Alamo Colleges

The authors report the CYP2D6 inhibitory effects of fluoxetine, paroxetine, sertraline, and venlafaxine in an open-label, multiple-dose, crossover design. Twelve CYP2D6 extensive metabolizers were phenotyped, using the dextromethorphan/dextrorphan (DM/DX) urinary ratio, before and after administration of fluoxetine 60 mg (loading dose strategy), paroxetine 20 mg, sertraline 100 mg, and venlafaxine 150 mg. Paroxetine, sertraline, and venlafaxine sequences were randomized with 2-week washouts between treatments; fluoxetine was the last antidepressant (AD) administered. Comparing within groups, baseline DM/DX ratios (0.017) were significantly lower than DM/DX ratios after treatment (DM/DXAD) with fluoxetine (0.313, p < 0.0001) and paroxetine (0.601, p < 0.0001) but not for sertraline (0.026, p = 0.066) or venlafaxine (0.023, p = 0.485). Between groups, DM/DXAD ratios were significantly higher for fluoxetine and paroxetine compared to sertraline and venlafaxine. No differences between DM/DXAD ratios were found for fluoxetine and paroxetine although more subjects phenocopied to PM status after receiving the latter (42% vs. 83%; chi 2 = 4.44, p = 0.049, df = 1). Similarly, no differences between DM/DXAD ratios were found for sertraline and venlafaxine. Of note, the DM/DXAD for 1 subject was much lower after treatment with paroxetine (0.058) compared to fluoxetine (0.490), while another subject exhibited a much lower ratio after treatment with fluoxetine (0.095) compared to paroxetine (0.397). Significant correlations between AD plasma concentration and DM/DXAD were found for paroxetine (r2 = 0.404, p = 0.026) and sertraline (r2 = 0.64, p = 0.002) but not fluoxetine or venlafaxine. In addition, DM/DXAD correlated with baseline isoenzyme activity for paroxetine, sertraline, and venlafaxine groups. These results demonstrate the potent, but variable, CYP2D6 inhibition of fluoxetine and paroxetine compared to sertraline and venlafaxine. CYP2D6 inhibition may be related, in part, to dose, plasma concentration, and baseline isoenzyme activity, and these correlations merit further investigation.

STUDY OBJECTIVE: To assess the correlation between plasma concentrations of four commonly administered selective serotonin reuptake inhibitors (SSRIs) and the magnitude of cytochrome P450 (CYP) 2D6 inhibition. DESIGN: Prospective analysis. SETTING: University-affiliated research laboratory. PATIENTS: Thirty-two healthy, drug-free volunteers. INTERVENTION: Subjects were randomized to four groups and received daily administration of either fluoxetine 60 mg (as a loading dose), fluvoxamine 100 mg, paroxetine 20 mg, or sertraline 100 mg for 8 days. MEASUREMENTS AND MAIN RESULTS: The urinary concentration ratio of dextromethorphan:dextrorphan (interpreted as an in vivo index of CYP2D6 activity) was determined for each subject before and after the 8 days of receiving SSRIs. Plasma SSRI trough concentrations were measured on days 6-9. The CYP2D6 genotype was determined in a subject with an undetectable paroxetine concentration. Inhibition of CYP2D6 correlated significantly with plasma concentrations of paroxetine and fluoxetine. In contrast, no significant correlations emerged between CYP2D6 inhibition and plasma concentrations of sertraline or fluvoxamine. The subject with an undetectable paroxetine concentration was found to carry at least three functional CYP2D6 genes. CONCLUSIONS: For paroxetine and fluoxetine, plasma concentrations and dosage strongly influence the magnitude of enzyme inhibition. The potential of paroxetine (a CYP2D6 substrate) as an inhibitor may be affected by the genotypes and metabolic capacities of individual subjects.

This paper is a detailed critique of Holt's study entitled "The Question of Lumbar Discography." His finding of a 37% false positive rate in asymptomatic volunteers has been used to discredit lumbar discography as a valid diagnostic study in the investigation of low back pain patients with nonprolapsing disc disease of the lumbar spine. The authors show why Holt's paper should no longer be used as scientific and authoritative evidence against the use of discography by today's standards.

Twenty-two cats with liver disease were evaluated for coagulation abnormalities including alterations in prothrombin time, activated partial thromboplastin time, thrombin time, factor VII activity, and platelet count. The purpose of the study was to determine the prevalence of coagulation abnormalities in this population of cats, classify abnormalities according to underlying pathogenesis, and determine if serum biochemical parameters typically used as indicators of liver disease showed any correlation with the coagulation abnormalities present. Study results indicated that at least 1 coagulation abnormality was present in 82% of the cats. Prolongation of prothrombin time was most common (16/22 cats) and factor VII activity was below reference range (< 60%) in 15 cats. When classified according to underlying pathogenesis, vitamin K deficiency was the most common abnormality found (11/22). Other abnormalities were less common and included hepatic synthetic failure (3/22), indeterminate (3/22), and disseminated intravascular coagulation (1/22). Increase in alkaline phosphatase (ALP) activity was the only biochemical abnormality that showed statistically significant correlation with coagulation abnormalities (P = .023). Cats with marked increases in ALP activity were more likely to have coagulation abnormalities than those with only mild increases in ALP activity.

BACKGROUND: Although balloon sinus dilation is a treatment option for adults with chronic rhinosinusitis (CRS), there have been few studies performed in pediatric patients. METHODS: This study was designed as a prospective, multicenter, single-arm investigation. Children (2 to 21 years old) with CRS who had failed medical management were treated with balloon sinus dilation and followed to 6 months postprocedure. RESULTS: Fifty children were treated at 4 centers; 33 participants were 2 to 12 years old (mean ± standard deviation age: 6.6 ± 2.2 years) and 17 participants were >12 to 21 years (mean age: 15.7 ± 2.5 years). A total of 157 sinus dilations were attempted (98 maxillary, 30 frontal, and 29 sphenoid sinuses) and all were successful with no complications. Significant improvement in the Sinus and Nasal Quality of Life Survey (SN-5) was seen for all children between baseline and 6 months (4.6 ± 1.2 vs 1.7 ± 0.8; p < 0.0001) and 92% improved by a minimal clinically important difference (MCID) of 1.0 or more. Those children aged 2 to 12 years with standalone balloon dilation also showed significant SN-5 improvements between baseline and follow-up (4.5 ± 1.0 vs 1.9 ± 0.8; p < 0.0001). Multivariate regression analysis showed no differences or associations of SN-5 improvement at 6 months with the presence of allergy, asthma, or concomitant procedures. For adolescents, overall 22-item Sino-Nasal Outcome Test (SNOT-22) mean scores were also significantly improved at 6 months (42.2 ± 19.2 vs 10.4 ± 9.7; p < 0.0001). CONCLUSION: Balloon sinus dilation is safe and appears effective for children with CRS aged 2 years and older.

Previous research has linked parental religiosity to a number of positive developmental characteristics in young children. This study introduces the concept of selective sanctification as a refinement to existing theory and, in doing so, adds to a small but growing body of longitudinal research on this topic. We explore how parents’ religious attendance (for fathers, mothers, and couples) and the household religious environment (parent–child religious discussions, spousal conflicts over religion) influence child development among third-graders. Analyses of longitudinal data from the Early Childhood Longitudinal Study (ECLS)-Kindergarten Cohort reveal a mix of salutary (beneficial) and adverse (detrimental) developmental outcomes based on teachers’ ratings and standardized test performance scores. Third-graders’ psychological adjustment and social competence are enhanced by various religious factors, but students’ performance on reading, math, and science tests is hampered by several forms of parental religiosity. We discuss the implications of these findings and suggest several avenues for future research.

Introduction: This Obesity Medicine Association (OMA) Expert Joint Perspective examines steatotic liver disease (SLD), which is composed of metabolic dysfunction-associated steatotic liver disease (MASLD), and metabolic dysfunction-associated steatohepatitis (MASH) in children with obesity. The prevalence of obesity is increasing, rates have tripled since 1963 from 5 % to now 19 % of US children affected in 2018. MASLD, is the most common liver disease seen in children, can be a precursor to the development of Type 2 Diabetes (T2DM) and is the primary reason for liver transplant listing in young adults. We must be vigilant in prevention and treatment of MASLD in childhood to prevent further progression. Methods: This joint clinical perspective is based upon scientific evidence, peer and clinical expertise. The medical literature was reviewed via PubMed search and appropriate articles were included in this review. This work was formulated from the collaboration of eight hepatologists/gastroenterologists with MASLD expertise and two physicians from the OMA. Results: The authors who are experts in the field, determined sentinel questions often asked by clinicians regarding MASLD in children with obesity. They created a consensus and clinical guideline for clinicians on the screening, diagnosis, and treatment of MASLD associated with obesity in children. Conclusions: Obesity and the comorbidity of MASLD is increasing in children, and this is a medical problem that needs to be addressed urgently. It is well known that children with metabolic associated chronic disease often continue to have these chronic diseases as adults, which leads to reduced life expectancy, quality of life, and increasing healthcare needs and financial burden. The authors of this paper recommend healthy weight reduction not only through lifestyle modification but through obesity pharmacotherapy and bariatric surgery. Therefore, this guidance reviews available therapies to achieve healthy weight reduction and reverse MASLD to prevent progressive liver fibrosis, and metabolic disease.

The purpose of this multi-institutional qualitative study was to understand the educational pathways of Latino males by underscoring the unique role female family members play in their academic pursuits—through the voice of these young men. Findings demonstrate female family members were identified as being primary supporters of their educational pursuits, and actively leveraged different sources of cultural capital to help Latino males enroll and persist through postsecondary education. This study reinforces extant literature on the importance of family in the educational pathways of Latina/o students. Furthermore, it makes a unique contribution by highlighting the important role female family members hold in the Latino family as educational advocates.

The Reproducibility Project: Cancer Biology seeks to address growing concerns about reproducibility in scientific research by conducting replications of selected experiments from a number of high-profile papers in the field of cancer biology. The papers, which were published between 2010 and 2012, were selected on the basis of citations and Altmetric scores (Errington et al., 2014). This Registered report describes the proposed replication plan of key experiments from 'A coding-independent function of gene and pseudogene mRNAs regulates tumour biology' by Poliseno et al. (2010), published in Nature in 2010. The key experiments to be replicated are reported in Figures 1D, 2F-H, and 4A. In these experiments, Poliseno and colleagues report microRNAs miR-19b and miR-20a transcriptionally suppress both PTEN and PTENP1 in prostate cancer cells (Figure 1D; Poliseno et al., 2010). Decreased expression of PTEN and/or PTENP1 resulted in downregulated PTEN protein levels (Figure 2H), downregulation of both mRNAs (Figure 2G), and increased tumor cell proliferation (Figure 2F; Poliseno et al., 2010). Furthermore, overexpression of the PTEN 3' UTR enhanced PTENP1 mRNA abundance limiting tumor cell proliferation, providing additional evidence for the co-regulation of PTEN and PTENP1 (Figure 4A; Poliseno et al., 2010). The Reproducibility Project: Cancer Biology is collaboration between the Center for Open Science and Science Exchange, and the results of the replications will be published in eLife.

Abstract Background Thyroid cysts are rare in cats and poorly documented. Objectives To report distinguishing clinical features and treatment responses of cats with thyroid cysts. Animals Forty client-owned cats. Methods Retrospective review of medical records for cats with thyroid cysts confirmed by scintigraphy, ultrasound, magnetic resonance imaging, or necropsy at 4 referral centers between 2005 and 2016. Signalment, clinical findings, diagnostic testing, treatment, and outcome were recorded. Results Cats ranged in age from 8 to 20 years with no apparent breed or sex predilection. 37 of 40 (93%) cats were hyperthyroid (duration, 1–96 months). Clinical findings included palpable neck mass (40/40, 100%), weight loss (15/40, 38%), dysphagia (8/40, 20%), decreased appetite (5/40, 13%), and dyspnea (4/40, 10%). Cysts were classified as small (≤8 cm3) in 16 (40%) and large (&amp;gt;8 cm3) in 24 (60%) cats. Of 25 cats treated with radioiodine, hyperthyroidism resolved in 23 (92%), whereas thyroid cysts resolved in 12 (50%). Radioiodine treatment resolved small cysts in 8 of 13 (62%) cats and large cysts in 4 of 11 (36%) cats. Eight cats, including 2 euthyroid cats, underwent thyroid-cystectomy; 3 with bilateral thyroid involvement were euthanized postoperatively for hypocalcemia. Excised cystic thyroid masses were identified as cystadenoma (4) and carcinoma (4). Conclusions and Clinical Importance Thyroid cysts are encountered in hyperthyroid and euthyroid cats with benign and malignant thyroid tumors. Radioiodine treatment alone inconsistently resolved thyroid cysts. Thyroid-cystectomy could be considered in cats with unilateral thyroid disease or when symptomatic cysts persist despite successful radioiodine treatment of hyperthyroidism.

Eighteen mothers identified as the perpetrator of physical abuse of their children were matched with respect to race, income and educational level with control mothers of children in daycare centers. Tests included: The Sense of Personal Worth Scale of the California Test of Personality, the Srole Anomia Scale, the Rosenberg Self-Esteem Scale, three scales from the Buss-Durkee Hostility Inventory and the Rational Behavior Inventory (RBI). An overall MANOVA was performed on scores of the seven personality measures. Stepdown F-tests were conducted on scores of the seven test measures. With the RBI entered first, none of the subsequent variables was significant. Three variables (RBI, Negativism and Anomia) significantly discriminated between the abuse and control groups. Examination of the discriminant function coefficients revealed that the RBI was the most important contributing variable.

(1970). Normality and Abnormality in Adolescence. The Psychoanalytic Study of the Child: Vol. 25, No. 1, pp. 309-339.

2-Octyl Cyanoacrylate (2-OCA) is a tissue adhesive developed for skin laceration closure that has not been previously evaluated for cardiac device implant wound closure. We reviewed 460 consecutive device implants with 475 incisions between November 1993 and May 2001. From November 1993 to December 1998, all patients (n 335) had a 3-layer reabsorbable suture closure with the application of topical bacitracin and dressing material. They were advised to avoid exposure to moisture for 10 days. From January 1999 to May 2001, the superficial suture layer was replaced with 2-OCA (n=125). No topical bacitracin or dressing was applied and patients were allowed to shower within 72 hours. The two groups did not differ significantly with respect to age (69 +/- 12 vs 70 +/- 13 years, P=NS), sex (59% vs 62% male, p=NS) or device type (77% vs 68% pacemakers/loop recorders, p=NS). All incisions were evaluated at 24 hours, 7-14 days, and 6-12 weeks postprocedure. The 2-OCA and suture groups did not differ significantly with respect to allergic reaction (0% vs 1.4%, P=NS), cellulitis (0% vs 0.9%, P=NS), and infection requiring explant (0.8% vs 0.3%, P=NS), respectively. Total adverse events occurred in 1 of 125 (0.8%) of the 2-OCA group versus 9 of 350 (2.6%) of the suture group (P=NS). In cardiac device implant closure 2-OCA obviated the need for topical antibiotics and dressing materials while facilitating wound care without increased complications.

Despite efforts over the past 50 or more years to estimate airborne dust or fiber concentrations for specific job tasks within different industries, there have been no known attempts to reconstruct historical asbestos exposures for the many types of trades employed in various nonmanufacturing settings. In this paper, 8-h time-weighted average (TWA) asbestos exposures were estimated for 12 different crafts from the 1940s to the present day at a large petroleum refinery in Beaumont, TX. The crafts evaluated were insulators, pipefitters, boilermakers, masons, welders, sheet-metal workers, millwrights, electricians, carpenters, painters, laborers, and maintenance workers. This analysis quantitatively accounts for (1) the historical use of asbestos-containing materials at the refinery, (2) the typical workday of the different crafts and specific opportunities for exposure to asbestos, (3) industrial hygiene asbestos air monitoring data collected at this refinery and similar facilities since the early 1970s, (4) published and unpublished data sets on task-specific dust or fiber concentrations encountered in various industrial settings since the late 1930s, and (5) the evolution of respirator use and other workplace practices that occurred as the hazards of asbestos became better understood over time. Due to limited air monitoring data for most crafts, 8-h TWA fiber concentrations were calculated only for insulators, while all other crafts were estimated to have experienced 8-h TWA fiber concentrations at some fraction of that experienced by insulators. A probabilistic (Monte Carlo) model was used to account for potential variability in the various data sets and the uncertainty in our knowledge of selected input parameters used to estimate exposure. Significant reliance was also placed on our collective professional experiences working in the fields of industrial hygiene, exposure assessment, and process engineering over the last 40 yr. Insulators at this refinery were estimated to have experienced 50th (and 95th) percentile 8-h TWA asbestos exposures (which incorporated 8-h TWA fiber concentrations, respirator use and effectiveness, and time spent working with asbestos-containing materials) of 9 (16) fibers/cc (cubic centimeter) from 1940 to 1950, 8 (13) fibers/cc from 1951 to 1965, 2 (5) fibers/cc from 1966 to 1971, 0.3 (0.5) fibers/cc from 1972 to 1975, and 0.005 (0.02) fibers/cc from 1976 to 1985 (estimated exposures were <0.001 fibers/cc after 1985). Estimated 8-h TWA exposures for all other crafts were at least 50- to 100-fold less than that of insulators, with the exception of laborers, whose estimated 8-h TWA exposures were approximately one-fifth to one-tenth of those of insulators. In spite of the data gaps, the available evidence indicates that our estimates of 8-h TWA asbestos exposures reasonably characterize the typical range of values for these categories of workers over time.

BACKGROUND: Nasal airway obstruction (NAO) is a highly prevalent disorder. Septal swell body (SSB) hypertrophy is an often overlooked contributor to NAO. SSB treatment may relieve symptoms of NAO. The objective of this study was to assess the clinical use of a temperature-controlled radiofrequency (TCRF) device to treat SSBs to improve symptoms in adults with NAO. METHODS: In this prospective, multicenter, open-label, single arm study, patients with severe or extreme NAO related to SSB hypertrophy received bilateral TCRF treatment in the SSB area. The primary endpoint was improvement in Nasal Obstruction Symptom Evaluation (NOSE) Scale scores from baseline to 3 months postprocedure. A subset of study patients underwent computed tomography (CT) imaging to evaluate posttreatment changes in SSB size. RESULTS: Mean NOSE Scale scores significantly improved from 73.5 (SD 14.2) at baseline to 27.9 (SD 17.2) at 3 months postprocedure, a reduction of -45.3 (SD 21.4, 95% confidence interval [CI]: -50.4 to -40.1; p < 0.0001); the responder rate was 95.7% (95% CI: 0.88 to 0.99; p < 0.0001). CT evaluation at 3 months showed statistically significant reductions in the SSB with the greatest reduction in the middle thickness (mean change -3.4 [SD 1.8] mL, 95% CI: -4.0 to -2.8; p < 0.0001). Minimal adverse events with any relationship to the device or procedure were reported; none were serious in nature and no septal perforations occurred. CONCLUSIONS: This study demonstrates that TCRF treatment of SSB hypertrophy is well tolerated and effective at reducing both SSB size and symptoms of NAO at 3 months posttreatment.

Abstract Background Brain and gut health are intricately connected via the gut‐microbiota‐brain axis. Studies have shown that gut dysbiosis is associated with neurodegenerative diseases, including Alzheimer’s disease. However, how cognitive changes affects the gut microbiome structure is currently understudied. We aimed to assess the association between the gut microbiome and global cognitive scores in the Framingham Heart Study (FHS). Method Our sample included 1,014 participants (mean age 52, 55% female) of the third generation FHS cohort with available stool samples, cognitive assessments, and no history of dementia or stroke ( Table 1 ). We quantified the gut microbiome composition using 16S rRNA sequencing and performed multivariable association and differential abundance analyses, adjusting for age, sex, education, BMI, and other confounders. The global cognitive score (GCS) was built using neuropsychological assessments of four cognitive domains: Executive function (trails‐making B); Processing speed (visual reproduction immediate and delayed); Language (similarity test); and Memory (logical memory immediate and delayed). Participants were additionally stratified by GCS with lower and higher scores indicating poor and normal cognition, respectively. Result Our results (Figure 1) showed that individuals with poor cognition have a decreased abundance of genera Clostridium (OR = 0.69, 95% CI [0.55, 0.86]) and Ruminococcus (0.93, [0.93, 0.94]). Meanwhile, the genus Alistipes, previously connected to anxiety, chronic fatigue syndrome, depression, and hypertension, was more abundant (1.06, [1.05, 1.06]) in the poor cognition group. Moreover, the genus Pseudobutyrivibrio, a butyrate‐producing bacteria from the rumen, was also found to be highly abundant (1.12, [1.11, 1.14]) in the poor cognition compared to normal. Finally, there was no difference in alpha and beta diversity between cognitive groups (Figure 2) . Conclusion Our study suggests that the abundance of several genera, including Pseudobutyrivibrio, Alistipes, Ruminococcus, and Clostridium is associated with cognition in middle‐age. Clostridium was previously proposed as novel probiotics for human health, and increasing its abundance was viewed as an effective strategy to regulate and maintain the homeostasis of the gut microbiota. As all these bacteria have neuroprotective effects, manipulating their abundance through diet and pre/pro‐biotics could be a research path for preserving global cognitive function in the future.

Summary The BP-operated Miller field poses a unique chemical challenge because it has arguably the harshest oilfield scaling regime in the North Sea, if not the world. An average of three to four squeeze treatments per week are performed across the online wells, creating tremendous operational, chemical, and logistical challenges. This produces the ideal environment in which to evaluate new technologies and engineering solutions in an attempt to increase the wells’ overall efficiency. Deep downhole chemical injection (DDHCI) was installed on Well A26/08 and brought on line in July 2003. The Miller DDHCI is unique to the industry because it allows the injection of a scale inhibitor at the perforations by means of a tail pipe, essentially protecting the whole of the tubing from scale deposition. This approach has the potential to reduce the need for additional scale control through squeeze treatments. Much emphasis has been placed on the efficiency of scale protection that DDHCI offers. A year of flowing the well under the protection of the continuous-injection chemical has yielded much information about the nature of the chemical delivery and inhibitor efficiency. Much also has been learned about the pumping hardware required to ensure continued performance. Further information has been provided by two intensive sampling exercises that have allowed independent analysis of the squeeze chemicals and the injected chemical. This paper details the design criteria of the DDHCI completion as well as the philosophy of installing such a device. It then gives details on the management strategy of using DDHCI in a proactive manner to maximize the time between squeeze treatments.

Background: Non-therapeutic hysterectomy has been performed to this day in Mexican women with intellectual disabilities (IDs), but the rationale for performing the procedure has been rarely submitted to clinical ethics committees. The objectives of the present research were to determine the frequency of hysterectomy and the clinical and epidemiologic characteristics that associated to the indication of hysterectomy in girls and young females with IDs and to analyse the emerging ethical issues related to the procedure. Materials and Methods: A medical chart review was conducted to identify female patients aged ≤ 25 years who had IDs based on anatomical pathologies and hospital records and underwent hysterectomy between January 2014 and December 2019 in nine high-concentration hospitals in Mexico City. Data were collected using a questionnaire developed ex professo and validated through a pilot study and analysed using the Statistical Package for the Social Sciences (SPSS) 21.0 software. Results: Information of 234 female patients with or without ID who were ≤ 25 years of age was reported by the departments of anatomical pathology and paediatrics. Of the patients, 184 (79%) were excluded because the information reported was found to be erroneous or incomplete during the medical records review. Most of the 50 emales included in the study had moderate ID ( n = 23, 46%) followed by those with severe ID ( n = 17, 34%). The mean age at hysterectomy was 15 ± 2.9 years. Prophylactic-total abdominal hysterectomy was the most frequently performed ( n = 42, 84%). A concurrence was observed between the parental and medical reasons justifying hysterectomy. The most frequent reasons were fertility control (parents vs. physicians: 46 vs. 42%), management of menstrual hygiene (28 vs. 30%) and risk of sexual abuse (6 vs. 6%). Conclusion: This study showed that performing non-therapeutic hysterectomy is subject to the clinical judgement of physicians according to their perception of the patient's quality of life. Therefore, the ethical quality of the decision to perform the procedure in girls and young females resides in the ethical value of its consequences.

Abstract An emphasis on assessment and accountability is virtually unavoidable if educational leaders are to address the challenge of improved quality and effectiveness.

Este artigo elabora um conjunto de indicadores que mapeiam a distribuição geográfica de conhecimentos e capacitações científicas e tecnológicas como proxies da distribuição geográfica das atividades de C,T&I e os aplica a dados e informações do Estado de São Paulo. A visão panorâmica da distribuição geográfica das atividades de C,T&I no estado é complementada, num corte analítico vertical, por uma visão dessas atividades em sistemas locais de produção e inovação com base num caso ilustrativo: as atividades de tecnologia de informação e comunicação da microrregião de Campinas. Os resultados mostram um padrão de distribuição regional das atividades de C,T&I ao longo dos eixos das principais rodovias do estado e no entorno de áreas metropolitanas (especialmente São Paulo e Campinas) e de regiões com forte concentração de instituições de ensino, pesquisa e desenvolvimento científico e tecnológico. A tendência à aglomeração de empresas nessas áreas e regiões, formando sistemas locais de produção e inovação, é evidenciada pela aderência do mapeamento desses sistemas ao mapeamento da distribuição geográfica mostrada pelos indicadores quantitativos e de capacitações institucionais. Isso reforça a assertiva, presente na literatura, de que as atividades inovativas das empresas têm fortes determinantes relacionados à geografia.<br>This paper develops multiple indicators to map the geographical distribution of knowledge and scientific and technological capabilities as proxies of the geographical distribution of S,T&I activities, and applies such indicators to data and information from the State of São Paulo. The overall view of the geographical distribution of S,T&I activities in the state is complemented by the analysis of the same activities in the perspective of a local production and innovation system: the case of information and communication technologies in the microrregion of Campinas. The results show a pattern for the regional distributions of S,T&I activities along the main highways of the state, around metropolitan areas such as São Paulo and Campinas, and in regions where educational, science and technology and R&D institutions are strongly concentrated. Firms tend to agglomerate in these areas and regions, forming local production and innovation systems. The paper produces evidence on the adherence of the geographical distribution of those systems to the geographical distribution of S,T&I activities as shown by the indicators. This confirms the empirical findings of the literature about the relationship between geography and innovation.