Brain structural and functional correlates of the heterogenous progression of mixed transcortical aphasia

Mixed transcortical aphasia (MTCA) is characterized by non-fluent speech and comprehension deficits coexisting with preserved repetition. MTCA may evolve to less severe variants of aphasias or even to full language recovery. Mechanistically, MCTA has traditionally been attributed to a disconnection between the spared left perisylvian language network (PSLN) responsible for preserved verbal repetition, and damaged left extrasylvian networks, which are responsible for language production and comprehension impairments. However, despite significant advances in in vivo neuroimaging, the structural and functional status of the PSLN network in MTCA and its evolution has not been investigated. Thus, the aim of the present study is to examine the status of the PSLN, both in terms of its functional activity and structural integrity, in four cases who developed acute post-stroke MTCA and progressed to different types of aphasia. For it, we conducted a neuroimaging- behavioral study performed in the chronic stage of four patients. The behavioral profile of MTCA persisted in one patient, whereas the other three patients progressed to less severe types of aphasias. Neuroimaging findings suggest that preserved verbal repetition in MTCA does not always depend on the optimal status of the PSLN and its dorsal connections. Instead, the right hemisphere or the left ventral pathway may also play a role in supporting verbal repetition. The variability in the clinical evolution of MTCA may be explained by the varying degree of PSLN alteration and individual premorbid neuroanatomical language substrates. This study offers a fresh perspective of MTCA through the lens of modern neuroscience and unveils novel insights into the neural underpinnings of repetition.Funding for open access publishing: Universidad Málaga/CBUA. This work was supported by the Spanish Ministry of Economy, Industry and Competitiveness, Instituto de Salud Carlos III under Grant: PI16/01514 (MLB and GD) and by the Junta de Andalucía under Grant: P20_00501 (GD). MLB was funded by the European Social Fund (FEDER). DL-B was supported by the Ayuda RYC2020-029495-I Ramón y Cajal funded by the MCIN/AEI/10.13039/501100011033 and by El FSE invierte en tu futuro; and by the Grant PID2021-127617NA-I00 Proyecto de Generación de Conocimiento 2021 funded by MCIN/AEI /10.13039/501100011033/ and FEDER Una manera de hacer Europa. JP-P was funded by a PhD scholarship (FPU16/05198) from the Spanish Ministry of Education, Culture and Sport under the FPU program. MJT-P was supported by a Margarita Salas postdoctoral fellowship by the University of Malaga, funded by the European Union– NextGenerationEU – and the Spanish Ministerio de Universidades, and by a mobility grant from the Spanish Ministry of Universities under the José Castillejo program

Protección multinivel de derechos humanos. Manual

Este Manual tiene como objeto el estudio de la protección multinivel de derechos humanos en América Latina desde una perspectiva comparada. Los contenidos se estructuran en cuatro grandes bloques. El primer bloque versa sobre la interpretación y protección de los derechos humanos en el marco multinivel y desarrolla un análisis conceptual de dos nociones clave: protección multinivel e interpretación de conformidad. El primer capítulo examina en qué medida puede trasladarse la noción de protección multinivel de derechos a América Latina. El segundo capítulo analiza la interpretación de los derechos constitucionales de conformidad con el derecho internacional de los derechos humanos desde la experiencia española, cuya Constitución de 1978 acuñó la cláusula de interpretación conforme en su artículo 10.2. Diversas constituciones en América Latina han incorporado cláusulas similares, y de manera reciente la Constitución Federal mexicana en la reforma de 2011. El segundo bloque, desde una perspectiva horizontal, contiene estudios sobre el sistema internacional de protección de derechos humanos, el sistema interamericano y el sistema europeo. La atención se centra en los mecanismos de garantía establecidos en cada ordenamiento. Se concluye con un capítulo sobre las relaciones recíprocas entre el sistema interamericano y el europeo. El tercer bloque analiza el Sistema Interamericano de Derechos Humanos y su relación con los sistemas jurídicos nacionales desde una perspectiva vertical. Se examinan temas centrales para el sistema de protección de derechos, como son: el requisito de agotamiento de los recursos internos; las reparaciones a las víctimas; el valor de la jurisprudencia de la Corte Interamericana de Derechos Humanos; el diálogo judicial, y en concreto la protección del derecho a la vida desde la perspectiva multinivel. Finalmente, el cuarto bloque adopta la perspectiva de los ordenamientos jurídicos nacionales para estudiar la recepción del derecho internacional de los derechos humanos en diversos países: Bolivia, Brasil, Colombia, Chile, Ecuador, España, Francia y Perú. Se solicitó a los autores que los estudios de caso siguieran la misma estructura de análisis, lo que facilita una lectura comparada.Programa financiado por la Comisión Europea. El Manual es producto de la Red de Derechos Humanos en la Educación Superior (RedDHES), un proyecto ALFA financiado por la Unión EuropeaCap. 1. ¿Protección multinivel de los derechos humanos en América Latina? Oportunidades, desafíos y riesgos / René Urueña. - Cap. 2. La interpretación de conformidad: significado y dimensión práctica (un análisis desde la Constitución española) / Alejandro Saiz Arnaiz. - Cap. 3. Sistema universal de protección de derechos humanos / Renata Bregaglio. - Cap. 4. El sistema interamericano de derechos humanos / Felipe Arias Ospina y Juliana Galindo Villareal. Cap. 5. El sistema europeo de protección de derechos humanos / Luis López Guerra. - Cap. 6. El diálogo judicial entre la Corte Interamericana de Derechos Humanos y la Corte Europea de Derechos Humanos / Laurence Burgorgue-Larsen y Nicolás Montoya Céspedes. Cap. 7. Agotamiento de los recursos internos y otras exigencias de admisibilidad / Itziar Gómez Fernández y Carmen Montesinos Padilla. Cap. 8. Aportaciones del sistema de reparaciones de la Corte Interamericana al Derecho Internacional de los Derechos Humanos / Fernando Silva. Cap. 9. El valor de la jurisprudencia de la Corte Interamericana de Derechos Humanos / George Rodrigo Bandeira Galindo. Cap. 10. Del diálogo entre las cortes supremas y la Corte Interamericana de Derechos Humanos al transconstitucionalismo en América Latina / Marcelo Neves. Cap. 11. Derecho a la vida y lo vivo como sujeto de derecho / Miguel Rábago. Cap. 12. Bolivia / Nataly Viviana Vargas Gamboa. Cap. 13. Brasil / Antonio Maués y George Galindo. Cap. 14. Colombia / María Angélica Prada. Cap. 15. Chile / Felipe Paredes. Cap. 16. España / Aida Torres Pérez. Cap. 17. Francia / Enzamaria Tramontana. Cap. 18. Perú / Renata Bregaglio

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Draft genome sequence data of Nothopassalora personata, peanut foliar pathogen from Argentina

Late leaf spot (LLS) caused by the Ascomycete Nothopassalora personata (N.p.) (Syn. Cercosporidium personatum) is the main foliar disease of peanuts in Argentina and in peanut producing areas of the world, causing up to 70% yield losses. The extremely slow growth of this fungus in culture, that takes around one month to form a 1 cm colony (0.45 mm/day), and the lack of adequate young tissues from where to extract nucleic acids, have hindered genetic studies of this pathogen. Here, we report the first genome sequence of a N. personata isolate from South America, as well as genetic variants on its conserved genes, and the complete sequence of its mating-type locus MAT1-2 idiomorph. The N. personata isolate IPAVE 0302 was obtained from peanut leaves in Córdoba, Argentina. The whole genome sequencing of IPAVE 0302 was performed as paired end 150 bp NovaSeq 6000 and de novo assembled. Clean reads were mapped to the reference genome for this species NRRL 64463 and the genetic variants on highly conserved genes and throughout the genome were analyzed. Sequencing data were submitted to NCBI GenBank Bioproject PRJNA948451, accession number SRR23957761. Additional Fasta files are available from Harvard Dataverse (https://doi.org/10.7910/DVN/9AGPMG and https://doi.org/10.7910/DVN/YDO3V6). The data reported here will be the basis for the analysis of genetic diversity of the LLS pathogen of peanut in Argentina, information that is critical to make decisions on management strategies.Fil: Monguillot, Joaquín Humberto. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Patología Vegetal; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Unidad de Fitopatología y Modelización Agrícola - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Unidad de Fitopatología y Modelización Agrícola; ArgentinaFil: Arias, Renee S.. United States Department of Agriculture; Estados UnidosFil: Orner, Valeria A.. United States Department of Agriculture; Estados UnidosFil: Massa, Alicia N.. United States Department of Agriculture; Estados UnidosFil: Sobolev, Victor S.. United States Department of Agriculture. Agriculture Research Service; Estados UnidosFil: Bernardi Lima, Nelson. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Patología Vegetal; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Unidad de Fitopatología y Modelización Agrícola - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Unidad de Fitopatología y Modelización Agrícola; ArgentinaFil: Paredes, Juan Andres. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Patología Vegetal; Argentina. Instituto Nacional de Tecnologia Agropecuaria. Centro de Investigaciones Agropecuarias. Unidad de Fitopatologia y Modelizacion Agricola. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Cordoba. Unidad de Fitopatologia y Modelizacion Agricola.; ArgentinaFil: Oddino, Claudio Marcelo. Universidad Nacional de Río Cuarto. Facultad de Ciencias Exactas Fisicoquímicas y Naturales. Instituto de Investigación en Micología y Micotoxicología. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigación en Micología y Micotoxicología; ArgentinaFil: Carmona, Marcelo Anibal. Universidad de Buenos Aires. Facultad de Agronomía; ArgentinaFil: Conforto, Cinthia. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Instituto de Patología Vegetal; Argentin

Albendazole and ivermectin for the control of soil-transmitted helminths in an area with high prevalence of Strongyloides stercoralis and hookworm in northwestern Argentina: A community-based pragmatic study

Background: Recommendations for soil-transmitted helminth (STH) control give a key role to deworming of school and pre-school age children with albendazole or mebendazole; which might be insufficient to achieve adequate control, particularly against Strongyloides stercoralis. The impact of preventive chemotherapy (PC) against STH morbidity is still incompletely understood. The aim of this study was to assess the effectiveness of a community-based program with albendazole and ivermectin in a high transmission setting for S. stercoralis and hookworm. Methodology: Community-based pragmatic trial conducted in Tartagal, Argentina; from 2012 to 2015. Six communities (5070 people) were enrolled for community-based PC with albendazole and ivermectin. Two communities (2721 people) were re-treated for second and third rounds. STH prevalence, anemia and malnutrition were explored through consecutive surveys. Anthropometric assessment of children, stool analysis, complete blood count and NIE-ELISA serology for S. stercoralis were performed. Principal findings: STH infection was associated with anemia and stunting in the baseline survey that included all communities and showed a STH prevalence of 47.6% (almost exclusively hookworm and S. stercoralis). Among communities with multiple interventions, STH prevalence decreased from 62% to 23% (p<0.001) after the first PC; anemia also diminished from 52% to 12% (p<0.001). After two interventions S. stercoralis seroprevalence declined, from 51% to 14% (p<0.001) and stunting prevalence decreased, from 19% to 12% (p = 0.009). Conclusions: Hookworm’ infections are associated with anemia in the general population and nutritional impairment in children. S. stercoralis is also associated with anemia. Community-based deworming with albendazole and ivermectin is effective for the reduction of STH prevalence and morbidity in communities with high prevalence of hookworm and S. stercoralis.Fil: Echazú, Adriana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Salta; ArgentinaFil: Juarez, Marisa. Universidad Nacional de Salta; ArgentinaFil: Vargas Flores, Paola Andrea. Universidad Nacional de Salta; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cajal, Silvana P.. Universidad Nacional de Salta; ArgentinaFil: Cimino, Rubén Oscar. Universidad Nacional de Salta; ArgentinaFil: Heredia, Viviana. Hospital Juan Domingo Perón; ArgentinaFil: Caropresi, Silvia. Hospital Juan Domingo Perón; ArgentinaFil: Paredes, Gladys. Hospital Juan Domingo Perón; ArgentinaFil: Arias, Luis M.. Ministerio de Salud Pública de la Provincia de Salta; ArgentinaFil: Abril, Marcelo. Fundación Mundo Sano; ArgentinaFil: Gold, Silvia. Fundación Mundo Sano; ArgentinaFil: Lammie, Patrick. Centers for Disease Control and Prevention; Estados UnidosFil: Krolewiecki, Alejandro Javier. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Salta; Argentin

Effects of a Six-Week International Tour on the Physical Performance and Body Composition of Young Chilean Tennis Players

In tennis, it is common for young male tennis players to spend several weeks away from their local training camps during the competition season, which could affect their performance. The purpose of the study was to analyze the effects of a six-week international tour on physical performance and body composition in young Chilean tennis players. Twenty-four men between the ages of 14 and 16 participated in this research. In body composition and anthropometric measurement, body weight, height, skinfolds, and perimeters were measured. Body fat percentage (BFP) and skeletal muscle mass (SMM) were calculated. For physical performance, 5-m and 10-m sprints, modified agility test (MAT test), countermovement jump (CMJ), and medicine ball throw (MBT) were evaluated. Results show that, in body composition, BFP and SMM significantly decreased post-tour (p p < 0.05, effect sizes ranging from −0.63 to 1.10). We conclude that after a six-week international tour, BFP, SMM, agility, and speed (linear sprint) tend to decrease significantly, with a greater effect in the sprint tests

Flow diagram of the participants and size of surveillance samples enrolled along the study.

<p>*In Lapacho Alto community 9 months went by between the first and the second intervention and 14 months between second and third intervention. ∞In Kilometro 6 the period between first and second intervention was 9 months and between second and third intervention was 20 months.</p

Comparison of relative IgG titers against <i>S</i>. <i>stercoralis</i>, between baseline and first and second follow-up*.

<p>* Relative IgG titers (measured IgG units/selected cutoff) reported.</p