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Background The increasing incidence of coeliac disease is leading to a growing interest in active search for associated factors, even the intrauterine and early life. The exposome approach to disease encompasses a life course perspective from conception onwards has recently been highlighted. Knowledge of early exposure to gluten immunogenic peptides (GIP) in utero could challenge the chronology of early prenatal tolerance or inflammation, rather than after the infant’s solid diet after birth. Methods We developed an accurate and specific immunoassay to detect GIP in amniotic fluid (AF) and studied their accumulates, excretion dynamics and foetal exposure resulting from AF swallowing. One hundred twenty-five pregnant women with different gluten diets and gestational ages were recruited. Results GIP were detectable in AF from at least the 16th gestational week in gluten-consuming women. Although no significant differences in GIP levels were observed during gestation, amniotic GIP late pregnancy was not altered by maternal fasting, suggesting closed-loop entailing foetal swallowing of GIP-containing AF and subsequent excretion via the foetal kidneys. Conclusions The study shows evidence, for the first time, of the foetal exposure to gluten immunogenic peptides and establishes a positive correlation with maternal gluten intake. The results obtained point to a novel physiological concept as they describe a plausible closed-loop circuit entailing foetal swallowing of GIP contained in AF and its subsequent excretion through the foetal kidneys. The study adds important new information to understanding the coeliac exposome.

El presente artículo propone una aproximación a la obra de Ruth Behar y Lourdes Casal, se centra en sus aportaciones teórico-metodológicas y en los proyectos en los que han estado involucradas. El objetivo es integrarlas a las genealogías y redes culturales cubanas que ellas ayudaron a configurar. Para tal propósito, utilizar las nociones de exilio, diáspora, minoría étnica y biculturalidad en una una misma figura (autoras y genealogías) añade complejidad a las mismas. Por otra parte, planteo su participación en proyectos que han buscado establecer puentes entre la intelectualidad cubana y la articulación de circuitos culturales que incluyen a autoras que residen en Cuba o en el exterior. Tales redes llaman la atención sobre otras voces tradicionalmente excluidas del canon (su representación en la producción cultural) y ofrece una panorámica en las transformaciones del contexto cultural. El present article proposa una aproximació a l'obra de Ruth Behar i Lourdes Casal, amb centro en les seves aportacions teòric-metodològiques i en els projectes en els quals han estat involucrades. L'objectiu és integrar-les a les genealogies i xarxes culturals cubanes que elles mateixes van ajudar a configurar. Per a tal propòsit, utilitzar les nocions d'exili, diàspora, minoria ètnica i biculturalidad en una sola figura (autores i genealogies) els afegeix una innegable complexitat. D'altra banda, plantejo la seva participació en projectes que han buscat establir ponts entre la intel·lectualitat cubana i l'articulació de circuits culturals que inclouen a autores residents a Cuba o en l'exterior. Tals xarxes criden l'atenció sobre altres veus tradicionalment excloses del cànon, per la seva falta de representació en la producció cultural, i ofereixen una panoràmica de les transformacions del context cultural. This article proposes an approach to the work of Ruth Behar and Lourdes Casal, focusing on their theoretical-methodological contributions and the projects in which they have been involved. The aim is to integrate them into the Cuban cultural genealogies and networks that they helped to shape. For this purpose, using the notions of exile, diaspora, ethnic minority and biculturality in the same figure (authors and genealogies) adds complexity to them. On the other hand, I discuss their participation in projects that have sought to establish bridges between Cuban intellectuals and the articulation of cultural circuits that include authors residing in Cuba or abroad. Such networks draw attention to other voices traditionally excluded from the canon and offer an overview of the transformations of the cultural context.

Vitamin D deficiency is a public health problem worldwide. Some studies have associated serum vitamin D deficiency with knee osteoarthritis. Additionally, some vitamin D receptor polymorphisms have been linked to knee osteoarthritis. This study analyzed the associations among the rs731236 polymorphism of the vitamin D receptor, blood levels of vitamin D and primary knee osteoarthritis in a population from northern Mexico. A case‒control study was conducted from November 2023 to June 2024 with 449 unrelated participants. The vitamin D concentration in the blood was measured semiquantitatively. The presence of vitamin D receptor gene polymorphism genotypes (rs731236) was determined via the rhAmpTM SNP Assay methodology. We used the chi-square test to compare the groups and odds ratios with confidence intervals to calculate risk. In the presence of vitamin D deficiency, subjects showed a 1.5-fold increased risk of primary knee osteoarthritis (59.5%; p  = 0.001). Notably, this association remained significant for subjects carrying the AA and AG genotypes and in a dominant model (60.0%, p  = 0.023; 61.1%, p  = 0.008 and 59.0%, p  = 0.042, respectively), after including a multivariate association model. Our study identified a high prevalence of Vitamin D deficiency among individuals with primary knee osteoarthritis. This study suggests a potential association between deficient levels of vitamin D and primary KOA in carriers of the AA and AG rs731236 genotypes. Key Points • We observed a significant 1.5-fold increased risk of primary knee osteoarthritis in the presence of vitamin D deficiency. • Vitamin D deficiency is significantly associated with primary knee osteoarthritis in carriers of AA and AG genotypes of rs73123.

The increasing off-label use of medications needs a robust pharmacovigilance system. This is particularly crucial given the abundance of scientific data that can be harnessed to ensure a product’s safety. Our review focuses on the off-label use of local anesthetics, a common practice in topical and intracameral applications. However, the occurrence of mydriasis, as indicated in the monographs/summaries of product characteristics, is an unexpected adverse event. Our aim is to provide a comprehensive understanding of mydriasis caused by local anesthetics, both as an unexpected adverse event and as an off-label use, to reinforce the importance of pharmacovigilance practices. We conducted a comprehensive search in Medline/PubMed and Google Scholar from two distinct perspectives: examining the occurrence of mydriasis with the use of local anesthetic as an adverse event and as an off-label use. Our search yielded 14 articles that reported mydriasis as an unexpected adverse event with the use of anesthetics, with dental procedures being a significant contributor to this type of event. Also, we identified eight articles that explored the off-label use of local anesthetics to induce mydriasis, with the most common method of drug administration being intracameral injection. These findings underscore the importance of our research in understanding the unexpected adverse event of mydriasis and the potential for off-label use of local anesthetics. They also highlight the need for continued involvement and vigilance in this area, as our understanding of these phenomena continues to evolve and further investigation is crucial. The use of local anesthetics for mydriasis holds significant promise, particularly in ophthalmological surgeries. This approach could potentially mitigate the adverse events associated with conventional mydriatics, offering a more efficient and safer alternative. Furthermore, using a single medication for akinesia, anesthesia, and mydriasis could significantly enhance the efficiency and convenience of surgical procedures. On the other hand, it is crucial to extend the knowledge of the mydriasis-anesthesia association through risk minimization activities (e.g., the inclusion of monographs/summary of product characteristics) to communicate the risk of mydriasis with the use of local anesthetics. Plain language summary Is mydriasis an unexpected adverse event induced by local anesthetics, or could it indicate a new therapeutic use? Why was the study done? Unknown side effects of drugs can lead to undesired effects, but in some cases, they can lead to the discovery of beneficial effects that could significantly improve patient health. What did the researchers do? We searched the literature in Medline/PubMed and Google Scholar from two perspectives on the presence of mydriasis with the use of local anesthetic as an undesired and beneficial effect. What did the researchers find? This review has found several cases of undesired mydriasis caused by local anesthetics. However, it is essential to note that their beneficial use as mydriatic is also commonly observed in topical and intracameral applications, especially in ophthalmic surgeries. What do the findings mean? Although mydriasis could be considered an undesired event in some therapeutic interventions, this review considers the potential use of local anesthetics to induce mydriasis since it represents a promising new therapeutic indication that interests the medical community, particularly given their frequent use in ophthalmological surgeries.

While other theorists have turned to Arendt's analysis of statelessness and superfluity to consider questions of immigration, \"illegality,\" and the status of noncitizens, this essay argues that Arendt's account of labor and her non-consequentialist account of action offer a richer optic for considering the undocumented in the United States. To explore this claim, this essay constructs an alternate account of the nationwide demonstrations for immigrant rights that occurred in 2006. Rather than defining \"success\" in terms of replicability or immediate legislative results, the author's analysis of the 2006 protests emphasizes the significance of noncitizens laying claim to the public realm. Considering Michael Warner's concept of counterpublics, the author argues that the demonstrations can be best understood as a moment of initiation and an inaugural performance of the political. Rereading Arendt's notion of animal laborans, the essay concludes by exploring the limitations of noncitizens invoking labor as a way to gain civic standing.

Purpose of Review Our aim was to assess the degree of acceptance of the European Clinical Practice Guidelines (CPG) on heart failure (HF) among Spanish physicians according to sex. This was a cross-sectional study, employing Google Forms, conducted by a group of HF experts from the Region of Madrid (Spain), between November 2021 and February 2022, among specialists and residents of Cardiology, Internal Medicine, and Primary Care from Spain. Recent Findings A total of 387 physicians—173 women (44.7%)—from 128 different centers completed the survey. Compared to men, women were significantly younger (38.2 ± 9.1 years vs. 40.6 ± 11.2 years; p  = 0.024) and had fewer years of clinical practice (12.1 ± 8.1 years vs. 14.5 ± 10.7 years; p  = 0.014). Briefly, women and men had a positive opinion of the guidelines and thought that implementing quadruple therapy is feasible in less than 8 weeks. Women followed more frequently than men the new paradigm of “4 pillars at lowest doses” and considered more frequently the establishment of quadruple therapy before implanting a cardiac device. Although they agreed about “low blood pressure” as the major limitation for achieving quadruple therapy in heart failure with reduced ejection fraction, there were discrepancies on the second most frequent barrier, and women were more proactive when initiating SGLT2 inhibitors. Summary In a large survey including nearly 400 doctors from all over Spain to provide real-world opinion on 2021 ESC HF Guidelines and experience with SGLT2 inhibitors, women follow more frequently the new paradigm of “4 pillars at lowest doses”, consider more frequently the establishment of quadruple therapy before implanting a cardiac device, and were more proactive when initiating SGLT2 inhibitors. Further studies confirming an association of sex with a better compliance of HF guidelines are needed.

Background/Objectives: Phrenic nerve conduction (PNC) studies are essential for evaluating respiratory dysfunction and neuromuscular disorders. Despite international reference data, no normative values exist for the Mexican population. This study aimed to establish reference values for PNC latency and amplitude in healthy Mexican adults. Methods: We conducted a cross-sectional study between June 2022 and February 2023 including healthy adults (>18 years). Bilateral PNC studies were performed using surface electrodes and a 4-channel stimulation device. Latency and amplitude were recorded, and demographic and anthropometric data were collected. Results: Fifty subjects (22 women, 44%; 28 men, 56%) were enrolled. Mean latency was 6.10 ms (SD ± 1.48), and mean amplitude was 0.60 mV (SD ± 0.20). Significant differences were observed in left phrenic nerve latency between women and men (median 5.83 vs. 6.37 ms, p = 0.0348) and in amplitude between left and right phrenic nerves (0.55 vs. 0.65 mV, p = 0.0036). No significant correlations were found between latency and age or between amplitude and thoracic perimeter; however, the correlation coefficient suggests a positive relationship for both that should be confirmed in future studies with a larger sample size. Conclusions: This is the first report of PNC normative values in Mexican adults. Findings are consistent with international data and provide locally relevant reference values. Larger multicenter studies are warranted to validate and expand these results.

Over the past decade, much attention has been given to the growing political influence of Latinos in the United States in order to define the so-called \"Latino vote.\" But the existence of a coherent Latino political agenda is highly debatable and likely unviable, as electoral and protest politics erase diversity and debate in favor of images of unity. Situated at the intersection of political theory and Latino studies, this book is the first comprehensive critique of civic Latinidad, analyzing the relationship among participatory democracy, public speech, and racial identification.

Abstract Adolescent polycystic ovary syndrome (PCOS) is characterized by androgen excess and oligomenorrhea, and commonly driven by hepato-visceral fat excess (“central obesity”) ensuing from a mismatch between prenatal and postnatal nutrition, on a background of genetic susceptibility. There is no approved treatment for adolescent PCOS. We report the pooled results of 2 pilot studies in nonobese girls with PCOS (N = 62, age 15.8 years) that compared the effects of randomized treatment for 1 year, either with an oral estro-progestogen contraceptive (OC), or with a low-dose combination of spironolactone-pioglitazone-metformin (SPIOMET, targeting the excess of ectopic fat). Auxological and endocrine-metabolic variables (including fasting insulin, androgens, high-molecular-weight adiponectin [HMW-adiponectin], and microRNA [miR]-451a), body composition (dual x-ray absorptiometry) and hepato-visceral fat (magnetic resonance imaging) were assessed on- and posttreatment. Data from menstrual diaries were combined with weekly salivary progesterone measurements to infer ovulation rates during the second and fourth quarter of the posttreatment year.OC and SPIOMET treatment reduced the androgen excess comparably, and had no differential effects on total-body lean or fat mass. However, SPIOMET was accompanied by more broadly normalizing effects, including on hepato-visceral fat and on circulating insulin, HMW-adiponectin, and miR-451a. On average, there were 3-fold more ovulations post-SPIOMET than post-OC; normovulation was only observed after SPIOMET; anovulation was >10-fold more prevalent post-OC.Pooled results of randomized studies in nonobese adolescent girls with PCOS indicate that SPIOMET treatment leads to an overall healthier, more insulin-sensitive condition—with less ectopic fat—than OC treatment, and to a more normal posttreatment ovulation rate.