To compare the completeness and quality of information about diabetic retinopathy on Wikipedia in the world's leading spoken languages in 2020. An observational, descriptive, cross-sectional study. ...The information on diabetic retinopathy obtained from the free encyclopedia Wikipedia.sup.® was assessed in languages with one hundred million or more total speakers. The term "diabetic retinopathy" was accessed in the corresponding Wikipedia entry in English, while the "more languages" function gives access to other languages. The information on the sites was collected by three ophthalmologist observers. A database was created with the most important subtopics for the education of patients with diabetic retinopathy in any of its classifications, based on a 25-question survey. The results were stratified on a scale from 0 to 4. A confirming correlation was found in the statistical analysis among the observers. No language achieved the label "excellent"; 2 languages were rated as "fair "; 4 languages qualified as "substandard"; and 7 languages were scored as "poor." No information could be found in five languages. As would be expected, the quality of content is variable across different languages. However, if anyone can edit Wikipedia, health professionals can do so as well to improve the quality and quantity of information for patients.
The aim was to evaluate the concordance in the diagnosis of precursor lesions of intestinal-type gastric carcinoma among observers with different levels of experience.
Gastric biopsies from 1 056 ...cases were studied: 341 from Colombia, 382 from Mexico, and 333 from Paraguay. Pathologists without experience (A) and with experience (B) in gastrointestinal pathology, as well as experts working in an international reference center (C) participated in the diagnosis of each case.
The concordance (k) between pathologists with experience and those without was poor for the diagnosis of atrophic gastritis (k=0.04 to 0.12) and dysplasia (k=0.11 to 0.05), and good for the diagnosis of intestinal metaplasia (k=0.52 to 0.58). Supervision of pathologists without experience by those with experience remarkably improved the concordance in the diagnosis of atrophic gastritis (k=0.65) and intestinal metaplasia (k=0.91), and to a lesser degree, of dysplasia (k=0.28). The concordance among experts before and after the consensus meeting showed no variation in the diagnosis of atrophic gastritis (k=0.57); the concordance varied from good to excellent in the diagnosis of intestinal metaplasia (k=0.67 to 0.81) and from poor to good in that of dysplasia (k=0.18 to 0.66).
The greatest differences arose in the diagnosis of chronic atrophic gastritis and dysplasia. The interobserver concordance depended on the experience of the observer and the consensus reading.
ObjectiveTo compare the completeness and quality of information about diabetic retinopathy on Wikipedia in the world's leading spoken languages in 2020.Design and methodsAn observational, ...descriptive, cross-sectional study. The information on diabetic retinopathy obtained from the free encyclopedia Wikipedia® was assessed in languages with one hundred million or more total speakers. The term "diabetic retinopathy" was accessed in the corresponding Wikipedia entry in English, while the "more languages" function gives access to other languages. The information on the sites was collected by three ophthalmologist observers. A database was created with the most important subtopics for the education of patients with diabetic retinopathy in any of its classifications, based on a 25-question survey. The results were stratified on a scale from 0 to 4. A confirming correlation was found in the statistical analysis among the observers.ResultsNo language achieved the label "excellent"; 2 languages were rated as "fair "; 4 languages qualified as "substandard"; and 7 languages were scored as "poor." No information could be found in five languages.ConclusionsAs would be expected, the quality of content is variable across different languages. However, if anyone can edit Wikipedia, health professionals can do so as well to improve the quality and quantity of information for patients.
Objetivo. Evaluar la concordancia en el diagnóstico de lesiones precursoras del carcinoma gástrico de tipo intestinal entre observadores con diferente experiencia. Material y métodos. Se estudiaron 1 ...056 casos de biopsias gástricas: 341 de Colombia, 382 de México y 333 de Paraguay. En el diagnóstico de cada caso participaron patólogos sin experiencia en patología gastrointestinal (A), patólogos con experiencia en patología gastrointestinal (B) y expertos que trabajan en un centro de referencia internacional (C). Resultados. La concordancia (k) entre patólogos inexpertos y expertos fue pobre en el diagnóstico de gastritis atrófica (k=0.04 a 0.12) y displasia (k=0.11 a 0.05) y buena en el diagnóstico de metaplasia intestinal (k=0.52 a 0.58); la supervisión de un patólogo inexperto por un experto mejoró notablemente la concordancia en el diagnóstico de gastritis atrófica (k=0.65) y metaplasia intestinal (k=0.91) y, en un menor grado, de displasia (k=0.28). Al comparar la concordancia entre expertos antes y después de la reunión de consenso no hubo variación en el diagnóstico de gastritis atrófica (k=0.57); la concordancia varió de buena a excelente en el de metaplasia intestinal (k=0.67 a 0.81) y de pobre a buena en el de displasia (k=0.18 a 0.66). Conclusión. Los principales problemas se presentan en el diagnóstico de la gastritis crónica atrófica y la displasia. La concordancia interobservador depende de la experiencia del observador y la lectura de consenso.
Objetivo. Evaluar la concordancia en el diagnóstico de lesiones precursoras del carcinoma gástrico de tipo intestinal entre observadores con diferente experiencia. Material y métodos. Se estudiaron 1 ...056 casos de biopsias gástricas: 341 de Colombia, 382 de México y 333 de Paraguay. En el diagnóstico de cada caso participaron patólogos sin experiencia en patología gastrointestinal (A), patólogos con experiencia en patología gastrointestinal (B) y expertos que trabajan en un centro de referencia internacional (C). Resultados. La concordancia (k) entre patólogos inexpertos y expertos fue pobre en el diagnóstico de gastritis atrófica (k=0.04 a 0.12) y displasia (k=0.11 a 0.05) y buena en el diagnóstico de metaplasia intestinal (k=0.52 a 0.58); la supervisión de un patólogo inexperto por un experto mejoró notablemente la concordancia en el diagnóstico de gastritis atrófica (k=0.65) y metaplasia intestinal (k=0.91) y, en un menor grado, de displasia (k=0.28). Al comparar la concordancia entre expertos antes y después de la reunión de consenso no hubo variación en el diagnóstico de gastritis atrófica (k=0.57); la concordancia varió de buena a excelente en el de metaplasia intestinal (k=0.67 a 0.81) y de pobre a buena en el de displasia (k=0.18 a 0.66). Conclusión. Los principales problemas se presentan en el diagnóstico de la gastritis crónica atrófica y la displasia. La concordancia interobservador depende de la experiencia del observador y la lectura de consenso.Objective. The aim was to evaluate the concordance in the diagnosis of precursor lesions of intestinal-type gastric carcinoma among observers with different levels of experience. Material and Methods. Gastric biopsies from 1 056 cases were studied: 341 from Colombia, 382 from Mexico, and 333 from Paraguay. Pathologists without experience (A) and with experience (B) in gastrointestinal pathology, as well as experts working in an international reference center (C) participated in the diagnosis of each case. Results. The concordance (k) between pathologists with experience and those without was poor for the diagnosis of atrophic gastritis (k=0.04 to 0.12) and dysplasia (k=0.11 to 0.05), and good for the diagnosis of intestinal metaplasia (k=0.52 to 0.58). Supervision of pathologists without experience by those with experience remarkably improved the concordance in the diagnosis of atrophic gastritis (k=0.65) and intestinal metaplasia (k=0.91), and to a lesser degree, of dysplasia (k=0.28). The concordance among experts before and after the consensus meeting showed no variation in the diagnosis of atrophic gastritis (k=0.57); the concordance varied from good to excellent in the diagnosis of intestinal metaplasia (k=0.67 to 0.81) and from poor to good in that of dysplasia (k=0.18 to 0.66). Conclusion. The greatest differences arose in the diagnosis of chronic atrophic gastritis and dysplasia. The interobserver concordance depended on the experience of the observer and the consensus reading.
Aim
Liver fibrosis results in a disproportion of the hepatic composition and architecture, characterized by a progressive accumulation of fibrillar proteins at the liver parenchyma. ...Modulated‐differential scanning calorimetry (mDSC) is an experimental methodology able to determine the specific thermal signature from any biological substance, based on the variation in heat flow and heat capacity. As these physicochemical properties are directly influenced by compositional and structural changes, we decided to study the thermal behavior of the liver during fibrosis using mDSC.
Methods
Liver fibrosis was induced in rats by bile duct ligation or carbon tetrachloride administration. Degree of liver fibrosis was determined by histological examination using the Masson‐trichrome stain, accompanied by hepatic expression of α‐smooth muscle actin. The thermal analysis was performed in a modulated‐differential scanning calorimeter using 20 mg of fresh liver mass.
Results
The liver showed a characteristic thermal signature in control animals, which progressively differed among mild (F1), moderate (F2) and advanced (F3–F4) liver fibrosis. For heat flow, the hepatic thermal signature from F3–F4 rats exhibited significant differences when compared with F1, F2 and controls. In terms of heat capacity, liver specimens provided a specific thermal signature for each stage of disease, characterized by a transition temperature onset at 95°C for controls, whereas in F1, F2 and F3–F4 animals this temperature significantly decreased to 93°C, 84°C and 75°C, respectively.
Conclusion
Because the liver shows a differential thermal signature according to the degree of fibrosis, mDSC could be a novel tool in the study of liver fibrosis progression.
The COVID-19 pandemic has prompted a transformation of medical training. Although there were obvious medical education and social interaction challenges, e-learning presented some advantages, which ...may have generated medical curricula innovation and adjustments to novel technological methodologies. This study aims to generate consensuses among medical students regarding medical education provided during the pandemic in the resource-limited context of a Global South university. The implementation of a participatory Delphi method included a recruitment campaign, training, constitution of Delphi panels and questions, and development of the Delphi exercises. Students from the second to the sixth year of medicine of a university in Quito, Ecuador, constituted two Delphi panels, developed questions about the education received during the pandemic, and answered them over 3.5 rounds. Twenty-two medical students participated in the Delphi exercises about their perception of medical education during the COVID-19 pandemic. The analysis consisted of a total of 22 Delphi questions divided into five distinct categories: adaptations and innovations, curriculum and assessment changes, virtual clinical practice, time management, and mental health. The authors established high, medium, and low consensuses for analysis. Consensuses were reached based on students' academic year and focused on the changes in lecture delivery, the usage of new technologies, patient care skills, the impact of the educational routine, and the mental health of the COVID-19 pandemic. The way the pandemic affected medical education in the Global South set the stage for the need for a comprehensive review of tools, skills, and curricula for students from culturally diverse backgrounds. This study offers a highly replicable methodology to generate consensuses and introduce students to academic research.
Advertising exhibits elements of culture either because they respond to social accepted aspects or because they do not transgress even though there is a disruptive and emotional type of advertising ...that can be applied (as a tendency for advertising communication). The advertising of the current century shows subjective, emotional and disruptive elements and along with it, in recent years it does not lose the opportunity to exhibit the conglomerate of Lesbians, Gays, Bisexuals, Transsexuals and Intersexes (LGBTI) in the media and in advertising in Ecuador either directly or apparently subtly or indirectly. There have been few cases arisen from brands and social causes in the Ecuadorian country where brands such as uber, pilsener and pringles were evidenced by the day of gay pride in 2019 in Guayaquil city. This work is treated from a humanistic epistemological foundation since it is known that these groups have been discriminated throughout the history of mankind and nowadays the media and advertising begin to gain a place for debate, and exposure, but at the same time the controversy that brings the disruptive publicity of this subject. Society is shifting towards the inclusion and acceptance of human rights, for this reason, this essay presents that thanks to this cultural and social transformation, the LGBTL conglomerate will have a greater presence in trademarks and media in Ecuador and will have an impact on society understanding, normalizing and accepting a group of people who have been unfairly discriminated.
La publicidad exhibe elementos de la cultura, ya sea porque estos responden a los aspectos socialmente aceptados o porque no transgreden a pesar de que se pueda aplicar un tipo de publicidad disruptiva y emocional (como tendencia de comunicación publicitaria). La publicidad del actual siglo muestra elementos subjetivos, emocionales y disruptivos, y junto con ello, en los últimos años no pierde la oportunidad de exhibir al conglomerado de Lesbianas, Gays, Bisexuales, Transexuales e Intersexuales (LGBTI) en los medios de comunicación y anuncios publicitarios en Ecuador. Ya sea de manera directa o aparentemente sutil o indirecta. Por lo tanto, no han sido escasos los casos que han surgido de marcas comerciales y causas sociales en el país ecuatoriano donde se evidenciaron marcas como “uber”, “pilsener” y “pringles” por el día del orgullo gay en el 2019 en la ciudad de Guayaquil. Este trabajo es tratado desde un fundamento epistemológico humanista ya que se conoce que estos colectivos han sido discriminados a lo largo de la historia de la humanidad y en la actualidad los medios de comunicación y la publicidad empiezan a ganar un lugar para el debate, la exposición justa, pero al mismo tiempo la polémica que trae consigo la publicidad disruptiva de este tema. La sociedad está cambiando hacia la inclusión y la aceptación de los derechos humanos, por este motivo, el presente ensayo alude a que gracias a esta transformación cultural y social, el conglomerado LGBTI tendrá mayor presencia en las marcas comerciales y medios de comunicación en el Ecuador y lo indicado va a repercutir en que la sociedad entienda, normalice y acepte a un grupo de personas que han sido injustamente discriminadas.
Context:
Genomic imprinting is the modification of the genome so that genes from only one (rather than two) of the parental alleles are expressed. The mechanism underlying imprinting is epigenetic, ...occurring via changes in DNA methylation and histone modifications rather than through alterations in the DNA sequence. To date, nine different imprinting disorders have been clinically and genetically identified and a considerable research effort has been focused on determining the cause of the corresponding methylation defects.
Objective:
Our objective was to identify multilocus imprinting defects and characterize any mutations in trans-acting genes in patients with pseudohypoparathyroidism (PHP) caused by epigenetic alterations at GNAS locus.
Design:
We have investigated multilocus imprinting defects in 22 PHP patients with aberrant methylation at the GNAS locus not due to previously described deletions or to paternal uniparental disomy (UPD) of chromosome 20.
Results:
We found that, in contrast to what has been described in growth disorders, multilocus hypomethylation is an uncommon event in PHP patients. We were also unable to identify any genetic alteration causative of the epigenetic defects in the currently known methylation regulatory genes.
Conclusion:
Our work suggests that a trans-acting gene regulating the establishment or maintenance of imprinting at GNAS locus, if it exists, should be specific to PHP cases caused by epigenetic defects at GNAS.
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