Fundacion Allende

Adults with severe to profound hearing loss have limited access to cochlear implants (CIs). The objective of this study was to assess the evidence to establish whether the uptake rate of CIs has changed over the past decade. A PubMed search, supplemented with manual searching, identified 15 relevant papers published from 2000 to 4 February 2025 reporting the uptake rate of CIs in adults. In addition, new calculations of uptake rates were made for 2019, based on total numbers of CIs implanted and the prevalence of hearing loss from the 2019 Global Burden of Disease Study. There was a lack of published data on the uptake rates for cochlear implants, with very little consensus in the methods used across studies. The overall uptake rates for adults and children combined, calculated for 2019 using the Lancet Global Burden of Disease Study, showed that uptake is still ≤20% for those with profound to complete hearing loss in most high-income countries. When the global population is considered (including high- to low-income countries), it is merely 2.5%. Despite the cochlear implant awareness activities of recent years, the percentage of profoundly deaf individuals with cochlear implants, even in high-income countries, remains low. Uptake rates are much worse than those for hearing aid use for severe to profound deafness. Better and more accurate data must be gathered on the number of CI recipients to meet the reporting requirements of the World Health Organisation's report on hearing.

Direct laser interference patterning (DLIP) with nanosecond laser pulses at 355 nm was employed to microstructure nickel Watts (Ni-Watts) electrodes with a periodic channel-like structure, aiming to enhance their performance toward the hydrogen evolution reaction (HER) in alkaline media. This technique enables the treatment of large surface areas with high reproducibility without significantly altering the chemical composition of the material. Electrochemical characterization at 30 °C in 2 M KOH revealed that the introduction of microchannels increases the catalytic activity for HER by increasing the current density up to 23% at −1.5 V versus SCE without affecting the kinetic and thermodynamic properties of the material. Although electrochemical impedance spectroscopy indicated no significant changes in the active surface area (roughness factor close to 1), this improvement is attributed to favorable modifications in bubble dynamics; Ni-Watts electrodes displayed multiple nucleation zones and smaller maximum bubble diameters, while Ni electrodes with 5 μm microchannels exhibited fewer nucleation sites and larger bubbles. These results demonstrate that DLIP structuring offers a promising strategy to optimize HER efficiency without requiring changes in material composition.

Introducción: la artroplastia total de cadera (ATC) es un procedimiento eficaz para mejorar la función y aliviar el dolor, pero la relación entre la calidad ósea, la actividad física y el retorno deportivo sigue poco explorada. El índice canal–diáfisis (CDR, las siglas por su nombre en inglés) se ha propuesto como un marcador radiográfico indirecto de calidad ósea. Materiales y métodos: estudio retrospectivo de 85 pacientes menores de 65 años sometidos a ATC primaria entre 2019 y 2022. Se evaluó la calidad ósea mediante el CDR, la actividad física según el componente estático del deporte y el retorno deportivo. Se aplicaron los cuestionarios IPAQ-SF y WOMAC. Resultados: la media del CDR fue 0.45 ± 0.10. Se observó una interacción significativa entre edad y tipo de actividad física (p <0.05), con menor CDR (mejor calidad ósea) en deportistas de alta carga estática. El 83 % de los pacientes retornó a su deporte previo en una mediana de 60 semanas. Los pacientes con mayor nivel de actividad física presentaron menores puntajes WOMAC (p para tendencia = 0.002). Conclusión: este estudio sugiere una relación significativa entre la calidad ósea medida por el índice canal-diáfisis (CDR), los niveles de actividad física y el retorno al deporte en pacientes sometidos a artroplastia total de cadera (ATC). Nivel de evidencia: IV. Estudio de Cohorte Retrospectiva

Nitrophenolate anions are molecules that release nitric oxide (NO) after electronic excitation. This class of molecules is particularly interesting for potential applications in skin cancer treatment, which requires the use of wavelengths in the biological transparency window. Among the various isomers, meta NP- (mNP-) has the lowest excitation energy with a band origin at 625 nm. Here, using cryogenic photodissociation spectroscopy, we studied the effect on the electronic spectroscopy of mNP- of methyl and amino electron-donating groups at the ortho position relative to NO2. Unlike the bare mNP- anion, all compounds exhibit broad photodissociation spectra, revealing significant geometric changes between the S0 and S1 (ππNO2*) states. While methyl substitution causes a blue shift of the absorption band maximum, amino-substituted mNP- anions show large red shifts, with the absorption band starting below 800 nm for 4NH2mNP-, i.e., in the biological transparency window, while still leading to NO photorelease. The spectral shifts induced by the substituents are interpreted by comparison with coupled-cluster calculations performed in the ground state and the first excited state. These electron-donating groups in the ortho position relative to NO2 perturb the electronic properties of mNP- through opposing steric and electrostatic effects.

Abstract Introduction Pulmonary arterial hypertension (PAH) is a progressive disease leading to right ventricular (RV) dysfunction and right heart failure. RV adaptation to increased afterload is a key prognostic factor. Traditional echocardiographic parameters offer insight but may not fully capture RV remodeling complexity. Phenotypic classifications combining RV size, contractility, and ventricular-arterial coupling may improve risk stratification. Methods A multicenter prospective cohort study was conducted in patients with de novo diagnosis of PAH as part of the TREPostinil Subcutáneo a LARgo Plazo en Hipertensión Pulmonar registry (TREPAR-HP). Six right ventricular (RV) phenotypes (A–F) were evaluated based on the RV basal diameter, fractional area change (FAC), and the ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP). This classification ranges from a normal and adapted RV (phenotypes A–C) to severe dysfunction and dilation (phenotypes D–F). Results Figure 1 shows the distribution of phenotypes. In a cohort of 93 patients (mean age 46.7 years, 86% women), the most common etiology was idiopathic (57%). Most patients presented with functional class III (62.4%) and received dual therapy (86%). Height (p=0.002), right atrial area (p=0.001), RV basal diameter (p<0.001), and TAPSE (p<0.001) showed significant differences between groups. The median BNP was 290.27 pg/mL, and the average cardiac output was 4.38 L/min (p=0.012). These findings highlight the functional and hemodynamic burden of the cohort. Figure 2 shows the distribution of phenotypes with respect to risk classification according to REVEAL. Conclusion RV phenotypic classification reveals distinct adaptation patterns in PAH. Advanced phenotypes (D–F) showed worse functional class, larger right atrial areas, and greater RV dysfunction. This approach may enhance risk stratification and guide management, underscoring the importance of early detection of RV maladaptation Figure 1. Distribution of phenotypes. Figure 2. distribution of phenotypes with respect to risk classification according to REVEAL.

Background/Objectives: Idiopathic toe walking (ITW) is a diagnosis of exclusion in children who demonstrate a persistent toe-walking gait without an identifiable underlying neuromuscular or orthopedic pathology. The classification of toe-walking behavior (TWB) in children with Autism Spectrum Disorder (ASD) remains an area of debate, with some considering it a part of the broader ITW spectrum, while others view it as a distinct entity. Children with TWB associated with ASD (Autistic Toe Walking—ATW) present unique clinical challenges. This subgroup exhibits a higher prevalence of toe walking, and their gait patterns are often associated with underlying neurodevelopmental differences, frequently leading to increased resistance to conventional treatment approaches and higher rates of persistence and recurrence. This narrative review aims to summarize the available evidence on interventions for ATW, highlight differences compared to ITW and discuss implications for clinical practice. Methods: A literature search was performed, including articles that addressed interventions for toe walking in children with ASD. Results: The literature is limited and heterogeneous. Identified interventions include physiotherapy, orthoses, botulinum toxin injections, serial casting, and surgical procedures. Evidence of effectiveness is scarce, with most studies consisting of small case series. ATW differs from classic ITW in some aspects of pathophysiology and clinical presentation. Treatment decisions should balance potential benefits with risks, particularly regarding repeated anesthesia exposure during casting versus earlier surgical options. Conclusions: Evidence for managing ATW is limited. While comparisons to ITW may be useful, clinicians must recognize that they present distinct characteristics. Future research should focus on standardized definitions and controlled trials to guide management.

Introduction: The Allurion® gastric balloon (AGB) is an innovative option for treating overweight individuals and those with grade I obesity, or as a bridging treatment for bariatric surgery, or for patients who do not desire surgical intervention. This study aimed to evaluate the efficacy and safety of the AGB in a multicentric cohort. Materials and Methods: A retrospective analysis of consecutive cases treated with AGB (≥18 years old with body mass index [BMI] ≥27) was performed in eight centers in three countries in Latin America (Argentina, Chile, and Perú), between September 2021 and September 2022, with a 12-month follow-up. Results: In total, 402 patients were included (median BMI of 32.81 kg/m2). Mean total weight loss percentage was 8.3%, 11.6%, and 14.9% at 3, 6, and 12 months, respectively, with a follow-up of 93.03%, 75.37%, and 40.54%. The adverse event rate was 1.24% (n = 5). During the first 7 days, 34.58% (n = 139) experienced concomitant symptoms, and 1.99% (n = 8) asked for endoscopic balloon extraction because of intolerance. The complication rate was 6.46% (n = 26). Readmission index was 4.97% (n = 20), and reintervention was 2.23% (n = 9). Balloon elimination was experienced by 5.7% of patients in the first 14 days, 29.10% (n = 117) before the third month, and 62.68% (n = 252) after the 16th week. Early deflation rate was 2.73% (n = 11). Digestive track elimination was perceived by 26.61%. Conclusions: AGB is a safe and effective option for the treatment of overweight and obesity in Latin America. Lifestyle changes and continuous support with a multidisciplinary team are essential to achieving good mid- to long-term outcomes.