Quality Improvement Project to Increase Hepatitis C Virus Screening for Ambulatory GME Internal Medicine Clinic Patients

Background: In 2020, CDC established new guideline expanding Hepatitis C virus (HCV) screening to all adults aged 18 to 79 years. Our QI project objective is to enhance HCV screening amongst the UTRGV-DHR IM department by establishing suitable reminders and educational sessions. Methods: We reviewed HCV screening status of all adult patients 18 to 79 years old from June 1st 2020 to December 1st 2020. We then provided one lecture on the new screening recommendation from CDC 2020 guideline. We also encouraged residents to educate patients on the importance of HCV screening, and to identify and overcome barriers against screening. We then measured HCV screening performed from March 1st 2021 to May 1st 2021. The primary objective is to increase HCV screening in the ambulatory setting by 50%. Results: Among 843 patients from June 1st 2020 to December 1st 2020, 219 patients were screened for HCV (26%). The results from March 1st 2021 to May 1st 2021 was 190 out 548 patients (35%). The difference was significant with p-value of 0.0005 using Chi-square statistical analysis. Conclusions: Even though we did not achieve our primary objective, HCV screening performance in our clinic had increased significantly from 26% to 35%. With this positive result, we will continue to enhance awareness among the residents by implementing didactic lectures to support evidence –based medicine practice about HCV screening. It is also important to identify the drawbacks of HCV screening including stress on patients and their family, future costs and side-effects of further testing and treatments

UHPLC-MS Phenolic Fingerprinting, Aorta Endothelium Relaxation Effect, Antioxidant, and Enzyme Inhibition Activities of Azara dentata Ruiz & Pav Berries

Azara dentata Ruiz & Pav. is a small Chilean native plant from Patagonia, a producer of small white reddish berries. For the first time, the proximal analysis of the fruits, phenolic fingerprinting, the antioxidant activity, and the enzymatic inhibition and relaxation effects in rat aorta induced by the ethanolic extract of these fruits were investigated. The proximal composition and the mineral (Ca: 2434 ± 40 mg/kg; Mg: 702 ± 13 mg/kg; Fe: 117.1 ± 1.6 mg/kg; Zn: 16.1 ± 0.4 mg/kg) and heavy metal (As: 121 ± 11 µg/kg; Cd: 152 ± 5 µg/kg; Hg: 7.7 ± 1.3 µg/kg; Pb 294 ± 4 µg/kg) contents were analyzed. Anthocyanins, flavonoids, phenolic acids, and coumarins were identified using UHPLC-PDA-QTOF-MS. The ethanolic extracts showed a total phenolic content of 23.50 ± 0.93 mg GAE/g extract. In addition, the antioxidant activity was assessed using both DPPH and TEAC (28.64 ± 1.87 and 34.72 ± 2.33 mg Trolox/g of dry fruit, respectively), FRAP (25.32 ± 0.23 mg Trolox equivalent/g dry fruit), and ORAC (64.95 ± 1.23 mg Trolox equivalents/g dry fruit). The inhibition of enzymatic activities (acetylcholinesterase IC50: 2.87 + 0.23 µg extract/mL, butyrylcholinesterase IC50: 6.73 + 0.07 µg extract/mL, amylase IC50: 5.6 ± 0.0 µg extract/mL, lipase IC50: 30.8 ± 0.0 µg extract/mL, and tyrosinase IC50: 9.25 ± 0.15 µg extract/mL) was also assessed. The extract showed 50–60% relaxation in rat aorta (intact), mediated thorough the release of endothelial nitric oxide. Our results suggest that A. dentata is a good source of compounds with the capacity to inhibit important enzymes, can be hypotensive, and can thus have good potentiality as supplements in the amelioration of neurodegenerative diseases and could also have potential to be used to develop new functional foods. The study highlights the benefits of these neglected small fruits and could boost their consumption.Fil: Cuesta Ramos, Lucia. Universidad de Valencia; EspañaFil: Palacios, Javier. Universidad Arturo Prat (unap);Fil: Barrientos, Ruth E.. Universidad Austral de Chile; ChileFil: Gómez Pelaytay, Jessica Belén. Universidad Nacional de San Juan; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Castagnini, Juan Manuel. Universidad de Valencia; EspañaFil: Barba, Francisco J.. Universidad de Valencia; EspañaFil: Tapia, Alejandro. Universidad Nacional de San Juan; ArgentinaFil: Paredes, Adrián. Universidad de Antofagasta (uantof);Fil: Cifuentes, Fredi. Universidad de Antofagasta (uantof);Fil: Simirgiotis, Mario J.. Universidad Austral de Chile; Chil

N=1 SQCD-like theories with N_f massive flavors from AdS/CFT and beta functions

We study new supergravity solutions related to large-$N_c$ ${\cal N}=1$ supersymmetric gauge field theories with a large number $N_f$ of massive flavors. We use a recently proposed framework based on configurations with $N_c$ color D5 branes and a distribution of $N_f$ flavor D5 branes, governed by a function $N_f S(r)$. Although the system admits many solutions, under plausible physical assumptions the relevant solution is uniquely determined for each value of $x\equiv N_f/N_c$. In the IR region, the solution smoothly approaches the deformed Maldacena-N\'u\~nez solution. In the UV region it approaches a linear dilaton solution. For $x<2$ the gauge coupling $\beta_g$ function computed holographically is negative definite, in the UV approaching the NSVZ $\beta$ function with anomalous dimension $\gamma_0= -1/2$ (approaching $-3/(32\pi^2)(2N_c-N_f)g^3$)), and with $\beta_g \to-\infty$ in the IR. For $x=2$, $\beta_g$ has a UV fixed point at strong coupling, suggesting the existence of an IR fixed point at a lower value of the coupling. We argue that the solutions with $x>2$ describe a "Seiberg dual" picture where $N_f-2N_c$ flips sign.Comment: 18 pages, 10 figure

El mazateco de Oaxaca

El proyecto analiza la variación y el cambio en la fonología, léxico, morfología y sintaxis del mazateco que se habla en las Regiones de la Cuenca y la Cañada (Santo Domingo del Río, Xalapa de Díaz, Huautla de Jiménez y Santa María Asunción) del estado de Oaxaca de la República Mexican

Dissolving microarray patches for transdermal delivery of risperidone for schizophrenia management

Schizophrenia is a psychiatric disorder that results from abnormal levels of neurotransmitters in the brain. Risperidone (RIS) is a common drug prescribed for the treatment of schizophrenia. RIS is a hydrophobic drug that is typically administered orally or intramuscularly. Transdermal drug delivery (TDD) could potentially improve the delivery of RIS. This study focused on the development of RIS nanocrystals (NCs), for the first time, which were incorporated into dissolving microneedle array patches (DMAPs) to facilitate the drug delivery of RIS. RIS NCs were formulated via wet-media milling technique using poly(vinylalcohol) (PVA) as a stabiliser. NCs with particle size of 300 nm were produced and showed an enhanced release profile up to 80 % over 28 days. Ex vivo results showed that 1.16 ± 0.04 mg of RIS was delivered to both the receiver compartment and full-thickness skin from NCs loaded DMAPs compared to 0.75 ± 0.07 mg from bulk RIS DMAPs. In an in vivo study conducted using female Sprague Dawley rats, both RIS and its active metabolite 9-hydroxyrisperidone (9-OH-RIS) were detected in plasma samples for 5 days. In comparison with the oral group, DMAPs improved the overall pharmacokinetic profile in plasma with a ∼ 15 folds higher area under the curve (AUC) value. This work has represented the novel delivery of the antipsychotic drug, RIS, through microneedles. It also offers substantial evidence to support the broader application of MAPs for the transdermal delivery of poorly water-soluble drugs

Ability to remotely monitor atrial high-rate episodes using a single-chamber implantable cardioverter-defibrillator with a floating atrial sensing dipole

Aims To allow timely initiation of anticoagulation therapy for the prevention of stroke, the European guidelines on atrial fibrillation (AF) recommend remote monitoring (RM) of device-detected atrial high-rate episodes (AHREs) and progression of arrhythmia duration along pre-specified strata (6 min…&lt;1 h, 1 h…&lt;24 h, ≥ 24 h). We used the MATRIX registry data to assess the capability of a single-lead implantable cardioverter-defibrillator (ICD) with atrial sensing dipole (DX ICD system) to follow this recommendation in patients with standard indication for single-chamber ICD. Methods In 1841 DX ICD patients with daily automatic RM transmissions, electrograms of first device-detected AHREs per patient in and results each duration stratum were adjudicated, and the corresponding positive predictive values (PPVs) for the detections to be true atrial arrhythmia were calculated. Moreover, the incidence and progression of new-onset AF was assessed in 1451 patients with no AF history. A total of 610 AHREs ≥6 min were adjudicated. The PPV was 95.1% (271 of 285) for episodes 6min…&lt;1 h, 99.6% (253/254) for episodes 1 h…&lt;24 h, 100% (71/71) for episodes ≥24 h, or 97.5% for all episodes (595/ 610). The incidence of new-onset AF was 8.2% (119/1451), and in 31.1% of them (37/119), new-onset AF progressed to a higher duration stratum. Nearly 80% of new-onset AF patients had high CHA 2DS 2-VASc stroke risk, and 70% were not on anticoagulation therapy. Age was the only significant predictor of new-onset AF. Conclusion A 99.7% detection accuracy for AHRE ≥1 h in patients with DX ICD systems in combination with daily RM allows a reliable guideline-recommended screening for subclinical AF and monitoring of AF-duration progression.</p

Impacto de la intervención con una adaptación grupal del método de musicoterapia BMGIM en pacientes con Enfermedad Inflamatoria Intestinal (Enfermedad de Crohn y COLITIS Ulcerosa)

Las terapias complementarias no farmacológicas han demostrado las mejoras que producen en pacientes crónicos, en especial las terapias psicológicas (Gracie et al., 2017), dentro de las cuales se encuentra la Musicoterapia (MT). Uno de los métodos de Musicoterapia reconocidos a nivel mundial es el método Bonny de Imaginación Guiada con Música (BMGIM), cuya aplicación ha mostrado la mejora al tratar pacientes con ciertas enfermedades crónicas, como artritis reumatoide (Jacobi & Eisenberg, 2001) y fibromialgia (Torres, 2015a, 2015b). Aun así, no hay estudios específicos que evalúen el impacto de un tratamiento basado en una adaptación grupal del BMGIM en pacientes con enfermedad inflamatoria intestinal (EII), concretamente Colitis Ulcerosa (CU y Enfermedad de Crohn (EC), y ese ha sido el objeto de este estudio de tesis doctoral. El objetivo consiste en determinar la eficacia de la intervención con una adaptación grupal del método de MT BMGIM, en la mejora del estado de salud de pacientes con EII (CU y EC).Medicin

El mazateco de Oaxaca

El proyecto analiza la variación y el cambio en la fonología, léxico, morfología y sintaxis del mazateco que se habla en las Regiones de la Cuenca y la Cañada (Santo Domingo del Río, Xalapa de Díaz, Huautla de Jiménez y Santa María Asunción) del estado de Oaxaca de la República Mexicana.Área temática: EtnopragmáticaFacultad de Humanidades y Ciencias de la Educació

Infectious Diseases, Social, Economic and Political Crises, Anthropogenic Disasters and Beyond: Venezuela 2019 – Implications for Public Health and Travel Medicine

During last months, there have been a significant increase in the evidences showing the catastrophic health situation in Venezuela. There are multiple epidemics, increase in emerging and reemerging infectious, tropical and parasitic diseases as consequences of the social, economic and political crises, which would be considered today a clearly anthropogenic disaster. Venezuela is facing in 2019, the worse sanitary conditions, with multiple implications for public health and travel medicine. So far, from a global perspective, this situation will be an impediment for the achievement of the sustainable development goals (SDG) in 2030. In this multiauthor review, there is a comprehensive analysis of the situation for infectious diseases, non-communicable diseases, their impact in the Americas region, given the migration crisis as well as the comparative status of the SDG 2030. This discussion can provide input for prioritizing emerging health problems and establish a future agenda