Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

Consenso Mexicano para el Tratamiento de la Hepatitis C

El objetivo del Consenso Mexicano para el Tratamiento de la Hepatitis C fue el de desarrollar un documento como guía en la práctica clínica con aplicabilidad en México. Se tomó en cuenta la opinión de expertos en el tema con especialidad en: gastroenterología, infectología y hepatología. Se realizó una revisión de la bibliografía en MEDLINE, EMBASE y CENTRAL mediante palabras claves referentes al tratamiento de la hepatitis C. Posteriormente se evaluó la calidad de la evidencia mediante el sistema GRADE y se redactaron enunciados, los cuales fueron sometidos a voto mediante un sistema modificado Delphi, y posteriormente se realizó revisión y corrección de los enunciados por un panel de 34 votantes. Finalmente se clasificó el nivel de acuerdo para cada oración. Esta guía busca dar recomendaciones con énfasis en los nuevos antivirales de acción directa y de esta manera facilitar su uso en la práctica clínica. Cada caso debe ser individualizado según sus comorbilidades y el manejo de estos pacientes siempre debe ser multidisciplinario. Abstract The aim of the Mexican Consensus on the Treatment of Hepatitis C was to develop clinical practice guidelines applicable to Mexico. The expert opinion of specialists in the following areas was taken into account: gastroenterology, infectious diseases, and hepatology. A search of the medical literature was carried out on the MEDLINE, EMBASE, and CENTRAL databases through keywords related to hepatitis C treatment. The quality of evidence was subsequently evaluated using the GRADE system and the consensus statements were formulated. The statements were then voted upon, using the modified Delphi system, and reviewed and corrected by a panel of 34 voting participants. Finally, the level of agreement was classified for each statement. The present guidelines provide recommendations with an emphasis on the new direct-acting antivirals, to facilitate their use in clinical practice. Each case must be individualized according to the comorbidities involved and patient management must always be multidisciplinary

Highly-parallelized simulation of a pixelated LArTPC on a GPU

The rapid development of general-purpose computing on graphics processing units (GPGPU) is allowing the implementation of highly-parallelized Monte Carlo simulation chains for particle physics experiments. This technique is particularly suitable for the simulation of a pixelated charge readout for time projection chambers, given the large number of channels that this technology employs. Here we present the first implementation of a full microphysical simulator of a liquid argon time projection chamber (LArTPC) equipped with light readout and pixelated charge readout, developed for the DUNE Near Detector. The software is implemented with an end-to-end set of GPU-optimized algorithms. The algorithms have been written in Python and translated into CUDA kernels using Numba, a just-in-time compiler for a subset of Python and NumPy instructions. The GPU implementation achieves a speed up of four orders of magnitude compared with the equivalent CPU version. The simulation of the current induced on 10^3 pixels takes around 1 ms on the GPU, compared with approximately 10 s on the CPU. The results of the simulation are compared against data from a pixel-readout LArTPC prototype

A special case of intramedullary teratoma in an adult. Literature review

Spinal teratomas that occur in adulthood are rare. The most accepted theory is that of a disembryogenic origin, but in this case we present the theory of misplaced germ cells.We present a 54-year-old male with saddle hypoesthesia, 3/5 paraesthesia of the lower extremities, urinary incontinence, loss of anal sphincter tone, and patellar and achilles hyporeflexia, of 10 months’ evolution. The MRI showed a heterogeneous, cystic and solid intramedullary lesion with defined edges. Laminoplasty surgery of L2 to L4 and complete resection of the lesion was performed. The histopathological study found a mature teratoma.The incidence of intraspinal teratomas is very low. There are two theories: the disembryogenic theory (most accepted) and the misplaced germ cell theory (our case). This pathogenesis of teratoma formation involves a niche of pluripotent cells from the primitive knot or a caudal cell mass that may precede the formation of a dysraphism. In this modified theory, teratoma growth sometimes causes disruption of the development field and dysraphism. Resumen: Los teratomas espinales, son raros que se presenten en edad adulta. La teoría más aceptada es disembriogénica, pero en este caso exponemos la teoría de células germinales del fuera de lugar.Presentamos un masculino de 54 años, de 10 meses de evolución con hipoestesia en silla de montar, parestesia miembros pélvicos 3/5, incontinencia urinaria, tono de esfínter anal ausente, hiporeflexia patelar y aquilea. RMN lumbar muestra lesión tumoral heterogénea intramedular, quística y solida, bordes definidos. Se realiza cirugía de laminoplastia de L2-L4 y resección total de lesión tumoral, con resultado del estudio histopatológico de Teratoma maduro. La incidencia de teratomas intraespinales es muy baja. Existen 2 teorías: teoría disembiogénica (más aceptada) y teoría de células germinales fuera de lugar (nuestro caso). Esta patogénesis de formación de teratoma tiene nicho de células pluripotentes a partir de nodos de Hensen o masa celular caudal que puede preceder a la formación de disrafismo. Esta teoría modificada, del crecimiento de teratoma a veces causa interrupción del campo del desarrollo y disrafismo. Keywords: Teratoma, Spinal tumour, Mollaret's meningitis, Aseptic meningitis, Intradural, Misplaced germ cell theory, Palabras clave: Teratoma, Tumour espinal, Meningitis Mollaret, Meningitis aséptica, Intradural, Teoría de las células germinales fuera de luga

Recomendaciones generales para mejorar la práctica de la ortopedia

Orthopedics is one of the specialties with more number of dissents received at CONAMED (National Medical Arbitration Commission of México). The cases related to this specialty were analyzed. Results: 28% of involved doctors didn�t have any board certification; deforming and degenerative were the main causes of application of service; the most frequent dissent reasons were delay of medical attention and delay or negation of diagnostics auxiliaries. The communication problems in the doctor-patient relationship reached 87.3% of the cases. The most outstanding deviation by frequency was a deficient diagnosis plan (40.9%). A group of prestigious specialist analyzed those results and emitted by Consensus these General Recommendations to improve the Practice of Orthopedics: 1) Have the board certification and re-certifications indispensable to exercise Orthopedics specialty, 2) Maintain appropriate medical communication with the patient and its responsible relative, 3) Assure the understanding and acceptance of the proposed diagnostic and therapeutic procedures, 4) Value the patient integrally, to structure diagnostic and establish treatments or opportune therapeutic measures, 5) Assure from the first contact the injured patient�s integral valuation, 6) Define and meditate with opportunity the handling for each case. They also emitted Specific Recommendations for the patient�s attention with Low Back Pain and with Sprain in extremities, because these were the most frequent sufferings found in the dissents.La Ortopedia es una de las especialidades con mayor número de inconformidades ante CONAMED. Se analizaron los casos relacionados a esta especialidad y se encontró que 28% de los médicos involucrados no contaban con ninguna certificación. Los padecimientos deformantes y degenerativos fueron las principales causas de solicitud de servicio. Los motivos de inconformidad más frecuentes fueron diferimiento de la atención, diferimiento y/o negación de auxiliares de diagnóstico. Los problemas de comunicación en la relación médico-paciente alcanzaron 87.3% de los casos. Se detectó que la desviación más relevante por frecuencia fue un protocolo de estudio deficiente (40.9%). Un grupo de prestigiados médicos especialistas analizó estos resultados y emitió por consenso las Recomendaciones Generales para mejorar la Práctica de la Ortopedia: 1) Contar con las certificación y recertificaciones indispensables para ejercer la especialidad de ortopedia, 2) Mantener comunicación médica adecuada con el paciente y su familiar responsable, 3) Asegurar la comprensión y la aceptación de los procedimientos diagnósticos y terapéuticos propuestos, 4) Valorar integralmente al paciente, estructurar diagnósticos y establecer tratamientos o medidas terapéuticas oportunas, 5) Asegurar desde el primer contacto la valoración integral del paciente lesionado, 6) Definir y reflexionar con oportunidad el manejo para cada caso. Emitieron también Recomendaciones Específicas para la atención del paciente con Lumbalgia y con Esguince en extremidades, pues estos fueron los padecimientos más frecuentes encontrados en las inconformidades

Uso de dimetil-formamida associada ou não ao glicerol na criopreservação de sêmen caprino Use of dimethylformamide associated or not with glycerol for goat semen cryopreservation

O objetivo neste trabalho foi avaliar os efeitos da dimetil-formamida na criopreservação de sêmen caprino, por meio de testes in vitro. As partidas de sêmen foram congeladas com os diluidores leite desnatado-gema, associado a diferentes crioprotetores e concentrações: 7% de glicerol (T1); 3,5% de glicerol e 3,5% de dimetil-formamida (T2) e 5% de dimetil-formamida (T3). O sêmen foi centrifugado e envasado em palhetas de 0,5 mL, sendo resfriado por 40 minutos, atingindo 5,0°C e permanecendo nesta temperatura por mais 1 hora e 20 minutos. Os parâmetros avaliados in vitro foram a motilidade progressiva e o vigor espermático, a integridade acrossômica, a integridade da membrana plasmática (HO) e a reação acrossômica. Observou-se perda de 30,0% da motilidade inicial quando as amostras foram submetidas aos procedimentos de criopreservação. A perda de integridade da membrana plasmática, avaliada pelo teste hiposmótico (HO) foi de 19%. As lesões de acrossoma aumentaram em 3% durante o teste de termo-resistência (TTR) lento. Não houve diferença entre os tratamentos quanto aos aspectos de motilidade nos tempos de 0,00; 0,05; e 1,00 horas do TTR e vigor em todos os tempos. No tempo de 2,00 horas do TTR, registrou-se diferença entre os tratamentos 1 e 2, de modo que a motilidade no tratamento 2 foi superior às demais. Os valores de integridade de membrana plasmática, integridade acrossômica e reação acrossômica pós-descongelamento não diferiram entre os tratamentos, indicando que a dimetil-formamida não foi superior ao glicerol na manutenção da qualidade espermática após a criopreservação.<br>The objective of this trial was to evaluate the efficiency of dimethylformamide on cryopreservation of goat semen using semen physical analyses and complementary tests. Alpine and Saanen bucks from the Dairy Goat Experimental Station- DZO were used. Semen samples were frozen with a yolk-skimmed milk diluent and cryoprotectors with different concentrations as follows: 7% glycerol (T1), 3.5% glycerol plus 3.5% dimethylformamide (T2) or 5% dimethylformamide (T3). Semen was centrifuged, diluted, and bottled in 0.5 mL straws followed by cooling for 40 minutes until reach 5.0°C and kept at this temperature for additional 80 minutes. Samples were then exposed to liquid nitrogen vapor for 15 minutes and finally frozen. Thawing was done in a waterbath at 37°C for 50 seconds. The following variables were evaluated in vitro: sperm progressive motility and vigor, acrosomal integrity and reaction, and plasmatic membrane integrity. The cryopreservation procedures reduced 30.0% of the initial motility and 19% of plasmatic membrane integrity that was evaluated using the hyposmotic swelling test (HOST). It was observed an increaseof 3% in acrosomal lesions when samples were submitted to a slow thermoresistance test (TRT). No significant differences in sperm motility were observed among treatments at 0, 5, and 60 minutes of TRT as well as in sperm vigor at all TRT times. However, at 120 minutes of TRT a significant difference in sperm motility was found comparing T1 and T2 while T3 was intermediate. There were no significant differences on plasmatic membrane integrity, acrosomal integrity, and post-thawing acrossomal reaction across treatments. It can be concluded that dimethylformamide can be a viable alternative for goat semen cryopreservation used alone or in association with glycerol

Finding genetically-supported drug targets for Parkinson’s disease using Mendelian randomization of the druggable genome

Parkinson’s disease is a neurodegenerative movement disorder that currently has no disease-modifying treatment, partly owing to inefficiencies in drug target identification and validation. We use Mendelian randomization to investigate over 3,000 genes that encode druggable proteins and predict their efficacy as drug targets for Parkinson’s disease. We use expression and protein quantitative trait loci to mimic exposure to medications, and we examine the causal effect on Parkinson’s disease risk (in two large cohorts), age at onset and progression. We propose 23 drug-targeting mechanisms for Parkinson’s disease, including four possible drug repurposing opportunities and two drugs which may increase Parkinson’s disease risk. Of these, we put forward six drug targets with the strongest Mendelian randomization evidence. There is remarkably little overlap between our drug targets to reduce Parkinson’s disease risk versus progression, suggesting different molecular mechanisms. Drugs with genetic support are considerably more likely to succeed in clinical trials, and we provide compelling genetic evidence and an analysis pipeline to prioritise Parkinson’s disease drug development

Consenso mexicano de la enfermedad por hígado graso no alcohólico

Resumen: La enfermedad por hígado graso no alcohólico (EHGNA) afecta prácticamente a un tercio de la población mundial. México es uno de los países cuya población reúne varios factores de riesgo para esta enfermedad y su prevalencia podría superar el 50%; es por eso que el panorama a mediano plazo es muy pesimista si no se toman acciones inmediatas para contrarrestar lo que ya se considera un problema de salud nacional.De ahí el interés de la Asociación Mexicana de Gastroenterología y de la Asociación Mexicana de Hepatología para realizar el Consenso mexicano de EHGNA, en el cual se hizo una revisión actualizada y a fondo de temas como epidemiología, fisiopatología, formas clínicas, diagnóstico y tratamiento, con el objetivo de ofrecer al médico mexicano una herramienta útil para la prevención y el manejo de esta enfermedad. Abstract: Nonalcoholic fatty liver disease (NAFLD) affects nearly one third of the population worldwide. Mexico is one of the countries whose population has several risk factors for the disease and its prevalence could surpass 50%. If immediate action is not taken to counteract what is now considered a national health problem, the medium-term panorama will be very bleak.This serious situation prompted the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología to produce the Mexican Consensus on Fatty Liver Disease. It is an up-to-date and detailed review of the epidemiology, pathophysiology, clinical forms, diagnosis, and treatment of the disease, whose aim is to provide the Mexican physician with a useful tool for the prevention and management of nonalcoholic fatty liver disease. Palabras clave: Enfermedad por hígado graso no alcohólico, Consenso mexicano, Keywords: Nonalcoholic fatty liver disease, Mexican consensu