tratamiento farmacológico , Mediadores de Inflamación/metabolismo , Ratones Obesos , Vasoconstricción/efectos de los fármacos , Inflamación/patología , Inflamación/metabolismo , Macrófagos/efectos de los fármacos , Macrófagos/metabolismo , Modelos Animales de EnfermedadRESUMEN
The involvement of central and peripheral inflammation in the pathogenesis and prognosis of major depressive disorder (MDD) has been demonstrated. The increase of pro-inflammatory cytokines (interleukin (IL)-1ß, IL-6, IL-18, and TNF-α) in individuals with depression may elicit neuroinflammatory processes and peripheral inflammation, mechanisms that, in turn, can contribute to gut microbiota dysbiosis. Together, neuroinflammation and gut dysbiosis induce alterations in tryptophan metabolism, culminating in decreased serotonin synthesis, impairments in neuroplasticity-related mechanisms, and glutamate-mediated excitotoxicity. This review aims to highlight the inflammatory mechanisms (neuroinflammation, peripheral inflammation, and gut dysbiosis) involved in the pathophysiology of MDD and to explore novel anti-inflammatory therapeutic approaches for this psychiatric disturbance. Several lines of evidence have indicated that in addition to antidepressants, physical exercise, probiotics, and nutraceuticals (agmatine, ascorbic acid, and vitamin D) possess anti-inflammatory effects that may contribute to their antidepressant properties. Further studies are necessary to explore the therapeutic benefits of these alternative therapies for MDD.
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Trastorno Depresivo Mayor , Humanos , Trastorno Depresivo Mayor/tratamiento farmacológico , Enfermedades Neuroinflamatorias , Disbiosis/tratamiento farmacológico , Antidepresivos/farmacología , Inflamación/metabolismo , Antiinflamatorios/uso terapéuticoRESUMEN
The main objective of this study was to evaluate the effects of supplementation the diet of pigs with grape pomace preserved in silage form (GPS) and its interaction with indoor and outdoor production systems, with and without access to vegetation, on the attributes of meat quality produced. Analyzes of proximal composition, cholesterol content, fatty acid profile, shear force, texture profile and sensory analysis were performed. During cold storage, oxidative stability and objective color were analyzed. Statistical analysis was performed in a 3x2 factorial design (production systems (S) x GPS-feed (F)) and the interaction between them (S*F). The results showed that there was no interaction between the production system and GPS feeding for the attributes evaluated. The proximate composition and fatty acid profile of the muscle remained unchanged. Additionally, it provides higher subjective and objective tenderness, higher red color intensity, and reduces lipid oxidation under refrigeration. The supplementation of pig feed with GPS improve the quality of the meat and constitute a sustainable alternative for the winemaking residue.
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Vitis , Animales , Porcinos , Criopreservación , Ácidos Grasos , Metabolismo de los Lípidos , CarneRESUMEN
Strategies to separately manufacture arterial-scale tissue engineered vascular grafts and microvascular networks have been well-established, but efforts to bridge these two length scales to create hierarchical vasculature capable of supporting parenchymal cell functions or restoring perfusion to ischemic tissues have been limited. This work aimed to create multiscale vascular constructs by assessing the capability of macroscopic vessels isolated from mice to form functional connections to engineered capillary networks ex vivo. Vessels of venous and arterial origins from both thoracic and femoral locations were isolated from mice, and then evaluated for their abilities to sprout endothelial cells (EC) capable of inosculating with surrounding human cell-derived microvasculature within bulk fibrin hydrogels. Comparing aortae, vena cavae, and femoral vessel bundles, we identified the thoracic aorta as the rodent macrovessel that yielded the greatest degree of sprouting and interconnection to surrounding capillaries. The presence of cells undergoing vascular morphogenesis in the surrounding hydrogel attenuated EC sprouting from the macrovessel compared to sprouting into acellular hydrogels, but ultimately sprouted mouse EC interacted with human cell-derived capillary networks in the bulk, yielding chimeric vessels. We then integrated micromolded mesovessels into the constructs to engineer a primitive 3-scale vascular hierarchy comprising capillaries, mesovessels, and macrovessels. Overall, this study yielded a primitive hierarchical vasculature suitable as proof-of-concept for regenerative medicine applications and as an experimental model to better understand the spontaneous formation of host-graft vessel anastomoses.
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Células Endoteliales , Ingeniería de Tejidos , Humanos , Animales , Ratones , Microvasos , Capilares , Hidrogeles , Neovascularización FisiológicaRESUMEN
Major depressive disorder (MDD) has a high prevalence and is a major contributor to the global burden of disease. This psychiatric disorder results from a complex interaction between environmental and genetic factors. In recent years, the role of the gut microbiota in brain health has received particular attention, and compelling evidence has shown that patients suffering from depression have gut dysbiosis. Several studies have reported that gut dysbiosis-induced inflammation may cause and/or contribute to the development of depression through dysregulation of the gut-brain axis. Indeed, as a consequence of gut dysbiosis, neuroinflammatory alterations caused by microglial activation together with impairments in neuroplasticity may contribute to the development of depressive symptoms. The modulation of the gut microbiota has been recognized as a potential therapeutic strategy for the management of MMD. In this regard, physical exercise has been shown to positively change microbiota composition and diversity, and this can underlie, at least in part, its antidepressant effects. Given this, the present review will explore the relationship between physical exercise, gut microbiota and depression, with an emphasis on the potential of physical exercise as a non-invasive strategy for modulating the gut microbiota and, through this, regulating the gut-brain axis and alleviating MDD-related symptoms.
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Trastorno Depresivo Mayor , Microbioma Gastrointestinal , Humanos , Trastorno Depresivo Mayor/terapia , Trastorno Depresivo Mayor/tratamiento farmacológico , Disbiosis , Inflamación , Ejercicio FísicoRESUMEN
OBJECTIVE: To evaluate the effect of home residency programs on outcomes in the otolaryngology residency match DESIGN: A retrospective online survey study during the 2015, 2018, 2019, 2020, and 2021 match cycles was conducted. All available otolaryngology residency positions listed by the National Resident Matching Program were compared with publicly available spreadsheets containing the following information: matriculated applicant name, medical school, whether the final match institution was the matriculated applicant's home program (HP), whether the matriculated applicant had completed an away rotation at their final matched institution (designated away institution, AI), or neither (designated Other Institution, OI). SETTING: Nonclinical survey study using publicly available spreadsheets containing The Match data from 2015 to 2021 located online at Otomatch.com. PARTICIPANTS: Newly matched United States otolaryngology-head and neck surgery residents completing the Otomatch.com survey RESULTS: A total of 1771 matched OHNS applicants were identified. Fifty-one percent of students were affiliated with their matched institution, with 25% of students matching at HPs, and 26% matching at AIs. Students with home programs had an increased likelihood of remaining in the same geographic region compared to students without home programs (OR 1.742 95% CI [1.21-2.506], pâ¯=â¯0.003). Applicants with HPs matched at significantly larger residency programs (p < 0.001). CONCLUSIONS: This study found that a majority of residents match at an institution with which they were affiliated, either their home program or away institution. Applicants with HPs are more likely to remain in the same geographic region as their medical school, and to match into larger residency programs compared to applicants without HPs.
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Internado y Residencia , Otolaringología , Humanos , Estados Unidos , Estudios Retrospectivos , Estudiantes , Encuestas y Cuestionarios , Otolaringología/educaciónRESUMEN
Paragonimiasis is a zoonotic, food-borne trematode infection that affects 21 million people globally. Trematodes interact with their hosts via extracellular vesicles (EV) that carry protein and RNA cargo. We analyzed EV in excretory-secretory products (ESP) released by Paragonimus kellicotti adult worms cultured in vitro (EV ESP) and EV isolated from lung cyst fluid (EV CFP) recovered from infected gerbils. The majority of EV were approximately 30-50 nm in diameter. We identified 548 P. kellicotti-derived proteins in EV ESP by mass spectrometry and 8 proteins in EV CFP of which 7 were also present in EV ESP. No parasite-derived proteins were reliably detected in EV isolated from plasma samples. A cysteine protease (MK050848, CP-6) was the most abundant protein found in EV CFP in all technical and biological replicates. Immunolocalization of CP-6 showed strong labeling in the tegument of P. kellicotti and in the adjacent cyst and lung tissue that contained worm eggs. It is likely that CP-6 present in EV is involved in parasite-host interactions. These results provide new insights into interactions between Paragonimus and their mammalian hosts, and they provide potential clues for development of novel diagnostic tools and treatments.
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Quistes , Vesículas Extracelulares , Paragonimus , Animales , Proteoma , Gerbillinae , PulmónRESUMEN
Ketamine, a racemic mixture of esketamine (S-ketamine) and arketamine (R-ketamine), has received particular attention for its rapid antidepressant and antisuicidal effects. NMDA receptor inhibition has been indicated as one of the main mechanisms of action of the racemic mixture, but other pharmacological targets have also been proposed. This study aimed to explore the possible multiple targets of ketamine enantiomers related to their antidepressant and antisuicidal effects. To this end, targets were predicted using Swiss Target Prediction software for each ketamine enantiomer. Targets related to depression and suicide were collected by the Gene Cards database. The intersections of targets were analyzed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Network pharmacology analysis was performed using Gene Mania and Cytoscape software. Molecular docking was used to predict the main targets of the network. The results indicated that esketamine and arketamine share some biological targets, particularly NMDA receptor and phosphodiesterases 3A, 7A, and 5A but have specific molecular targets. While esketamine is predicted to interact with the GABAergic system, arketamine may interact with macrophage migration inhibitory factor (MIF). Both ketamine enantiomers activate neuroplasticity-related signaling pathways and show addiction potential. Our results identified novel, poorly explored molecular targets that may be related to the beneficial effects of esketamine and arketamine against depression and suicide.
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OBJECTIVE: Otolaryngology (OTO) is a competitive specialty, and medical school factors outside an applicant's control, such as presence of OTO student resources and an affiliated OTO residency program, can impact the competitiveness of a student's application. This study sought to evaluate the extent of OTO resources United States (U.S.) allopathic medical schools provide to help their students be successful, and to evaluate for medical school factors which may bias toward inequitable distribution of student OTO resources. METHODS: A 48-question cross-sectional survey evaluating the extent of OTO resources was distributed by email to LCME accredited U.S. allopathic medical schools in 2020 and 2021. RESULTS: Schools with residency programs and where faculty were employed through an OTO or surgery department were more likely to have an Otolaryngology Interest Group (OIG), an Otolaryngology Medical Student Education Director (OMSED), and were more likely to provide opportunities for OTO research.
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Internado y Residencia , Otolaringología , Estudiantes de Medicina , Humanos , Estados Unidos , Facultades de Medicina , Estudios Transversales , Otolaringología/educaciónRESUMEN
OBJECTIVES: With an ever-expanding medical knowledge base and requirements for clinical training, medical schools struggle to incorporate subspecialty education, such as otolaryngology (OTO), into curricula. This study aims to assess the current state of OTO education, and evaluate factors contributing to the extent of OTO teaching in United States (U.S.) medical schools. METHODS: A 48-question survey evaluated the extent and practices of OTO teaching. The survey was distributed by email to all 155 LCME accredited U.S. allopathic medical schools in 2020 and 2021. RESULTS: Sixty-eight unique responses were received (43.9% of U.S. allopathic medical schools). 36.8% (n = 25) of schools reported having formal expectations of OTO knowledge in their core curriculum. Only 1 school (1.5%) had a required OTO rotation; the majority of schools offered an optional third or fourth year clerkship rotation (76.5% and 95.6%, respectively). Schools with residency programs and who employ their faculty through an OTO or surgery department were more likely to have otolaryngologists teach basic science lectures and the Head & Neck exam, offer an optional third year rotation, and have formal expectations of rotating students. CONCLUSIONS: Medical schools with residency programs and who employ their faculty through an OTO or surgery department have more robust OTO curricula. Despite the ubiquity of OTO presentations across specialties, incorporation of OTO knowledge in U.S. medical school curricula remains variable, and at times limited.
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Internado y Residencia , Otolaringología , Estados Unidos , Humanos , Facultades de Medicina , Estudios Transversales , Curriculum , Otolaringología/educaciónRESUMEN
This paper presents a new methodology to obtain prediction regions of the output of a dynamical system. The proposed approach uses stored past outputs of the system and it is entirely data-based. Only two hyperparameters are necessary to apply the proposed methodology. These scalars are chosen so that the size of the obtained regions is minimized while fulfilling the desired empirical probability in a validation set. In this paper, methods to optimally estimate both hyperparameters are provided. The provided prediction regions are convex and checking if a given point belongs to a computed prediction region amounts to solving a convex optimization problem. Also, approximation methods to build ellipsoidal prediction regions are provided. These approximations are useful when explicit descriptions of the regions are necessary. Finally, some numerical examples and comparisons for the case of a non-linear uncertain kite system are provided to prove the effectiveness of the proposed methodology.
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Sponges from South America and Antarctica are evolutionarily closely related. Specific symbiont signatures that could differentiate these two geographic regions are unknown. This study aimed to investigate the microbiome diversity of sponges from South America and Antarctica. In total 71 sponge specimens were analyzed (Antarctica: N = 59, 13 different species; South America: N = 12, 6 different species). Illumina 16S rRNA sequences were generated (2.88 million sequences; 40K ± 29K/sample). The most abundant symbionts were heterotrophic (94.8 %) and belonged mainly to Proteobacteria and Bacteroidota. EC94 was the most abundant symbiont and dominated the microbiome of some species (70-87 %), comprising at least 10 phylogroups. Each of the EC94 phylogroups was specific to one genus or species of sponge. Furthermore, South America sponges had higher abundance of photosynthetic microorganisms (2.3 %) and sponges from Antarctica, the highest abundance of chemosynthetic (5.5 %). Sponge symbionts may contribute to the function of their hosts. The unique features from each of these two regions (e.g., light, temperature, and nutrients) possibly stimulate distinct microbiome diversity from sponges biogeographically distributed across continents.
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Microbiota , Fotosíntesis , ARN Ribosómico 16S/genética , Regiones Antárticas , Bacteroidetes/genética , FilogeniaRESUMEN
Titanium dioxide nanoparticles-multiwalled carbon nanotubes (TiO2-MWCNT) nanohydrid has an enhanced photocatalytic activity across the visible light with promising applications in environmental remediation, solar energy devices and antimicrobial technologies. However, it is necessary to evaluate the toxicological effects of TiO2-MWCNT towards safe and sustainable development of nanohybrids. In this work, we studied the cytotoxicity, protein corona formation and cellular internalisation of TiO2-MWCNT on fibroblasts derived from gonadal rainbow trout tissue (RTG-2) for the first time. This nanohydrid did not show any toxicity effect on RTG-2 cells up to 100 mg L-1 after 24 h of exposure as monitored by alamar blue, neutral red and trypan blue assays (in presence or absence of foetal bovine serum, FBS). Futhermore, cryo-transmission electron microscopy analysis demonstrated that TiO2 particles is attached on nanotube surface after FBS-protein corona formation in cell culture medium. Raman spectroscopy imaging showed that TiO2-MWCNT can be internalised by RTG-2 cells. This work is a novel contribution towards better understanding the nanobiointeractions of nanohydrids linked to their in vitro effects on fish cells in aquatic nanoecotoxicology.