Prótesis total de cadera con disco a compresión (PDC)

Se describe en este trabajo, un implante protésico total no cementado de cadera, sin anclaje intramedular. Se estudia la biomecánica de la articulación de la cadera, de los implantes endomedulares y se marcan las características de la prótesis PDC: transmisión de las fuerzas resultantes de la cadera directamente al hueso cortical media1 del cuello femoral y la ausencia de manipulación del canal medular. Por último se realiza una somera descripción de la técnica de implantación

Spes Nova II

Este PAP consistió en el seguimiento del proyecto iniciado en Otoño de 2022 en donde se siguió trabajando en colaboración con Spes Nova de la Universidad de Fordham para impulsar el comercio y desarrollo social de artesanos de la Zona Metropolitana de Guadalajara. Como continuación de este trabajo, los principales puntos que se abordaron fueron los siguientes: Se revisaron los aspectos legales, tanto documentos como económicos para la salida de artesanías de territorio nacional, se hizo un seguimiento con las dos partes, con el artesano en cuanto el pedido de muestras para elaboración de fichas técnicas y seguimiento de la producción de los productos, y hacia Spes Nova con el tema del seguimiento previo y para la solicitud de la orden del compra; para el apartado logístico se trabajó en la selección de los proveedores del servicio y coordinación con estos; en el tema financiero, se habló con ambas partes sobre que opciones de pago/cobro era más conveniente para cada uno y la selección del método adecuado; la realización de la documentación de todo el proceso realizado, a manera de guía, para que el artesano pueda continuar de manera autónoma. Por último todo este trabajo concluyó con el envío de las artesanías hacia Spes Nova.ITESO, A.C

Reassessing climate and pre-Columbian drivers of paleofire activity in the Bolivian Amazon

A 50,000-year-old sediment core record from Laguna Chaplin is reanalyzed to explore potential paleoecological methods to detect the extent of pre-Columbian disturbance in the Bolivian Amazon. High-resolution (sub-centennial) macrocharcoal data are analyzed using statistical algorithm software including Regime Shift Detection and CHAR Analysis to detect changes in past fire regimes. These data are compared with existing charcoal records from throughout the Bolivian lowlands to provide a regional scale context of past biomass burning. During the mid-Holocene, changes in precipitation are the dominant driver of fire activity and biomass burning at Laguna Chaplin and across the Bolivian lowlands. During the late Holocene, increased fire activity across ecosystems ranging from fire-adapted to fire-intolerant forests is attributed to the apex of pre-Columbian activity. These data suggest human-caused ignitions during the late Holocene are the driving factor of regional scale fire activity in the Bolivian lowlands. After ca. 650 cal yr BP, there is an increase in biomass burning and fire frequency synchronous with the expansion of Moraceae/Urticaceae pollen (>50%) at Laguna Chaplin. This occurs during the time-transgressive southward expansion of the rainforest boundary, during the apex of pre-Columbian activity in the region. The increase in biomass burning at Laguna Chaplin is reflected at other sites in the region with known human occupation histories. The presence of Zea mays ca. 970 to 170 cal yr BP indicates maize cultivation is practiced in the immediate vicinity surrounding Laguna Chaplin. The simultaneous increase in fire activity with the expansion of the less flammable humid rainforest vegetation suggests human fire management practices. These data are interpreted as the use of frequent, low severity, human-caused fires to clear the croplands from encroaching rainforest vegetation. Despite evidence of pre-Columbian fire management during the late Holocene, vegetation and fire data indicate the extent of human-landscape modification and fire management at Laguna Chaplin, is not enough to inhibit the climate-driven regional forest expansion of the savanna-rainforest ecotonal boundary to its most southern extent in the last 50,000 years. This study demonstrates the utility of applying a multi-proxy, high-resolution paleoecological method to disentangle climate and pre-Columbian disturbance in the Bolivian Amazon

Time- and energy-resolved effects in the boron-10 based Multi-Grid and helium-3 based thermal neutron detectors

The boron-10 based Multi-Grid detector is being developed as an alternative to helium-3 based neutron detectors. At the European Spallation Source, the detector will be used for time-of-flight neutron spectroscopy at cold to thermal neutron energies. The objective of this work is to investigate fine time- and energy-resolved effects of the Multi-Grid detector, down to a few $\mu$eV, while comparing it to the performance of a typical helium-3 tube. Furthermore, it is to characterize differences between the detector technologies in terms of internal scattering, as well as the time reconstruction of ~ $\mu$s short neutron pulses. The data were taken at the Helmholtz Zentrum Berlin, where the Multi-Grid detector and a helium-3 tube were installed at the ESS test beamline, V20. Using a Fermi-chopper, the neutron beam of the reactor was chopped into a few tens of $\mu$s wide pulses before reaching the detector, located a few tens of cm downstream. The data of the measurements show an agreement between the derived and calculated neutron detection efficiency curve. The data also provide fine details on the effect of internal scattering, and how it can be reduced. For the first time, the chopper resolution was comparable to the timing resolution of the Multi-Grid detector. This allowed a detailed study of time- and energy resolved effects, as well as a comparison with a typical helium-3 tube.Comment: 37 pages, 21 figure

A Multi-Step Process of Viral Adaptation to a Mutagenic Nucleoside Analogue by Modulation of Transition Types Leads to Extinction-Escape

Resistance of viruses to mutagenic agents is an important problem for the development of lethal mutagenesis as an antiviral strategy. Previous studies with RNA viruses have documented that resistance to the mutagenic nucleoside analogue ribavirin (1-β-D-ribofuranosyl-1-H-1,2,4-triazole-3-carboxamide) is mediated by amino acid substitutions in the viral polymerase that either increase the general template copying fidelity of the enzyme or decrease the incorporation of ribavirin into RNA. Here we describe experiments that show that replication of the important picornavirus pathogen foot-and-mouth disease virus (FMDV) in the presence of increasing concentrations of ribavirin results in the sequential incorporation of three amino acid substitutions (M296I, P44S and P169S) in the viral polymerase (3D). The main biological effect of these substitutions is to attenuate the consequences of the mutagenic activity of ribavirin —by avoiding the biased repertoire of transition mutations produced by this purine analogue—and to maintain the replicative fitness of the virus which is able to escape extinction by ribavirin. This is achieved through alteration of the pairing behavior of ribavirin-triphosphate (RTP), as evidenced by in vitro polymerization assays with purified mutant 3Ds. Comparison of the three-dimensional structure of wild type and mutant polymerases suggests that the amino acid substitutions alter the position of the template RNA in the entry channel of the enzyme, thereby affecting nucleotide recognition. The results provide evidence of a new mechanism of resistance to a mutagenic nucleoside analogue which allows the virus to maintain a balance among mutation types introduced into progeny genomes during replication under strong mutagenic pressure

Consenso Mexicano de Hepatitis Alcohólica

La hepatitis alcohólica es una condición frecuente en la población mexicana, se caracteriza por insuficiencia hepática aguda sobre crónica, importante reacción inflamatoria sistémica y fallo multiorgánico, que en la variante grave de la enfermedad implica una elevada mortalidad. Por lo anterior, la Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Hepatología conjuntaron un equipo multidisciplinario de profesionales de la salud para elaborar el primer consenso mexicano de hepatitis alcohólica. El consenso fue elaborado con la metodología Delphi, emitiendo 37 recomendaciones. La enfermedad hepática relacionada con el consumo de alcohol comprende un amplio espectro, que incluye esteatosis, esteatohepatitis, fibrosis en diferentes grados, cirrosis y sus complicaciones. La hepatitis alcohólica grave se define por una función modificada de Maddrey ≥ 32 o por un puntaje de MELD (Model for End- Stage Liver Disease) igual o mayor a 21. Actualmente no existe un biomarcador específico para el diagnóstico. La presencia de leucocitosis con neutrofilia, hiperbilirrubinemia (> 3 mg/dL),AST > 50 U/L ( 1.5-2 pueden orientar al diagnóstico. La piedraangular del tratamiento es la abstiencia junto con el soporte nutricional. Los esteroides estanindicados en la forma grave, en donde han resultado efectivos para reducir la mortalidad a28 días. El trasplante hepático es en la actualidad la única opción con que se cuenta parasalvar la vida de pacientes que no responden a los esteroides. Ciertos fármacos, como la N-acetilcisteína, el factor estimulante de colonias de granulocitos y la metadoxina, pueden seruna terapia adyuvante que puede mejorar la supervivencia de los pacientes

The Mexican consensus on alcoholic hepatitis

Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized by acute-on-chronic liver failure, important systemic inflammatory response, and multiple organ failure. The severe variant of the disease implies elevated mortality. Therefore, the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología brought together a multidisciplinary team of health professionals to formulate the first Mexican consensus on alcoholic hepatitis, carried out utilizing the Delphi method and resultingin 37 recommendations. Alcohol-related liver disease covers a broad spectrum of patholo-gies that includes steatosis, steatohepatitis, different grades of fibrosis, and cirrhosis and itscomplications. Severe alcoholic hepatitis is defined by a modified Maddrey’s discriminant func-tion score ≥ 32 or by a Model for End-Stage Liver Disease (MELD) score equal to or above 21.There is currently no specific biomarker for its diagnosis. Leukocytosis with neutrophilia, hyper-bilirubinemia (>3 mg/dl), AST > 50 U/l ( 1.5-2 can guide thediagnosis. Abstinence from alcohol, together with nutritional support, is the cornerstone oftreatment. Steroids are indicated for severe disease and have been effective in reducing the28-day mortality rate. At present, liver transplantation is the only life-saving option for patientsthat are nonresponders to steroids. Certain drugs, such as N-acetylcysteine, granulocyte-colonystimulating factor, and metadoxine, can be adjuvant therapies with a positive impact on patientsurvival

Time- and energy-resolved effects in the boron-10 based multi-grid and helium-3 based thermal neutron detectors

The boron-10 based multi-grid detector is being developed as an alternative to helium-3 based neutron detectors. At the European Spallation Source, the detector will be used for time-of-flight neutron spectroscopy at cold to thermal neutron energies. The objective of this work is to investigate fine time- and energy-resolved effects of the Multi-Grid detector, down to a few µeV, while comparing it to the performance of a typical helium-3 tube. Furthermore, it is to characterize differences between the detector technologies in terms of internal scattering, as well as the time reconstruction of ∼ µs short neutron pulses. The data were taken at the Helmholtz Zentrum Berlin, where the Multi-Grid detector and a helium-3 tube were installed at the ESS test beamline, V20. Using a Fermi-chopper, the neutron beam of the reactor was chopped into a few tens of µs wide pulses before reaching the detector, located a few tens of cm downstream. The data of the measurements show an agreement between the derived and calculated neutron detection efficiency curve. The data also provide fine details on the effect of internal scattering, and how it can be reduced. For the first time, the chopper resolution was comparable to the timing resolution of the Multi-Grid detector. This allowed a detailed study of time- and energy resolved effects, as well as a comparison with a typical helium-3 tube

The discovery and follow-up of four transiting short-period sub-Neptunes orbiting M dwarfs

Sub-Neptunes with radii of 2–3 R⊕ are intermediate in size between rocky planets and Neptune-sized planets. The orbital properties and bulk compositions of transiting sub-Neptunes provide clues to the formation and evolution of close-in small planets. In this paper, we present the discovery and follow-up of four sub-Neptunes orbiting M dwarfs (TOI-782, TOI-1448, TOI-2120, and TOI-2406), three of which were newly validated by ground-based follow-up observations and statistical analyses. TOI-782 b, TOI-1448 b, TOI-2120 b, and TOI-2406 b have radii of Rp = 2.740 +0.082-0.079 R⊕, 2.769+0.073-0.068 R⊕, 2.120 ± 0.067 R⊕, and 2.830+0.068-0.066 R⊕ and orbital periods of P = 8.02, 8.11, 5.80, and 3.08 days, respectively. Doppler monitoring with the Subaru/InfraRed Doppler instrument led to 2σ upper limits on the masses of <19.1 M⊕, <19.5 M⊕, <6.8 M⊕, and <15.6 M⊕ for TOI-782 b, TOI-1448 b, TOI-2120 b, and TOI-2406 b, respectively. The mass–radius relationship of these four sub-Neptunes testifies to the existence of volatile material in their interiors. These four sub-Neptunes, which are located above the so-called "radius valley," are likely to retain a significant atmosphere and/or an icy mantle on the core, such as a water world. We find that at least three of the four sub-Neptunes (TOI-782 b, TOI-2120 b, and TOI-2406 b), orbiting M dwarfs older than 1 Gyr, are likely to have eccentricities of e ∼ 0.2–0.3. The fact that tidal circularization of their orbits is not achieved over 1 Gyr suggests inefficient tidal dissipation in their interiors.Peer reviewe

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms