Fetal hemoglobin (HbF) has a higher affinity to oxygen than adult hemoglobin, allowing for a slower oxygen transfer to peripheral tissue, creating a microenvironment conducive to adequate fetal ...development
. However, most preterm infants receive packed red blood cell transfusions from adult donors leading to a drastic nonphysiological descent of circulating HbF. We hypothesized that this drop could enhance oxygen delivery to peripheral tissues generating a hyperoxic pro-oxidant environment. To investigate this, we assessed differences in oxidative stress biomarkers determined in urine samples in a cohort of 56 preterm infants born <32 weeks' gestation. Median oxidative stress biomarkers were compared between patients with circulating HbF above or below median HbF levels using Wilcoxon rank sum test. Oxidative stress biomarkers were significantly higher in the group of patients with lower levels of HbF. This study provides the initial evidence indicating elevated levels of oxidative stress biomarkers in preterm neonates with lower HbF levels. Based on the results, we hypothesize that HbF may contribute to preventing free radical-associated conditions during the newborn period.
40, 453-459.
Ventilator-associated pneumonia (VAP) constitutes a serious nosocomial infection. Our aim was to evaluate the reliability of cytokines and oxidative stress/inflammation biomarkers in bronchoalveolar ...lavage fluid (BALF) and tracheal aspirates (TA) as early biomarkers of VAP in preterm infants.
Two cohorts were enrolled, one to select candidates and the other for validation. In both, we included preterms with suspected VAP, according to BALF culture, they were classified into confirmed VAP and no VAP. Concentration of 16 cytokines and 8 oxidative stress/inflammation biomarkers in BALF and TA was determined in all patients.
In the first batch, IL-17A and TNF-α in BALF, and in the second one IL-10, IL-6, and TNF-α in BALF were significantly higher in VAP patients. BALF TNF-α AUC in both cohorts was 0.86 (sensitivity 0.83, specificity 0.88). No cytokine was shown to be predictive of VAP in TA. A statistically significant increase in the VAP group was found for glutathione sulfonamide (GSA) in BALF and TA.
TNF-α in BALF and GSA in BALF and TA were associated with VAP in preterm newborns; thus, they could be used as early biomarkers of VAP. Further studies with an increased number of patients are needed to confirm these results.
We found that TNF-α BALF and GSA in both BALF and TA are capable of discriminating preterm infants with VAP from those with pulmonary pathology without infection. This is the first study in preterm infants aiming to evaluate the reliability of cytokines and oxidative stress/inflammation biomarkers in BALF and TA as early diagnostic markers of VAP. We have validated these results in two independent cohorts of patients. Previously studies have focused on full-term neonates and toddlers and determined biomarkers mostly in TA, but none was exclusively conducted in preterm infants.
This is a narrative review about the mechanisms involved in bacterial sepsis in preterm infants, which is an illness with a high incidence, morbidity, and mortality. The role of the innate immune ...response and its relationship with oxidative stress in the pathogenesis are described as well as their potential implementation as early biomarkers. Moreover, we address the impact that all the mechanisms triggered by sepsis have on the dysbiosis and the changes on neonatal microbiota.
Women are underrepresented in acute myocardial infarction (AMI) studies. Furthermore, there is scarce information regarding women with AMI in Latin America.
To describe the presentation, clinical ...characteristics, risk factor burden, evidence-based care, and in-hospital outcome in a population of women with AMI admitted to a coronary care unit (CCU) in Mexico.
Retrospective cohort study including patients with AMI admitted from January 2006 to December 2021 in a CCU. We identified patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). We described demographic characteristics, clinical variables, treatment, and in-hospital outcomes according to gender. Cox regression analysis was used to identify predictors of mortality.
Our study included 12,069 patients with AMI, of whom 7,599 had STEMI and 4,470 had NSTEMI. Women represented 19.6% of the population. Women had higher rates of hypertension, diabetes, stroke, and atrial fibrillation than men. For STEMI, women were less likely to receive reperfusion therapy (fibrinolysis; 23.7 vs. 28.5%, p < 0.001 and primary percutaneous coronary intervention (PCI); 31.2 vs. 35.1%, p = 0.001) and had more major adverse events than men: heart failure (4.2 vs. 2.5%, p = 0.002), pulmonary edema (3.4% vs. 1.7%, p < 0.001), major bleeding (2.1% vs. 1%, p = 0.002), stroke (1.3% vs. 0.6%, p = 0.008), and mortality (15.1% vs. 8.1%, p < 0.001). For NSTEMI, women were less likely to undergo coronary angiography or PCI and had more major bleeding and mortality. Multivariate Cox regression analysis revealed that females had an increase in mortality in STEMI and NSTEMI (HR 1.21, CI 1.01-1.47, p = 0.05 and HR 1.39, CI 1.06-1.81, p = 0.01).
Real-world evidence from a hospital in a Latin American low- to middle-income country (LMIC) showed that women with AMI had more comorbidities, received less reperfusion treatment or invasive strategies, and had worse outcomes. In STEMI and NSTEMI, female gender represented an independent predictor of in-hospital mortality.
Introduction
In the world, 33% of soils are degraded, and 2.9 million people are affected by land degradation, with problems associated with food security, conflicts over natural resources, and ...migration with different impacts on men or women. To support sustainable soil management, it is necessary to include women’s contributions to soil Sciences; their achievements and academic performance still need to be represented. Women in Science represent 30% worldwide. In Mexico, only 24% of top academic positions are women. For commitment to soil Sciences for Sustainable Development Goals (SDGs), UNAM created the University Program for Interdisciplinary Soil Studies (PUEIS).
Methods
This research evaluates women’s representation through gender indicators in the PUEIS and SNI datasets and discusses their implications for the gender gap in the soil Science community from Mexico. The data was collected with an online semi-structured survey and the gender indicators selected were related to participation, gender gap, sexism, equal opportunities, exclusion, and academic performance.
Results
The results show that in the PUEIS, 54% of members identify themselves as women and 46% as men. The gender gap shows equality in the total number of members. However, low-rank jobs, such as lecturers and lab technicians are women dominated, and the top-ranked positions as a full professor, associate professor, and research scientist are equal. One result to consider for the PUEIS members is that the younger generation, as is the older generation, is dominated by men. This could indicate a setback in intermediate generations’ progress toward achieving gender equality. In the case of SNI members, there is a gender gap problem; of members with a Ph.D. degree, only 38% are women, and the elite group of scientists with a Ph.D. at the top position is represented only by 24% of females.
Discussion
This work constitutes the first gender exercise for analyzing women’s participation in the soil Sciences in Mexico. From our perspective, it is not about competition in scientific careers between women and men; however, it is essential to recognize that gender inequalities are related to income, professional development, and science funding inequalities, and these disparities impact women more than men.
Cell migration plays a critical role in development, angiogenesis, immune response, wound healing and cancer metastasis. During these processes, cells are often directed to migrate towards targets by ...sensing aligned fibers or gradients in concentration, mechanical properties or electric field. Often times, cells must integrate migrational information from several of these different cues. While the cell migration behavior, signal transduction and cytoskeleton dynamics elicited by individual directional cues has been largely determined, responses to multiple directional cues are much less understood. However, initial work has pointed to several interesting behaviors in multi-cue environments, including competition and cooperation between cues to determine the migrational responses of cells. Much of the work on multi-cue sensing has been driven by the recent development of approaches to systematically and simultaneously control directional cues
in vitro
coupled with analysis and modeling that quantitatively describe those responses. In this review we present an overview of multi-cue directed migration with an emphasis on how cues compete or cooperate. We outline how multi-cue responses such as cue dominance might change depending on other environmental inputs. Finally, the challenges associated with the design of the environments to control multiple cues and the analysis and modeling of cell migration in multi-cue environments as well as some interesting biological questions associated with migration in complex environments are discussed. Understanding multi-cue migrational responses is critical to the mechanistic description of physiology and pathology, but also to the design of engineered tissues, where cell migration must be orchestrated to form specific tissue structures.
In vivo
, directed cell migration is driven by multiple simultaneously presented cues, consequently understanding cue integration requires engineering complex environments.
•We present a standardisation for evaluating segmentation algorithms for late enhancement imaging of infarct in the left ventricle.•We demonstrate that widely used fixed thresholding methods such as ...the standard deviation method can have inaccuracies and is user-dependent.•We provide a consensus ground truth obtained with statistical modelling on the benchmark datasets. Future algorithms can thus be benchmarked to provide a more reliable result.
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Studies have demonstrated the feasibility of late Gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging for guiding the management of patients with sequelae to myocardial infarction, such as ventricular tachycardia and heart failure. Clinical implementation of these developments necessitates a reproducible and reliable segmentation of the infarcted regions. It is challenging to compare new algorithms for infarct segmentation in the left ventricle (LV) with existing algorithms. Benchmarking datasets with evaluation strategies are much needed to facilitate comparison. This manuscript presents a benchmarking evaluation framework for future algorithms that segment infarct from LGE CMR of the LV. The image database consists of 30 LGE CMR images of both humans and pigs that were acquired from two separate imaging centres. A consensus ground truth was obtained for all data using maximum likelihood estimation.
Six widely-used fixed-thresholding methods and five recently developed algorithms are tested on the benchmarking framework. Results demonstrate that the algorithms have better overlap with the consensus ground truth than most of the n-SD fixed-thresholding methods, with the exception of the Full-Width-at-Half-Maximum (FWHM) fixed-thresholding method. Some of the pitfalls of fixed thresholding methods are demonstrated in this work. The benchmarking evaluation framework, which is a contribution of this work, can be used to test and benchmark future algorithms that detect and quantify infarct in LGE CMR images of the LV. The datasets, ground truth and evaluation code have been made publicly available through the website: https://www.cardiacatlas.org/web/guest/challenges.
El presente proyecto tiene como objetivo diseñar una estrategia de internacionalización para pymes de la industria de la madera en Colombia. Lo anterior por medio de un proceso metodológico mixto, ...con primacía cualitativa. Esto mediante el análisis de datos encontrados en Emis University de 228 empresas pertenecientes al subsector maderero, con las cuales se realiza una caracterización para determinar el posible comportamiento de la industria. Adicionalmente se realiza una serie de entrevistas a empresas potenciales para la internacionalización con el fin de conocer oportunidades, amenazas, debilidades y fortalezas; en el momento que la empresa decide tener una visión a mercados globales. Por eso se pretende diseñar una estrategia de internacionalización que en primer momento se enfoque en las empresas dedicadas exclusivamente al tratamiento, manipulación y venta de productos a base de madera, pero que no se cierra a la oportunidad de que dicha estrategia sirva para otros sectores económicos.
La endocarditis asociada a ANCA anti-PR3 e insuficiencia renal plantea un dilema tanto en su diagnóstico como tratamiento. Para abordar una revisión de dicho tema, se presenta el caso de un paciente ...con glomerulonefritis rápidamente progresiva secundaria a endocarditis subaguda por Enterococcus faecalis y positividad para ANCA anti-PR3. El diagnóstico diferencial principal se establecería entre una afectación renal de una vasculitis asociada a ANCA no diagnosticada previamente vs una glomerulonefritis postinfecciosa secundaria a la endocarditis. En muchos casos es necesario disponer de una biopsia renal que esclarezca el diagnóstico, ya que una inmunofluorescencia negativa orientará hacia una vasculitis, mientras que una positividad para inmunocomplejos iría a favor de una glomerulonefritis postestreptocócica. El tratamiento a seguir es otro reto que se plantea en la coexistencia de insuficiencia renal aguda, endocarditis y ANCA anti-PR3 positivo. La positividad de ANCAs induce a valorar iniciar tratamiento con inmunosupresores, no obstante, en el lecho de una endocarditis puede resultar desaconsejado e incluso poner en riesgo la vida del paciente someterlo a un estado de inmunosupresión. Es, por tanto, controvertido el uso de inmunosupresión en combinación con antibioterapia en el proceso agudo en contraposición al uso de antibioterapia exclusivamente. En el actual artículo se recogen los 19 casos publicados en la literatura de endocarditis asociados a ANCA anti-PR3, así como el tratamiento que se realizó en cada uno de los casos y la evolución en la función renal de cada paciente, concluyendo, en general, una mejor recuperación de la función renal en los pacientes tratados con antibioterapia en exclusiva que en aquellos tratados con la combinación antibióticocorticoides. Sin embargo, dado el pequeño tamaño muestral, no se puede considerar significativa la diferencia entre ambos tratamientos.
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