Physical Mathematical Evaluation of the Cardiac Dynamic Applying the Zipf-Mandelbrot Law

Introduction: The law of Zipf-Mandelbrot is a power law, which has been observed in natural languages. A mathematical diagnosis of fetal cardiac dynamics has been developed with this law. Objective: To develop a methodology for diagnostic aid to assess the degree of complexity of adult cardiac dynamics by Zipf-Mandelbrot law. Methodology: A mathematical induction was done for this;two groups of Holter recordings were selected: 11 with normal diagnosis and 11 with acute disease of each group, one Holter of each group was chosen for the induction, the law of Zipf-Mandelbrot was applied to evaluate the degree of complexity of each Holter, searching similarities or differences between the dynamics. A blind study was done with 20 Holters calculating sensitivity, specificity and the coefficient kappa. Results: The complexity grade of a normal cardiac dynamics varied between 0.9483 and 0.7046, and for an acute dynamic between 0.6707 and 0.4228. Conclusions: A new physical mathematical methodology for diagnostic aid was developed;it showed that the degree of complexity of normal cardiac dynamics was higher than those with acute disease, showing quantitatively how cardiac dynamics can evolve to acute state.

Geometrical Evaluation of Cervical Cells. Fractal and Euclidean Diagnostic Methodology of Clinical Application

Background: The concomitant use of fractal and Euclidian measurements has led to the development of new methodologies of cell evaluation, including a diagnosis of cervical cells that set up differences between normality and various degrees of lesion, to carcinoma. Aim: To confirm the diagnostic capacity of the methodology based on fractal and Euclidian geometry for the mathematical diagnosis through a blind study of normal cells and with different types of lesion, as atypia of undetermined significance (ASCUS), low grade squamous intra-epithelial lesion (LGSIL) and high grade squamous intra-epithelial lesion (HGSIL). Methods: 100 cells of Papanicolaou tests were analyzed and divided into 4 groups according to conventional parameters: 25 normal, 25 ASCUS, 25 LGSIL and 25 HGSIL. By means of the Box-counting Fractal Space, we calculated the fractal dimension and occupying spaces of the border and surface in pixels of the cell nucleus and cytoplasm. The diagnostic parameters of the previously developed methodology were applied and compared with the conventional diagnosis, setting up sensibility, specificity, negative likelihood ratio and Kappa coefficient. Results: The values of the occupation of the border and surface of the cell nucleus and cytoplasm were consistent with the values found by the diagnostic methodology previously found. The subtraction of the nucleus and cytoplasm frontiers presented values between: 189 and 482 for normality;159 and 432 for ASCUS;126 to 401 for LGSIL and 39 to 122 for HGSIL. A sensitivity and specificity of 100%, and a Kappa coefficient of 1 were obtained. Conclusions: The capacity of the methodology to diagnose quantitatively the different stages in the evolution of the cervical cells observed in Papanicolaou tests was confirmed, from normality to HGSIL.

Prevalence of refractive errors in school-aged and preadolescent children in Colombia

AIM:To describe the distribution of refractive errors by age and sex among schoolchildren in Soacha,Colombia.METHODS:This was an observational cross-sectional study conducted in five urban public schools in the municipality of Soacha.A total of 1161 school-aged and pre-adolescent children,aged 5-12y were examined during the school year 2021-2022.Examinations included visual acuity and static refraction.Spherical equivalent(SE)was analysed as follows:myopia SE≤-0.50 D and uncorrected visual acuity of 20/25 or worse;high myopia SE≤-6.00 D;hyperopia SE≥+1.00 D(≥7y)or SE≥+2.00 D(5-6y);significant hyperopia SE≥+3.00 D.Astigmatism was defined as a cylinder in at least one eye≥1.00 D(≥7y)or≥1.75 D(5-6y).If at least one eye was ametropic,children were classified according to the refractive error found.RESULTS:Of the 1139 schoolchildren included,50.6%were male,58.8%were aged between 5 and 9y,and 12.1%were already using optical correction.The most common refractive error was astigmatism(31.1%),followed by myopia(20.8%)and hyperopia(13.1%).There was no significant relationship between refractive error and sex.There was a significant increase in astigmatism(P<0.001)and myopia(P<0.0001)with age.CONCLUSION:Astigmatism is the most common refractive error in children in an urban area of Colombia.Emmetropia decreased and myopia increased with age.

A Systematic Bibliographical Review: Barriers and Facilitators for Access to Legal Abortion in Low and Middle Income Countries

Background: There is a complex interplay between women’s preferences, abortion services availability and the context in which these are provided. Even in countries where it is legal, denial of abortion is common, especially in low and middle income countries, forcing women to look for the service elsewhere and bringing serious consequences to the health and wellbeing of many women and their families. This non-systematic review pretends to answer the question: Which are the barriers to and facilitators for the access to legal abortion services in low and middle income countries? Methods: A non-systematic bibliographical review. Inclusion criteria: all quantitative, qualitative and evidence synthesis studies performed in low and middle income countries according to the World Bank classification for 2015 and published in English, Spanish and Portuguese language, between 2005 and 2017. Exclusion criteria: articles evaluating the efficacy of interventions, addressing the knowledge about abortion procedures among health care students and personnel, as well as those that only included sex workers. Results: The database search yield 199 articles in MEDLINE. 24 in Scopus and 38 in Scielo. A total of 22 articles including 15 countries from Africa (n = 6), Asia (n = 5), Central and South America (n = 3) and Europe (n = 1). The legal status of abortion in each of these countries was studied and described. For the analysis of the information, three categories of deepening were established: Laws and policies, Service delivery and Women’s abortion care-seeking behavior. Conclusion: the determinants of access to abortion in low and middle income countries are convoluted as multiple delays and barriers usually overlap. Similarly, stigmatization has a great impact across all the steps of abortion provision. Multiple facilitators were proposed in the three aspects of abortion provision, but they need to be adjusted depending on the context of each country.

Primary Leiomyosarcoma of the Ovary: A Case Report

Leiomyosarcoma of the ovary is a rare disease, with aggressive behavior and poor prognosis, which mainly occurs in postmenopausal women. Surgery is the cornerstone of treatment, while the role of chemotherapy and radiotherapy is still not clear because substantial data is lacking. This paper presents the case of an adult woman who is diagnosed with primary leiomyosarcoma of the left ovary, and who receives a surgical approach and adjuvant treatment with chemotherapy currently achieving 20 months free from disease.

Food Allergy Mimicking Pylorus Hypertrophy

Food allergy (FA) is a disease with increasing prevalence and a wide spectrum of clinical manifestations. These include the eosinophilic disorders, which can involve any segment of the gastrointestinal tract (GIT), including the stomach. In this context, three patients with a confirmed diagnosis of food allergy, who were initially diagnosed with pyloric hypertrophy, are presented. All cases showed an adequate response to nutritional management. It is essential to consider food allergy, such as eosinophilic gastroenteritis, as part of the differential diagnosis of gastric outlet obstruction in those patients who present vomiting secondary to pyloric hypertrophy.

Investigation of temporal and spatial heterogeneities of the immune responses to Bordetella pertussis infection in the lung and spleen of mice via analysis and modeling of dynamic microarray gene expression data

Bordetella pertussis(B.pertussis)is the causative agent of pertussis,also referenced as whooping cough.Although pertussis has been appropriately controlled by routine immunization of infants,it has experienced a resurgence since the beginning of the 21st century.Given that elucidating the immune response to pertussis is a crucial factor to improve therapeutic and preventive treatments,we re-analyzed a time course microarray dataset of B.pertussis infection by applying a newly developed dynamic data analysis pipeline.Our results indicate that the immune response to B.pertussis is highly dynamic and heterologous across different organs during infection.Th1 and Th17 cells,which are two critical types of T helper cell populations in the immune response to B.pertussis,and follicular T helper cells(TFHs),which are also essential for generating antibodies,might be generated at different time points and distinct locations after infection.This phenomenon may indicate that different lymphoid organs may have their unique functions during infection.These findings provide a better understanding of the basic immunology of bacterial infection,which may provide valuable insights for the improvement of pertussis vaccine design in the future.