Playing the Game : A Case Study of Latinx Leaders in an Agricultural Youth Organization

Latinx members of the FFA Organization are disproportionately underrepresented in leadership positions. When they do get elected to leadership offices, they oftentimes have to accept behaviors that erase their cultural identity. This study aims to find what aspects of their identity they feel they have to give up in order to be seen as a potential state or national FFA candidate. Findings include the participation of the state-officer game, joining cliques that fit the white mold, and overall, assimilation on an individual and group scale. Recommendations include systemic change for state and national FFA staff, agricultural education, and the agricultural youth organizatio

Retrospective Analysis of Emergency Department Ultrasound for Acute Appendicitis

OBJECTIVES: To determine whether emergency physicians (EPs) who have skills in the other applications of ultrasound can apply these in appendicitis diagnosis. METHODS: EPs did not have focused training in bedside ultrasound for appendicitis. We identified patients receiving an ED bedside ultrasound evaluation for appendicitis from our ultrasound log. Criterion reference was radiology ultrasound (RUS), CT scan, or pathology report. RESULTS: We performed 155 ED ultrasounds for appendicitis. There were 27/155 cases where the ED ultrasound was true positive and agreed with pathology (sensitivity = 39%, 95% CI 28 – 52%). In 42/155 (27%) the ED ultrasound was non-diagnostic (false negative) with pathology positive. In 77 cases the ED ultrasound was true negative with non-visualization of the appendix in concert with non-visualization by RUS or CT scan (specificity = 90%, 95% CI 81-95%). In nine cases (6%), ED ultrasound was falsely positive, compared to CT scan with surgical consult. CONCLUSION: ED ultrasound by EPs prior to focused appendicitis ultrasound training is insufficiently accurate

Effect of a Medical Student Emergency Ultrasound Clerkship on Number of Emergency Department Ultrasounds

Objective: To determine whether a medical student emergency ultrasound clerkship has an effect on the number of patients undergoing ultrasonography and the number of total scans in the emergency department.Methods: We conducted a prospective, single-blinded study of scanning by emergency medicine residents and attendings with and without medical students. Rotating ultrasound medical students were assigned to work equally on all days of the week. We collected the number of patients scanned and the number of scans, as well as participation of resident and faculty.Results: In seven months 2,186 scans were done on the 109 days with students and 707 scans on the 72 days without them. Data on 22 days was not recorded. A median of 13 patients per day were scanned with medical students (CI 12-15) versus seven (CI 6-9) when not. In addition, the median number of scans was 18 per day with medical students (CI 16-20) versus eight (CI 6-10) without them.Conclusion: There were significantly more patients scanned and scans done when ultrasound medical students were present. [West J Emerg Med. 2010; 11:31-34]

Accuracy of ED Bedside Ultrasound for Identification of gallstones: retrospective analysis of 575 studies

Study Objective: To determine the ability of emergency department (ED) physicians to diagnose cholelithiasis with bedside ultrasound. Methods: ED gallbladder ultrasounds recorded over 37 months were compared to radiology ultrasound interpretation. Results: Of 1,690 ED gallbladder ultrasound scans performed during this period, radiology ultrasound was performed in 575/1690 (34%) cases. ED physician bedside interpretation was 88% sensitive [95% CI, 84-91] and 87% specific [95% CI, 82-91], while positive predictive value (PPV) was 91% [88- 94%] and negative predictive value (NPV) was 83% [78-87%], using radiology interpretation as the criterion reference. Conclusion: ED physician ultrasound of the gallbladder for cholelithiasis is both sensitive and specific

Neuroprotection, Photoperiod, and Sleep

After an acquired brain injury, responses that induce cell death are activated; however, neuroprotective mechanisms are also activated. The relation between these responses determines the destination of the damaged tissue. This relation presents variations throughout the day; numerous studies have shown that the onset of a stroke occurs preferably in the morning. In the rat, ischemia causes more damage when it is induced during the night. The damage caused by a traumatic brain injury (TBI), in the rat, varies depending on the time of day it is induced. Minor behavioral damage has been reported when the TBI occurs during the night, a period that coincides with the wakefulness of the rat. It also has been observed that sleep deprivation accelerates the recovery. Our group has documented that this is due, in part, to a difference in the degree of activation of cannabinergic, GABAergyc, and glutamatergic systems

Educational Assessment of Medical Student Rotation in Emergency Ultrasound

Background: Medical student ultrasound education is sparse. In 2002, we began the first medical student rotation in emergency ultrasound. Objective: To evaluate if medical students can learn and retain sonographic skills during a two- or four-week elective. Methods: We gave students an exam on the first and last days of the rotation. Six months later, students took the exam a third time. A control group was used for comparison. Results: Over a 19-month period, we enrolled 45 students (25 on the two-week and 20 on the four-week elective). The four-week student post-test score was significantly better than the two- week posttest score (81% vs. 72%, p=0.003). On the six-month exam, the four-week student post-test score was significantly better than the two-week post-test score (77% vs 69%, p=0.008). The control group did not statistically improve. Conclusion: Medical students can learn bedside ultrasound interpretation with clinical integration and retain the knowledge six months later

Intranasal dexamethasone: a new clinical trial for the control of inflammation and neuroinflammation in COVID-19 patients

Background: By end December of 2021, COVID-19 has infected around 276 million individuals and caused over 5 million deaths worldwide. Infection results in dysregulated systemic inflammation, multi-organ dysfunction, and critical illness. Cells of the central nervous system are also affected, triggering an uncontrolled neuroinflammatory response. Low doses of glucocorticoids, administered orally or intravenously, reduce mortality among moderate and severe COVID-19 patients. However, low doses administered by these routes do not reach therapeutic levels in the CNS. In contrast, intranasally administered dexamethasone can result in therapeutic doses in the CNS even at low doses. Methods: This is an approved open-label, multicenter, randomized controlled trial to compare the effectiveness of intranasal versus intravenous dexamethasone administered in low doses to moderate and severe COVID-19 adult patients. The protocol is conducted in five health institutions in Mexico City. A total of 120 patients will be randomized into two groups (intravenous vs. intranasal) at a 1:1 ratio. Both groups will be treated with the corresponding dexamethasone scheme for 10 days. The primary outcome of the study will be clinical improvement, defined as a statistically significant reduction in the NEWS-2 score of patients with intranasal versus intravenous dexamethasone administration. The secondary outcome will be the reduction in mortality during hospitalization. Conclusions: This protocol is currently in progress to improve the efficacy of the standard therapeutic dexamethasone regimen for moderate and severe COVID-19 patients. Trial registration: ClinicalTrials.gov NCT04513184 . Registered November 12, 2020. Approved by La Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS) with identification number DI/20/407/04/36. People are currently being recruited

Evaluación de la posición condilar mediante tomografía computarizada de haz cónico en pacientes Clase III sometidos a cirugía ortognática

Objective. The purpose of this study was to compare the changes by conical beam computed tomography in the condylar positioning of Class III patients before and after a sagittal osteotomy of the bilateral mandibular ramus in Class III indicated for mandibular retroposition. Methods. Thirty patients were analyzed, 16 women and 14 men with an age range of 15 to 40 years and untreated Class III dentofacial deformity who were attended by diagnostic consultation during the period from 2013 to 2016 at the “General Ignacio Zaragoza” Regional Hospital (CDMX, Mexico), performing measurements of the condylar position in three stages: presurgical, intermediate (4 days after surgery) and final (9 months after surgery), in two planes: sagittal section and coronal section. Results. No significant difference was observed in the anterior, central and posterior spaces before (2.56 ± 0.55 mm; 1.78 ± 0.48 mm; 1.92 ± 0.36 mm) and after (2.68 ± 0.51 mm; 1.87 ± 0.43 mm; 2.01 ± 0.37 mm), mean difference -0.120; -0,085; -0.090 p=0.921; 0.948 and 0.778, respectively. Similarly, in the coronal section there are no significant changes in the right condylar angles before (68.25 ± 1.56 °) and after (68.77 ± 1.63°) p=0.217; and left before (68.92 ± 1.63°) and then (69.30 ± 2°) p=0.215. Conclusions. Sagittal osteotomy of the bilateral mandibular ramus in Class III patients is a surgical technique that offers minimal condylar alterations, since it maintains a condylar stability in the postoperative period at 9 months.Objetivo. El propósito de este estudio fue comparar los cambios mediante tomografía computarizada de haz cónico en el posicionamiento condilar de pacientes Clase III antes y después de una osteotomía sagital bilateral de rama mandibular indicada para la retroposición mandibular. Métodos. Se analizaron 30 pacientes, 16 mujeres y 14 hombres con rango de edad de 15 a 40 años y deformidad dentofacial Clase III no tratada que asistieron a consulta de diagnóstico en el periodo del año 2013 al 2016 en el Hospital Regional “General Ignacio Zaragoza” (CDMX, México), realizándoseles mediciones de la posición condilar en tres tiempos: prequirúrgico, intermedio (4 días posquirúrgico) y final (9 meses posquirúrgico), en dos planos: corte sagital y corte coronal. Resultados. No se observó diferencia significativa en los espacios anterior, central y posterior antes (2,56 ± 0,55 mm; 1,78 ± 0,48 mm; 1,92 ± 0,36 mm) y después (2,68 ± 0,51 mm; 1,87 ± 0,43 mm; 2,01 ± 0,37 mm), diferencia de medias -0,120; -0,085; -0,090 p=0,921; 0,948 y 0,778, respectivamente. Del mismo modo, en el corte coronal no se observan cambios significativos en los ángulos condilares derecho antes (68,25 ± 1,56°) y después (68,77 ± 1,63°) p=0,217; e izquierdo antes (68,92 ± 1,63°) y después (69,30 ± 2°) p=0,215. Conclusiones. La osteotomía sagital bilateral de rama mandibular en pacientes Clase III es una técnica quirúrgica que ofrece mínimas alteraciones condilares, pues mantiene una estabilidad condilar en el posoperatorio a 9 meses

Reversal of gastrointestinal carcinoma-induced immunosuppression and induction of antitumoural immunity by a combination of cyclophosphamide and gene transfer of IL-12

Immunotherapy-based strategies for gastrointestinal carcinomas (GIC) have been exploited so far, but these approaches have to face strong mechanisms of immune escape induced by tumours. We previously demonstrated that sub-therapeutic doses of an adenovirus expressing IL-12 genes (AdIL-12) mediated a potent antitumour effect against subcutaneous (s.c.) colorectal carcinomas (CRC) in mice pre-treated with low doses of cyclophosphamide (Cy). In our study we used this combination to assess its impact on the immunosuppressive microenvironment. In s.c. CRC model we demonstrated that non-responder mice failed to decrease Tregs in tumour, spleen and peripheral blood. Reconstitution of Tregs into tumour-bearing mice treated with combined therapy abolished the antitumoural effect. In addition, Cy + AdIL-12 modified Tregs functionality by inhibiting the in vitro secretion of IL-10 and TGF-β and their ability to inhibit dendritic cells activation. Combined treatment decreased the number of myeloid-derived suppressor cells (MDSCs) in comparison to non-treated mice and, interestingly, administration of Tregs restored splenic MDSCs population. Furthermore, combined therapy potently generated specific cytotoxic IFN-γ-secreting CD4+ T cells able to eradicate established CRC tumours after adoptive transfer. Finally, we evaluated the combination on disseminated CRC and pancreatic carcinoma (PC). Cy + AdIL-12 were able to eradicate liver metastatic CRC (47%) and PC tumour nodules (40%) and to prolong animal survival. The results of this study support the hypothesis that Cy + AdIL-12 might be a valid immunotherapeutic strategy for advanced GIC.Fil: Malvicini, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; ArgentinaFil: Ingolotti, Mariana. Universidad Austral; ArgentinaFil: Piccioni, Flavia Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; ArgentinaFil: García, Mariana Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; ArgentinaFil: Bayo Fina, Juan Miguel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; ArgentinaFil: Atorrasagasti, María Catalina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; ArgentinaFil: Alaniz, Laura Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; ArgentinaFil: Aquino, Jorge Benjamin. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; ArgentinaFil: Espinoza, Jaime A.. Universidad Adolfo Ibañez; Chile. Universidad de La Frontera; ChileFil: Gidekel, Manuel. Universidad Adolfo Ibañez; ChileFil: Scharovsky, Olga Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Medicas. Instituto de Genetica Experimental; ArgentinaFil: Matar, Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Rosario. Facultad de Ciencias Medicas. Instituto de Genetica Experimental; ArgentinaFil: Mazzolini Rizzo, Guillermo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Austral; Argentin