A thalamocortical mechanism for the absence of overt motor behavior in covertly aware patients:Thalamocortical Mechanism for the Absence of Overt Motor Behavior

Importance It is well accepted that a significant number of patients in a vegetative state are covertly aware and capable of following commands by modulating their neural responses in motor imagery tasks despite remaining nonresponsive behaviorally. To date, there have been few attempts to explain this dissociation between preserved covert motor behavior and absent overt motor behavior. Objectives To investigate the differential neural substrates of overt and covert motor behavior and assess the structural integrity of the underlying networks in behaviorally nonresponsive patients. Design, Setting, and Participants A case-control study was conducted at an academic center between February 7, 2012, and November 6, 2014. Data analysis was performed between March 2014 and June 2015. Participants included a convenience sample of 2 patients with severe brain injury: a paradigmatic patient who fulfilled all clinical criteria for the vegetative state but produced repeated evidence of covert awareness (patient 1) and, as a control case, a patient with similar clinical variables but capable of behavioral command following (patient 2). Fifteen volunteers participated in the study as a healthy control group. Main Outcomes and Measures We used dynamic causal modeling of functional magnetic resonance imaging to compare voluntary motor imagery and motor execution. We then used fiber tractography to assess the structural integrity of the fibers that our functional magnetic resonance imaging study revealed as essential for successful motor execution. Results The functional magnetic resonance imaging study revealed that, in contrast to mental imagery, motor execution was associated with an excitatory coupling between the thalamus and primary motor cortex (Bayesian model selection; winning model Bayes factors >17). Moreover, we detected a selective structural disruption in the fibers connecting these 2 regions in patient 1 (fractional anisotropy, 0.294; P = .047) but not in patient 2 (fractional anisotropy, 0.413; P = .35). Conclusions and Relevance These results suggest a possible biomarker for the absence of intentional movement in covertly aware patients (ie, specific damage to motor thalamocortical fibers), highlight the importance of the thalamus for the execution of intentional movements, and may provide a target for restorative therapies in behaviorally nonresponsive patients

Producción de Oxalis tuberosa M., Tropaeolum tuberosum R & P, Lupinus mutabilis S. y Stangea rhizantha A. Gray Killip en Junín

Universidad Nacional Agraria La Molina. Facultad de Agronomía. Departamento Académico de FitotecniaCon el fin de contribuir al conocimiento y mejor aprovechamiento de la oca (Oxalis tuberosa M.), mashua (Tropaeolum tuberosum R&P), tarwi (Lupinus mutabilis S.) y el chicuro (Stangea rhizantha (A. Gray) Killip), durante el año 2016 se caracterizó indicadores productivos de estas especies en cinco provincias de Junín (Concepción, Huancayo, Chupaca, Jauja y Yauli). Se sistematizó la información secundaria disponible y entrevistó a 1500 agricultores en 57 distritos ubicados entre los 3155 a 4259 msnm mediante una encuesta que caracterizó las provincias, parcelas, tecnología de producción, comercialización y postcosecha. Los resultados mostraron los vacíos no cubiertos en las investigaciones como mejoramiento genético, variedades, riego, producción de semilla, producción orgánica, procesamiento y conservación. El 89% de la población entrevistada cultiva oca y mashua, un 37% tarwi y un 5% recolecta chicuro. Los tubérculos fueron sembrados mayormente en Concepción y Huancayo, el tarwi en Jauja y el chicuro en Yauli. Los cultivos se realizan principalmente bajo secano, con semillas propias seleccionadas de la cosecha anterior, abonadas con guano, en rotación y sin asociación, con arado de tracción animal, chaquitaclla, control químico y una producción para autoconsumo y venta en ferias locales. El tamaño de parcela más frecuente es de 0.25 – 0.5 hectáreas. Se registró la presencia de 5, 8, 1, 1 variedades de oca, mashua, tarwi y chicuro respectivamente. Se siembran entre Julio – Noviembre (oca y mashua), Abril – Julio (tarwi) y se cosecha entre Marzo – Julio (oca y mashua), Abril – Julio (tarwi) y Enero – Marzo (Chicuro). Se reporta la incidencia de dos plagas y una enfermedad en oca, una plaga y ninguna enfermedad en mashua y una plaga y una enfermedad en tarwi. Previo al consumo los tubérculos son soleados durante 3 a 7 días y el tarwi es desamargado en un periodo de 8 a 15 días. Se halló 5 formas de preparación culinaria con oca, 6 en mashua y 8 formas de consumo de tarwi. Los agricultores atribuyen usos medicinales a la oca (antibiótico y diurético), a la mashua (repelente, desinflamatorio prostático y anticancerígeno). El tarwi se empleó como antidiabético y antiparasitario, el chicuro como analgésico y anticancerígeno. Los tubérculos se almacenan durante 6 meses en trojas de paja y el tarwi en costales hasta por tres años.In order to contribute to the knowledge and better use of the oca (Oxalis tuberosa M.), mashua (Tropaeolum tuberosum R & P), tarwi (Lupinus mutabilis S.) and chicuro (Stangea rhizantha (A. Gray) Killip), in the year 2016, productive indicators of these species were characterized in five provinces of Junín (Concepción, Huancayo, Chupaca, Jauja and Yauli). The available secondary information was systematized and 1,500 farmers were interviewed in 57 districts located between 3155 and 4259 msnm by a survey that characterized the provinces, plots, production technology, marketing and postharvest. The results showed the gaps not covered in research such as genetic improvement, varieties, irrigation, seed production, organic production, processing and conservation. 89% of the population interviewed cultivate oca and mashua, 37% tarwi and 5% gather chicuro. The tubers were planted mainly in Concepción and Huancayo, the tarwi in Jauja and Chicuro in Yauli. The crops are made mainly under dry conditions, with own seeds selected from the previous harvest, fertilized with guano, in rotation and without association, with animal traction plow, chaquitaclla, chemical control and a production for self consumption and sale in local fairs. The most frequent plot size is 0.25 - 0.5 hectares. It was recorded the presence of 5, 8, 1, 1 varieties of oca, mashua, tarwi and chicuro respectively. They are sown between July - November (oca and mashua), April - July (tarwi) and harvested between March - July (oca and mashua), April - July (tarwi) and January - March (Chicuro). The incidence of two pests and one disease in oca, one pest and no disease in mashua and one pest and disease in tarwi are reported. Prior to consumption the tubers are sunny for 3 to 7 days and the tarwi is peeled in a period of 8 to 15 days. We found 5 forms of culinary preparation with oca, 6 in mashua and 8 forms of consumption of tarwi. The farmers attribute medicianal uses to the oca (antibiotic and diuretic), to the mashua (repellent, prostatic and anticancer antidepressant). Tarwi was used as antidiabetic and antiparasitic, chicur as analgesic and anticancer. The tubers are stored for 6 months in troja straw and the tarwi in sacks for up to three years.Tesi

Somatosensory attention identifies both overt and covert awareness in disorders of consciousness

Objective Some patients diagnosed with disorders of consciousness retain sensory and cognitive abilities beyond those apparent from their overt behavior. Characterizing these covert abilities is crucial for diagnosis, prognosis, and medical ethics. This multimodal study investigates the relationship between electroencephalographic evidence for perceptual/cognitive preservation and both overt and covert markers of awareness. Methods Fourteen patients with severe brain injuries were evaluated with an electroencephalographic vibrotactile attention task designed to identify a hierarchy of residual somatosensory and cognitive abilities: (1) somatosensory steady-state evoked responses, (2) bottom-up attention orienting (P3a event-related potential), and (3) top-down attention (P3b event-related potential). Each patient was also assessed with a clinical behavioral scale and 2 functional magnetic resonance imaging assessments of covert command following. Results Six patients produced only sensory responses, with no evidence of cognitive event-related potentials. A further 8 patients demonstrated reliable bottom-up attention-orienting responses (P3a). No patient showed evidence of top-down attention (P3b). Only those patients who followed commands, whether overtly with behavior or covertly with functional neuroimaging, also demonstrated event-related potential evidence of attentional orienting. Interpretation Somatosensory attention-orienting event-related potentials differentiated patients who could follow commands from those who could not. Crucially, this differentiation was irrespective of whether command following was evident through overt external behavior, or through covert functional neuroimaging methods. Bedside electroencephalographic methods may corroborate more expensive and challenging methods such as functional neuroimaging, and thereby assist in the accurate diagnosis of awareness

Diffusion tensor imaging and white matter abnormalities in patients with disorders of consciousness.

Progress in neuroimaging has yielded new powerful tools which, potentially, can be applied to clinical populations, improve the diagnosis of neurological disorders and predict outcome. At present, the diagnosis of consciousness disorders is limited to subjective assessment and objective measurements of behavior, with an emerging role for neuroimaging techniques. In this review we focus on white matter alterations measured using Diffusion Tensor Imaging on patients with consciousness disorders, examining the most common diffusion imaging acquisition protocols and considering the main issues related to diffusion imaging analyses. We conclude by considering some of the remaining challenges to overcome, the existing knowledge gaps and the potential role of neuroimaging in understanding the pathogenesis and clinical features of disorders of consciousness

Relación entre la hemoglobina glicosilada (HbA1c) y el perfil lipídico en pacientes que acudieron al SAAAC durante el período 2010-2013

Se realizó un estudio observacional, descriptivo, correlacional, retrospectivo y de corte transversal con el objetivo principal de explicar la relación bioquímica entre la hemoglobina glicosilada y el perfil lipídico en 222 pacientes, con edades comprendidas entre 30 a 90 años, que acudieron al Servicio Académico Asistencial de Análisis Clínicos (SAAAC) de la Facultad de Farmacia y Bioquímica de la Universidad Nacional Mayor de San Marcos, del 2010 al 2013, a los cuales se les realizó las siguientes pruebas de laboratorio: determinación de hemoglobina glicosilada por el método de resina ion-cambio, glucosa por el método de glucosa oxidasa y peroxidasa; colesterol total, triglicéridos y HDLc por los métodos enzimáticos convencionales. Para el cálculo de LDLc y VLDLc se utilizó la fórmula de Friedewald. Se encontró que 79,3 % de la población tiene valores de HbA1c por encima del rango normal; 52,2 % presentaron hipertrigliceridemia y 39,6 % hipercolesterolemia. Los coeficientes de correlación de Pearson demostraron relación directa estadísticamente significativa entre la HbA1c y el colesterol total, LDLc, VLDLc y triglicéridos, mientras que con el HDLc, la relación resultó inversa y no significativa. Aplicando correlación de Pearson para cada grupo clasificado según nivel de hemoglobina HbA1c, género y edad, se halló un incremento significativo en la correlación en el grupo con nivel elevado de HbA1c (sólo en CT, VLDLc y TG), en el género femenino y en el grupo de 51 a 70 años (sólo en CT, VLDLc y TG). Los mecanismos bioquímicos que sustentarían la relación son específicos según el estado de salud del paciente: acetil-CoA y glicerol-3fosfato mediarían la relación en sujetos sanos; mientras que los AGEs y las alteraciones de las proteínas reguladoras serían las causas en pacientes diabéticos. Palabras clave: hemoglobina glicosilada, perfil lipídico, lipoproteínas.--- An observational, descriptive, correlational , cross-sectional and retrospective study was conducted was done in order to explain the main biochemical relationship between Glycated hemoglobin and lipid profile in 222 patients with ages included between 30 to 90 years who presented to the Academic Assistance Clinical Analysis (SAAAC), of The Faculty of Pharmacy and Biochemistry of The Major National University of San Marcos (UNMSM), from 2010 to 2013. It was done laboratory tests in these patients: glycated hemoglobin determination by the method of ion-exchange resin, glucose by the method of glucose oxidase and peroxidase, total cholesterol, triglycerides and HDLc by the conventional enzymatic methods. It was used the Friedewald formula for the calculation of LDLc and VLDLc. It was found that 79.3% of the population have HbA1c values above the normal range, 52.2% had hypertriglyceridemia, and 39.6% had hypercholesterolemia. The Pearson correlation coefficients showed statistically significant direct relationship between HbA1c and total cholesterol, LDLc, VLDLc and triglycerides, whereas with HDLc, the relationship was inverse and not significant. Applying Pearson correlation for each classified group according to levels of HbA1c, gender and age a significant increase in the correlation in the group with elevated HbA1c (only CT , VLDLc and TG ) in females and in the group of 51-70 years ( only CT , VLDLc and TG) was found.The biochemical mechanisms that support the relationship probably are specific of the state of health of patient: the acetyl-CoA and glycerol-3-phosphate would mediate the relationship in healthy subjects; while AGEs and alterations in regulatory proteins would be intermediaries in diabetic patients Keywords: glycosylated hemoglobin, lipid profile, lipoproteins.Tesi

Programa “Kutirimpuy" para fomentar las habilidades sociales en adolescentes de un CAR de la ciudad de Huancayo 2022

La presente investigación tuvo como finalidad determinar la influencia del programa Kutirimpuy para desarrollar las habilidades sociales en adolescentes de un Centro de Atención Residencial (CAR) de la ciudad de Huancayo (2022). De esta manera, dicho estudio tuvo un diseño metodológico cuasiexperimental, tipo aplicada, de nivel tecnológico, que está caracterizado con un procedimiento de pretest y postest en un solo grupo, la muestra estuvo conformada por 30 adolescentes. Se utilizó como instrumento el Test de habilidades sociales de Goldstein; se aplicó la prueba no paramétrica de comparación de medias de W de Wilcoxon para muestras relacionadas para la contrastación y prueba de hipótesis; donde se llegó a la conclusión que el programa Kutirimpuy fomenta e influye significativamente (Wilcoxon = -4.574; p=0.000) en el desarrollo de las habilidades sociales. También, se evidenció que el programa Kutirimpuy fomenta e influye significativamente en el desarrollo de las dimensiones “primeras habilidades sociales” (Wilcoxon = -4.055; p=0.000), “habilidades sociales avanzadas” (Wilcoxon = -4.223; p=0.000), “habilidades sociales relacionadas a los sentimientos” (Wilcoxon = -3.957; p=0.000), “habilidades sociales alternativas a la agresión” (Wilcoxon = -4.353; p=0.000), “habilidades sociales para combatir el estrés” (Wilcoxon = -4.136; p=0.000) y las “habilidades sociales de planificación” (Wilcoxon = -4.055; p=0.000). Además, la presente investigación tuvo un alcance de conocer y determinar el nivel de las habilidades sociales, en cuya gran mayoría se evidenció niveles bajos en el pretest y niveles medio en el postest. Por otra parte, en el presente estudio se tuvo una limitación al momento de aplicar el programa, ya que solo estaba diseñado para adolescentes y se tenía el tiempo limitado, así como el número de sesiones que fueron cortas para que el adolescente cumpla satisfactoriamente los indicadores establecidos para el buen desarrollo de las habilidades sociales

Insectos asociados entre un cultivo de Curuba y un fragmento de bosque alto andino de la Sabana de Bogotá

En el municipio de Madrid (Cundinamarca) se estableció un cultivo ecológico de curuba cerca de un Bosque Alto Andino y se realizaron muestreos semanales en bosque y cultivo para determinar los insectos asociados de importancia agroecológica. Se recuperaron 30 familias de insectos pertenecientes a los órdenes Diptera, Hymenoptera, Coleoptera, Hemiptera y Lepidoptera de las cuales 24 se hallaron en el bosque y 21 en el cultivo; 14 de ellas se consideraron de importancia agroecológica, debido a que están reportadas cumpliendo hábitos fitófagos, enemigos naturales o polinizadores. Del total de insectos recuperados considerados de importancia agroecológica el 30.99% correspondieron a fitófagos de las familias Tephritidae y Lonchaeidae (Diptera), Chrysomelidae y Curculionidae (Coleóptera), Cicadellidae (Hemiptera) y Nymphalidae (Lepidóptera). El 21.18% correspondió a enemigos naturales de las familias Braconidae, Ichneumonidae, Diapriidae y Megaspilidae (Hymenoptera). El 47.83% correspondió a polinizadores de las familias Halictidae y Apidae (Hymenoptera) y Tachinidae y Syrphidae (Díptera). El fragmento de bosque presentó mayor riqueza y abundancia de familias de insectos lo cual puede ser tenido en cuenta para procesos específico de aprovechamiento sostenible de enemigos naturales y polinizadores en agroecosistemas.

Prognostic Role of the Expression of Latent-Membrane Protein 1 of Epstein-Barr Virus in Classical Hodgkin Lymphoma

The prognostic impact of the presence of Epstein-Barr virus (EBV) in classical Hodgkin lymphoma (cHL) is controversial. Previous studies reported heterogeneous results, rendering difficult the clinical validation of EBV as a prognostic biomarker in this lymphoma. The objective of this study was to evaluate the survival impact of the expression of EBV Latent-Membrane Protein 1 (EBV-LMP1) in tumoral Hodgkin-Reed-Sternberg (HRS) cells of primary diagnostic samples of cHL. Formalin-Fixed Paraffin-Embedded (FFPE) lymph node samples from 88 patients with cHL were analyzed. Patients were treated with the standard first-line chemotherapy (CT) with Adriamycin, Bleomycin, Vinblastine and Dacarbazine (ABVD) followed by radiotherapy. The Kaplan-Meier method and the Cox proportional hazards model were used for carrying out the survival analysis. In order to investigate whether the influence of EBV was age-dependent, analyses were performed both for patients of all ages and for age-stratified subgroups. In bivariate analysis, the expression of EBV was associated with older age (p = 0.011), mixed cellularity subtype cHL (p < 0.001) and high risk International Prognostic Score (IPS) (p = 0.023). Overall survival (OS) and progression-free survival (PFS) were associated with the presence of bulky disease (p = 0.009) and advanced disease at diagnosis (p = 0.016). EBV-positive cases did not present a significantly lower OS and PFS in comparison with EBV-negative cases, for all ages and when stratifying for age. When adjusted for covariates, absence of bulky disease at diagnosis (HR: 0.102, 95% CI: 0.02-0.48, p = 0.004) and limited disease stages (I-II) (HR: 0.074, 95% CI: 0.01-0.47, p = 0.006) were associated with a significant better OS. For PFS, limited-disease stages also retained prognostic impact in the multivariate Cox regression (HR: 0.145, 95% CI: 0.04-0.57, p = 0.006). These results are of importance as the early identification of prognostic biomarkers in cHL is critical for guiding and personalizing therapeutic decisions. The prognostic role of EBV in cHL could be modulated by the type of CT protocol employed and interact with the rest of presenting features

The Holocene Cedrus pollen record from Sierra Nevada (S Spain), a proxy for climate change in N Africa

Comprehending the effects of climate variability and disturbance on forested ecosystems is paramount to successfully managing forest environments under future climate scenarios (e.g., global warming, aridi-fication increase). Changes in fossil pollen abundance in sedimentary archives record past vegetation dynamics at regional scales, mainly related to climate changes and, in the last few millennia, to human impact. Pollen records can thus provide long databases with information on how the environment reacted to climate change before the historical record. In this study, we synthesized fossil pollen data from seven sites from the Sierra Nevada in southern Spain to investigate the response of forests in the western Mediterranean area to millennial-scale climate changes and to human impact during the Holocene. In particular, here we focused on Cedrus pollen abundances, which most-likely originated from Northern Africa and were carried to Sierra Nevada by wind. Cedrus pollen has received little attention in the Iberian Peninsula palynological records, for it occurs in low concentrations and has an African source, and thus this article explores the potential to reconstruct its past history and climate. Although Cedrus abundances are generally lower than 1% in the studied pollen samples, a comparison with North African (Moroccan) Cedrus pollen records shows similar trends at long- and short-term time-scales. Therefore, this record could be used as a proxy for changes in this forest species in North Africa. As observed in the Sierra Nevada synthetic record, the increasing trend of Cedrus pollen during the Middle and Late Holocene closely correlates with decreasing summer insolation. This would have produced overall cooler annual temperatures in Northern Africa (Middle Atlas and Rif Mountains) as well as lower summer evaporation, benefiting the growth of this cool-adapted montane tree species while increasing available moisture during the summer, which is critical for this water-demanding species. Millennial-scale variability also characterizes the Sierra Nevada Cedrus synthetic pollen record. Cedrus abundance oscillations co-vary with well-known millennial-scale climatic variability that controlled cedar abundance and altitudinal distribution in montane areas of N Africa. (C) 2020 Elsevier Ltd. All rights reserved.Peer reviewe