Hepatic encephalopathy: a neurochemical, neuroanatomical, and neuropsychological study.

Hepatic encephalopathy (HE) is normally diagnosed by neuropsychological (NP) tests, which are not very specific and do not reveal the underlying pathology. Magnetic resonance imaging (MRI) and spectroscopy (MRS) of the brain offer alternative and possibly more specific markers for HE. These methods were applied in conjunction with NP testing in order to determine their usefulness in the identification of HE and to understand the pathogenesis of HE more clearly. MR imaging and spectroscopy examinations, in addition to a battery of 15 NP tests, were administered to investigate 31 patients awaiting liver transplantation and 23 healthy controls. MR image intensities from the globus pallidus region were calculated and normalized to those of the thalamus. Absolute concentrations and ratios with respect to creatine (Cr) of several metabolites were computed from MR spectra. The MR data were correlated with the results of NP tests. The patients showed impairment in NP tests of attention and visuospatial and verbal fluency. In T1-weighted MRI, the relative intensity of the globus pallidus with respect to that of the thalamus region was significantly elevated in patients and correlated(negatively) with three NP tests (Hooper, FAS, and Trails B). The absolute concentrations of myo-inositol (mI) and choline (Ch) were significantly reduced in three brain regions. In addition, the absolute concentrations of glutamine (Gln) and combined glutamate and glutamine (Glx) were increased in all three locations, with Gln increase being significant in all areas while that of Glx only in the occipital white matter. In summary, this study partially confirms a hypothesized mechanism of HE pathogenesis, an increased synthesis of glutamine by brain glutamate in astrocytes due to excessive blood ammonia, followed by a compensatory loss of myo-inositol to maintain astrocyte volume homeostasis. It also indicates that the hyperintensity observed in globus pallidus could be used as complementary to the NP test scores in evaluating the mental health of HE patients

Estudio de los estilos de enseñanza aplicados por los profesores de educación física en estudiantes de cuarto año básico en cuatro colegios de la provincia de Santiago

Tesis (Profesor de Educación Física, Licenciado en Educación)La presente investigación tiene como objetivo analizar los estilos de enseñanza de los profesores de Educación Física de la provincia de Santiago. La investigación cuenta con tres etapas, la primera estuvo destinada a la validación y prueba de los instrumentos de evaluación. En la segunda se realizó una caracterización de los estilos de enseñanza desde un diagnóstico del criterio. En la tercera etapa se aplican los instrumentos validados por la Universidad Andrés Bello. Metodológicamente se consideró una investigación descriptiva con una muestra que corresponde a 108 estudiantes de cuarto año básico y cinco profesores de Educación Física del Colegio Pedro de Valdivia de la comuna Las Condes, Colegio Juan Pablo II de la comuna de Las Condes, Colegio Rafael Sanhueza de la comuna de Recoleta y Colegio Saint Gabriel de la comuna de Las Condes, esto representa finalmente a una muestra de 113 sujetos en su totalidad, quienes fueron estudiados mediante dos instrumentos. El primero, una Encuesta aplicada a los profesores, y el segundo, una observación realizada a la clase de Educación Física, con el objetivo de analizar la utilización de estilos de enseñanza por parte del docente. Los datos arrojados fueron examinados a través de la suma de las frecuencias y sus respectivos porcentajes dando como resultados que el estilo de enseñanza mando directo, predomina entre los profesores de Educación Física investigados

Conceptual and Methodological Elements for Cumulative Environmental Effects Assessment (CEEA) in Subtropical Forests. The Case of Eastern Salta, Argentina

En el norte argentino se ha producido una fuerte expansión agropecuaria a costa del desmonte de bosques xerofíticos. En la Provincia de Salta, entre 1977 y 2008 se desmontó 26% del total de bosques existentes. A fines de 2007, frente a la inminente sanción de la Ley Nº 26331 de Presupuestos Mínimos de Protección Ambiental de los Bosques Nativos, se registra el valor más alto de la historia con una tasa de desmonte de 2.1%. Frente a esta situación, comunidades originarias y criollas del este de Salta presentaron un recurso de amparo a la Corte Suprema de Justicia de la Nación, la cual solicitó a esta provincia la elaboración de una Evaluación de Impacto Ambiental Acumulativo (EIAAc) de los procesos de tala y desmonte en 4 departamentos. Los objetivos de este trabajo son proponer un marco conceptual para la EIAAc en el este de Salta y presentar evidencias y metodologías disponibles para la caracterización de esos impactos a partir de datos propios y de la literatura. El marco conceptual propuesto se basa en la cuantificación de los cambios en los niveles de provisión de servicios ecosistémicos (SE) en función de los factores de estrés y perturbación más importantes. Se analizaron los efectos del desmonte sobre cuatro SE clave: dinámica del C, balance de energía y emisión de gases con efecto invernadero (GEI), dinámica del agua y estructura del paisaje. Los desmontes generan emisiones de C superiores a 20 Gg C/año, disminuciones en la reflectancia de 1.1 watt/m2, emisiones de 2000 t de CH4, 200 t de N2O y 4400 TJ de energía radiativa por fuegos, aumentos del riesgo de salinización de suelos y fragmentación del paisaje. La consideración de estos aspectos provee elementos objetivos para la evaluación de alternativas de manejo y la elaboración de planes de seguimiento. Esto plantea no sólo desafíos técnicos sino también institucionales y políticos.Northern Argentina experienced an unprecedented deforestation rate of xerophitic forests as a consequence of agricultural expansion. In the Province of Salta, 26% of the forest were removed between 1977 and 2008. At the end of 2007, just before the No. 26331 Law of Native Forest Protection was voted by the Congress, the highest annual rate of deforestation was registered, reaching a value of 2.1%. Regarding this situation, indigenous people of Eastern Salta along with the ocriollosp (local small ranchers) appealed to the National Supreme Court of Justice for legal protection. The Court requested the province to elaborate a Cumulative Environmental Effects Assessment (CEEA) regarding the process of logging and deforestation in four departments of Salta Province (San Martín, Rivadavia, Santa Victoria, and Orán). The aim of this work is to present a conceptual framework to conduct a CEEA in eastern Salta and to present the evidences and existing methodologies to characterize the impacts of deforestation. The conceptual framework suggested depends on the quantitative characterization of the changes in the provision level of key ecosystem services as a function of the stress and/or disturbance level (in this case deforestation). Based on the literature and our own data, the effects of deforestation on four key ecosystem services have been assessed: C dynamics, energy balance and greenhouse gases emissions, water dynamics and landscape structure. Deforestation produced emissions of 2000 t of CH4, 200 t of N2O, above 20 Gg of C/year, a 1.1 watt/m2 reduction in reflected radiation and 4400 TJ radiative energy emissions caused by deforestation fires, increases in the risk of soil salinization and landscape fragmentation. Considering these aspects of the structure and functioning of the ecosystems provides objective elements to evaluate management alternatives and to elaborate monitoring programmes. To consider such management and monitoring alternatives arises technical challenges but also institutional and political ones

Hepatic encephalopathy: a neurochemical, neuroanatomical, and neuropsychological study.

Hepatic encephalopathy (HE) is normally diagnosed by neuropsychological (NP) tests, which are not very specific and do not reveal the underlying pathology. Magnetic resonance imaging (MRI) and spectroscopy (MRS) of the brain offer alternative and possibly more specific markers for HE. These methods were applied in conjunction with NP testing in order to determine their usefulness in the identification of HE and to understand the pathogenesis of HE more clearly. MR imaging and spectroscopy examinations, in addition to a battery of 15 NP tests, were administered to investigate 31 patients awaiting liver transplantation and 23 healthy controls. MR image intensities from the globus pallidus region were calculated and normalized to those of the thalamus. Absolute concentrations and ratios with respect to creatine (Cr) of several metabolites were computed from MR spectra. The MR data were correlated with the results of NP tests. The patients showed impairment in NP tests of attention and visuospatial and verbal fluency. In T1-weighted MRI, the relative intensity of the globus pallidus with respect to that of the thalamus region was significantly elevated in patients and correlated(negatively) with three NP tests (Hooper, FAS, and Trails B). The absolute concentrations of myo-inositol (mI) and choline (Ch) were significantly reduced in three brain regions. In addition, the absolute concentrations of glutamine (Gln) and combined glutamate and glutamine (Glx) were increased in all three locations, with Gln increase being significant in all areas while that of Glx only in the occipital white matter. In summary, this study partially confirms a hypothesized mechanism of HE pathogenesis, an increased synthesis of glutamine by brain glutamate in astrocytes due to excessive blood ammonia, followed by a compensatory loss of myo-inositol to maintain astrocyte volume homeostasis. It also indicates that the hyperintensity observed in globus pallidus could be used as complementary to the NP test scores in evaluating the mental health of HE patients

PD-1/PD-L1 blockade abrogates a dysfunctional innate-adaptive immune axis in critical β-coronavirus disease

International audienceSevere COVID-19 is associated with hyperinflammation and weak T cell responses against SARS-CoV-2. However, the links between those processes remain partially characterized. Moreover, whether and how therapeutically manipulating T cells may benefit patients are unknown. Our genetic and pharmacological evidence demonstrates that the ion channel TMEM176B inhibited inflammasome activation triggered by SARS-CoV-2 and SARS-CoV-2–related murine β-coronavirus. Tmem176b −/− mice infected with murine β-coronavirus developed inflammasome-dependent T cell dysfunction and critical disease, which was controlled by modulating dysfunctional T cells with PD-1 blockers. In critical COVID-19, inflammasome activation correlated with dysfunctional T cells and low monocytic TMEM176B expression, whereas PD-L1 blockade rescued T cell functionality. Here, we mechanistically link T cell dysfunction and inflammation, supporting a cancer immunotherapy to reinforce T cell immunity in critical β-coronavirus disease

Validity and reliability of the kiddie schedule for affective disorders and schizophrenia present and lifetime version DSM-5 (K-SADS-PL-5) Spanish version

Abstract Background There are various language adaptations of the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL). In order to comply with the changes in DSM classification, the Spanish edition of the interview was in need of update and evaluation. Methods K-SADS-PL was adapted to correspond to DSM-5 categories. All clinicians received training, and a 90% agreement was reached. Patients and their parents or guardians were interviewed and videotaped, and the videos were exchanged between raters. Factor analysis was performed and inter-rater reliability was calculated only in the case of diagnoses in which there were more than five patients. Results A total of 74 subjects were included. The Factor Analysis yielded six factors (Depressive, Stress Hyperarousal, Disruptive Behavioral, Irritable Explosive, Obsessive Repetitive and Encopresis), representing 72% of the variance. Kappa values for inter-rater agreement were larger than 0.7 for over half of the disorders. Conclusions The factor structure of diagnoses, made with the instrument was found to correspond to the DSM-5 disorder organization. The instrument showed good construct validity and inter-rater reliability, which makes it a useful tool for clinical research studies in children and adolescents

PD-1/PD-L1 blockade abrogates a dysfunctional innate-adaptive immune axis in critical β-coronavirus disease

Severe COVID-19 is associated with hyperinflammation and weak T cell responses against SARS-CoV-2. However, the links between those processes remain partially characterized. Moreover, whether and how therapeutically manipulating T cells may benefit patients are unknown. Our genetic and pharmacological evidence demonstrates that the ion channel TMEM176B inhibited inflammasome activation triggered by SARS-CoV-2 and SARS-CoV-2- related murine β-coronavirus. Tmem176b-/- mice infected with murine β-coronavirus developed inflammasome-dependent T cell dysfunction and critical disease, which was controlled by modulating dysfunctional T cells with PD-1 blockers. In critical COVID-19, inflammasome activation correlated with dysfunctional T cells and low monocytic TMEM176B expression, whereas PD-L1 blockade rescued T cell functionality. Here, we mechanistically link T cell dysfunction and inflammation, supporting a cancer immunotherapy to reinforce T cell immunity in critical β-coronavirus disease.Fil: Duhalde Vega, Maite. Institut Pasteur de Montevideo; Uruguay. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Físico-Química Biológicas "Prof. Alejandro C. Paladini". Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Físico-Química Biológicas; ArgentinaFil: Olivera, Daniela. Institut Pasteur de Montevideo; Uruguay. Universidad de la República; UruguayFil: Davanzo, Gustavo Gastão. Universidade Estadual de Campinas; BrasilFil: Bertullo, Mauricio. Immunoregulation And Inflammation Lab; UruguayFil: Noya, Verónica. Sanatorio Americano; UruguayFil: de Souza, Gabriela Fabiano. Universidade Estadual de Campinas; BrasilFil: Muraro, Stéfanie Primon. Universidade Estadual de Campinas; BrasilFil: Castro, Icaro. Hospital Israelita Albert Einstein; BrasilFil: Arévalo, Ana Paula. Institut Pasteur de Montevideo; UruguayFil: Crispo, Martina. Institut Pasteur de Montevideo; UruguayFil: Galliussi, Germán. Institut Pasteur de Montevideo; UruguayFil: Russo, Sofía. Institut Pasteur de Montevideo; Uruguay. Universidad de la República; UruguayFil: Charbonnier, David. Institut Pasteur de Montevideo; UruguayFil: Rammauro, Florencia. Institut Pasteur de Montevideo; Uruguay. Universidad de la República; UruguayFil: Jeldres, Mathías. Institut Pasteur de Montevideo; Uruguay. Universidad de la República; UruguayFil: Alamón, Catalina. Institut Pasteur de Montevideo; UruguayFil: Varela, Valentina. Institut Pasteur de Montevideo; UruguayFil: Batthyany, Carlos. Institut Pasteur de Montevideo; UruguayFil: Bollati Fogolín, Mariela. Institut Pasteur de Montevideo; UruguayFil: Oppezzo, Pablo. Institut Pasteur de Montevideo; UruguayFil: Pritsch, Otto. Institut Pasteur de Montevideo; Uruguay. Universidad de la República; UruguayFil: Proença Módena, José Luiz. Universidade Estadual de Campinas; BrasilFil: Nakaya, Helder I.. Hospital Israelita Albert Einstein; BrasilFil: Trias, Emiliano. Institut Pasteur de Montevideo; UruguayFil: Barbeito, Luis. Institut Pasteur de Montevideo; UruguayFil: Anegon, Ignacio. Center For Research In Transplantation And Immunology; FranciaFil: Cuturi, María Cristina. Center For Research In Transplantation And Immunology; FranciaFil: Moraes Vieira, Pedro. Universidade Estadual de Campinas; BrasilFil: Segovia, Mercedes. Institut Pasteur de Montevideo; Uruguay. Universidad de la República; UruguayFil: Hill, Marcelo. Universidad de la República; Uruguay. Institut Pasteur de Montevideo; Urugua