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Introducción. La miopía patológica es una causa importante de pérdida de visión irreversible y es la cuarta a novena causa más frecuente de ceguera en el mundo. Es también conocida como miopía alta, degenerativa o maligna; condición en la que los individuos tienen una longitud axial superior a 25,5 - 26,5mm, y/o un error de refracción de por lo menos -5.0 dioptrías, acompañado por cambios patológicos. La neovascularización coroidea (NVC) asociada a miopía patológica puede resultar en la pérdida significativa de la visión y/o la ceguera. La NVC suele ser subfoveal y es una importante complicación, desarrollándose en aproximadamente 5-10% de ojos con miopía patológica. De manera similar que en otras enfermedades maculares asociadas a NVC, se ha encontrado un aumento del nivel del factor de crecimiento de endotelial (VEGF) en NVC miópicas, y por lo tanto, la terapia anti-VEGF sería útil. Desde la introducción en oftalmología de agentes anti factor de crecimiento de endotelial (anti-VEGF), el tratamiento anti-angiogénico con antiVEGF intravítreo se ha convertido en el tratamiento de primera línea para la NVC miópica. El bevacizumab es un anticuerpo monoclonal humano, anti factor de crecimiento endotelial (anti-VEGF), que inhibe la proliferación de nuevas células endoteliales produciendo un bloqueo de la fosforilación de las uniones estrechas (tight junctions) de las mismas. Este mecanismo produciría una mejoría anatómica-funcional en los pacientes e impediría una de las complicaciones más importantes de esta patología como lo es la neovascularización. Objetivo. Evaluar la eficacia de bevacizumab intravítreo (Avastin ®™) como tratamiento de la neovascularización coroidea (NVC) en miopías patológicas. Pacientes y métodos. Se evaluaron retrospectivamente 22 pacientes con diagnóstico de maculopatía miópica neovascular tratados mediante inyección intravítrea de bevacizumab, con un seguimiento mínimo de 12 meses. La agudeza visual se evaluó mediante tabla de Snellen y se convirtió en unidades LogMAR. El espesor macular se evaluó mediante tomografía de coherencia óptica (OCT). Las variables cuantitativas se analizaron mediante medidas de tendencia central, dispersión y forma. Los cambios en la agudeza visual se calcularon utilizando la prueba de Wilcoxon para variables apareadas y con la prueba de Mann Whitneypara comparar variables independientes. Las diferencias entre variables continuas con distribución normal y de muestras independientes fueron calculadas mediante la prueba T de Student. Resultado. Se estudiaron 22 pacientes con diagnóstico de maculopatía miópica neovascular, cuya edad promedio fue de 59,68 (DE 11,75; rango 34,00 – 85,00), de los cuales 7 (31,8%) fueron hombres y 15 (68,2%) fueron mujeres. El tiempo de seguimiento fue de 12 meses. El tiempo promedio transcurrido entre el comienzo de los síntomas y el inicio del tratamiento fue 38,68 (DE 34,63) días. El 68,2% (15) de los pacientes consultaron por disminución brusca de la agudeza visual del ojo afectado y 31,8% (7) consultaron por metamorfopsias. Todos los pacientes presentaron miopía patológica (> 5.0 dioptrías). La cantidad total de inyecciones durante el seguimiento tuvo una media de 4,27 (DE 1.86; Rango 2,00 – 9,00), con un máximo de 9 inyecciones y un mínimo de 2 inyecciones. Durante los primeros 6 meses se realizaron la mayor parte de las inyecciones con una media de 3,36 (DE 1,22; Rango 1,00 – 6,00). La mediana de la AV al momento del tratamiento fue de 1,00 (P25-75=0,40- 1,00). Al analizar la totalidad de los pacientes se encontró que existe una diferencia significativa al comparar las agudezas visuales previas al tratamiento y a los 12 meses de tratamiento (p=

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This article shows the application and design of a hybrid algorithm capable of classifying people into risk groups using data such as prehensile strength, body mass index and percentage of fat. The implementation was done on Python and proposes a tool to help make medical decisions regarding the cardiovascular health of patients. The data were taken in a systematic way, k-means and c-means algorithms were used for the classification of the data, for the prediction of new data two vectorial support machines were used, one for the k-means and the other for the c-means, obtaining as a result a 100% of precision in the vectorial support machine with c-means and a 92% in the one of k-means. [ABSTRACT FROM AUTHOR]

This paper proposes a method to determine urban travel time using imprecise variables. The model calculates values for each edge of the network utilize base a Fuzzy Logic scheme and an adaptive architecture with neural networks. For the uncertainty, the effect of three variables for each street considers; the State of the streets, Traffic zones, and Rainfall (intensity of rain) with an adaptable neural network's architecture. The membership functions experimentally are calculated, getting times closer to the real. The model evaluates the uncertainty for each of the network's edges (streets), intending to adjust the set route travel time; finally, the model updates and modifies the membership functions, making it adaptable to new scenarios. The validation is compared to the MANFIS travel time model with the Fuzzy Logic model, probabilistic model, and desired travel time. The mean absolute percentage error of the three models and the travel time compared, obtaining the ANFIS model a lower result. [ABSTRACT FROM AUTHOR]

Classic Hodgkin lymphoma (cHL) in young children (ages 0–6) is rare in high income countries (HICs) but is more prevalent in low- and middle-income countries (LMICs) like Guatemala. Given that the majority of cHL studies have evaluated adolescent/adults, and the immune system changes with age, we sought to characterize Epstein-Barr virus (EBV) expression, immune regulatory pathway markers and the tumor microenvironment in 42 children ages 0–6 with cHL from Guatemala. We found a very high frequency of EBV expression (97.5%). Hodgkin cells showed increased expression of PD1 ligands and CD137, indicative of shared immune regulatory mechanisms with adult cHL. Pediatric cHL also showed an increase in CD8+ tumor infiltrating lymphocytes and tumor associated macrophages within the tumor microenvironment. Despite 25 having high risk disease, only 4 patients died from progressive disease, relapse or infection. [ABSTRACT FROM AUTHOR]

Mountain social‐ecological systems (MtSES) are vital to humanity, providing ecosystem services to over half the planet's human population. Despite their importance, there has been no global assessment of threats to MtSES, even as they face unprecedented challenges to their sustainability. With survey data from 57 MtSES sites worldwide, we test a conceptual model of the types and scales of stressors and ecosystem services in MtSES and explore their distinct configurations according to their primary economic orientation and land use. We find that MtSES worldwide are experiencing both gradual and abrupt climatic, economic, and governance changes, with policies made by outsiders as the most ubiquitous challenge. Mountains that support primarily subsistence‐oriented livelihoods, especially agropastoral systems, deliver abundant services but are also most at risk. Moreover, transitions from subsistence‐ to market‐oriented economies are often accompanied by increased physical connectedness, reduced diversity of cross‐scale ecosystem services, lowered importance of local knowledge, and shifting vulnerabilities to threats. Addressing the complex challenges facing MtSES and catalyzing transformations to MtSES sustainability will require cross‐scale partnerships among researchers, stakeholders, and decision makers to jointly identify desired futures and adaptation pathways, assess trade‐offs in prioritizing ecosystem services, and share best practices for sustainability. These transdisciplinary approaches will allow local stakeholders, researchers, and practitioners to jointly address MtSES knowledge gaps while simultaneously focusing on critical issues of poverty and food security. Plain Language Summary: Mountain ecosystems and the human communities that inhabit them deliver critical resources—such as fresh water and timber—to over half the planet's human population. Despite their importance, there has been no global assessment of threats to mountain systems, even as they face unprecedented challenges to their sustainability. With survey data from 57 mountain sites worldwide, we test our understanding of the types of stresses that are threatening mountain systems as well as the resources and benefits that come from mountains. We find that mountain systems worldwide are experiencing both gradual and abrupt climatic, economic, and governance changes. One of the most ubiquitous challenges facing mountain systems is that policies directly affecting mountain systems are being made by those living outside of the mountains themselves. Mountains that support primarily subsistence‐oriented livelihoods in the developing world, especially mixed agriculture and animal husbandry systems, deliver abundant services but are also most at risk. Addressing the complex challenges facing mountain systems will require partnerships among researchers, stakeholders, and decision makers to jointly identify the types of futures they desire and the actions to achieve these. This approach will address knowledge gaps in mountains while simultaneously focusing on critical issues of poverty and food security. Key Points: Mountain social‐ecological systems (MtSES) worldwide face climatic, economic, and governance threats; policies made by outsiders are a critical challengeMountains that support subsistence‐oriented livelihoods deliver abundant cross‐scale ecosystems services, but these MtSES are also most threatenedAddressing threats to MtSES requires the united effort of policymakers, land users, scientists, and practitioners at local to global scales [ABSTRACT FROM AUTHOR]

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)