Maternal and fetal risks of planned vaginal breech delivery vs planned caesarean section for term breech birth: A systematic review and meta-analysis

Background Breech presentation delivery approach is a controversial issue in obstetrics. How to cope with breech delivery (vaginal or C-section) has been discussed to find the safest in terms of morbidity. The aim of this study was to assess the risks of foetal and maternal mortality and perinatal morbidity associated with vaginal delivery against elective caesarean in breech presentations, as reported in observational studies. Methods Studies assessing perinatal morbidity and mortality associated with breech presentations births. Cochrane, Medline, Scopus, Embase, Web of Science, and Cuiden databases were consulted. This protocol was registered in PROSPERO CRD42020197598. Selection criteria were: years between 2010 and 2020, in English language, and full-term gestation (37-42 weeks). The methodological quality of the eligible articles was assessed according to the Newcastle-Ottawa scale. Meta-analyses were performed to study each parameter related to neonatal mortality and maternal morbidity. Results The meta-analysis included 94 285 births with breech presentation. The relative risk of perinatal mortality was 5.48 (95% confidence interval (CI) = 2.61-11.51) times higher in the vaginal delivery group, 4.12 (95% CI = 2.46-6.89) for birth trauma and 3.33 (95% CI = 1.95-5.67) for Apgar results. Maternal morbidity showed a relative risk 0.30 (95% CI = 0.13-0.67) times higher in the planned caesarean group. Conclusions An increment in the risk of perinatal mortality, birth trauma, and Apgar lower than 7 was identified in planned vaginal delivery. However, the risk of severe maternal morbidity because of complications of a planned caesarean was slightly higher

Revealing the air pollution burden associated with internal Migration in Peru

This study aims to quantify changes in outdoor (ambient) air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality. Data on ambient fine particulate matter (PM2.5) was obtained from the National Aeronautics and Space Administration (NASA). Census data was used to calculate rates of within-country migration at the district level. We calculated differences in PM2.5 exposure between "current" (2016-2017) and "origin" (2012) districts for each migration patterns. Using an exposure-response relationship for PM2.5 extracted from a meta-analysis, and mortality rates from the Peruvian Ministry of Health, we quantified premature mortality attributable to each migration pattern. Changes in outdoor PM2.5 exposure were observed between 2012 and 2016 with highest levels of PM2.5 in the Department of Lima. A strong spatial autocorrelation of outdoor PM2.5 values (Moran's I = 0.847, p-value=0.001) was observed. In Greater Lima, rural-to-urban and urban-to-urban migrants experienced 10-fold increases in outdoor PM2.5 exposure in comparison with non-migrants. Changes in outdoor PM2.5 exposure due to migration drove 137.1 (95%CI: 93.2, 179.4) premature deaths related to air pollution, with rural-urban producing the highest risk of mortality from exposure to higher levels of ambient air pollution. Our results demonstrate that the rural-urban and urban-urban migrant groups have higher rates of air pollution-related deaths

Author Correction: Revealing the air pollution burden associated with internal Migration in Peru.

An amendment to this paper has been published and can be accessed via a link at the top of the paper

Anomalías de forma y número en dentición temporal en una población Mexicana

Objetivo: Determinar la frecuencia y distribución de las anomalías de forma y de número en dentición temporal.  Material y Métodos: Estudio retro-prolectivo, transversal y descriptivo. Muestreo probabilístico por conveniencia estratificado por género. Se revisaron 1568 expedientes de pacientes que acudieron a la Clínica de Estomatología Pediátrica de la FEBUAP, durante el periodo 2012 a 2014, se incluyeron 720 expedientes (321 niñas y 399 niños) de 1 a 10 años, que presentaron estudios radiográficos completos, nítidos, con presencia de anomalías de forma o número, el estudio fue dividido en pacientes activos e inactivos. Para los inactivos se tomaron fotografías de las radiografías con presencia de anomalías de forma y/o número. En el caso de los activos, se realizó una entrevista con alguno de los padres, se solicitó autorización bajo consentimiento informado, asentimiento por parte del niño para realizar la exploración clínica y la toma de fotografías intraorales. Resultados: En total 63 niños tuvieron anomalías (17 niñas y 46 niños). La prevalencia total de las anomalías dentarias fue de 9%, de los cuales el 3,1% fueron (dientes fusionados y geminados), 1,1% (agenesias) y 1,9% (supernumerarios), 1,3% (raíces supernumerarias), 0,27% (macrodoncia), 0,11% (microdoncia) y finalmente el 0,27% correspondió a (talón cuspídeo). Conclusiones: A pesar de que la prevalencia de estas anomalías no es alta, es importante el examen radiográfico de rutina para realizar un diagnóstico temprano y así aplicar las medidas preventivas correctas, para establecer el mejor plan de tratamiento

Singularities of surface mixing activity in the Western Mediterranean influence bluefin tuna larval habitats

Understanding how the surface dynamics of the ocean influence the spawning and larval ecology of many large pelagic species, in particular tuna species, is a major challenge. For temperate tunas, the selection of geographically restricted spawning grounds is influenced by environmental conditions, but the influence of surface mixing properties on the early life stages of these species remains poorly understood. Here, based on ichthyoplankton samples collected over 4 yr and satellite-derived finite size Lyapunov exponents (FSLEs), we examined how horizontal mixing activity drives the probability of presence of Atlantic bluefin tuna Thunnus thynnus larvae. We further analyzed the spatial and temporal scales of the FSLE variability at which the relationship between larval presence and mesoscale activity is maximized. We found that moderate mixing activity strongly favors the spatial-temporal distribution of larval habitats, evidencing an optimal environmental window of bluefin tuna spawning and early life development within the mesoscale dynamics. During the spawning season, the Balearic Sea presents a unique spatial and temporal hydrodynamic scenario within the Western Mediterranean. These results can be used for developing oceanographic indicators and improving larval abundance indices that are currently used in Atlantic bluefin tuna stock assessments.En prensa2,48

Effect of phenylephrine on static and dynamic accommodation.

PURPOSE: We tested the hypothesis that changes in accommodation after instillation of Phenylephrine Hydrochloride (PHCl) observed in some studies could be caused by changes in optics. METHODS: We performed two experiments to test the effects of PHCl on static and on dynamic accommodation in 8 and 6 subjects, respectively. Objective wavefront measurements were recorded of the static accommodation response to a stimulus at different distances or dynamic accommodation response to a sinusoidally moving stimulus (between 1 and 3 D of accommodative demand at 0.2Hz). The responses were characterized using two methods: one that takes into account the mydriatic optical effects on the accommodation produced by higher-order aberrations of the eye and another that takes into account only power changes paraxially due to the action of the ciliary muscle and regardless of the pupil size. RESULTS: When mydriatic optical effects were taken into account, differences in responses before and after PHCl instillation were 0.51±0.53 D, and 0.12±0.15, for static and dynamic accommodation, respectively, and were statistically significant (p0.313). CONCLUSIONS: The mydriatic effect of the PHCl causes optical changes in the eye that can reduce the objective and subjective measurement of accommodation

Bacteria-instructed B cells cross-prime naïve CD8+ T cells triggering effective cytotoxic responses.

In addition to triggering humoral responses, conventional B cells have been described in vitro to cross-present exogenous antigens activating naïve CD8+ T cells. Nevertheless, the way B cells capture these exogenous antigens and the physiological roles of B cell-mediated cross-presentation remain poorly explored. Here, we show that B cells capture bacteria by trans-phagocytosis from previously infected dendritic cells (DC) when they are in close contact. Bacterial encounter "instructs" the B cells to acquire antigen cross-presentation abilities, in a process that involves autophagy. Bacteria-instructed B cells, henceforth referred to as BacB cells, rapidly degrade phagocytosed bacteria, process bacterial antigens and cross-prime naïve CD8+ T cells which differentiate into specific cytotoxic cells that efficiently control bacterial infections. Moreover, a proof-of-concept experiment shows that BacB cells that have captured bacteria expressing tumor antigens could be useful as novel cellular immunotherapies against cancer.We are grateful to advanced light microscopy and cytometry facilities of CNB for technical supporting. The research is supported by grants: SAF2017-84091- R, and PID2020-116393RB-I00/AEI/10.13039/501100011033, financed by MCIN, BFERO2020.04, financed by FERO foundation and PI20/0036 from ISCIII. RGF is supported by BES-2016-076526 from the Spanish Ministry of Economy Industry and Competitiveness, JOP is supported by fellowship LCF/BQ/SO16/ 52270012 from La Caixa, BHF is supported by FPU18/00895 and AMP by FPU18/03199 from Ministry of Science, Innovation and Universities. LdC has been supported by Juan de la Cierva grant IJC2018-035386-I and a contract associated to SEV-2017-0712. EVC, AMP, AMAM, and NMM belong to the Spanish National Research Council (CSIC)’s Cancer Hub. Synopsis image made with biorender.com by Eduardo Roman Camacho and Esteban Veiga. We thanks Prof. Dan Portnoy who kindly provided bacterial strains.S

Casos de estudio en México y Latinoamérica

Ante la presencia de conflictos sociales y territoriales, las comunidades organizadas buscan estrategias de solución y confrontación. Es el estudio de dichos movimientos, lo que motiva a la publicación de éste libro: Respuestas comunitarias ante conflictos ambientales. Casos de estudio en México y Latinoamérica, reúne catorce textos que analizan las respuestas sociales y documentan la acción colectiva de comunidades que se han organizado para autogestionar soluciones ante conflictos territoriales, económicos y ambientales, en su propio entorno. Las aportaciones de investigadores y activistas, desde enfoques teóricos y metodológicos particulares, exponen casos de estudio sobre organizaciones formales e informales que se han conformado para afrontar los retos que representan proyectos productivos como fábricas cementeras, mineras, puertos, productores de energía, entre otros. Los enfoques analíticos tocan también temas nodales en el estudio de la acción colectiva como la ética, el despojo, los derechos humanos y las estrategias de comunicación y visibilización. Este material, que reúne estudios hechos en distintos lugares de México y Latinoamérica, es un compendio de métodos de investigación y un acercamiento al estudio de los movimientos sociales.UAEMEX, CONACyT, SE

First year of energetic particle measurements in the inner heliosphere with Solar Orbiter's Energetic Particle Detector

Context. Solar Orbiter strives to unveil how the Sun controls and shapes the heliosphere and fills it with energetic particle radiation. To this end, its Energetic Particle Detector (EPD) has now been in operation, providing excellent data, for just over a year. Aims. EPD measures suprathermal and energetic particles in the energy range from a few keV up to (near-) relativistic energies (few MeV for electrons and about 500 MeV nuc−1 for ions). We present an overview of the initial results from the first year of operations and we provide a first assessment of issues and limitations. In addition, we present areas where EPD excels and provides opportunities for significant scientific progress in understanding how our Sun shapes the heliosphere. Methods. We used the solar particle events observed by Solar Orbiter on 21 July and between 10 and 11 December 2020 to discuss the capabilities, along with updates and open issues related to EPD on Solar Orbiter. We also give some words of caution and caveats related to the use of EPD-derived data. Results. During this first year of operations of the Solar Orbiter mission, EPD has recorded several particle events at distances between 0.5 and 1 au from the Sun. We present dynamic and time-averaged energy spectra for ions that were measured with a combination of all four EPD sensors, namely: the SupraThermal Electron and Proton sensor (STEP), the Electron Proton Telescope (EPT), the Suprathermal Ion Spectrograph (SIS), and the High-Energy Telescope (HET) as well as the associated energy spectra for electrons measured with STEP and EPT. We illustrate the capabilities of the EPD suite using the 10 and 11 December 2020 solar particle event. This event showed an enrichment of heavy ions as well as 3He, for which we also present dynamic spectra measured with SIS. The high anisotropy of electrons at the onset of the event and its temporal evolution is also shown using data from these sensors. We discuss the ongoing in-flight calibration and a few open instrumental issues using data from the 21 July and the 10 and 11 December 2020 events and give guidelines and examples for the usage of the EPD data. We explain how spacecraft operations may affect EPD data and we present a list of such time periods in the appendix. A list of the most significant particle enhancements as observed by EPT during this first year is also provided.Ministerio de Economía y CompetitividadAgencia Estatal de Investigació